Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sports University Cologne, Cologne, Germany.
Institute of Psychology, German Sports University Cologne, Cologne, Germany.
BMC Public Health. 2024 Sep 19;24(1):2566. doi: 10.1186/s12889-024-20034-6.
Chronic diseases such as type 2 diabetes mellitus and coronary heart disease cause medical, social, and economic burdens worldwide. Disease management programs in Germany mostly lack components to improve patients' self-management and health-promoting lifestyles despite clear guideline recommendations. Therefore, a Personalized Self-Management Support Program (P-SUP) was developed, which includes: (1) peer support groups; (2) telephone coaching; (3) feedback reports and, (4) a web portal. This study aims to explore patients' and implementing stakeholders' experiences in the implementation of P-SUP to identify barriers and facilitators to the implementation of the intervention.
A qualitative study was conducted using face-to-face focus group interviews with participating patients and telephone-based one-to-one expert interviews with implementing stakeholders, involved in the delivery of the intervention. The transcribed interview reports were analyzed using qualitative content analysis, and the contents were categorized according to Donabedian's Structure-Process-Outcome framework.
A total of six themes among patients (N = 35) and five themes among implementing stakeholders (N = 32) represent the experiences. The patient themes were: (1) technical conditions, (2) indoor facilities, (3) group composition, (4) acceptance of digital components, (5) supervision and feedback and (6) impact on lifestyle behavior. The themes among the implementing stakeholders were: (1) multiprofessional approach, (2) human resources, (3) patient acceptance, (4) supervision and feedback and (5) impact on lifestyle behavior.
Multiprofessional interventions such as P-SUP appear to be valuable for patients and implementing stakeholders. Although infrastructural barriers made the implementation of peer support and digital patient education difficult, patients rated the exchange with peers and experts on health-related topics positively. The lack of supervision and feedback during the course of the intervention might be compensated by regular telephone coaching. The findings from this study can be used in future studies to guide researchers and implementing stakeholders and to improve the feasibility and effectiveness of complex interventions in different contexts.
The P-SUP study was registered in the German Clinical Trials Register (DRKS) on 16/07/2020 under the registration number DRKS00020592.
2 型糖尿病和冠心病等慢性病在全球范围内造成了医疗、社会和经济负担。尽管有明确的指南建议，但德国的疾病管理计划大多缺乏改善患者自我管理和促进健康生活方式的内容。因此，开发了个性化自我管理支持计划（P-SUP），其中包括：（1）同伴支持小组；（2）电话辅导；（3）反馈报告和（4）一个网络门户。本研究旨在探讨患者和实施利益相关者在实施 P-SUP 方面的经验，以确定干预实施的障碍和促进因素。
采用面对面焦点小组访谈和参与干预实施的患者和实施利益相关者的电话一对一专家访谈进行定性研究。使用定性内容分析对转录的访谈报告进行分析，并根据 Donabedian 的结构-过程-结果框架对内容进行分类。
患者（N=35）和实施利益相关者（N=32）共提出了 6 个主题，代表了他们的经验。患者主题包括：（1）技术条件；（2）室内设施；（3）小组组成；（4）对数字组件的接受程度；（5）监督和反馈；（6）对生活方式行为的影响。实施利益相关者的主题包括：（1）多专业方法；（2）人力资源；（3）患者接受度；（4）监督和反馈；（5）对生活方式行为的影响。
多专业干预措施，如 P-SUP，对患者和实施利益相关者似乎很有价值。尽管基础设施障碍使得同伴支持和数字患者教育的实施变得困难，但患者对与同伴和专家就健康相关话题的交流评价很高。在干预过程中缺乏监督和反馈可以通过定期的电话辅导来弥补。本研究的结果可用于未来的研究，为研究人员和实施利益相关者提供指导，并提高不同背景下复杂干预措施的可行性和有效性。
P-SUP 研究于 2020 年 7 月 16 日在德国临床试验注册处（DRKS）注册，注册号为 DRKS00020592。
