Wildevuur Sabine, Thomese Fleur, Ferguson Julie, Klink Ab
J Particip Med. 2017 Jul 7;9(1):e14. doi: 10.2196/jopm.8846.
In order to alleviate the pressure on health care systems exerted by the growing prevalence of chronic diseases, information and communication technologies (ICT) are being introduced to enable self-management of chronic diseases by supporting partnerships between patients and health care professionals. This move towards chronic disease self-management is accompanied by a shift in focus on integrating the patient with his or her perceptions on the chronic disease as a full-fledged partner into the health care system. This new perspective has been described as "person-centered care" (PCC). To date, information and communication technologies only partially build on the principles of PCC. This paper examines the preconditions of ICT to enable a person-centered approach to chronic disease management.
Using cancer treatment as a case study for ICT-enabled PCC, we conducted a comparative analysis of thirteen scientific studies on interventions presented as ICT-enabled PCC for cancer treatment, to answer the research question: What are the preconditions of ICT-enabled PCC in chronic disease management? Based on the intended and actual outcomes, we distilled in several analytic steps the preconditions of ICT-enabled PCC for chronic disease self-management.
We distinguished four user-related preconditions of ICT-enabled PCC: (shared) decision making, personalized ICT, health-related quality of life, and efficiency.
We argue that these four preconditions together can improve people's self-management of chronic diseases by strengthening the partnership between the patient and the healthcare professional. Moreover, the study revealed a discrepancy between intended and reported actual outcomes in terms of realizing person-centered care.
为了缓解慢性病患病率上升给医疗保健系统带来的压力,信息通信技术(ICT)正被引入,通过支持患者与医疗保健专业人员之间的伙伴关系来实现慢性病的自我管理。向慢性病自我管理的这一转变伴随着关注点的转移,即将患者及其对慢性病的认知作为正式伙伴融入医疗保健系统。这种新观点被描述为“以患者为中心的护理”(PCC)。迄今为止,信息通信技术仅部分基于PCC原则。本文探讨了信息通信技术实现以患者为中心的慢性病管理方法的前提条件。
以癌症治疗作为信息通信技术支持的以患者为中心护理的案例研究,我们对13项关于作为信息通信技术支持的癌症治疗以患者为中心护理干预措施的科学研究进行了比较分析,以回答研究问题:信息通信技术支持的以患者为中心护理在慢性病管理中的前提条件是什么?基于预期结果和实际结果,我们通过几个分析步骤提炼出了信息通信技术支持的以患者为中心护理用于慢性病自我管理的前提条件。
我们区分了信息通信技术支持的以患者为中心护理的四个与用户相关的前提条件:(共同)决策、个性化信息通信技术、健康相关生活质量和效率。
我们认为,这四个前提条件共同作用,可以通过加强患者与医疗保健专业人员之间的伙伴关系来改善人们对慢性病的自我管理。此外,该研究揭示了在实现以患者为中心的护理方面预期结果与报告的实际结果之间的差异。