TY - JOUR AU - Suutari, Anne-Marie AU - Thor, Johan AU - Nordin, Annika M M AU - Kjellström, Sofia AU - Areskoug Josefsson, Kristina PY - 2021 DA - 201/5/11 TI -改善心脏衰竭患者的健康:联合生产的健康和护理JO - J参与医学SP - e27125 VL - 13 IS - 2千瓦-联合生产的健康和护理千瓦-能力千瓦-动机千瓦-机会千瓦-能力，机会和动机行为模型千瓦-焦点组千瓦-心力衰竭千瓦-瑞典千瓦-初级保健千瓦-心脏病学千瓦-联合生产AB -背景:由患者、患者家属和护理过程中的专业人员参与的健康和护理联合生产，可以共同学习如何满足患者的需求。虽然之前在各种医疗保健环境中已经研究了联合生产的障碍和促进因素，但瑞典慢性心脏病护理环境中的先决条件尚未探索。这项研究以瑞典Jönköping县地区的卫生系统为背景，是全系统促进心力衰竭(HF)患者健康的努力的一部分。目的:本研究的目的是测试能力、机会和动机行为(COM-B)模型在评估瑞典慢性心脏护理环境中心衰患者、心衰患者家庭成员和专业人员感知的健康和护理联合生产的障碍和促进因素时的有用性，以作为后续举措的指南。方法:数据收集包括1例HF患者(n=5)、1例HF患者家属(n=5)、1例初级保健专业人员(n=7)、1例心脏保健专业人员(n=4)的焦点小组访谈(FGI)。此外，心衰患者会记录他们对合拍片的想法。使用以COM-B模型为基础的演绎方法进行内容分析，将障碍和促进因素分类为共同生产卫生和保健的能力、机会和动机。结果:参与者对联合生产的理解有限。 They appeared to view it as a privilege to be offered to patients on top of traditional care and rarely as an approach for improving health care processes. The interviews revealed the limited health literacy among patients and the struggle of professionals to convey health information to these patients. Co-production was considered to be more resource-intensive than traditional care. Different expectations of stakeholders’ roles were revealed: professionals expected older patients not to want to co-produce health and care, and all participants expected professionals to be in charge of health care services. The family members’ position involved trying to balance their desire to support their relatives with understanding when, how, and with whom to co-produce. Presumed benefits motivated stakeholders: co-production was recognized to motivate patients to improve self-care. However, the participants recognized that motivation to get involved in health and care decisions varies over time among stakeholders. Conclusions: Co-production can be facilitated by the stakeholders’ motivation. However, varying levels of understanding of co-production, patients’ limited health literacy, unease with power sharing between patients and professionals, and resource constraints are barriers that need to be managed to promote co-produced care and better health for persons living with HF. Further research is warranted to explore how to co-produce health care services with patients with HF and how leaders can facilitate the inevitable cultural change it requires and represents. SN - 2152-7202 UR - https://jopm.www.mybigtv.com/2021/2/e27125 UR - https://doi.org/10.2196/27125 UR - http://www.ncbi.nlm.nih.gov/pubmed/33973859 DO - 10.2196/27125 ID - info:doi/10.2196/27125 ER -