在COPD患者中遵守多重疾病恶化行动计划的促进者和障碍 - - 定性研究
J Schrijver1,2, T Effing3,4, M Brusse-Keizer5,6
1Section Cognition, Data and Education, Faculty of Behavioral, Management and Social Sciences, University of Twente, Enschede, Netherlands.
COPD
|July 28, 2023
概括
对慢性阻塞性肺病 (COPD) 行动计划的遵守情况不佳. 这项研究确定了促进者,如更好的理解和信心,以及障碍,如症状识别困难,以改善COPD自我管理.
科学领域:
- 肺部医学 肺部医学
- 行为科学 行为科学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 慢性阻塞性肺病 (COPD) 的自我管理行动计划改善了结果,但患者的坚持通常很低.
- 了解影响遵守的因素对于有效的COPD自我管理干预至关重要.
- 量身定制的,多种疾病的行动计划解决了COPD和并发性疾病,但坚持挑战仍然存在.
研究的目的:
- 确定促进者和障碍者,以遵守针对COPD患者量身定制的多种疾病恶化行动计划.
- 探索患者在疾病管理中的角色和医疗保健专业人员在疾病管理中的角色的观点.
- 应用行为能力,机会和动机 (COM-B) 模型来理解坚持.
主要方法:
- 在干预后,与十名COPD患者 (荷兰-澳大利亚人) 进行了个别的半结构面试.
- 使用由COM-B模型指导的演方法,采用了主题分析.
- 参与者完成了为期一年的自我管理干预,重点是定制的恶化行动计划.
主要成果:
- 遵守的促进因素包括增强的疾病理解,积极的干预经验,增加的自信和专业的支持.
- 障碍包括难以识别症状,厌恶日常监测,负面的干预感知,低情绪和计划/日记复杂性.
- 患者对责任的看法各不相同,从主要负责的感觉到将医疗保健专业人员视为主要负责人.
结论:
- 该COM-B模型有效地确定了影响遵守多种疾病COPD行动计划的促进者和障碍.
- 未来的自我管理干预措施应针对已识别的促进者和障碍物,以改善患者的坚持.
- 解决患者对责任的看法可能会加强对COPD自我管理策略的参与.
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