Ma Jing, Sun Xu, Wang Xinwei, Liu Bingjian, Shi Kaiqi
Faculty of Science and Engineering, University of Nottingham, Ningbo, People's Republic of China.
Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, Ningbo, People's Republic of China.
Patient Prefer Adherence. 2023 Mar 3;17:531-545. doi: 10.2147/PPA.S395327. eCollection 2023.
This study aims to explore factors that affect patient adherence to inhalation therapy by applying a patient-centered approach.
We conducted a qualitative study to identify the factors that influence adherent behaviors among asthma/COPD patients. 35 semi-structured interviews with patients, and 15 semi-structured interviews with healthcare providers (HCPs) who manage asthma/COPD patients were conducted. The SEIPS 2.0 model was applied as a conceptual framework for guiding the interview content and analysis of the interview data.
Based on the findings of this study, a conceptual framework of patient adherence in asthma/COPD during inhalation therapy was constructed including five themes: person, task, tool, physical environment, and culture and society. Person-related factors include patient ability and emotional experience. Task-related factors refer to task type and frequency and flexibility. Tool-related factors are the type of inhalers and usability of inhalers. Physical environment-related factors include home environment and COVID-19 situation. Culture and social related factors consist of two aspects: cultural beliefs and social stigma.
The findings of the study identified 10 influential factors that impact on patient adherence to inhalation therapy. A SEIPS-based conceptual model was constructed based on the responses of patients and HCPs to explore the experiences of patients engaging in inhalation therapy and interacting with inhalation devices. In particular, new insight about factors of emotional experience, physical environment and traditional cultural beliefs were found crucial for patients with Asthma/COPD to conduct patients' adherent behaviors.
本研究旨在通过采用以患者为中心的方法,探索影响患者吸入治疗依从性的因素。
我们进行了一项定性研究,以确定影响哮喘/慢性阻塞性肺疾病(COPD)患者依从行为的因素。对患者进行了35次半结构化访谈,并对管理哮喘/COPD患者的医疗服务提供者(HCPs)进行了15次半结构化访谈。应用SEIPS 2.0模型作为概念框架,指导访谈内容和访谈数据分析。
基于本研究的结果,构建了哮喘/COPD患者吸入治疗依从性的概念框架,包括五个主题:人、任务、工具、物理环境以及文化和社会。与人相关的因素包括患者能力和情感体验。与任务相关的因素是指任务类型、频率和灵活性。与工具相关的因素是吸入器的类型和吸入器可用性。与物理环境相关的因素包括家庭环境和新冠疫情情况。与文化和社会相关的因素包括两个方面:文化信仰和社会耻辱感。
该研究结果确定了10个影响患者吸入治疗依从性的因素。基于患者和HCPs的回答构建了一个基于SEIPS的概念模型,以探索患者进行吸入治疗以及与吸入装置互动的体验。特别是,发现关于情感体验、物理环境和传统文化信仰等因素的新见解对于哮喘/COPD患者进行依从行为至关重要。