Patient Self-management of Chronic Disease in Primary Care

医学 自我管理 病人教育 生活质量(医疗保健) 普通合伙企业 疾病 物理疗法 疾病管理 护理部 财务 病理 机器学习 计算机科学 帕金森病 经济
作者
Thomas Bodenheimer
出处
期刊:JAMA [American Medical Association]
卷期号:288 (19): 2469-2469 被引量:3503
标识
DOI:10.1001/jama.288.19.2469
摘要

Patients with chronic conditions make day-to-day decisions about--self-manage--their illnesses. This reality introduces a new chronic disease paradigm: the patient-professional partnership, involving collaborative care and self-management education. Self-management education complements traditional patient education in supporting patients to live the best possible quality of life with their chronic condition. Whereas traditional patient education offers information and technical skills, self-management education teaches problem-solving skills. A central concept in self-management is self-efficacy--confidence to carry out a behavior necessary to reach a desired goal. Self-efficacy is enhanced when patients succeed in solving patient-identified problems. Evidence from controlled clinical trials suggests that (1) programs teaching self-management skills are more effective than information-only patient education in improving clinical outcomes; (2) in some circumstances, self-management education improves outcomes and can reduce costs for arthritis and probably for adult asthma patients; and (3) in initial studies, a self-management education program bringing together patients with a variety of chronic conditions may improve outcomes and reduce costs. Self-management education for chronic illness may soon become an integral part of high-quality primary care.
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