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探索并解决肌萎缩侧索硬化症患者重要他人的“担忧”以拓展对生活质量的理解:一项定性研究

Exploring and Addressing 'Concerns' for Significant Others to Extend the Understanding of Quality of Life With Amyotrophic Lateral Sclerosis: A Qualitative Study.

作者信息

Ando Hikari, Cousins Rosanna, Young Carolyn A

机构信息

Respiratory Laboratory, Aintree University Hospital NHS Foundation Trust, Liverpool, UK.

Department of Psychology, Liverpool Hope University, Liverpool, UK.

出版信息

J Cent Nerv Syst Dis. 2019 Jul 8;11:1179573519859360. doi: 10.1177/1179573519859360. eCollection 2019.

Abstract

BACKGROUND

The absence of curative medication for amyotrophic lateral sclerosis (ALS) makes palliative care and understanding quality of life (QoL) in ALS a clinical priority. Previous qualitative research has explored the concept of QoL in terms of illness impact on life perspectives and sense of self.

OBJECTIVE

In this research, we explored 'concerns' - one of the four aspects in the World Health Organisation's conceptualisation of QoL - towards adding to the literature.

METHODS

In-depth interviews with 26 individuals with ALS were subjected to thematic analysis involving both inductive and deductive approaches to explore participant's concerns, and to evaluate the relevance of their concerns for understanding QoL in ALS.

FINDINGS

The analysis showed that concerns for significant others contribute to participant's QoL because of their existential value. It was important for participants to minimise the impact of limitations and burdens associated with ALS on significant others, even at a cost to self.

DISCUSSION

The current study supports a holistic approach in service provision, ensuring the inclusion of relevant significant others. It is further suggested that clinicians explore the specifics of burdens perceived by patients in order to support them in minimising the burdens for their significant others.

摘要

背景

由于缺乏治疗肌萎缩侧索硬化症(ALS)的治愈性药物,姑息治疗以及了解ALS患者的生活质量(QoL)成为临床重点。以往的定性研究从疾病对生活观念和自我意识的影响方面探讨了生活质量的概念。

目的

在本研究中,我们探讨了“关切”——世界卫生组织生活质量概念的四个方面之一,以丰富相关文献。

方法

对26名ALS患者进行了深入访谈,并采用归纳和演绎相结合的主题分析方法,以探究参与者的关切,并评估他们的关切对于理解ALS患者生活质量的相关性。

结果

分析表明,对重要他人的关切因其存在价值而有助于参与者的生活质量。对参与者来说,即使以牺牲自身为代价,尽量减少与ALS相关的限制和负担对重要他人的影响也很重要。

讨论

本研究支持在服务提供中采取整体方法,确保纳入相关重要他人。还建议临床医生探索患者所感受到的负担细节,以帮助他们尽量减轻对重要他人的负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7899/6614934/d923d88962da/10.1177_1179573519859360-fig1.jpg

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