Department of Critical and Invasive-Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
Graduate School of Nursing, National College of Nursing, Tokyo, Japan.
J Clin Nurs. 2023 Jun;32(11-12):2880-2891. doi: 10.1111/jocn.16395. Epub 2022 Jun 5.
To explore the process by which people with hypersensitivity pneumonitis implement continuous antigen avoidance, alongside the situations that influence this process.
Antigen avoidance is the primary treatment for people with hypersensitivity pneumonitis. However, the best method to support antigen avoidance has not yet been established.
The present qualitative study used a constructivist grounded theory approach.
The participants were inpatients or outpatients with hypersensitivity pneumonitis diagnosed at a Japanese urban university hospital. In parallel with semi-structured interviews and a medical record survey from 2016 to 2021, we conducted coding, categorising, writing memos, theoretical sampling and continuous comparisons of experiences from finding physical abnormalities to implementing antigen avoidance. The COREQ checklist was followed for reporting.
Interpreting the experiences leading to the implementation of continuous antigen avoidance by 28 participants provided a process consisting of a core category: trying to maintain one's desired life under uncertain situations, and four phases: (1) searching for a convincing cause of the illness, (2) gradually understanding the disease, (3) realising the need for behaviour change and (4) seeking a good balance between behaviour change and one's desired life. The situations that influenced the process were also revealed.
Being convinced of the cause of one's illness and realising its severity led to the participants' realisation of the need for a behavioural change to avoid antigens. The uncertainty of the cause of illness and measures taken, a lack of clear advice from healthcare providers and one's desired life influenced participants' implementation of continuous antigen avoidance.
This study provides important insights regarding how healthcare providers should better understand and support people with hypersensitivity pneumonitis in avoiding antigens.
探索患有过敏性肺炎的人实施持续抗原回避的过程，以及影响这一过程的情况。
抗原回避是治疗过敏性肺炎患者的主要方法。然而，支持抗原回避的最佳方法尚未确定。
本定性研究采用建构主义扎根理论方法。
参与者为 2016 年至 2021 年在日本一所城市大学医院诊断为过敏性肺炎的住院或门诊患者。我们在进行半结构化访谈和病历调查的同时，对从发现身体异常到实施抗原回避的经验进行了编码、分类、写备忘录、理论抽样和持续比较。报告遵循了 COREQ 清单。
对 28 名参与者实施持续抗原回避的经验进行解释，提供了一个由核心类别组成的过程：在不确定的情况下努力维持自己想要的生活，以及四个阶段：（1）寻找疾病的可信病因，（2）逐渐了解疾病，（3）意识到需要行为改变，（4）在行为改变和自己想要的生活之间寻求良好的平衡。还揭示了影响这一过程的情况。
确信自己疾病的病因并意识到其严重性，导致参与者意识到需要改变行为来避免抗原。疾病病因和采取的措施的不确定性、医疗保健提供者缺乏明确的建议以及自己想要的生活影响了参与者持续实施抗原回避。
本研究提供了重要的见解，说明医疗保健提供者应该如何更好地理解和支持过敏性肺炎患者避免抗原。
