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个体特定证据具有调动关系能力的能力:在长期健康状况人群中发展的四步扎根理论。

Person-specific evidence has the ability to mobilize relational capacity: A four-step grounded theory developed in people with long-term health conditions.

机构信息

The Interdisciplinary Research Unit of Women's, Children's and Families' Health, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark.

Department of Public Health, University of Copenhagen, Copenhagen K, Denmark.

出版信息

Nurs Inq. 2023 Jul;30(3):e12555. doi: 10.1111/nin.12555. Epub 2023 Apr 16.

Abstract

Person-specific evidence was developed as a grounded theory by analyzing 20 selected case descriptions from interventions using the guided self-determination method with people with various long-term health conditions. It explains the mechanisms of mobilizing relational capacity by including person-specific evidence in shared decision-making. Person-specific self-insight was the first step, achieved as individuals completed reflection sheets enabling them to clarify their personal values and identify actions or omissions related to self-management challenges. This step paved the way for sharing these insights and challenges in a relationship with a supportive health professional, who could then rely on person-specific evidence instead of assumptions or a narrow disease perspective for shared decision-making. Trust in the evidence encouraged the supportive health professional to transfer it to the interdisciplinary team. Person-specific evidence then enhanced the ability of team members to apply general evidence in a meaningful way. The increased openness achieved by individuals through these steps enabled them to eventually share their new self-insights in daily life with other people, decreasing loneliness they experienced in self-management. Relational capacity, the core of the theory, is mobilized in both people with long-term health conditions and healthcare professionals. Further research on person-specific evidence and relational capacity in healthcare is recommended.

摘要

个体化证据是通过对使用引导自主决策方法干预的 20 个选定案例描述进行扎根理论分析而得出的。它通过将个体化证据纳入共同决策,解释了调动关系能力的机制。个体化自我洞察是第一步,个体完成反思表,从而能够明确自己的个人价值观,并确定与自我管理挑战相关的行动或不作为。这一步为与支持性健康专业人员分享这些见解和挑战铺平了道路,后者可以依靠个体化证据而不是假设或狭隘的疾病观点来进行共同决策。对证据的信任鼓励支持性健康专业人员将其转移到跨学科团队。个体化证据随后增强了团队成员以有意义的方式应用一般证据的能力。个体通过这些步骤实现的开放性增加,使他们能够最终在日常生活中与其他人分享新的自我洞察,减少自我管理中所经历的孤独感。关系能力是理论的核心,在患有长期健康状况的人和医疗保健专业人员中都得到了调动。建议进一步研究医疗保健中的个体化证据和关系能力。

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