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伊朗骨关节炎患者对疼痛管理的求医行为与认知:一项定性研究

The Health Seeking Behaviors and Perceptions of Iranian Patient with Osteoarthritis about Pain Management: A Qualitative Study.

作者信息

Zamanzadeh Vahid, Ahmadi Fazlollah, Foolady Marjaneh, Behshid Mozhgan, Irajpoor Alireza

机构信息

Department of Medical Surgical Nursing, Tabriz Health Services Management Research Centre, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences ,Tabriz, Iran.

Department of Nursing, Medical Sciences Faculty, Tarbiat Modares University, Tehran, Iran.

出版信息

J Caring Sci. 2017 Mar 1;6(1):81-93. doi: 10.15171/jcs.2017.009. eCollection 2017 Mar.

Abstract

Pain is the main reason for patients with osteoarthritis (OA) to visit health clinics. Health seeking behaviors indicate unmet patient needs and lack of understanding of OA pain patterns. This study aimed to describe the experiences of Iranian patients with OA and explore their health seeking behaviors and perceptions on pain management related to osteoarthritis. Using a qualitative approach, data was collected by interviewing 19 patients, 2 family members, and 5 health care providers from the in-patient and out-patient clinics, and physicians' offices. Data saturation was reached after 31 in-depth and semi-structured interviews (five second interviews). Data were analyzed by qualitative content analysis, using comparison, reflection and interpretation techniques. The criteria used to enhance rigor included credibility, transferability, dependability, and confirmability. Two main categories and six subcategories emerged from data analysis. The first main category included "adapting to the reality" which had three subcategories: Facing OA pain, seeking health care, and accepting pain as a part of life. The second main category included "behavior fluctuation" with three subcategory of role conflict, responsibility for self-care and, adherence to prescribed treatment versus self-treatment. Care seeking behaviors for chronic pain sufferers are void of cultural, emotional, social and financial situation and patient expectations. Some misconceptions emerged about the health problem and its management, which may lead to negative attitudes toward treatment and therapists and finally lead to non-adherence to treatment. Patients need for education to enhance appropriate health care utilization.

摘要

疼痛是骨关节炎(OA)患者前往健康诊所就诊的主要原因。就医行为表明患者的需求未得到满足,且对OA疼痛模式缺乏了解。本研究旨在描述伊朗OA患者的经历,探讨他们的就医行为以及对骨关节炎疼痛管理的看法。采用定性研究方法,通过对19名患者、2名家庭成员以及来自住院和门诊诊所及医生办公室的5名医护人员进行访谈来收集数据。在进行了31次深入的半结构化访谈(其中5次为第二次访谈)后达到了数据饱和。采用比较、反思和解释技术,通过定性内容分析法对数据进行分析。用于提高严谨性的标准包括可信度、可转移性、可靠性和可证实性。数据分析得出两个主要类别和六个子类别。第一个主要类别包括“适应现实”,它有三个子类别:面对OA疼痛、寻求医疗保健以及将疼痛视为生活的一部分。第二个主要类别包括“行为波动”,其有三个子类别:角色冲突、自我护理责任以及坚持规定治疗与自我治疗。慢性疼痛患者的就医行为不受文化、情感、社会和经济状况以及患者期望的影响。对健康问题及其管理出现了一些误解,这可能导致对治疗和治疗师的消极态度,最终导致不坚持治疗。患者需要接受教育以提高适当的医疗保健利用率。

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