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反复发作性外阴阴道念珠菌病的医学管理体验:一项不确定旅程的定性研究。

Lived experience of medical management in recurrent vulvovaginal candidiasis: a qualitative study of an uncertain journey.

机构信息

School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia.

School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.

出版信息

BMC Womens Health. 2022 Sep 19;22(1):384. doi: 10.1186/s12905-022-01973-x.

Abstract

BACKGROUND

Recurrent vulvovaginal candidiasis (RVVC) is experienced by up to 10% of pre-menopausal women globally, yet there is limited research exploring the perspective of women living with this challenging condition.

METHODS

Semi-structured interviews with Australian women experiencing RVVC were conducted between April-July 2021. Interviews were transcribed verbatim, and qualitative interpretative phenomenological analysis (IPA) was conducted.

RESULTS

Ten RVVC patients were interviewed. IPA revealed an uncertain journey living with RVVC for all participants ranging from initial symptoms and difficulties in obtaining a diagnosis, the trial and error of symptom management, to the overall debilitating impact of living with a personal and intimate health condition. Four key themes were identified: Theme 1 outlined challenges and delays in diagnosis and clinically appropriate management. Theme 2 found that health care professional (HCP) knowledge limitations impacted RVVC management. Theme 3 illustrated the consequences of a lack of HCP support leading to self-referral and self-education. Theme 4 details the significant emotional and psycho-social repercussions of RVVC.

CONCLUSIONS

This debilitating, life-long disease has a prolonged effect on women both physically and psychologically. Living with RVVC seems an uncertain journey that, to a large degree, women feel they must navigate alone. While resilience and self-empowerment were noted, better support through evidence-based treatment options, educated and evidence-informed HCPs and a sympathetic social support network is needed to decrease the disease burden. Future clinical management guidelines and patient support need to consider the findings of this study.

摘要

背景

全球多达 10%的绝经前女性经历过复发性外阴阴道念珠菌病(RVVC),但对于患有这种具有挑战性疾病的女性的观点,研究十分有限。

方法

2021 年 4 月至 7 月,对澳大利亚患有 RVVC 的女性进行了半结构化访谈。访谈逐字记录,并进行了定性解释现象学分析(IPA)。

结果

对 10 名 RVVC 患者进行了访谈。IPA 显示,所有参与者都经历了 RVVC 的不确定之旅,从最初的症状和诊断困难,到症状管理的反复试验,再到个人和私密健康状况的整体衰弱影响。确定了四个关键主题:主题 1 概述了诊断和临床适当管理方面的挑战和延迟。主题 2 发现医疗保健专业人员(HCP)知识有限会影响 RVVC 的管理。主题 3 说明了缺乏 HCP 支持导致自我转诊和自我教育的后果。主题 4 详细说明了 RVVC 缺乏 HCP 支持导致的重大情绪和心理社会影响。

结论

这种使人衰弱的终身疾病在身体和心理上都对女性产生长期影响。患有 RVVC 似乎是一段不确定的旅程,在很大程度上,女性觉得自己必须独自应对。尽管有韧性和自我赋权,但需要更好的支持,包括基于证据的治疗选择、受过教育和基于证据的 HCP 以及富有同情心的社会支持网络,以减轻疾病负担。未来的临床管理指南和患者支持需要考虑本研究的结果。

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