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与功能性运动障碍共存:三个战役的故事。一种解释性现象学分析。

Living with functional movement disorders: a tale of three battles. An interpretative phenomenological analysis.

机构信息

Division of Health Research, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, UK.

出版信息

Psychol Health. 2024 Aug;39(8):1130-1147. doi: 10.1080/08870446.2022.2130312. Epub 2022 Oct 12.

Abstract

OBJECTIVES

Functional movement disorders (FMD) have poor prognosis and high physical and psychological co-morbidity. Their pathogenesis remains unclear, clinicians often find them difficult to treat, and lack of agreement between healthcare providers and patients is common. This study aimed to explore the experiences of living with FMD to improve understanding of its impact and patients' needs.

METHODS

Ten participants across the UK were recruited online through a charity's social media platforms. Semi structured interviews were conducted via video calls and were audio recorded and verbatim transcripts were analysed using interpretative phenomenological analysis.

RESULTS

Three superordinate themes were generated from the data, representing the three battles fought by the participants: (1) intrapersonal: the tug of war with the secret agent within- the power struggle with symptoms; (2) interpersonal: navigating stigma and self-preservation; (3) systemic: pursuing hope and treatments against helplessness and passivity.

CONCLUSIONS

Loss of control, feelings of powerlessness and oppression by symptoms is often mirrored in participants' experiences of seeking healthcare and navigating societal stigma. Active efforts to regain influence, improve quality of life and maintain hope can be jeopardised by others' dismissive attitudes and lack of knowledge. Antonovsky's model of salutogenesis is proposed as a useful framework for facilitating empowerment in FMD service provision.

摘要

目的

功能性运动障碍 (FMD) 预后不良,且身体和心理合并症发病率高。其发病机制仍不清楚,临床医生往往发现难以治疗,且医护人员和患者之间常缺乏共识。本研究旨在探索 FMD 患者的生活体验,以提高对其影响和患者需求的认识。

方法

通过慈善机构的社交媒体平台在线招募了英国各地的 10 名参与者。通过视频通话进行半结构化访谈,并对音频进行录音,使用解释性现象学分析对逐字记录进行分析。

结果

从数据中生成了三个上位主题,代表参与者进行的三场战斗:(1) 个体内部:与体内特工的拉锯战——与症状的权力斗争;(2) 人际间:应对污名和自我保护;(3) 系统:追求希望和治疗,以对抗无助和被动。

结论

对症状失去控制和无力感以及压迫感,往往反映在参与者寻求医疗保健和应对社会污名的经历中。积极努力重新获得影响力、提高生活质量和保持希望,可能会因他人的不屑一顾的态度和缺乏知识而受到威胁。Antonovsky 的健康促进理论模型被提议作为促进 FMD 服务提供中赋权的有用框架。

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