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采用微观现象学方法探索法国普通实践中首次肺量测定检查诊断 COPD 时患者的体验。

Micro-phenomenological approach to explore the patient experience during an initial spirometry examination to diagnose COPD in general practice in France.

机构信息

Department of Education and Training Sciences, University of Tours, Tours, France.

EA7505 EES, University of Tours, Tours, France.

出版信息

BMJ Open. 2021 Jul 2;11(7):e049121. doi: 10.1136/bmjopen-2021-049121.

Abstract

OBJECTIVES

To explore the patient experience of a spirometry test used to confirm chronic obstructive pulmonary disease (COPD) diagnosis in patients with suspected smoking-related COPD.

DESIGN

This is a qualitative study, performed with open interviews in adults following a routine spirometry test to confirm COPD diagnosis. Data were analysed with a phenomenological-inspired micro-phenomenology approach.

PARTICIPANTS

Eligible patients were recruited through their general practitioner, 10 were interviewed.

SETTING

Primary care in Centre-Val-De-Loire area, France, in 2018.

RESULTS

Participants reported the spirometry test experience as being unfamiliar but gave meaning to the symptoms they experience. Participants expressed a desire to perform the test well and a willingness to confront their state of health. After the spirometry had been completed and the results announced, participants moved through stages of grief from their pre-spirometry self and symptom perception to a state of acceptance. Overall, participants expressed a narrative of an evolving cognitive and corporeal awareness during this spirometry experience. The verbatim quotes describe a cognitive rupture with their chronic illness usually considered as a 'way of life'.

CONCLUSIONS

A spirometry test goes beyond a diagnostic value, providing patients with an opportunity to gain awareness of their own state of health, reframe their breathlessness-related limitations and thus begin to accept the disease. These awareness gains may be considered as small steps towards health behavioural change. Spirometry may have educative potential and support lifestyle changes.

摘要

目的

探索用于确诊疑似与吸烟相关的慢性阻塞性肺疾病(COPD)患者 COPD 的肺活量测定试验的患者体验。

设计

这是一项定性研究,对常规肺活量测定试验后确诊 COPD 的成年患者进行开放式访谈。采用现象学启发的微观现象学方法进行数据分析。

参与者

通过全科医生招募符合条件的患者,共招募了 10 名患者进行访谈。

地点

2018 年法国中央-卢瓦尔河谷地区的初级保健。

结果

参与者报告说,他们对肺活量测定试验的体验感到陌生,但对他们所经历的症状赋予了意义。参与者表示希望能很好地完成测试,并愿意面对自己的健康状况。在肺活量测定试验完成并公布结果后,参与者经历了从测前自我和症状感知到接受状态的悲伤阶段。总体而言,参与者在这个肺活量测定试验体验中表达了一种不断发展的认知和身体意识的叙述。逐字引述描述了与他们通常认为是“生活方式”的慢性疾病的认知破裂。

结论

肺活量测定试验不仅仅具有诊断价值,它还为患者提供了一个了解自身健康状况的机会,重新审视与呼吸困难相关的限制,从而开始接受疾病。这些意识上的提高可以被视为朝着健康行为改变迈出的一小步。肺活量测定试验可能具有教育潜力,并支持生活方式的改变。

相似文献

本文引用的文献

1
[Study of the feasibility of spirometry in general practice].[肺量计在全科医疗中的可行性研究]
Rev Mal Respir. 2018 Mar;35(3):238-248. doi: 10.1016/j.rmr.2017.05.003. Epub 2018 Mar 29.
2
"At First I Couldn't Catch My Breath": Process and Strategies for Managing Chronic Obstructive Pulmonary Disease.
Int J Aging Hum Dev. 2018 Mar;86(2):191-214. doi: 10.1177/0091415017697727. Epub 2017 Mar 15.

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