Faculty of Health Sciences, University of Western Ontario, London, Canada.
Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada.
Patient Educ Couns. 2023 Sep;114:107836. doi: 10.1016/j.pec.2023.107836. Epub 2023 Jun 3.
To explore how patients with chronic obstructive pulmonary disease (COPD) perceive their engagement and roles within an interdisciplinary team-based care model.
A single intrinsic case study was used. Focus group participants were recruited from the Best Care COPD program across nine sites. Transcripts from patient focus groups were supplemented by healthcare provider focus group transcripts and thematically analysed.
The majority of patients viewed themselves as having an inherent or central role on the team, which was corroborated by healthcare providers. Both positive (e.g., a desire to learn) and negative drivers (e.g., fear of inadequate care without self-advocacy) of active engagement were identified, for which patient-led communication was key. Components of the interdisciplinary team-based care model, including provider coordination and action planning, enabled positively driven active engagement and increased self-management.
Although patients had heterogenous perspectives about engagement, most patients viewed themselves as, and were satisfied with, having a central role in their care. Active and passive engagement preferences were influenced by personal motivations and past experiences, amongst other factors.
This study demonstrates how interdisciplinary chronic disease management programs can support patient engagement. Clarity of provider expectations, and communication about patients' roles and preferences, are recommended.
探讨慢性阻塞性肺疾病(COPD)患者如何看待自己在基于跨学科团队的护理模式中的参与度和角色。
采用单一个案内在研究方法。从九个地点的最佳 COPD 护理计划中招募了焦点小组参与者。对患者焦点小组的转录本进行补充,并进行主题分析。
大多数患者认为自己在团队中具有内在的或核心的角色,这得到了医疗保健提供者的证实。积极参与(例如,渴望学习)和消极参与(例如,担心没有自我倡导就得不到充分的护理)的驱动力都被确定了,而患者主导的沟通是关键。跨学科团队护理模式的组成部分,包括提供者协调和行动计划,使积极参与和自我管理得以实现。
尽管患者对参与度有不同的看法,但大多数患者认为自己在护理中扮演核心角色,并且对这一角色感到满意。积极和消极参与的偏好受到个人动机和以往经验等因素的影响。
本研究展示了慢性病管理的跨学科项目如何支持患者的参与。建议明确提供者的期望,并就患者的角色和偏好进行沟通。