Academic rheumatology, faculty of medicine & health sciences, school of medicine, university of Nottingham, Nottingham, UK; Rheumatology research group, institute of inflammation and ageing, university of Birmingham, Birmingham, UK.
Academic rheumatology, faculty of medicine & health sciences, school of medicine, university of Nottingham, Nottingham, UK; Nottingham NIHR biomedical research centre, Nottingham, UK.
Joint Bone Spine. 2019 May;86(3):357-362. doi: 10.1016/j.jbspin.2018.10.008. Epub 2018 Oct 27.
To explore patient perception of the role of a nurse-led complex package of care in facilitating engagement with urate-lowering therapies (ULTs) in the management of gout.
Thirty people who had participated in a randomised controlled trial investigating the effect of a nurse-led complex package of care for gout, were purposively sampled and interviewed between 18-26 months after the end of the trial. Interviews were recorded, transcribed and analysed using a modified grounded-theory approach. Data were managed using Nvivo. STATA v15 was used to describe summary statistics.
Participants described their views and experiences of engaging with a nurse-led intervention designed to provide holistic assessment, individualised patient education, and involvement in shared decision-making for the long-term management of gout. The analysis revealed key themes in how nurse-led intervention facilitated engagement with ULT, namely by proving improved knowledge and understanding of gout and its treatment, involvement of patients in decision-making about treatment, and increased confidence about benefits from treatment. However, some treatment uncertainty and concern remained and one participant free of gout flares discontinued ULT, while another halved the dose after the end of the trial.
This study reports data on patient experience of engaging with ULT to manage gout after receiving nurse-led care. It demonstrates that shared decision-making and the joint efforts of fully informed practitioners and patients persuades patients to engage with ULTs, and that experiencing the benefits of curative treatment motivates them to maintain adherence.
探讨患者对护士主导的综合护理包在促进降尿酸治疗（ULTs）方面的作用的看法，以管理痛风。
在一项针对痛风患者护士主导的综合护理包的随机对照试验结束后 18-26 个月，对 30 名参与者进行了目的抽样和访谈。使用改良的扎根理论方法对访谈进行记录、转录和分析。使用 Nvivo 管理数据。STATA v15 用于描述摘要统计数据。
参与者描述了他们对参与护士主导的干预措施的看法和经验，该干预措施旨在提供全面评估、个体化患者教育，并参与长期痛风管理的共同决策。分析揭示了护士主导的干预措施如何促进 ULT 参与的关键主题，即通过提供对痛风及其治疗的更好理解和认识，让患者参与治疗决策，并对治疗的益处增加信心。然而，一些治疗的不确定性和担忧仍然存在，一名无痛风发作的参与者停止了 ULT，另一名参与者在试验结束后将剂量减半。
本研究报告了接受护士主导的护理后，患者参与 ULT 以管理痛风的体验数据。它表明，共同决策以及充分知情的从业者和患者的共同努力，促使患者参与 ULT，并使他们体验到治愈治疗的益处，从而促使他们保持依从性。
