Currie G R, Kennedy B L, S M Benseler, R S M Yeung, J F Swart, S J Vastert, N M Wulffraat, M M A Kip, MacKean Gail, Marshall D A
Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Musculoskeletal Care. 2023 Dec;21(4):1248-1260. doi: 10.1002/msc.1805. Epub 2023 Aug 19.
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and causes short- and long-term disability. Optimal management requires pharmacologic and non-pharmacologic interventions. Few studies have explored the youth and family experience of the management of JIA. This study's objective was to explore the management experience of youth with JIA and their parents.
This qualitative study used semi-structured interviews with youth 12-18 years of age with JIA receiving biological medication and parents of children with JIA on biological medication. Participants were recruited in clinics using convenience sampling. A thematic analysis approach was employed for data analysis.
Nine youth and 14 parents participated. Four themes were identified that encompassed an overarching theme of participants managing JIA within the context of their life: aspects of life affected by JIA and its management, lived experience with JIA management, medication decision-making, and involvement in decision-making. Juvenile idiopathic arthritis management is situated within the context of their life but is normally (outside acute events) not central.
Two dimensions were added to those in the literature: parents' overall approaches to health and the sense of urgency surrounding decision-making. Our findings reinforce the importance of person- and family-centred care in paediatric rheumatology. That is, identifying what matters most to youth and their parents given their current life circumstances to provide a foundation for discussions of how they want to manage their JIA.
青少年特发性关节炎(JIA)是儿童中最常见的风湿性疾病,会导致短期和长期残疾。最佳管理需要药物和非药物干预措施。很少有研究探讨青少年特发性关节炎管理中青年及其家庭的经历。本研究的目的是探讨青少年特发性关节炎患者及其父母的管理经历。
这项定性研究采用半结构化访谈,对象为年龄在12至18岁、正在接受生物药物治疗的青少年特发性关节炎患者以及正在接受生物药物治疗的青少年特发性关节炎患儿的父母。采用便利抽样法在诊所招募参与者。采用主题分析法进行数据分析。
9名青少年和14名父母参与了研究。确定了四个主题,这些主题包含了一个总体主题,即参与者在其生活背景下管理青少年特发性关节炎:青少年特发性关节炎及其管理对生活的影响方面、青少年特发性关节炎管理的实际经历、药物决策以及参与决策。青少年特发性关节炎的管理处于他们生活的背景中,但通常(在急性事件之外)并非核心。
在已有文献基础上增加了两个维度:父母的整体健康方法以及决策时的紧迫感。我们的研究结果强化了儿科风湿病学中以个人和家庭为中心的护理的重要性。也就是说,鉴于他们当前的生活状况,确定对青少年及其父母最重要的事情,为讨论他们希望如何管理青少年特发性关节炎奠定基础。