Hôpital Lariboisière, service de rhumatologie, pôle locomoteur, AP-HP, 2, rue Ambroise Paré 75010 Paris, France.
Université Paris Diderot, département de médecine générale, 75018 Paris, France.
Joint Bone Spine. 2019 Nov;86(6):769-776. doi: 10.1016/j.jbspin.2019.04.010. Epub 2019 May 5.
Adherence to gout treatment is poor. Partners of patients and nurses are two major communicators with gouty patients, and their perceptions of illness may affect patient behavior.
To explore partners' and nurses' knowledge and representations of gout.
We used a qualitative grounded approach with semi-structured face-to-face individual interviews with a purposive sample of hospital nurses working in rheumatology and internal medicine departments and patient partners. Interviews were audio-recorded and transcribed. All authors met regularly to discuss coding and data interpretation.
Overall, 20 nurses and 12 partners participated in the interviews. Four major themes were evidenced: knowledge gaps (gout cause was unknown, unawareness of urate-lowering therapy and the possibility to cure gout, focus in gout flare and diet); lack of information and education on gout (knowledge acquired by personal experiences, nurses complained to be insufficiently educated, partners highlighted the lack of information and that general practitioners did not have time to educate patients); gout consequences and social impacts (handicapping disease, avoid social activities like dinner with friends); attitudes towards gout flare and patient management (feeling powerless during flare, negative feelings such as being ashamed leading to postpone medical seek or unconcerned about their partner disease). Nurses regretted that they had not enough time to discuss issues with patients.
Partners and nurses' knowledge of gout is based on daily experiences. Participants were eager to learn more about gout. Nurses' education and education programs including partners may improve gout management and patient adherence to treatment.
痛风治疗的依从性很差。患者的伴侣和护士是与痛风患者沟通的两个主要对象，他们对疾病的认知可能会影响患者的行为。
探讨患者伴侣和护士对痛风的认知和看法。
我们采用了定性扎根方法，对在风湿病和内科部门工作的医院护士和患者伴侣进行了有针对性的半结构式面对面个人访谈。访谈进行了录音和转录。所有作者定期开会讨论编码和数据解释。
共有 20 名护士和 12 名伴侣参与了访谈。有四个主要主题：知识差距（痛风的病因未知，对降尿酸治疗和治愈痛风的可能性缺乏认识，关注痛风发作和饮食）；缺乏痛风相关信息和教育（通过个人经验获得知识，护士抱怨接受的教育不足，伴侣强调缺乏信息，而且全科医生没有时间教育患者）；痛风的后果和社会影响（致残性疾病，避免社交活动，如与朋友共进晚餐）；对痛风发作和患者管理的态度（发作时感到无能为力，负面情绪如羞耻感导致延迟就医或对伴侣的疾病漠不关心）。护士们遗憾的是，他们没有足够的时间与患者讨论问题。
患者伴侣和护士对痛风的认识是基于日常经验。参与者渴望更多地了解痛风。护士的教育和包括伴侣在内的教育项目可以改善痛风管理和患者对治疗的依从性。
