Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Stratenum 6.131, P.O. Box 85500, Utrecht, the Netherlands.
University of Pennsylvania, School of Nursing, Philadelphia, PA, USA.
Heart Lung. 2022 Nov-Dec;56:40-49. doi: 10.1016/j.hrtlng.2022.06.001. Epub 2022 Jun 13.
Chronically medically ill patients often need clinical assistance with symptom management, as well as self-care interventions that can help to reduce the impact of bothersome symptoms. Experienced clinicians can help to guide the development of more effective self-care interventions.
To create a consensus-based list of common bothersome symptoms of chronic conditions and of self-care management behaviors recommended to patients by clinicians to reduce the impact of these symptoms.
A two-round Delphi study was performed among an international panel of 47 clinicians using online surveys to identify common and bothersome symptoms and related self-care management behaviors recommended to patients with heart failure, chronic obstructive pulmonary disease, asthma, type 2 diabetes, or arthritis.
A total of 30 common bothersome symptoms and 158 self-care management behaviors across the five conditions were listed. Each chronic condition has its own bothersome symptoms and self-care management behaviors. Consensus was reached on the vast majority of recommended behaviors.
The list of common bothersome symptoms and self-care management behaviors reflect consensus across four countries on many points but also disagreement on others, and a few recommendations are inconsistent with current guidelines. Efforts to encourage clinicians to recommend effective self-care management behaviors may reduce symptom impact in chronically ill patient populations.
慢性疾病患者通常需要临床医生在症状管理方面提供帮助，还需要接受自我护理干预，以减轻恼人症状的影响。经验丰富的临床医生可以帮助制定更有效的自我护理干预措施。
制定一份基于共识的常见慢性疾病症状清单，以及临床医生建议患者采取的自我护理管理行为，以减轻这些症状的影响。
采用两轮在线德尔菲调查法，对来自 47 位国际临床医生的小组进行研究，以确定心力衰竭、慢性阻塞性肺疾病、哮喘、2 型糖尿病或关节炎患者常见的和恼人的症状，以及相关的自我护理管理行为。
共列出了 30 种常见的恼人症状和 158 种自我护理管理行为，涵盖了这 5 种疾病。每种慢性疾病都有其特有的恼人症状和自我护理管理行为。绝大多数推荐的行为都达成了共识。
常见恼人症状和自我护理管理行为清单反映了四个国家在许多方面的共识，但也存在一些分歧，而且一些建议与当前指南不一致。鼓励临床医生推荐有效的自我护理管理行为的努力可能会减轻慢性病患者群体的症状影响。
