Sawicki Gregory S, Heller Karen S, Demars Nathan, Robinson Walter M
Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts.
Pediatr Pulmonol. 2015 Feb;50(2):127-36. doi: 10.1002/ppul.23017. Epub 2014 Mar 10.
As advances in the care of individuals with cystic fibrosis (CF) have resulted in improved survival, therapeutic regimens for treatment of CF have become increasingly complex. This high treatment burden poses challenges to chronic disease self-management, particularly amongst adolescents. The aim of this qualitative study was to understand the barriers and facilitators of adherence to chronic CF therapies as perceived by adolescents with CF and their parents. In a series of structured interviews with 18 youth and their parents, we explored issues related to daily routines, youth and parental roles regarding chronic therapy, and motivators for adherence. All interviews were audio-recorded and coded for themes and patterns. Reported barriers to adherence included time pressures, competing priorities, heightened awareness of disease trajectory, privacy concerns, and lack of perceived consequences from non-adherence. Identified facilitators for adherence included recognizing the importance of therapies, developing strong relationships with care teams, establishing structured routines, and focusing on shifting responsibilities from a parent to their adolescent child. The themes uncovered by these interviews identify areas for intervention and support by clinical programs seeking to improve adherence and self-management strategies for adolescents with CF.
随着囊性纤维化(CF)患者护理水平的提高,其生存率有所改善,CF的治疗方案也变得越来越复杂。这种高治疗负担给慢性病自我管理带来了挑战,尤其是在青少年中。这项定性研究的目的是了解CF青少年及其父母所认为的坚持慢性CF治疗的障碍和促进因素。在对18名青少年及其父母进行的一系列结构化访谈中,我们探讨了与日常生活、青少年和父母在慢性治疗中的角色以及坚持治疗的动机相关的问题。所有访谈均进行了录音,并针对主题和模式进行了编码。报告的坚持治疗的障碍包括时间压力、相互竞争的优先事项、对疾病轨迹的更高认识、隐私问题以及对不坚持治疗后果的认知不足。确定的坚持治疗的促进因素包括认识到治疗的重要性、与护理团队建立牢固的关系、建立结构化的日常生活以及关注将责任从父母转移到青少年子女身上。这些访谈揭示的主题为临床项目确定了干预和支持领域,这些项目旨在改善CF青少年的坚持治疗和自我管理策略。