Vinter-Repalust Nevenka, Petricek Goranka, Katić Milica
Department of Family Medicine, Andrija Stampar School of Public Health, Zagreb University School of Medicine, Croatia.
Croat Med J. 2004 Oct;45(5):630-6.
To explore type 2 diabetic patients' attitudes, thoughts, and fears connected with their illness; their expectations of the health care system; and the problems they encountered while adhering to the therapeutic regimen.
Explanatory descriptive focus groups were held with 49 type 2 diabetic patients. Patients were recruited by their general/family practitioners and divided into seven focus groups. The group discussions were audio taped and transcribed, then analyzed to find emerging themes and sub-themes. Textual data were explored inductively using content analysis to generate categories and explanations. Hypotheses were derived from the qualitative content analysis.
Eight major themes and explanatory models of patient's perspective emerged out of the data: confronting the diagnosis, illness-related changes, treatment of illness, social context, relation to the health professionals, self-control, knowledge about the illness, and expectations from health professionals. Health beliefs, quality of the doctor-patient relationship, social environment of the family, workplace, health care system, and quality of the information they receive from health professionals and media were all important factors in patient adherence.
There were many obstacles for bettering patients adhering to the therapeutic regimen, as from the patients' socio-economical aspect, and in the existing health system of Croatia as well. Providing of updated information about the disease, empathy and support of physicians can improve adherence to treatment.
探讨2型糖尿病患者对其疾病的态度、想法和恐惧；他们对医疗保健系统的期望；以及他们在坚持治疗方案时遇到的问题。
对49名2型糖尿病患者进行了解释性描述性焦点小组访谈。患者由其全科医生/家庭医生招募，并分为7个焦点小组。小组讨论进行了录音和转录，然后进行分析以找出新出现的主题和子主题。使用内容分析法对文本数据进行归纳探索，以生成类别和解释。假设来自定性内容分析。
从数据中得出了患者观点的八个主要主题和解释模型：面对诊断、疾病相关变化、疾病治疗、社会背景、与医护人员的关系、自我控制、对疾病的了解以及对医护人员的期望。健康信念、医患关系质量、家庭、工作场所的社会环境、医疗保健系统以及他们从医护人员和媒体获得的信息质量都是影响患者依从性的重要因素。
在改善患者坚持治疗方案方面存在许多障碍，这既来自患者的社会经济层面，也存在于克罗地亚现有的卫生系统中。提供有关疾病的最新信息、医生的同理心和支持可以提高治疗依从性。
