Columbia University School of Nursing, USA.
University of Pennsylvania School of Nursing, USA.
Heart Lung. 2016 Jan-Feb;45(1):70-8. doi: 10.1016/j.hrtlng.2015.11.002.
To explore whether patient's personal beliefs about inhaled corticosteroid (ICS) and integrative medicine (IM) are discussed at routine primary care visits for asthma.
Negative medication beliefs and preferences for IM can be salient barriers to effective asthma self-management.
A qualitative analysis of transcripts from 33 audio-recorded primary care visits using conventional content analysis techniques.
Four themes emerged when providers had knowledge of patient's beliefs: negative ICS beliefs, IM use for asthma, decision-making and healthy lifestyles. Two themes were identified when providers did not have this knowledge: asthma self-management and healthy lifestyles.
When providers had knowledge of their patient's IM endorsement or negative ICS beliefs, they initiated conversations about these modifiable beliefs. Without training in IM and in effective communication techniques, it is unlikely that providers will be able to effectively engage in shared decision-making aimed at improving asthma self-management.
探讨在常规初级保健就诊中是否讨论了患者对吸入性皮质类固醇(ICS)和整体医学(IM)的个人信念。
对药物的负面信念和对 IM 的偏好可能是有效哮喘自我管理的显著障碍。
对 33 次音频记录的初级保健就诊记录进行定性分析,使用常规内容分析技术。
当提供者了解患者的信念时,出现了四个主题:负面 ICS 信念、IM 在哮喘中的应用、决策和健康生活方式。当提供者不了解这些知识时,出现了两个主题:哮喘自我管理和健康生活方式。
当提供者了解患者对 IM 的认可或对 ICS 的负面信念时,他们会就这些可改变的信念展开讨论。如果没有 IM 方面的培训和有效的沟通技巧,提供者不太可能能够有效地参与旨在改善哮喘自我管理的共同决策。