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提高帕金森病患者的以患者为中心的护理:对护理伙伴关于他们参与讨论“关闭”期的定性访谈。

Improving patient-centred care for persons with Parkinson's: Qualitative interviews with care partners about their engagement in discussions of "off" periods.

机构信息

University Health Network, Toronto, Ontario, Canada.

Department of Neurology, University of Florida, Gainesville, Florida.

出版信息

Health Expect. 2019 Jun;22(3):555-564. doi: 10.1111/hex.12884. Epub 2019 Apr 12.

Abstract

OBJECTIVE

This study explored how care partners (CPs) of persons with Parkinson's (PwP) are engaged in discussions of "off" symptoms.

METHODS

During qualitative interviews, CPs of PwP sampled by convenience through the Michael J Fox Foundation online clinical trial matching service were asked to describe their familiarity with "off" symptoms, how "off" symptoms were discussed with clinicians, and the impact of "off" symptoms on them. Data were analysed using constant comparative technique by all members of the research team.

RESULTS

A total of 20 CPs were interviewed. Compared with PwP, they were more likely to describe "off" symptoms to clinicians. CPs identified important aspects of patient-centred care for PD: establishing a therapeutic relationship, soliciting and actively listening to information about symptoms, and providing self-management support to both PwP and CPs. CPs said that clinicians did not always engage CPs, ask about "off" symptoms or provide self-management guidance, limiting their ability to function as caregivers.

CONCLUSION

By not engaging and educating CPs, "off" symptoms may not be identified or addressed, leading to suboptimal medical management and quality of life for PwP. These findings must be confirmed on a broader scale through ongoing research but suggest the potential need for interventions targeted at clinicians and at CPs to promote patient-centred care for PwP.

摘要

目的

本研究探讨了帕金森病患者的照护者(CPs)如何参与“关期”症状的讨论。

方法

通过迈克尔·J·福克斯基金会在线临床试验匹配服务,采用便利抽样方法选取了帕金森病患者的 CPs 作为研究对象,对其进行定性访谈,要求他们描述对“关期”症状的熟悉程度、与临床医生讨论“关期”症状的情况,以及“关期”症状对他们的影响。采用全体研究人员的恒定比较技术对数据进行分析。

结果

共访谈了 20 名 CPs。与帕金森病患者相比,他们更有可能向临床医生描述“关期”症状。CPs 确定了以患者为中心的 PD 护理的重要方面:建立治疗关系、征求和积极倾听有关症状的信息,以及为帕金森病患者和 CPs 提供自我管理支持。CPs 表示,临床医生并非总是与 CPs 互动、询问“关期”症状或提供自我管理指导,这限制了他们作为照护者的功能。

结论

如果不与 CPs 互动和教育,“关期”症状可能无法被识别或处理,从而导致帕金森病患者的医疗管理和生活质量欠佳。这些发现必须通过正在进行的研究在更广泛的范围内得到证实,但表明可能需要针对临床医生和 CPs 的干预措施,以促进以患者为中心的帕金森病患者护理。

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