Raymond M C, Brown J B
Family Medicine Unit, Maisonneuve-Rosemont Hospital.
Can Fam Physician. 2000 May;46:1100-6.
To explore illness experiences of patients diagnosed with fibromyalgia.
Qualitative method of in-depth interviews.
Midsize city in Ontario.
Seven patients diagnosed with fibromyalgia.
Seven in-depth interviews were conducted to explore the illness experience of patients diagnosed with fibromyalgia. All interviews were audiotaped and transcribed verbatim. All interview transcriptions were read independently by the researchers, who then compared and combined their analysis. Final analysis involved examining all interviews collectively, thus permitting relationships between and among central themes to emerge. The analysis strategy used a phenomenologic approach and occurred concurrently rather than sequentially.
Themes that emerged from the interpretive analysis depict patients' journeys along a continuum from experiencing symptoms, through seeking a diagnosis, to coping with the illness. Experiencing symptoms was composed of four subcategories: pain, a precipitating event, associated symptoms, and modulating factors. Seeking a diagnosis entailed frustration and social isolation. Confirmation of diagnosis brought relief as well as anxiety about the future. After diagnosis, several steps led to creation of adaptive coping strategies, which were influenced by several factors.
Findings suggest that the conventional medical model fails to address the complex experience of fibromyalgia. Adopting a patient-centred approach is important for helping patients cope with this disease.
探讨被诊断为纤维肌痛的患者的患病经历。
深度访谈的定性研究方法。
安大略省的一个中等规模城市。
七名被诊断为纤维肌痛的患者。
进行了七次深度访谈,以探究被诊断为纤维肌痛的患者的患病经历。所有访谈均进行了录音并逐字转录。研究人员独立阅读所有访谈转录内容,然后比较并综合他们的分析。最终分析涉及对所有访谈进行整体审视,从而使核心主题之间的关系得以显现。分析策略采用现象学方法,同时而非按顺序进行。
解释性分析得出的主题描绘了患者从经历症状、寻求诊断到应对疾病的连续过程。经历症状由四个子类别组成:疼痛、诱发事件、相关症状和调节因素。寻求诊断带来了挫折感和社交孤立感。确诊既带来了宽慰,也引发了对未来的焦虑。确诊后,经过几个步骤形成了适应性应对策略,这些策略受到多种因素的影响。
研究结果表明,传统医学模式未能解决纤维肌痛的复杂患病经历。采用以患者为中心的方法对于帮助患者应对这种疾病很重要。