Ondersteuning van astma zelfmanagement in de huisartsenpraktijk via internet: Karakteristieken van patiënten en het PatiëntCoach webportaal

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1 Ondersteuning van astma zelfmanagement in de huisartsenpraktijk via internet: Karakteristieken van patiënten en het PatiëntCoach webportaal Jaap K. Sont, associate professor Afdeling Medische Besliskunde Leids Universitair Medisch Centrum

2 Definitie zelfmanagement Het zodanig omgaan met de chronische aandoening symptomen, behandeling, lichamelijke, sociale consequenties en bijbehorende aanpassingen in leefstijl, dat de aandoening optimaal wordt ingepast in het leven ww.zelfmanagement.com Astma zelfmanagement via internet 2

3 PRECEDE-PROCEED Model Predisposing factors Knowledge Attitudes Self-efficacy Intentions Emotions Sociodemographic factors Reinforcing factors Attitude/behaviour of health personnel, peers and parents Symptom relief Behaviour and lifestyle Preventive actions Compliance Self-care Health Quality of life Enabling factors Availability/accessability of resources Education Skills Environment Modified PRECEDE-PROCEED Model for Health Promotion, adapted from Health Promotion Planning: An Educational and Environmental Approach (2nd ed.) by Green L.W. et al. Mountain View, Cal.: Mayfield, Astma zelfmanagement via internet 3

4 Health education impact Questionnaire (HeiQ) Profile of health education / self-management outcomes 40 questions 8 domains: Health directed behaviour Positive and active engagement in life Emotional well-being Self monitoring and insight Constructive attitudes and approaches Skill and technique acquisition Social integration and support Health service navigation Osborne et al. Patient Educ Couns 2007 Astma zelfmanagement via internet 4

5 Patient characteristics IMPASSE self-management implementation study N = 24 asthma diagnosed by GP 4 male / 20 female Age (range): 38.5 (18-65) years Lung function FEV 1 (range): 88.3 (56-116) % predicted Asthma control ACQ (range): 1.04 ( ) Astma zelfmanagement via internet 5

6 Asthma related quality of life (AQLQ) AQLQ total score Rs = 0.59 P < HeiQ total score Astma zelfmanagement via internet 6

7 Lung function FEV1 (% predicted) FEV 1 (% predicted) Rs = 0.48 P < HeiQ total score Astma zelfmanagement via internet 7

8 HeiQ-score HeiQ profile Health directed behaviour Constructive attitudes Pos. engagement in life Skills acquisition Emotional Social support Self monitoring Health service navigation Astma zelfmanagement via internet 8

9 PatiëntCoach home page Astma zelfmanagement via internet 9

10 PatiëntCoach zorgverlenerportaal Astma zelfmanagement via internet 10

11 PatiëntCoach astma monitoring Astma zelfmanagement via internet 11

12 PatiëntCoach COPD monitoring Astma zelfmanagement via internet 12

13 PatiëntCoach agenda Astma zelfmanagement via internet 13

14 PatientCoach actieplan COPD Astma zelfmanagement via internet 14

15 PatiëntCoach individueel zorgplan (thuis)monitoren van streefdoelen en fysiologische-, gedrags- en functionele parameters motivationele feedback persoonlijke agenda met acties, afspraken en notities e-consult / e-bericht reminders interactieve educatie op maat helpdesk persoonlijke pagina te delen met vrienden nieuwsberichten forum voor patiënten forum voor zorgverleners inloggen en authenticatie van patiënten via DigiD inloggen en authenticatie van zorgverleners via UZI-pas of Digi-pas inloggen en authenticatie van zorgverleners vanuit eigen informatiesysteem (HIS / EZIS) Astma zelfmanagement via internet 15

16 Conclusies Gunstiger zelfmanagement kenmerken hangen samen met een betere longfunctie, betere astma controle en betere astma gerelateerde kwaliteit van leven De HeiQ geeft inzicht in het zelfmanagement profiel van individuele patiënten PatiëntCoach is een generiek, flexibel en modulair platform voor ondersteuning van zelfmanagement bij chronische aandoeningen maakt met specifieke zelfmanagement modules ondersteuning op maat mogelijk Astma zelfmanagement via internet 16

17 PatientCoach asthma / COPD Partners Funding Astma zelfmanagement via internet 17

18 Astma zelfmanagement via internet 18

19 Health education impact Questionnaire (HeiQ) Health directed behaviour healthful behaviours: prevention, diet, exercise, relaxation; tangible change Positive and active engagement in life getting engaged in life, intent for actions, indicators of now being involved in life Emotional well-being health-related negative affect; attitude to life; anxiety, stress, anger and depression Self monitoring and insight self monitoring of (sub)clinical indicators, setting reasonable limits or targets, and insight into living with a health problem Constructive attitudes and approaches minimising the illness I am not going to let this disease control my life Skill and technique acquisition symptom relief skills, skills and techniques to manage own health Social integration and support social interaction, feelings of social isolation as a result of the illness, sense of support, seeking support from others Health service navigation communication, decision processes, relationships, understanding; interaction with and negotiation of the healthcare system Astma zelfmanagement via internet 19