Pyatak Elizabeth A, Florindez Daniella, Weigensberg Marc J
Division of Occupational Science and Occupational Therapy, University of Southern California, USA.
Patient Prefer Adherence. 2013 Jul 29;7:709-18. doi: 10.2147/PPA.S47577. Print 2013.
The purpose of this study was to explore motivations underlying nonadherent treatment decisions made by young adults with type 1 diabetes.
Eight emerging adults each completed a series of semi-structured interviews concerning their approaches to diabetes care, relationships with clinicians, and everyday activities and routines. A narrative thematic analysis was used to develop initial themes and refine them through continued data collection and review of the research literature.
FIVE THEMES WERE IDENTIFIED AS MOTIVATING NONADHERENCE: (1) efforts to mislead health care providers, (2) adherence to alternative standards, (3) treatment fatigue and burnout, (4) social support problems, and (5) emotional and self-efficacy problems.
Instances of nonadherence generally involved a combination of the five identified themes. Participants reporting nonadherence also described difficulties communicating with care providers regarding their treatment. Nonjudgmental communication between providers and emerging adults may be particularly important in promoting positive health outcomes in this population.
本研究旨在探究1型糖尿病青年成人做出不依从治疗决定背后的动机。
八名新兴成年人各自完成了一系列半结构化访谈，内容涉及他们的糖尿病护理方法、与临床医生的关系以及日常活动和常规。采用叙事主题分析法来形成初始主题，并通过持续的数据收集和对研究文献的回顾来完善这些主题。
确定了五个促使不依从的主题：（1）误导医疗服务提供者的行为，（2）遵循替代标准，（3）治疗疲劳和倦怠，（4）社会支持问题，以及（5）情绪和自我效能问题。
不依从的情况通常涉及所确定的五个主题的组合。报告不依从的参与者还描述了在与护理提供者沟通其治疗方面存在困难。在促进这一人群的积极健康结果方面，提供者与新兴成年人之间的非评判性沟通可能尤为重要。
