Lazarus Monica, Yew Tong Wei, Tan Wee Hian, Venkataraman Kavita, Valderas Jose Maria, Young Doris Yee Ling, Tai E Shyong, Loh Victor Weng Keong
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore.
Department of Medicine, National University Hospital (NUH), Singapore, Singapore.
BJGP Open. 2024 Apr 25;8(1). doi: 10.3399/BJGPO.2023.0055. Print 2024 Apr.
Personalised care and support planning (CSP) is a person-centred approach for the care of people living with long-term conditions. Patient Activation through Community Empowerment/Engagement for Diabetes Management (PACE-D) adapts the Year of Care Partnerships (YOCP) approach to CSP in the UK for people living with diabetes at Singapore polyclinics. Polyclinics are multi-storey primary care hubs that provide affordable, multidisciplinary, comprehensive, and high-throughput public health care for the multi-ethnic, multilingual Singapore population.
To explore the experience of PACE-D-enrolled people living with diabetes with personalised CSP at Singapore polyclinics.
DESIGN & SETTING: Qualitative interviews of people living with diabetes who experienced personalised CSP at National University Polyclinics (NUP) in Singapore between July 2020 and November 2021.
PACE-D-enrolled people living with diabetes who experienced personalised CSP were purposively sampled. In-depth semi-structured interviews were recorded, transcribed, and analysed using Braun and Clarke's reflexive thematic analysis.
Fifty-two patients participated in the study. Four main themes were identified. Theme 1 was the importance of the care-planning letter. Patients reported that the CPL prompted reflection and patient preparation for CSP conversations. Theme 2 was the role of the programme coordinator. PACE-D programme coordinators amplified self-management by playing advocate and confidant beyond administrative duties. Theme 3 was the value of the personalised CSP conversation. CSP providers were perceived as partners in care, with more time to listen compared with usual consultations. Patient engagement was affected by language confidence. Theme 4 was agency in self-management. With adequate time and support, patients increased in confidence and agency both in CSP engagement and diabetes self-management.
While language confidence may affect patient engagement, personalised CSP shows promise for strengthening patient engagement and self-management among people living with diabetes at Singapore polyclinics.
个性化护理与支持计划（CSP）是一种以患者为中心的方法，用于护理患有长期疾病的人群。通过社区赋权/参与实现糖尿病管理的患者激活（PACE-D）将英国护理伙伴关系年（YOCP）方法应用于新加坡综合诊所中糖尿病患者的CSP。综合诊所是多层基层医疗中心，为多民族、多语言的新加坡人口提供经济实惠、多学科、全面且高流量的公共医疗服务。
探索在新加坡综合诊所参加PACE-D的糖尿病患者对个性化CSP的体验。
对2020年7月至2021年11月期间在新加坡国立大学综合诊所（NUP）体验过个性化CSP的糖尿病患者进行定性访谈。
有目的地抽取参加了PACE-D且体验过个性化CSP的糖尿病患者。使用布劳恩和克拉克的反思性主题分析法对深入的半结构化访谈进行记录、转录和分析。
52名患者参与了该研究。确定了四个主要主题。主题1是护理计划信的重要性。患者报告称，CPL促使他们进行反思并为CSP对话做好患者准备。主题2是项目协调员的角色。PACE-D项目协调员除履行行政职责外，还通过充当倡导者和知己来增强自我管理。主题3是个性化CSP对话的价值。CSP提供者被视为护理伙伴，与常规咨询相比，有更多时间倾听。患者参与度受语言信心影响。主题4是自我管理中的能动性。有了足够的时间和支持，患者在CSP参与和糖尿病自我管理方面的信心和能动性都有所增强。
虽然语言信心可能会影响患者参与度，但个性化CSP有望增强新加坡综合诊所中糖尿病患者的参与度和自我管理能力。
