van Merode Tiny, van de Ven Karin, van den Akker Marjan
Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, The Netherlands.
Academic Center for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
J Comorb. 2018 Mar 8;8(1):9-15. doi: 10.15256/joc.2018.8.119. eCollection 2018.
Physicians and other healthcare professionals involved in the care of patients with multimorbidity should consider the problems these patients experience in managing their own conditions. However, treatment burden from the patient's perspective has been poorly explored, even though this might hamper treatment adherence.
The present study examined the experiences of patients with multimorbidity in primary care in the Netherlands and Belgium using semi-structured interviews, with special attention to the daily life domains of treatment burden.
Individual interviews gathering qualitative data to explore the treatment burden experienced by patients with multimorbidity in primary care. Twenty-two patients agreed to participate: seven men and fifteen women. The recorded interviews were transcribed verbatim and evaluated using thematic content analysis.
The patients reported numerous aspects of treatment burden they experienced in various domains of their daily lives. These topics were categorized into four daily life domains of burden: organization of care, medication, patient's role, and impact on daily life (including the involvement of caregivers).
The findings indicate that primary care patients with multimorbidity report treatment burden in several domains of their daily lives, not restricted to medical issues, such as side effects of medication. Some issues, such as those related to organization of care, seem easily modifiable. Further research is required focusing on special factors of treatment burden as experienced by patients with multimorbidity, and the implications for treatment adherence, especially in European settings, as little information is currently available.
参与多病共存患者护理的医生和其他医疗保健专业人员应考虑这些患者在自我病情管理中所面临的问题。然而，尽管患者视角的治疗负担可能会妨碍治疗依从性，但这方面的研究却很少。
本研究采用半结构式访谈，调查了荷兰和比利时初级保健中多病共存患者的经历，并特别关注治疗负担的日常生活领域。
通过个体访谈收集定性数据，以探究初级保健中多病共存患者所经历的治疗负担。22名患者同意参与：7名男性和15名女性。访谈录音逐字转录，并采用主题内容分析法进行评估。
患者报告了他们在日常生活各个领域所经历的治疗负担的诸多方面。这些主题被归类为四个日常生活负担领域：护理安排、药物治疗、患者角色以及对日常生活的影响（包括照顾者的参与）。
研究结果表明，初级保健中的多病共存患者在其日常生活的多个领域都报告了治疗负担，并不局限于医疗问题，如药物副作用。一些问题，如与护理安排相关的问题，似乎易于调整。由于目前可用信息较少，因此需要进一步研究聚焦于多病共存患者所经历的治疗负担的特殊因素，以及对治疗依从性的影响，尤其是在欧洲背景下。
