Håkanson Cecilia, Sahlberg-Blom Eva, Ternestedt Britt-Marie, Nyhlin Henry
Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden.
Scand J Caring Sci. 2012 Dec;26(4):738-46. doi: 10.1111/j.1471-6712.2012.00990.x. Epub 2012 Apr 4.
People with irritable bowel syndrome (IBS) often experience severe illness-related troubles in their everyday lives. Many persons also perceive their disease-related knowledge to be insufficient, and they feel dissatisfied with their inability to improve well-being. Previous research about patient education and IBS has emphasized biomedical outcomes of symptoms, health-promoting behaviours, coping and health-related quality of life, rather than people's experiences.
To explore people's experiences of participating in a multidisciplinary group-based patient education programme about IBS and of the influence of this programme on everyday life with illness.
Focus group interviews were performed with 31 persons after their participation in the patient education programme. Interpretive description guided the inductive analysis of data. The study was approved by the local research ethics committee.
The analysis revealed four patterns; being part of a safe community, learning about oneself through others, understanding and controlling the body and illness as a whole, and being outside of the community. The pattern of learning about oneself through others can be described as a reciprocal activity of learning by listening to, telling and observing others. Being among similar others had created feelings among most of the focus group participants of being part of a safe community where taboo subjects related to IBS-symptoms could be outspoken. Understanding the body and illness as a whole had enhanced their ability to interpret bodily signals and to handle trouble some situations with greater self-confidence, and this regained their access to the social everyday world.
The combination of reciprocal sharing of experiences and the provision of professional scientific knowledge during the patient education programme together contributed to a growing readiness to improve well-being in everyday life, for most of the participating individuals. This was based on new understandings of the body and illness as a whole and of new abilities to make knowledge-based decisions about what strategies to use in overcoming illness-related troubles.
肠易激综合征(IBS)患者在日常生活中常常经历与疾病相关的严重困扰。许多患者还认为自己对疾病的了解不足,并且对无法改善健康状况感到不满。先前关于患者教育与肠易激综合征的研究强调了症状的生物医学结果、促进健康的行为、应对方式以及与健康相关的生活质量,而非患者的体验。
探讨人们参与以多学科小组为基础的肠易激综合征患者教育项目的体验,以及该项目对患病日常生活的影响。
31人参与患者教育项目后进行了焦点小组访谈。解释性描述指导了数据的归纳分析。该研究获得了当地研究伦理委员会的批准。
分析揭示了四种模式:成为安全社区的一员、通过他人了解自己、将身体和疾病作为一个整体来理解和控制、以及置身于社区之外。通过他人了解自己的模式可以描述为一种通过倾听、讲述和观察他人来相互学习的活动。与有相似经历的人在一起,让大多数焦点小组参与者产生了一种成为安全社区一员的感觉,在这个社区里,与肠易激综合征症状相关的禁忌话题可以直言不讳。将身体和疾病作为一个整体来理解,增强了他们解读身体信号的能力,使他们更自信地应对棘手情况,从而重新融入社会日常生活。
在患者教育项目中,经验的相互分享与专业科学知识的提供相结合,共同促使大多数参与个体在日常生活中更愿意改善健康状况。这是基于对身体和疾病整体的新理解,以及对如何运用基于知识的策略来克服与疾病相关困扰做出决策的新能力。