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“犹如定时炸弹”:一项探索成人肾结石病患者疾病体验的定性研究。

'Like a ticking time bomb': A qualitative study exploring the illness experiences of adults with kidney stone disease.

机构信息

Department of Psychology, University of Limerick, Limerick, Ireland.

Health Research Institute, University of Limerick, Limerick, Ireland.

出版信息

Br J Health Psychol. 2023 Sep;28(3):705-723. doi: 10.1111/bjhp.12649. Epub 2023 Feb 1.

Abstract

OBJECTIVE

Kidney stone disease (KSD) is a common, complex and painful urological condition, but how patients make sense of and respond to the challenges of KSD is poorly understood. Using the common-sense model of illness self-regulation (CSM-SR), we aimed to explore the illness experiences of individuals with KSD.

DESIGN

A qualitative design using individual semi-structured interviews.

METHODS

Thirty-three patients with KSD attending outpatient urology services participated in interviews informed by the CSM-SR. Data were analysed using reflexive thematic analysis. Themes were mapped onto the domains of the CSM-SR.

RESULTS

Five main themes were generated, broadly echoing domains within the CSM-SR: (1) making sense of KSD, (2) normality paused, (3) the psychological burden of KSD, (4) the tensions of managing KSD, and (5) improving understanding of KSD. Additionally, findings suggested that partners' perceptions of KSD were an additional contextual factor that informed patients' own perceptions and management of KSD. Participants appraised initial KSD symptoms as indicative of a serious health threat. Diagnosis brought some relief, however, KSD wielded multi-dimensional impacts on patients' perceptions, self-management and well-being. Anxiety, including fear of KSD recurrence, and low mood were common psychological burdens across narratives.

CONCLUSION

The majority of the themes identified were commensurate with an extended CSM-SR. This model has utility in informing how patients perceive and manage KSD. Examining patients' KSD representations and routinely assessing for psychological distress may be of benefit to improve health outcomes for this patient group.

摘要

目的

肾结石病(KSD)是一种常见、复杂且痛苦的泌尿科疾病,但患者如何理解和应对 KSD 的挑战还知之甚少。我们使用疾病自我调节的常识模型(CSM-SR)来探讨 KSD 患者的疾病体验。

设计

采用个体半结构式访谈的定性设计。

方法

33 名接受门诊泌尿科服务的 KSD 患者参与了基于 CSM-SR 的访谈。使用反思性主题分析对数据进行分析。将主题映射到 CSM-SR 的领域。

结果

生成了五个主要主题,广泛呼应 CSM-SR 的领域:(1)理解 KSD,(2)暂停正常,(3)KSD 的心理负担,(4)管理 KSD 的紧张,(5)提高对 KSD 的理解。此外,研究结果表明,伴侣对 KSD 的看法是影响患者自身对 KSD 的看法和管理的另一个背景因素。患者将最初的 KSD 症状评估为严重健康威胁的迹象。诊断带来了一些缓解,但 KSD 对患者的感知、自我管理和幸福感产生了多维度的影响。焦虑,包括对 KSD 复发的恐惧和情绪低落,是叙述中常见的心理负担。

结论

确定的大多数主题与扩展的 CSM-SR 一致。该模型可用于告知患者如何感知和管理 KSD。检查患者的 KSD 表现并定期评估心理困扰可能有助于改善该患者群体的健康结果。

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