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Abstract：
BACKGROUND: A significant proportion of patients and informal caregivers favor an active role in decisions concerning their health. Simultaneously, governments aim to shift treatment from a professional care setting to a community setting, in light of an ageing population, a decreasing number of health workers and allocation of scarce resources. This transition of care solicits patients\' and informal caregivers\' ability to self-manage. Therefore, the Maastricht University Medical Centre + has established the Academy for Patients and Informal caregivers. The aim is to proactively and professionally support patients and their informal caregivers to enhance their self-management. For that, the Academy offers activities in three categories: (1) instruction of nursing techniques, (2) training of e-health competencies and (3) the provision of self-management programs. Both patients with an episodic care need, as well as patients and informal caregivers with chronic illness, are eligible to participate in the Academy\'s activities. However, little is known about the experience of these interventions from the perspective of patients, informal caregivers and healthcare professionals.
METHODS: We conducted semi-structured interviews with 15 patients, 8 informal caregivers and 19 health care professionals who either participated in, referred to or received patients from the Academy. Topics revolved around self-management and the Quadruple aim, covering topics such as patient experiences, healthcare costs, health and well-being of the population and improving work life for health professionals. Data were analyzed using thematic analysis.
RESULTS: Patients and caregivers experienced an increase in the ability to manage health needs independently, leading to increased mental well-being and self-efficacy. They felt recognized as partners in care, although managing illness needs came with its own burdens. Health care professionals indicated that they felt assured of the quality, uniformity and availability of activities due to its central organization, with instruction nurses finding greater meaning in their work. On the level of health care systems, participants in this study mentioned a decrease in use of formal healthcare, whilst enabling a more equitable division of care.
CONCLUSIONS: Stakeholders\' experiences with the Academy for Patients and Informal caregivers indicate that participation contributes to development of self-management, whilst also improving working conditions, reducing the appeal to formal care and advancing equity in healthcare. The burden for patients and informal caregivers is to be considered in future developments.
METHODS: We conducted semi-structured interviews with 15 patients, 8 informal caregivers and 19 health care professionals who either participated in, referred to or received patients from the Academy. Topics revolved around self-management and the Quadruple aim, covering topics such as patient experiences, healthcare costs, health and well-being of the population and improving work life for health professionals. Data were analyzed using thematic analysis.
RESULTS: Patients and caregivers experienced an increase in the ability to manage health needs independently, leading to increased mental well-being and self-efficacy. They felt recognized as partners in care, although managing illness needs came with its own burdens. Health care professionals indicated that they felt assured of the quality, uniformity and availability of activities due to its central organization, with instruction nurses finding greater meaning in their work. On the level of health care systems, participants in this study mentioned a decrease in use of formal healthcare, whilst enabling a more equitable division of care.
CONCLUSIONS: Stakeholders\' experiences with the Academy for Patients and Informal caregivers indicate that participation contributes to development of self-management, whilst also improving working conditions, reducing the appeal to formal care and advancing equity in healthcare. The burden for patients and informal caregivers is to be considered in future developments.
摘要：
背景：相当比例的患者和非正式护理人员支持在有关其健康的决策中发挥积极作用。同时,政府的目标是将治疗从专业护理环境转变为社区环境，鉴于人口老龄化，卫生工作者数量的减少和稀缺资源的分配。这种护理转变要求患者和非正式护理人员自我管理的能力。因此,马斯特里赫特大学医学中心+建立了患者和非正式护理人员学院。目的是积极和专业地支持患者及其非正式护理人员，以加强他们的自我管理。为此，学院提供三类活动:(1)护理技术指导，（2）培训电子卫生能力；（3）提供自我管理计划。两个都有偶发性护理需求的病人，以及患有慢性病的患者和非正式护理人员，有资格参加学院的活动。然而,从患者的角度来看，对这些干预措施的经验知之甚少，非正式护理人员和医疗保健专业人员。
方法：我们对15名患者进行了半结构化访谈，8名非正式护理人员和19名医疗保健专业人员参与，转介或接受学院的患者。主题围绕自我管理和四重目标，涵盖患者体验等主题，医疗费用,人口的健康和福祉，并改善卫生专业人员的工作生活。采用专题分析法对数据进行分析。
结果：患者和护理人员独立管理健康需求的能力有所提高，提高心理健康和自我效能感。他们觉得自己是被认可的护理伙伴，虽然管理疾病的需要有它自己的负担。卫生保健专业人员表示，他们对质量感到放心，由于其中央组织，活动的统一性和可用性，指导护士在工作中发现更大的意义。在医疗保健系统的层面上，这项研究的参与者提到正规医疗保健的使用减少，同时实现更公平的护理分工。
结论：利益相关者与患者和非正式照顾者学院的经验表明，参与有助于自我管理的发展，在改善工作条件的同时，减少对正规医疗的吸引力，推进医疗保健公平。患者和非正式护理人员的负担将在未来的发展中考虑。
方法：我们对15名患者进行了半结构化访谈，8名非正式护理人员和19名医疗保健专业人员参与，转介或接受学院的患者。主题围绕自我管理和四重目标，涵盖患者体验等主题，医疗费用,人口的健康和福祉，并改善卫生专业人员的工作生活。采用专题分析法对数据进行分析。
结果：患者和护理人员独立管理健康需求的能力有所提高，提高心理健康和自我效能感。他们觉得自己是被认可的护理伙伴，虽然管理疾病的需要有它自己的负担。卫生保健专业人员表示，他们对质量感到放心，由于其中央组织，活动的统一性和可用性，指导护士在工作中发现更大的意义。在医疗保健系统的层面上，这项研究的参与者提到正规医疗保健的使用减少，同时实现更公平的护理分工。
结论：利益相关者与患者和非正式照顾者学院的经验表明，参与有助于自我管理的发展，在改善工作条件的同时，减少对正规医疗的吸引力，推进医疗保健公平。患者和非正式护理人员的负担将在未来的发展中考虑。
