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理解健康信息在患者经历中的作用:对德国癌症确诊患者定性叙事访谈的二次分析

Understanding the role of health information in patients' experiences: secondary analysis of qualitative narrative interviews with people diagnosed with cancer in Germany.

作者信息

Blödt Susanne, Kaiser Maleen, Adam Yvonne, Adami Sandra, Schultze Martin, Müller-Nordhorn Jacqueline, Holmberg Christine

机构信息

Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Unversität zu Berlin, and Berlin Institute of Health, Institute of Public Health, Berlin, Germany.

Albert-Ludwigs University Freiburg; Institute of psychology, department of rehabilitation psychology and psychotherapy, Germany.

出版信息

BMJ Open. 2018 Mar 12;8(3):e019576. doi: 10.1136/bmjopen-2017-019576.

Abstract

OBJECTIVE

To analyse the role and meaning of health information in individuals' experiences with either breast, colorectal or prostate cancer in order to better understand unmet information needs of people with a cancer diagnosis.

DESIGN

This is a secondary analysis of data from a qualitative interview study including narrative interviews and maximum variation sampling. A thematic analysis was conducted, followed by an in-depth analysis based on the principles of grounded theory.

SETTING

Interviewees were sought across Germany through self-help organisations, primary care clinics, rehabilitation facilities, physicians and other healthcare professionals to develop cancer modules for the website krankheitserfahrungen.de (illness experiences.de).

PARTICIPANTS

Women with a diagnosis of breast cancer, individuals with a diagnosis of colorectal cancer and men with a diagnosis of prostate cancer.

RESULTS

The meaning and role of information in the illness experiences were clearly associated with gaining control in a seemingly uncontrollable situation in which others -people, the disease- take over. Four categories characterise the ways in which information helped interviewees to regain a sense of control following a diagnosis of cancer: 'becoming confident in one's treatment decision', 'taking responsibility for one's situation', 'understanding the consequences of the disease and treatment for one's life', and 'dealing with fear'. There was, however, always a fine line between information seeking and becoming overwhelmed by information.

CONCLUSIONS

Information needs to be understood as a management tool for handling the disease and its (potential) consequences. Patients' unmet needs for information might not be easily solved by a simple increase in the amount of information because emotional support and respect for patient autonomy might also play a role. The evaluation of one's own information behaviour and the information received is closely linked to how the illness unfolds. This makes it challenging to document unmet information needs and satisfaction with information independent of an individual's illness trajectory over time.

摘要

目的

分析健康信息在个体乳腺癌、结直肠癌或前列腺癌经历中的作用和意义,以便更好地理解癌症诊断患者未满足的信息需求。

设计

这是一项对定性访谈研究数据的二次分析,包括叙事访谈和最大差异抽样。进行了主题分析,随后基于扎根理论原则进行了深入分析。

背景

通过自助组织、基层医疗诊所、康复机构、医生和其他医疗专业人员在德国各地寻找受访者,为网站krankheitserfahrungen.de(疾病经历.de)开发癌症模块。

参与者

乳腺癌诊断患者、结直肠癌诊断患者和前列腺癌诊断患者。

结果

信息在疾病经历中的意义和作用与在看似无法控制的情况下重新获得控制密切相关,在这种情况下,他人(他人、疾病)占据主导。四类特征描述了信息帮助受访者在癌症诊断后重新获得控制感的方式:“对自己的治疗决定有信心”、“对自己的情况负责”、“理解疾病和治疗对自己生活的影响”以及“应对恐惧”。然而,在寻求信息和被信息淹没之间始终存在一条微妙的界限。

结论

信息需要被理解为应对疾病及其(潜在)后果的管理工具。患者未满足的信息需求可能无法通过简单增加信息量轻易解决,因为情感支持和对患者自主权的尊重也可能起作用。对自己信息行为和所接收信息的评估与疾病的发展方式密切相关。这使得记录未满足的信息需求以及对信息的满意度独立于个体随时间的疾病轨迹具有挑战性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bed2/5857676/75418b0d4ce2/bmjopen-2017-019576f01.jpg

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