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慢性病身体残疾者自我管理的利益相关者观点、需求和障碍:焦点小组研究

Stakeholders' Perspectives, Needs, and Barriers to Self-Management for People With Physical Disabilities Experiencing Chronic Conditions: Focus Group Study.

作者信息

Evans Eric, Zengul Ayse, Knight Amy, Willig Amanda, Cherrington Andrea, Mehta Tapan, Thirumalai Mohanraj

机构信息

Department of Family and Community Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States.

Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States.

出版信息

JMIR Rehabil Assist Technol. 2023 Dec 18;10:e43309. doi: 10.2196/43309.

Abstract

BACKGROUND

While self-management programs have had significant improvements for individuals with chronic conditions, less is known about the impact of self-management programs for individuals with physical disabilities who experience chronic conditions, as no holistic self-management programs exist for this population. Similarly, there is limited knowledge of how other stakeholders, such as caregivers, health experts, and researchers, view self-management programs in the context of disability, chronic health conditions, and assistive technologies.

OBJECTIVE

This study aimed to obtain insight into how stakeholders perceive self-management relating to physical disability, chronic conditions, and assistive technologies.

METHODS

Nine focus groups were conducted by 2 trained facilitators using semistructured interview guides. Each guide contained questions relating to stakeholders' experiences, challenges with self-management programs, and perceptions of assistive technologies. Focus groups were audio recorded and transcribed. Thematic analysis was conducted on the focus group data.

RESULTS

A total of 47 individuals participated in the focus groups. By using a constructivist grounded approach and inductive data collection, three main themes emerged from the focus groups: (1) perspectives, (2) needs, and (3) barriers of stakeholders. Stakeholders emphasized the importance of physical activity, mental health, symptom management, medication management, participant centeredness, and chronic disease and disability education. Participants viewed technology as a beneficial aide to their daily self-management and expressed their desire to have peer-to-peer support in web-based self-management programs. Additional views of technology included the ability to access individualized, educational content and connect with other individuals who experience similar health conditions or struggle with caregiving duties.

CONCLUSIONS

The findings suggest that the development of any web-based self-management program should include mental health education and resources in addition to physical activity content and symptom management and be cost-effective. Beyond the inclusion of educational resources, stakeholders desired customization or patient centeredness in the program to meet the overall needs of individuals with physical disabilities and caregivers. The development of web-based self-management programs should be holistic in meeting the needs of all stakeholders.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05481593; https://clinicaltrials.gov/study/NCT05481593.

摘要

背景

虽然自我管理项目已使慢性病患者有了显著改善,但对于患有慢性病的身体残疾者而言,自我管理项目的影响却鲜为人知,因为针对这一人群尚无全面的自我管理项目。同样,对于其他利益相关者,如护理人员、健康专家和研究人员,在残疾、慢性健康状况和辅助技术背景下如何看待自我管理项目,了解也有限。

目的

本研究旨在深入了解利益相关者如何看待与身体残疾、慢性疾病和辅助技术相关的自我管理。

方法

由2名经过培训的主持人使用半结构化访谈指南进行了9次焦点小组讨论。每个指南都包含与利益相关者的经历、自我管理项目面临的挑战以及对辅助技术的看法相关的问题。焦点小组讨论进行了录音并转录。对焦点小组数据进行了主题分析。

结果

共有47人参加了焦点小组讨论。通过使用建构主义扎根方法和归纳性数据收集,焦点小组讨论中出现了三个主要主题:(1)利益相关者的观点,(2)需求,以及(3)障碍。利益相关者强调了身体活动、心理健康、症状管理、药物管理、以参与者为中心以及慢性病和残疾教育的重要性。参与者将技术视为日常自我管理的有益助手,并表示希望在基于网络的自我管理项目中获得同伴支持。对技术的其他看法包括能够获取个性化的教育内容以及与经历类似健康状况或在护理职责方面有困难的其他人建立联系。

结论

研究结果表明,任何基于网络的自我管理项目的开发除了身体活动内容和症状管理外,还应包括心理健康教育和资源,并且具有成本效益。除了纳入教育资源外,利益相关者还希望项目具有定制性或以患者为中心,以满足身体残疾者和护理人员的总体需求。基于网络的自我管理项目的开发应全面满足所有利益相关者的需求。

试验注册

ClinicalTrials.gov NCT05481593;https://clinicaltrials.gov/study/NCT05481593

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