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中国山东省甲型血友病患者预防性治疗的障碍:一项定性研究。

Barriers to prophylactic treatment among patients with haemophilia A in Shandong Province, China: a qualitative study.

机构信息

Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.

NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.

出版信息

Orphanet J Rare Dis. 2023 Aug 3;18(1):226. doi: 10.1186/s13023-023-02838-8.

Abstract

BACKGROUND

Haemophilia A is a rare, hereditary haemorrhagic disease that manifests as induced spontaneous bleeding and leads to disability or premature death in severe cases. Prophylactic treatment is optimal for patients to prevent uncontrolled bleeding and reduce the severity of the injury. However, little is known about the use of prophylactic treatment among patients with haemophilia A in China, especially barriers that predispose them to low or non-adherence. In this study, we explore the barriers to the prophylactic treatment of patients with haemophilia A.

METHOD

We used personal interviews and focus groups to collect the data and analysed the data through thematic analysis. Purposive sampling was employed to recruit our participants. We continued recruiting participants until data saturation was reached from the thematic analysis. Ultimately, we obtained 37 participants, among whom 19 participated in personal interviews and 18 participated in focus groups (i.e., 3 focus groups with 6 participants each).

RESULTS

Three themes and nine subthemes were identified from the thematic analysis. Nine subthemes (i.e., perceived barriers) emerged from the analysis, which were further clustered into three themes: (1) poor primary health care, (2) inadequate financial support, and (3) a lack of patient-centred care.

CONCLUSION

The findings presented in this descriptive qualitative study offer a unique view of Chinese patients with haemophilia A and their barriers to prophylactic treatment. Our findings not only provide an in-depth understanding of barriers to prophylactic treatment encountered by Chinese patients with haemophilia A but also address the urgent need to strengthen primary care, provide adequate financial support, and establish patient-centred care for these suffering patients.

摘要

背景

血友病 A 是一种罕见的遗传性出血性疾病,表现为自发性诱导出血,严重情况下可导致残疾或过早死亡。预防性治疗是患者预防失控性出血和降低损伤严重程度的最佳选择。然而,对于中国的血友病 A 患者,预防性治疗的使用情况,尤其是导致其低或不依从的障碍因素,知之甚少。本研究旨在探讨血友病 A 患者预防性治疗的障碍因素。

方法

我们采用个人访谈和焦点小组收集数据,并通过主题分析进行数据分析。采用目的性抽样招募参与者。从主题分析中,我们不断招募参与者,直到达到数据饱和。最终,我们获得了 37 名参与者,其中 19 名参与了个人访谈,18 名参与了焦点小组(即 3 个焦点小组,每组 6 名参与者)。

结果

从主题分析中确定了三个主题和九个子主题。分析产生了九个子主题(即感知障碍),进一步聚类为三个主题:(1)初级卫生保健不佳,(2)经济支持不足,以及(3)缺乏以患者为中心的护理。

结论

本描述性定性研究的结果提供了中国血友病 A 患者及其预防性治疗障碍的独特视角。我们的研究结果不仅深入了解了中国血友病 A 患者在预防性治疗方面面临的障碍,还针对这些患者迫切需要加强初级保健、提供充足的经济支持以及建立以患者为中心的护理提供了思路。

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本文引用的文献

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Women with haemophilia also exist.患血友病的女性也存在。
Lancet Haematol. 2021 Jan;8(1):e18. doi: 10.1016/S2352-3026(20)30409-9. Epub 2020 Dec 22.

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