目的 探讨患者积极度概念的定义及内涵.方法 系统检索中国知网、万方数据、维普网、PubMed、SinoMed、CINAHL、Co-chrane Library、Web of Science、Embase数据库中患者积极度的相关文献,采用Walker和Avant的概念分析法对纳入文献进行分析.结果 共纳入41篇文献.患者积极度的定义属性为参与自我健康管理意愿、参与自我健康管理知识、参与自我健康管理行动和参与自我健康管理信心;其前因为人口学特征、疾病相关因素、心理因素、社会因素;后果为促进健康行为、改善临床结局、降低医疗使用率与成本.测量工具包括患者积极度量表、医疗消费者参与度量表、医疗消费者健康积极指数、糖尿病患者积极度影响和动机量表.结论 该研究明确了患者积极度的定义属性、前因及后果,可为以后国内研制不同疾病患者积极度特异性评估工具,构建本土化的患者积极度干预方案等提供参考.
Concept analysis of patient activation
Objective To identify the concept and connotation of patient activation.Methods Literature on patient activation was sys-tematically retrieved from CNKI,Wanfang,VIP,PubMed,SinoMed,CINAHL,the Cochrane Library,Web of Science,and Embase.Walker and Avant's conceptual analysis method was used to carry out conceptual analysis of the included literature.Results A total of 41 articles were included.Attributes defining patient engagement were identified as the willingness to participate in health self-management,knowledge for health self-management,actions towards health self-management,and confidence in health self-man-agement;antecedents included demographic characteristics,disease-related factors,psychological factors,and social factors;conse-quences consisted of promoting health behavior,improving clinical outcomes,and reducing healthcare utilization and costs.Meas-urement tools encompassed the Patient Activation Measure,the Altarum Consumer Engagement Measure,the Consumer Health Activation Index,and Influence and the Motivation for Patient ACTivation in Diabetes care.Conclusion This study clarified the defi-ning attributes,antecedents and consequences of patient activation,laid a foundation for the development of disease-specific assess-ment tools,and the construction of localized a localized patient activation intervention program in the future.
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