Hopwood Max, Treloar Carla
National Centre in HIV Social Research, The University of New South Wales, Sydney, Australia.
J Adv Nurs. 2007 Aug;59(3):248-54. doi: 10.1111/j.1365-2648.2007.04305.x. Epub 2007 May 25.
This paper is a report of a study to explore how healthcare professionals prepare patients for hepatitis C treatment and the management strategy used during this treatment.
A high proportion of patients receiving hepatitis C treatment has dose reductions or discontinues treatment because of adverse events arising from the therapeutic drugs.
An exploratory study was carried out in Australia in 2004 and 2005 using semi-structured interviews with a sample of six healthcare professionals with experience in managing hepatitis C treatment regimens.
Participants reported that pretreatment preparation focused on information provision regarding the adverse events and the medical strategies that could ameliorate their impact. Patients' vulnerabilities and supports were assessed prior to treatment and healthcare professionals sought to address patients' problems as they arose during treatment. Participants discussed patients' resilient coping style and the beneficial impact this had on treatment management.
Among our sample, a deficits-based approach was taken to hepatitis C treatment management. While some attempts were made to assess patients' strengths, these were limited to identifying those in family, work and social networks who could lend support to patients when problems occurred. Exploring patients' past experiences of adversity and making a detailed evaluation of a range of patients' strengths might assist clinicians in managing hepatitis C treatment regimens.
本文报告一项研究,探讨医护人员如何为丙型肝炎治疗做准备以及治疗期间所采用的管理策略。
接受丙型肝炎治疗的患者中,很大一部分因治疗药物引发的不良事件而减少剂量或中断治疗。
2004年和2005年在澳大利亚开展了一项探索性研究,对六位有丙型肝炎治疗方案管理经验的医护人员进行半结构化访谈。
参与者报告称,治疗前准备工作重点是提供有关不良事件及可减轻其影响的医疗策略的信息。治疗前会评估患者的脆弱性和支持因素,医护人员会在治疗期间出现问题时设法解决患者的问题。参与者讨论了患者的适应方式及其对治疗管理的有益影响。
在我们的样本中,丙型肝炎治疗管理采用了基于缺陷的方法。虽然曾尝试评估患者的优势,但仅限于识别家庭、工作和社交网络中在问题出现时可为患者提供支持的人员。探索患者过去的逆境经历并详细评估患者的一系列优势,可能有助于临床医生管理丙型肝炎治疗方案。