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学会与肠易激综合征共处。一项基于小组的患者教育计划对人们在日常生活中管理疾病能力的影响。

Learning to live with irritabel bowel syndrome. The influence of a group-based patient education programme on peoples' ability to manage illness in everyday life.

作者信息

Håkanson Cecilia, Sahlberg-Blom Eva, Ternestedt Britt-Marie, Nyhlin Henry

机构信息

Ersta Hospital, Stockholm, Sweden.

出版信息

Scand J Caring Sci. 2011 Sep;25(3):491-8. doi: 10.1111/j.1471-6712.2010.00855.x. Epub 2010 Dec 22.

Abstract

BACKGROUND

Living with chronic irritable bowel syndrome sets limitations in peoples' everyday lives. This is due to bad health and the difficulty to find strategies that will manage their problem. In encounters with health care providers, these people feel that they are not getting the appropriate support to manage their illness-related troubles, and they perceive themselves to be insufficiently informed about the disease.

AIM

To evaluate the influence of a group-based patient education programme about irritable bowel syndrome, on people's ability to manage their illness in everyday life.

METHODS

The study used an evaluative research design. Fifty-one individuals with irritable bowel syndrome completed the ways of coping questionnaire, and the irritable bowel syndrome severity scoring system, before and after participating in a multidisciplinary group-based patient education programme.

RESULTS

In the participants' self assessments, statistical significances (p > 0.05) were found for the mean frequency of efforts used on the coping strategies distancing and escape-avoidance. Distancing was used more often after the education programme, while escape-avoidance, was used more seldom. The proportional use of the strategy self-controlling (relative score) was enhanced after the education programme. The participants' overall severity of symptoms was significantly reduced after the education programme. The individuals with a clinically noteworthy improvement in symptom severity (decrease ≤ 50) had greater changes in relative score values than those that showed a lesser improvement in symptom severity.

CONCLUSION

Coping patterns were changed and symptoms were scored significantly less severe among the participants who participated in the education programme. Controlled studies following individuals over a longer period are suggested to establish the validity and sustainability of these changes, and qualitative interview studies would provide additional understanding about the significance of the separate parts of the education programme, and about the meaning of the programme to peoples' everyday lives as a whole.

摘要

背景

患有慢性肠易激综合征会给人们的日常生活带来诸多限制。这是由于健康状况不佳以及难以找到应对问题的策略所致。在与医疗服务提供者接触时,这些人感觉自己没有得到应对与疾病相关困扰的适当支持,并且认为自己对该疾病了解不足。

目的

评估一项基于小组的肠易激综合征患者教育项目对人们在日常生活中管理疾病能力的影响。

方法

本研究采用评估性研究设计。51名肠易激综合征患者在参加基于多学科小组的患者教育项目之前和之后,完成了应对方式问卷和肠易激综合征严重程度评分系统。

结果

在参与者的自我评估中,发现应对策略“疏离”和“逃避 - 回避”的平均使用频率具有统计学意义(p > 0.05)。教育项目后,“疏离”策略的使用频率增加,而“逃避 - 回避”策略的使用频率减少。教育项目后,“自我控制”策略(相对得分)的使用比例有所提高。教育项目后,参与者的总体症状严重程度显著降低。症状严重程度有临床显著改善(降低≤50)的个体,其相对得分值的变化比症状严重程度改善较小的个体更大。

结论

参与教育项目的参与者的应对模式发生了改变,症状严重程度评分显著降低。建议对个体进行更长时间的对照研究,以确定这些变化的有效性和可持续性,而定性访谈研究将有助于进一步理解教育项目各部分的意义,以及该项目对人们整体日常生活的意义。

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