Louisville Center, Pacific Institute for Research and Evaluation, Louisville, KY, United States.
Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States.
Front Public Health. 2023 Jan 5;10:968281. doi: 10.3389/fpubh.2022.968281. eCollection 2022.
This study assessed the relevance, value, and effectiveness of "Taking Charge of My Life and Health" (TCMLH), a patient wellbeing peer group program for U.S. veterans focused on empowering them to identify what really matters in their lives and to work toward health goals that align with their mission, aspirations, or purpose in life. The potential of TCMLH to empower veterans to engage in self-care behaviors, make health behavior changes, and participate in health care decision making is important, as veterans are more likely than the general population to suffer from multiple chronic conditions that require ongoing self-management.
We conducted individual semi-structured interviews with 19 TCMLH facilitators serving in eight U.S. Veteran's Health Administration medical centers. Data were analyzed using an inductive approach to identify salient themes in facilitators' experiences.
Facilitators reported that TCMLH participants demonstrated positive attitude changes (e.g., greater confidence and hope) and behavior changes (e.g., making healthcare appointments and implementing self-care practices) by program completion. Further, findings show that mindful awareness practices, the peer group setting, Whole Health assessment tools, and goal setting tools were perceived as the most impactful program elements leading to positive health behavior change.
Overall, findings suggest that this non-clinical peer group program can enhance patient wellbeing, and that there are certain program elements of TCMLH that are driving key attitudinal and behavioral changes.
本研究评估了“掌控我的生活和健康”(TCMLH)的相关性、价值和有效性,这是一个针对美国退伍军人的患者健康同伴小组计划,旨在赋予他们识别生活中真正重要的东西的能力,并努力实现与他们的使命、愿望或生活目标相一致的健康目标。TCMLH 有可能使退伍军人能够参与自我保健行为、改变健康行为,并参与医疗保健决策,因为退伍军人比一般人群更容易患有多种需要持续自我管理的慢性疾病。
我们对在八个美国退伍军人健康管理局医疗中心服务的 19 名 TCMLH 协调员进行了个体半结构化访谈。使用归纳方法对数据进行分析,以确定协调员在经验中的突出主题。
协调员报告说,TCMLH 参与者在完成计划后表现出积极的态度变化(例如,更大的信心和希望)和行为变化(例如,预约医疗保健和实施自我保健实践)。此外,研究结果表明,正念意识实践、同伴小组环境、整体健康评估工具和目标设定工具被认为是导致积极健康行为改变的最具影响力的计划要素。
总体而言,研究结果表明,这种非临床同伴小组计划可以增强患者的幸福感,并且 TCMLH 具有某些计划要素可以推动关键的态度和行为改变。