School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.
Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
BMJ Open. 2019 Apr 1;9(4):e024326. doi: 10.1136/bmjopen-2018-024326.
To (a) explore the experiences of persistent postural-perceptual dizziness (PPPD), formerly chronic subjective dizziness on the personal, work and social lives of working-age adults; (b) enhance current understandings of the condition and its impact on the lives of working-age adults and (c) highlight points for consideration and importance to clinical practice.
This qualitative exploratory study drew on interpretive descriptive methodology. Working-age adults (n=8) diagnosed with PPPD were recruited from a single New Zealand community-based specialist clinic. Data from interviews (n=8) and postinterview reflections (n=2) were analysed using thematic analysis.
Three themes were constructed: (1) It sounds like I'm crazy-referring to the lack of medical, social and self-validation associated with PPPD; (2) I'm a shadow of my former self-representing the impact of the condition on sense of self and life trajectory and (3) How will I survive?- highlighting individual coping processes.
This study contributed to the existing body of knowledge by highlighting the complexity and fluidity of experiencing PPPD. It also drew attention to the tension between the acute illness framework that forms the basis of many therapeutic interactions and the enduring psychosocial support needs of the person experiencing PPPD. The findings highlighted that contextual factors need to be taken into account and that a person-centred and biopsychosocial approach, rather than a condition-specific biomedical approach, is needed for care to be perceived as meaningful and satisfactory.
(a) 探索持续性姿势感知性头晕(PPPD),即以前慢性主观性头晕对处于工作年龄的成年人的个人、工作和社会生活的影响;(b) 增强对该病症及其对处于工作年龄成年人生活的影响的现有认识;(c) 强调临床实践需要考虑的要点和重要性。
本定性探索性研究借鉴了解释性描述方法学。从新西兰一个基于社区的专科诊所招募了 8 名被诊断为 PPPD 的处于工作年龄的成年人。对 8 次访谈(n=8)和访谈后反思(n=2)的数据进行主题分析。
构建了三个主题:(1) 听起来我像个疯子-指的是与 PPPD 相关的缺乏医疗、社会和自我认同;(2) 我是我从前的影子-代表了该病症对自我意识和生活轨迹的影响;(3) 我将如何生存?-突出了个人应对的过程。
本研究通过强调经历 PPPD 的复杂性和流动性,为现有知识体系做出了贡献。它还提请注意形成许多治疗性互动基础的急性疾病框架与经历 PPPD 的人持久的心理社会支持需求之间的紧张关系。研究结果强调需要考虑背景因素,需要采取以人为中心的、生物心理社会方法,而不是针对特定病症的生物医学方法,才能使护理被认为是有意义和满意的。