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人类 T 细胞白血病病毒 1 型相关脊髓病/热带痉挛性截瘫(HAM/TSP)的生活体验:一项现象学研究。

Lived Experience of Human T-cell Leukemia Virus type-1 -Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP): A Phenomenology Study.

机构信息

Student Research Committee, Department of Community Health Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

Department of Neurology, School of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Iran J Med Sci. 2024 May 1;49(5):294-301. doi: 10.30476/IJMS.2023.97867.2973. eCollection 2024 May.

Abstract

BACKGROUND

Human T-cell Leukemia Virus type-1 (HTLV-1) -associated myelopathy causes sufferers to experience changes in several aspects of their lives. Gaining a deeper understanding of these changes can help healthcare professionals improve care, enhance strategic decision-making, meet expectations, and manage patients effectively. However, there is no information about the experience and problems of patients with HTLV-1-associated myelopathy/tropical spastic paraparesis in Iran. Therefore, this study aimed to explain the lived experience of patients with HTLV-1-associated myelopathy/tropical spastic paraparesis.

METHODS

This qualitative study used hermeneutic phenomenology in 2022 in Mashhad, Iran. Participants were selected using purposeful sampling. Data were collected through 21 semi-structured in-depth interviews with 20 eligible patients with HTLV-1-associated myelopathy/tropical spastic paraparesis. The data were analyzed in MAXQDA/2020 using the six stages proposed by Van Manen.

RESULTS

The main concept of "Reduced self-sufficiency and social dignity" emerged from the narratives of the patients, which included three main categories "Disruption of desirable personal and social life", "reduced perception of role competencies", and "obligatory unpleasant lifestyle changes".

CONCLUSION

HTLV-1-associated myelopathy/tropical spastic paraparesis slowly makes patients feel insufficient and causes a sense of degradation in dignity. The disease can fundamentally change personal and social life. Thus, due to its incurability and progressiveness, palliative care should be provided to them to live with dignity.

摘要

背景

人类 T 细胞白血病病毒 1 型(HTLV-1)相关脊髓病使患者在生活的多个方面发生变化。深入了解这些变化可以帮助医疗保健专业人员改善护理、增强战略决策、满足期望并有效地管理患者。然而,伊朗没有关于 HTLV-1 相关脊髓病/热带痉挛性截瘫患者的经历和问题的信息。因此,本研究旨在解释 HTLV-1 相关脊髓病/热带痉挛性截瘫患者的生活体验。

方法

这是一项 2022 年在伊朗马什哈德进行的定性研究,采用解释现象学方法。参与者采用目的抽样法选择。通过对 20 名符合条件的 HTLV-1 相关脊髓病/热带痉挛性截瘫患者进行 21 次半结构化深入访谈收集数据。使用 MAXQDA/2020 按照 van Manen 提出的六个阶段对数据进行分析。

结果

患者的叙述中出现了“自我效能和社会尊严降低”的主要概念,包括“破坏理想的个人和社会生活”、“降低角色能力感”和“强制性的不愉快生活方式改变”三个主要类别。

结论

HTLV-1 相关脊髓病/热带痉挛性截瘫使患者逐渐感到效能不足,并导致尊严感下降。这种疾病可以从根本上改变个人和社会生活。因此,由于其不可治愈性和进行性,应该为他们提供姑息治疗,让他们有尊严地生活。

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