伊朗慢性阻塞性肺疾病男性患者自我管理的促进因素和障碍：一项定性研究。

Facilitators and barriers to self-management in Iranian men with chronic obstructive pulmonary disease: a qualitative study.

机构信息

Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran.

Department of Pediatric and Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.

出版信息

BMJ Open Respir Res. 2024 May 15;11(1):e002245. doi: 10.1136/bmjresp-2023-002245.

DOI:10.1136/bmjresp-2023-002245

PMID:38749535

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11097885/

Abstract

INTRODUCTION

Self-management, as the most common method of chronic obstructive pulmonary disease (COPD) management, is not an isolated behaviour, but a set of physical, social, cultural, psychological and existential factors affecting it.

AIM

This study aimed to explore the facilitators and barriers to self-management in men with COPD in the unique social, cultural, political and economic context of Iran.

METHODS

This paper reports part of the findings of a qualitative grounded theory study aimed at exploring the process of self-management in Iranian men with COPD, which was conducted in Iran from January 2019 to July 2023. Participants included men with COPD, their family members and pulmonologists. The selection of participants in this research began with the purposeful sampling method. Data was collected using semistructured interviews. Data collection continued until the data saturation was achieved. A total of 15 interviews were conducted with nine patients, three family members of patients and three pulmonologists. The data was analysed using the constant comparative analysis method.

RESULTS

The findings of this study showed that knowledge, education, experience, family involvement and financial support are the factors that facilitate self-management. Factors related to deficits include lack of education, lack of treatment support, family cooperation deficit, financial problems, medication obtaining problems and factors related to disease impacts include specific nature of the disease, residual effect, comorbidity and factors related to negative patients characteristics include false beliefs, poor self-efficacy, feeling shame and non-adherence are barriers to self-management in men with COPD.

CONCLUSION

Based on results of this study, healthcare providers and health planners can strengthen the factors that facilitate self-management and weaken or remove the barriers to self-management, so that these patients use self-management strategies with maximum capacity to control the disease.

摘要

引言

自我管理作为慢性阻塞性肺疾病（COPD）管理最常见的方法，并非孤立行为，而是一套影响自我管理的生理、社会、文化、心理和存在因素。

目的

本研究旨在探讨伊朗独特的社会、文化、政治和经济背景下 COPD 男性患者自我管理的促进因素和障碍。

方法

本文报告了一项定性扎根理论研究的部分结果，该研究旨在探讨伊朗 COPD 男性患者自我管理的过程，该研究于 2019 年 1 月至 2023 年 7 月在伊朗进行。参与者包括 COPD 男性患者、他们的家庭成员和肺病专家。本研究的参与者选择采用目的抽样法。使用半结构化访谈收集数据。数据收集继续进行，直到达到数据饱和。共对 9 名患者、3 名患者家属和 3 名肺病专家进行了 15 次访谈。使用恒定比较分析方法对数据进行分析。

结果

本研究的结果表明，知识、教育、经验、家庭参与和经济支持是促进自我管理的因素。与缺陷相关的因素包括缺乏教育、缺乏治疗支持、家庭合作缺陷、经济问题、药物获取问题以及与疾病影响相关的因素包括疾病的特定性质、残留效应、合并症和与患者特征相关的负面因素包括错误信念、自我效能差、羞耻感和不遵医嘱是 COPD 男性患者自我管理的障碍。