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疾病认知与文化习俗在儿童哮喘的以患者为中心的护理中发挥作用:墨西哥母亲的经历。

Illness representations and cultural practices play a role in patient-centered care in childhood asthma: experiences of Mexican mothers.

作者信息

Arcoleo Kimberly, Zayas Luis E, Hawthorne April, Begay Rachelle

机构信息

a College of Nursing, The Ohio State University , Columbus , OH , USA .

出版信息

J Asthma. 2015 Sep;52(7):699-706. doi: 10.3109/02770903.2014.1001905. Epub 2015 Mar 10.

DOI:10.3109/02770903.2014.1001905
PMID:25539396
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4818096/
Abstract

OBJECTIVE

Patients' cultural health beliefs and behaviors may conflict with biomedical healthcare values and practices potentially leading to non-adherence with asthma treatment regimens. To optimize shared decision-making, healthcare providers should understand and be sensitive to these cultural beliefs and behaviors and negotiate an asthma management plan acceptable to parents. The purpose of this study was to obtain the perspective of Mexican mothers regarding (1) their experiences of living with a child with asthma, (2) their understanding of the nature of asthma, and (3) how their cultural beliefs influence asthma management.

METHODS

A qualitative, phenomenological study design was employed to assess mothers' lived experiences with and perceptions of their child's asthma. Individual in-depth interviews were conducted with a purposeful sample of 20 Mexican mothers of children ages 5-17 years with asthma. An inductive, theory-driven, phenomenological analysis approach was used to elicit thematic findings.

RESULTS

Mothers expressed a symptomatic perception of asthma and limited understanding of the disease. Most believe the disease is present only when their child is symptomatic. Many are surprised and puzzled by the unpredictability of their child's asthma attacks, which they report as sometimes "silent". The inconsistency of triggers also leads to frustration and worry, which may reflect their concerns around daily controller medication use and preference for alternative illness management strategies.

CONCLUSIONS

Our clinical encounters should be refocused to better understand the context of these families' lives and the cultural lens through which they view their child's asthma.

摘要

目的

患者的文化健康观念和行为可能与生物医学医疗价值观及实践相冲突,这有可能导致不遵守哮喘治疗方案。为了优化共同决策,医疗服务提供者应理解并敏锐感知这些文化观念和行为,并协商出一个家长可接受的哮喘管理计划。本研究的目的是了解墨西哥母亲对于(1)她们与患有哮喘的孩子共同生活的经历、(2)她们对哮喘本质的理解,以及(3)她们的文化观念如何影响哮喘管理的看法。

方法

采用定性的现象学研究设计来评估母亲们与孩子哮喘相关的生活经历和认知。对20名年龄在5至17岁患有哮喘孩子的墨西哥母亲进行了有目的抽样的个人深度访谈。采用归纳性、理论驱动的现象学分析方法得出主题性研究结果。

结果

母亲们对哮喘的认知停留在症状层面,对该疾病的理解有限。大多数人认为只有在孩子出现症状时疾病才存在。许多人对孩子哮喘发作的不可预测性感到惊讶和困惑,她们称发作有时是“悄无声息的”。诱发因素的不一致也会导致沮丧和担忧,这可能反映出她们对日常控制药物使用的顾虑以及对替代疾病管理策略的偏好。

结论

我们的临床问诊应重新聚焦,以更好地了解这些家庭的生活背景以及她们看待孩子哮喘的文化视角。

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