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2型糖尿病合并慢性肾脏病患者的自我管理体验:一项定性研究。

The self-management experience of patients with type 2 diabetes and chronic kidney disease: A qualitative study.

作者信息

Shirazian Shayan, Crnosija Natalie, Weinger Katie, Jacobson Alan M, Park Joonho, Tanenbaum Molly L, Gonzalez Jeffrey S, Mattana Joseph, Hammock Amy C

机构信息

Department of Medicine, Winthrop University Hospital, Mineola, NY, USA

Program in Public Health, Stony Brook University, Stony Brook, NY, USA.

出版信息

Chronic Illn. 2016 Mar;12(1):18-28. doi: 10.1177/1742395315614381. Epub 2015 Nov 3.

Abstract

BACKGROUND

The purpose of this study was to explore views related to the self-management of type 2 diabetes and chronic kidney disease.

METHODS

We conducted three semi-structured focus groups in participants with type 2 diabetes and chronic kidney disease. Interviews were transcribed, coded, and analyzed using thematic analysis. Credibility was supported through triangulation of data sources and the use of multiple investigators from different disciplines.

RESULTS

Twenty-three adults participated. Three major themes were identified: emotional reactions to health state, the impact of family dynamics on self-management, and the burden of self-management regimens. Family dynamics were found to be a barrier and support to self-management, while complicated self-management regimens were found to be a barrier. Additionally, participants expressed several emotional reactions related to their CKD status, including regret related to having developed CKD and distress related both to their treatment regimens and the future possibility of dialysis.

CONCLUSIONS

This exploratory study of patients with type 2 diabetes and chronic kidney disease describes barriers and supports to self-management and emotional reactions to chronic kidney disease status. Future research should confirm these findings in a larger population and should include family members and/or health care providers to help further define problems with self-management in patients with type 2 diabetes and chronic kidney disease.

摘要

背景

本研究旨在探讨与2型糖尿病和慢性肾脏病自我管理相关的观点。

方法

我们对患有2型糖尿病和慢性肾脏病的参与者进行了三次半结构化焦点小组访谈。访谈内容经转录、编码,并采用主题分析法进行分析。通过对数据源进行三角验证以及使用来自不同学科的多名研究人员来确保研究的可信度。

结果

23名成年人参与了研究。确定了三个主要主题:对健康状况的情绪反应、家庭动态对自我管理的影响以及自我管理方案的负担。研究发现,家庭动态既是自我管理的障碍,也是自我管理的支持因素,而复杂的自我管理方案则是一个障碍。此外,参与者表达了与他们的慢性肾脏病状况相关的几种情绪反应,包括对患慢性肾脏病的遗憾以及对治疗方案和未来透析可能性的苦恼。

结论

这项对2型糖尿病和慢性肾脏病患者的探索性研究描述了自我管理的障碍和支持因素以及对慢性肾脏病状况的情绪反应。未来的研究应在更大规模的人群中证实这些发现,并且应纳入家庭成员和/或医疗保健提供者,以帮助进一步明确2型糖尿病和慢性肾脏病患者自我管理方面的问题。

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