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了解男性、女性和糖皮质激素性骨质疏松症患者的骨质疏松类型、观点和教育需求:改善疾病管理的定性研究。

Understanding Patients' Perspectives and Educational Needs by Type of Osteoporosis in Men and Women and People with Glucocorticosteroid-Induced Osteoporosis: A Qualitative Study to Improve Disease Management.

机构信息

Rheumatology Department, Hôpital Universitaire Saint Antoine, APHP, Paris, France.

Rheumatology Department, Centre Hospitalier régional Metz-Thionville, Thionville, France.

出版信息

Calcif Tissue Int. 2019 Dec;105(6):589-608. doi: 10.1007/s00223-019-00607-z. Epub 2019 Sep 10.

Abstract

The aim of the study was to investigate similarities and differences in health beliefs, experiences and educational needs by type of osteoporosis (OP), particularly in people with glucocorticoid-induced OP (GIOP) and men. A qualitative study was conducted via focus groups involving post-menopausal women with or without osteoporotic fractures, osteoporotic men and people with GIOP. Fifty-three participants were included in eight groups. A wide range of health beliefs was found for all types of OP. Osteoporosis was considered a natural consequence of ageing except in men or conversely a serious disease associated with risk of new fractures and disability. GIOP patients had heterogeneous knowledge of OP and reported fewer prevention behaviours, and their quality of life was affected by the causal illness. Men had difficulties coping with the loss of their functional abilities and felt that OP was a "women's" disease. Beliefs about treatments ranged from confidence to fear of adverse effects or doubt about efficacy in all types of OP. Participants were interested in physical activity, fall prevention and diet, and preferred group sessions. GIOP patients and men had an interest in face-to-face education. Men were also interested in brief information including via the Internet. Patients' beliefs about OP differed by type of OP. Specific populations such as men or people with GIOP need particular care owing to experiences and needs. Offering group sessions in educational interventions is of interest to allow for sharing experiences and also face-to-face education for men and GIOP patients or the Internet for men.

摘要

本研究旨在通过骨质疏松症(OP)的类型,特别是糖皮质激素诱导的 OP(GIOP)和男性,来探讨健康信念、经验和教育需求的异同。通过焦点小组进行了一项定性研究,参与者包括有或无骨质疏松性骨折的绝经后妇女、骨质疏松症男性和 GIOP 患者。8 个小组共纳入 53 名参与者。研究发现,所有类型的 OP 都存在广泛的健康信念。除了男性,骨质疏松症被认为是衰老的自然结果,或者相反,它是一种与新骨折和残疾风险相关的严重疾病。GIOP 患者对 OP 的了解存在差异,报告的预防行为较少,他们的生活质量受到病因疾病的影响。男性难以应对其功能能力的丧失,并且认为 OP 是一种“女性”疾病。对治疗的信念从信心到对不良反应的恐惧或对所有类型 OP 的疗效的怀疑不等。参与者对体育活动、预防跌倒和饮食感兴趣,并且更喜欢小组会议。GIOP 患者和男性对面对面教育感兴趣。男性也对包括通过互联网在内的简短信息感兴趣。患者对 OP 的信念因 OP 的类型而异。由于经历和需求的不同,特定人群(如男性或 GIOP 患者)需要特别关注。提供教育干预小组会议有助于分享经验,并且对男性和 GIOP 患者提供面对面教育或对男性提供互联网教育都很有意义。

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