Balbezit door de patiënt
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Balbezit door de patiënt

Balbezit door de patiënt
Wat betekent zelfmanagement voor de patiënt?
Per Åke Zillén, nierpatiënt en tandarts

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Balbezit door de patiënt Presentation Transcript

  • 1. Self-management
  • 2.  
  • 3. My perspective
  • 4.
    • My kidney function
    0 50 years
  • 5. 1990 2001 100% My kidney function 10% ?
  • 6. 1990 2001 100% My kidney function 10% ? Stupid me
  • 7.
    • Two diseases
    • A kidney carcinoma
    • 10% kidney function
  • 8.
    • Two diseases
    • A kidney carcinoma
    • Nephrectomy
    • 10% kidney function
    • Dialysis
  • 9.
    • Acute Chronic
    • Duration Short For life
    • Goal Well again Not worse
    • Attitude Fight it Accept it
    • Responsible HC staff Shared
    • Treatment HC staff Patient
    • Education None Considerable
    • Life-style As before Changed
  • 10.
    • Acute Chronic
    • Duration Short For life
    • Goal Well again Not worse
    • Attitude Fight it Accept it
    • Responsible HC staff Shared
    • Treatment HC staff Patient
    • Education None Considerable
    • Life-style As before Changed
    • Action Reflection
  • 11.
    • My trauma
    • Healthy individual
    • Emergency patient
  • 12.
    • My trauma
    • Healthy individual
    • Emergency patient
    • Chronically ill patient
  • 13.
    • My trauma
    • Healthy individual
    • Emergency patient
    • Chronically ill patient
    • Pre-dialysis patient
  • 14.
    • Stages of CKD
    • GFR, %
    • Normal function > 90
    • Mild reduction 90-60
    • Moderate reduction 60-30
    • Severe reduction 30-15
    • Kidney failure < 15
  • 15. Life is wonderful ... considering the alternative
  • 16. Expectations
  • 17.
    • In the 60´s
    • End stage
    • dental disease
  • 18.
    • Prevention
    • Keep clean
    • Use fluoride
    • Regular check-ups
  • 19.
    • 8 760 hours/year
  • 20.
    • 8 760 hours/year
    • - 2 dental office
  • 21.
    • 8 760 hours/year
    • - 2 dental office
    • 8 758 hours/year
    • = my responsibility
    • = self-management, self-care
  • 22.
    • Long term change
    • My parents
    • My generation
    • My children
    • My grandchildren
  • 23.  
  • 24.
    • Real health care
    • Prevention
    • Early detection
    • Early life-style change
    • Early treatment
    • Slow or stop progression
    • Replacement
  • 25. Slow or even stop the disease?
  • 26.
    • What
    • can I do
    • MYSELF
    • ?
  • 27.
    • Treatment plan
    • 1. Medication
    • 2. Special diet
    • 3. Healthy life-style
  • 28.
    • Blood pressure
    • Medication
  • 29.
    • Blood pressure
    • Medication
    • Regular physical activity
    • Weight control
    • Stop smoking
    • Less salt, no extra
    • Drink less
    • Stress management
    • Relax and sleep well
    • Get a pet
  • 30.
    • The special diet
    • helps minimize the symptoms and slow the progression
    • +
    • makes me feel in charge
    • keeps my family involved
  • 31.
    • Health behaviour
    • Regular physical activity
    • Blood pressure control
    • Glucose control
    • Weight control
    • No smoking
    • Healthy diet
  • 32.
    • My daily to-do-list Patient
    • Medication Yes
    • Blood pressure Yes
    • Blood sugar Yes
    • Weight control Yes
    • No smoking Yes
    • Physical activity Yes
    • Special diet Yes
    • Mental health Yes
  • 33.
    • My daily to-do-list
    • Patient Doctor
    • Medication Yes Yes
    • Blood pressure Yes
    • Blood sugar Yes
    • Weight control Yes
    • No smoking Yes
    • Physical activity Yes
    • Special diet Yes
    • Mental health Yes
  • 34.
    • Outside the clinic
    • No doctor
    • No nurse
    • No dietician
    • No physiotherapist
  • 35.
    • It´s so obvious:
    • My health is
    • my responsibility
    • My illness is
    • my problem
  • 36.
    • My doctor and
    • all health care staff
    • are my
    • medical advisors
  • 37.
    • To be able to assume
    • Responsibility
    • We need:
    • Good relations
    • Partnership
    • Education
  • 38.  
  • 39.
    • Relations
    • Compliance
    • Adherence
    • Empowerment
    • Self-management
  • 40.
    • Em- power -ment
    • The Doctor
    • - Expertise
    • - Integrity
    • - Decisions
  • 41.
    • Em- power -ment
    • The Doctor The Patient
    • - Expertise - Expertise
    • - Integrity - Integrity
    • - Decisions - Decisions
  • 42.
    • Em- power -ment
    • The Doctor The Patient
    • - Expertise - Expertise
    • - Integrity - Integrity
    • - Decisions - Decisions
    • - Mutual respect
    • - Mutual empowerment
    • - Agreements
    • - Partnership
  • 43. Patient information
  • 44.  
  • 45.
    • Education
    • Knowledge
    • Learning is more important than teaching
  • 46.
    • Education
    • Knowledge
    • Learning more important than teaching
    • Motivation
    • Enhanced through group discussions
  • 47.
    • Education
    • Knowledge
    • Learning more important than teaching
    • Motivation
    • Enhanced through group discussions
    • Healthy behaviour
    • A process of change
  • 48.
    • Change of behaviour
    • When we are:
    • Ready
    • Convinced
    • Empowered
    • Entrusted
    • Supported
  • 49. 1990 2001 100% My kidney function 10% ?
  • 50. My medication
  • 51. My CKD diet Protein down Energy up Balanced+balancing
  • 52.
    • My healthy
    • life-style
  • 53.
    • The outcome
    100% 10% 1990 2001 2007 No dialysis Tolerable symptoms
  • 54.
    • It worked for me
    • ___________________________________
    • It may work
    • for others
    • ___________________________________
    • Not for all
  • 55.
    • Gains
    • Me: 6 years of health, freedom
    • The clinic: 15 min/2 months
    • Local gov: Saved €400000
    • My doctor: My HERO
  • 56. Thank you