Promoting and supporting self-management for adults living in the community with physical chronic illness: A systematic review of the effectiveness and meaningfulness of the patient-practitioner encounter.

摘要: Background There has been a reported rise in the number of people with chronic illness (also referred to as long-term disease) Western world. One hundred million United States have at least one condition and Kingdom (UK) many 17.5 adults may be living disease. New models care developed which recognise complexities managing where there is overlap between wider community, health system provider organisations, for example, Chronic Care Model Expert Patient Programme. These new herald shift away from idea chronically ill patients passive recipients towards active engagement, partnership professionals, their own care. Partnership, ideally, involves collaborative self-management education. This support self-care alongside medical, preventative maintenance interventions. In this context nature patient-practitioner consultation promoting takes on importance. Objective The overall objective review was determine best available evidence regarding promotion management community during encounter. Specifically sought determine: What effectiveness patientpractitioner encounter supporting illness? are individual organisational factors help or hinder recognition, disease strategies? similarities differences how ‘effectiveness’ defined by different practitioners? Inclusion Criteria Types participants The focussed self-caring aged nineteen years older physical illness, not currently being treated an in-patient. For diabetes, asthma, arthritis, coronary disease, lung heart failure, epilepsy, kidney inflammatory bowel Since meet various professionals variety settings care, practitioner included doctors (physicians General Practitioners), nurses, nurse specialists, dieticians, podiatrists workers. Types outcome measures A outcomes measures used evaluate effective management. physiological measurements such as: HbA1c, blood pressure, body weight, lipids; lifestyle measurements, example activity; determinants knowledge, attitude; behaviours regarding, diet exercise, medication. The explore meaningfulness encounter, concerned patients’, physicians’ nurses’ views perceptions selfcare support. Types studies The considered all types quantitative qualitative evidence focus. studies reviewed systematic reviews, randomised controlled trials (RCTs), quasi-experimental studies, survey studies. Qualitative interview designs, vignette technique, qualitative evaluation, grounded theory, exploratory descriptive design. Search Strategy search find both published unpublished 1990 2005. year deemed appropriate since it precedes development heralded important part care-management. An initial CINAHL MEDLINE databases undertaken identify terms illness. A strategy then using identified MeSH headings key words following were searched: - Ovid CINAHL; (R); EMBASE; EBM Reviews (CDSR, ACP Journal Club, DARE, CCTR); ASSIA; SIGLE; TRUNCATED AT 600 WORDS.