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类风湿关节炎女性患者与护士在门诊咨询期间的互动:一项定性研究。

Interactions between women with rheumatoid arthritis and nurses during outpatient consultations: A qualitative study.

作者信息

Feddersen Helle, Kristiansen Tine Mechlenborg, Andersen Pernille Tanggaard, Hørslev-Petersen Kim, Primdahl Jette

机构信息

Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.

Institute of Health Studies, University College of Southern Denmark, Sønderborg, Denmark.

出版信息

Musculoskeletal Care. 2019 Dec;17(4):363-371. doi: 10.1002/msc.1435. Epub 2019 Nov 27.

Abstract

INTRODUCTION

Rheumatoid arthritis (RA) is a chronic inflammatory disease, and patients with RA receive services in various settings-for example, in nurse-led follow-up consultations. The present study aimed to investigate how the management of RA in everyday life is expressed in interactions between nurses and women with RA during nursing consultations.

METHODS

The study was conducted in accordance with constructivist grounded theory, with data based on participant observations and subsequent interviews with 10 women with RA.

RESULTS

A core category was developed, "Collaboration through mutual acknowledgement", which documented how the women and nurses confirmed their shared understanding of the content and the structure of the consultation. Three subcategories were identified: (i) "On safe ground", which illustrated that biomedical factors, such as blood test results and pharmacological treatment, structured the basis of the dialogue; (ii) "Venturing forward", which documented how both parties were aware of each other's reactions when the dialogue dealt with women's perspectives of illness in their everyday lives; and (iii) "Gentle steering", which showed that the nurses gently steered the dialogue if the women strayed from the planned content.

CONCLUSIONS

Both parties agreed that a disease perspective consistent with biomedical factors formed the basis for further dialogue. Subsequently, the women's perspectives on illness were included, and the women felt acknowledged. Therefore, the recommendation is that the consultations start by all parties agreeing on a shared agenda to facilitate the inclusion of the women's perspectives on illness.

摘要

引言

类风湿性关节炎(RA)是一种慢性炎症性疾病,类风湿性关节炎患者在各种环境中接受服务,例如在护士主导的随访咨询中。本研究旨在调查在护理咨询期间,护士与患有类风湿性关节炎的女性之间的互动中,类风湿性关节炎的日常生活管理是如何体现的。

方法

该研究按照建构主义扎根理论进行,数据基于参与观察以及随后对10名患有类风湿性关节炎的女性进行的访谈。

结果

形成了一个核心类别“通过相互认可进行协作”,记录了女性和护士如何确认他们对咨询内容和结构的共同理解。确定了三个子类别:(i)“处于安全地带”,说明生物医学因素,如血液检测结果和药物治疗,构成了对话的基础;(ii)“向前迈进”,记录了在对话涉及女性对日常生活中疾病的看法时,双方如何意识到彼此的反应;(iii)“温和引导”,表明如果女性偏离计划内容,护士会温和地引导对话。

结论

双方一致认为,与生物医学因素一致的疾病观点构成了进一步对话的基础。随后,纳入了女性对疾病的看法,女性感到得到了认可。因此,建议咨询开始时各方就共同议程达成一致,以促进纳入女性对疾病的看法。

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