an intervention to promote patient participation and self-management in long term conditions development and feasibility testing一个干预促进病人参与和自我管理在长期条件下开发和可行性测试.pdfVIP

Protheroe et al. BMC Health Services Research 2010, 10:206 /1472-6963/10/206 R E S E A R C H A R T I C L E Open Access Research article An intervention to promote patient participation and self-management in long term conditions: development and feasibility testing Joanne Protheroe*, Tom Blakeman, Peter Bower, Carolyn Chew-Graham and Anne Kennedy Abstract Background: There is worldwide interest in managing the global burden of long-term co nditions. Current health policy places emphasis on self-management and supporting patient participation as ways of improving patient outcomes and reducing costs. However, achieving genuine participation is difficult. This paper describes the development of an intervention designed to promote participation in the consultation and facilitate self-management in long-term conditions. In line with current guidance on the development of complex interventions, our aim was to develop and refine the initial intervention using qualitative methods, prior to more formal evaluation. Methods: We based the intervention on published evidence on effective ways of improving participation. The intervention was developed, piloted and evaluated using a range of qualitative methods. Firstly, focus groups with stakeholders (5 patients and 3 clinicians) were held to introduce the prototype and elucidate how it could be improved. Then individual think aloud and qualitative interviews (n = 10) were used to explore how patients responded to and understood the form and provide further refinement. Results: The literature highlighted that effective methods of increasing participation include the use of patient reported outcome measures and values clarification exercises. The intervention (called PRISMS) integrated these processes, using a structured form which required patients to identify problems, rate their magni