Lack Sarah, Noddings Robert, Hewlett Sarah
Plymouth University, Plymouth, UK.
Musculoskeletal Care. 2011 Jun;9(2):102-12. doi: 10.1002/msc.203.
There is a lack of evidence for understanding the clinical needs of men with rheumatoid arthritis (RA). This study investigated the psychosocial experience of this group, to inform clinical practice and generate further research.
Twelve adult male patients with RA were interviewed once. Interview data were analysed using an inductive thematic analysis procedure. Categories and themes were validated by a second researcher and a male RA patient research partner.
Four themes were generated: loss of power and control; use of power and control; adjustment; influencing factors (age, pain, medication, relationships and health staff communication). Loss of power and control left participants vulnerable to low mood. Participants asserted power and control over RA by adopting a problem-solving stance in order to continue with ordinary life. An accepting attitude characterized the adjustment theme where men respected their bodies' limits. The final theme consisted of factors which influenced these three themes.
These data suggest that when RA results in loss of personal power and control, patients experience distress, which they may not express to their clinicians. Findings indicate directions for further research investigating the possibility that men and women may have differing clinical needs.
缺乏了解类风湿性关节炎(RA)男性患者临床需求的证据。本研究调查了该群体的心理社会体验,为临床实践提供信息并推动进一步研究。
对12名成年男性RA患者进行了一次访谈。访谈数据采用归纳主题分析程序进行分析。类别和主题由另一位研究人员和一名男性RA患者研究伙伴进行了验证。
产生了四个主题:失去权力和控制权;权力和控制的运用;调整;影响因素(年龄、疼痛、药物治疗、人际关系和医护人员沟通)。失去权力和控制权使参与者容易情绪低落。参与者通过采取解决问题的姿态来对RA施加权力和控制,以便继续正常生活。接受态度是调整主题的特征,男性在这个主题中尊重自己身体的极限。最后一个主题由影响这三个主题的因素组成。
这些数据表明,当RA导致个人权力和控制权丧失时,患者会感到痛苦,而他们可能不会向临床医生表达这种痛苦。研究结果为进一步研究指明了方向,即调查男性和女性可能有不同临床需求的可能性。