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帕金森病药物治疗的起始:定性描述

Initiation of medications for Parkinson's disease: a qualitative description.

作者信息

Shin Ju Young, Habermann Barbara

机构信息

School of Nursing, College of Health Sciences, University of Delaware, Newark, DE, USA.

出版信息

J Clin Nurs. 2016 Jan;25(1-2):127-33. doi: 10.1111/jocn.13009. Epub 2015 Sep 30.

Abstract

AIMS AND OBJECTIVES

To understand experiences of people with Parkinson's disease to initiate medication therapy for Parkinson's disease.

BACKGROUND

Nonadherence to medication regimens and reluctance to initiate medication therapy among people with Parkinson's disease has been documented in previous research. However, little is known about experiences and decisions of people with Parkinson's disease to initiate antiparkinsonian medications and their beliefs or levels of understanding of antiparkinsonian medications in the USA.

DESIGN

An exploratory, descriptive qualitative study was employed.

METHODS

Semi-structured interviews were conducted with 16 community-dwelling individuals with Parkinson's disease (69% male) and five family caregivers (40% male). Data analysis was performed using content analysis.

RESULTS

Two domains emerged from the data: decision-making to initiate antiparkinsonian medications as prescribed and reasons to delay initiation of levodopa to a later stage of Parkinson's disease.

CONCLUSIONS

Acceptance of antiparkinsonian medications at the early stage of Parkinson's disease was influenced by the trusting relationship between participants and their health care provider. Fear of levodopa's long-term side effects led to acceptance of non-levodopa therapies first. Complementary and Alternative Medicine was used to manage Parkinson's disease symptoms among participants who delayed antiparkinsonian medication therapy.

RELEVANCE TO CLINICAL PRACTICE

Nurses may have a role to assess individuals' beliefs and concerns about antiparkinsonian medication therapy and to provide adequate information to assist with the decision about Parkinson's disease symptom management.

摘要

目的与目标

了解帕金森病患者开始帕金森病药物治疗的经历。

背景

先前的研究已记录了帕金森病患者不遵守药物治疗方案以及不愿开始药物治疗的情况。然而,在美国,关于帕金森病患者开始抗帕金森药物治疗的经历和决策,以及他们对抗帕金森药物的认知或理解程度,人们知之甚少。

设计

采用探索性、描述性定性研究方法。

方法

对16名社区居住的帕金森病患者(69%为男性)和5名家庭护理人员(40%为男性)进行了半结构化访谈。使用内容分析法进行数据分析。

结果

数据中出现了两个主题:按医嘱开始抗帕金森药物治疗的决策过程,以及将左旋多巴的起始治疗推迟到帕金森病后期的原因。

结论

帕金森病早期对抗帕金森药物的接受程度受参与者与其医疗服务提供者之间信任关系的影响。对左旋多巴长期副作用的恐惧导致首先接受非左旋多巴疗法。在推迟抗帕金森药物治疗的参与者中,使用补充和替代医学来管理帕金森病症状。

与临床实践的相关性

护士可在评估个体对抗帕金森药物治疗的信念和担忧方面发挥作用,并提供足够的信息以协助做出帕金森病症状管理的决策。

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