肾移植患者对自我管理支持的态度：一项Q方法学研究。

Kidney transplant patients' attitudes towards self-management support: A Q-methodological study.

作者信息

Grijpma J W, Tielen M, van Staa A L, Maasdam L, van Gelder T, Berger S P, Busschbach J J, Betjes M G H, Weimar W, Massey E K

机构信息

Erasmus MC, Department of Internal Medicine, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.

Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, The Netherlands; Erasmus University Rotterdam, Institute of Health Policy & Management (iBMG), Rotterdam, The Netherlands.

出版信息

Patient Educ Couns. 2016 May;99(5):836-43. doi: 10.1016/j.pec.2015.11.018. Epub 2015 Nov 23.

DOI:10.1016/j.pec.2015.11.018

PMID:26682972

Abstract

OBJECTIVE

Kidney transplant recipients face many self-management challenges. We aimed to identify profiles of attitudes towards self-management support (SMS) shortly after kidney transplantation.

METHODS

Profiles were generated using Q-methodology: In face-to-face interviews participants rank-ordered opinion statements on aspects of SMS according to agreement. Socio-demographic and medical characteristics were assessed using a questionnaire. By-person factor analysis was used to analyze the rankings and qualitative data was used to support choice of profiles. The resulting factors represent clusters of patients with similar attitudes towards SMS.

RESULTS

Forty-three patients (mean age=56; 77% male) participated. Four profiles were identified: (A) transplant-focused and obedient; (B) holistic and collaborative; (C) life-focused and self-determined; and (D) was bipolar. The positive pole (D+) minimalizing and disengaged and the negative pole (D-) coping-focused and needy represent opposing viewpoints within the same profile. Socio-demographic and medical characteristics were not related to profile membership.

DISCUSSION

Each profile represents a specific attitude on post-transplant life, responsibility for health and decision-making, SMS needs, and preferences for SMS.

PRACTICAL IMPLICATIONS

Patients vary in their attitude, needs and preferences for SMS indicating the necessity of providing personalized support after kidney transplantation. Health professionals should explore patients' SMS needs and adapt support accordingly.

摘要

目的

肾移植受者面临诸多自我管理挑战。我们旨在确定肾移植后不久对自我管理支持（SMS）的态度概况。

方法

采用Q方法生成概况：在面对面访谈中，参与者根据认同程度对关于SMS各方面的观点陈述进行排序。使用问卷评估社会人口统计学和医学特征。采用个人因素分析来分析排序情况，并使用定性数据来支持概况的选择。所得因素代表了对SMS态度相似的患者群体。

结果

43名患者（平均年龄 = 56岁；77%为男性）参与。确定了四种概况：（A）以移植为重点且顺从的；（B）全面且协作的；（C）以生活为重点且自主的；以及（D）两极化的。积极极点（D +）最小化且不参与，消极极点（D -）以应对为重点且有需求，代表了同一概况内的相反观点。社会人口统计学和医学特征与概况归属无关。