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对中东难民和移民中高血压知识及认知对药物依从性影响的定性探索。

A qualitative exploration of the impact of knowledge and perceptions about hypertension in medication adherence in Middle Eastern refugees and migrants.

作者信息

Shahin Wejdan, Kennedy Gerard A, Stupans Ieva

机构信息

School of Health & Biomedical Sciences, RMIT University, PO Box 71, Bundoora, Victoria 3083, Australia.

School of Science, Psychology and Sport, Federation University, University Drive, Mount Helen, Ballarat, Melbourne, Australia.

出版信息

Explor Res Clin Soc Pharm. 2021 Jul 21;3:100038. doi: 10.1016/j.rcsop.2021.100038. eCollection 2021 Sep.

Abstract

BACKGROUND

Knowledge and perceptions about chronic disease and medications play a crucial role in determining long-term treatment adherence to diseases such as hypertension. Exploring in depth the barriers and enablers to medication adherence in specific population subgroups such as Middle Eastern refugees and migrants in Australia is important. This may provide a better understanding of each of these groups' beliefs and knowledge and suggest strategies and interventions to improve medication adherence.

OBJECTIVES

This study aimed to understand Middle Eastern refugees' and migrants' experiences, perceptions, and knowledge about hypertension and to explore factors affecting medication adherence.

METHODS

In this study 15 participants who identified themselves as Middle Eastern refugees and migrants in Australia and had been diagnosed with hypertension were interviewed (migrants = 5, refugees =10) using semi-structured interviews. Recorded interviews were analysed using a thematic analysis framework and the findings were reported according to consolidated criteria for reporting qualitative research.

RESULTS

Three key themes emerged from the interview analysis: (1) dealing with the illness in terms of understanding the symptoms and causes, self-managing of high blood pressure, and coping and acquaintance with the illness; (2) beliefs, practices around medication adherence and the barriers and facilitators to taking medications regularly; and (3) healthcare encounters represented by participants trust in healthcare providers. Differences were found between refugees and migrants relating to the understanding, control, and coping with hypertension, beliefs about medications, trust of healthcare providers, and taking medications as prescribed. There were also differences in the social context of the two groups.

CONCLUSION

Understanding the factors that prevent adherence to hypertension in Middle Eastern refugees addressed the gap in the literature regarding refugees' beliefs and medication adherence. Future studies are recommended to assess the improvement in medication adherence in refugees by modifying their beliefs, attitude, and knowledge about medications and illness. In addition, healthcare providers should consider the differences between Middle Eastern refugees and migrants when providing the health advice that targets each of these population independently to ultimately improve their overall health and adherence to medications.

摘要

背景

关于慢性病和药物治疗的知识与认知在决定高血压等疾病的长期治疗依从性方面起着关键作用。深入探究澳大利亚中东难民和移民等特定人群亚组中药物治疗依从性的障碍与促进因素很重要。这有助于更好地理解这些群体的信念和知识,并提出改善药物治疗依从性的策略和干预措施。

目的

本研究旨在了解中东难民和移民对高血压的经历、认知和知识,并探究影响药物治疗依从性的因素。

方法

在本研究中,对15名自认为是澳大利亚中东难民和移民且已被诊断患有高血压的参与者(移民 = 5名,难民 = 10名)进行了半结构化访谈。使用主题分析框架对访谈记录进行分析,并根据定性研究报告的统一标准报告研究结果。

结果

访谈分析得出三个关键主题:(1)从理解症状和病因、自我管理高血压以及应对和了解疾病方面来应对疾病;(2)关于药物治疗依从性的信念、做法以及定期服药的障碍和促进因素;(3)以参与者对医疗服务提供者的信任为代表的医疗接触。在难民和移民之间,在对高血压的理解、控制和应对、对药物的信念、对医疗服务提供者的信任以及按处方服药方面存在差异。两组在社会背景方面也存在差异。

结论

了解中东难民中导致高血压治疗依从性不佳的因素填补了文献中关于难民信念和药物治疗依从性方面的空白。建议未来的研究通过改变难民对药物和疾病的信念、态度和知识来评估难民药物治疗依从性的改善情况。此外,医疗服务提供者在针对这些人群分别提供健康建议时应考虑中东难民和移民之间的差异,以最终改善他们的整体健康状况和药物治疗依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3f0/9030275/d95293788c88/gr1.jpg

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