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基于社会生态学模型探讨年龄相关性黄斑变性患者营养素养的影响因素:来自中国的定性研究。

Exploring the factors influencing nutritional literacy based on the socioecological model among patients with age-related macular degeneration: a qualitative study from China.

机构信息

Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China.

Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, People's Republic of China.

出版信息

BMJ Open. 2024 May 28;14(5):e081468. doi: 10.1136/bmjopen-2023-081468.

Abstract

OBJECTIVES

Although nutritional support is beneficial to the visual rehabilitation of patients with age-related macular degeneration (AMD), a large gap continues to exist between the relevant guidelines and the actual practices of AMD patients; this gap can be attributed to a lack of nutritional literacy. Therefore, this study explored the factors affecting nutritional literacy among AMD patients.

DESIGN

A qualitative study was carried out based on individual in-person interviews with 15 AMD patients; a semistructured interview guide was used for data collection. The socioecological model (SEM) was employed for data analysis.

SETTING

The Southwest Hospital in Chongqing Province, China.

PARTICIPANTS

A purposive sample of 15 AMD patients was recruited between May and June 2023.

RESULTS

The social ecosystem of patients with AMD has not been positive. At the intrapersonal level, the factors affecting the nutritional literacy of such patients are lack of knowledge, nutrition self-efficacy, economic burdens, dietary preferences and health status. At the interpersonal level, the factors that can influence patients' nutritional literacy are social support and social roles. At the institutional level, the relevant factors are doctor-patient trust and interdisciplinary-team consistency. Finally, at the policy level, a powerful factor is the large gap between policy and implementation.

DISCUSSION

Nutritional literacy focuses on the changes in an individual's knowledge and behaviour concerning nutrition. To inform the development of nutritional-literacy interventions for people with AMD, medical staff should consider multiple perspectives that can remove the barriers to the SEM at all levels.

摘要

目的

尽管营养支持有益于年龄相关性黄斑变性(AMD)患者的视觉康复,但相关指南与 AMD 患者的实际实践之间仍存在较大差距;这一差距可归因于营养素养的缺乏。因此,本研究探讨了影响 AMD 患者营养素养的因素。

设计

基于对 15 名 AMD 患者的个人面对面访谈进行了定性研究;使用半结构式访谈指南进行数据收集。采用社会生态模型(SEM)进行数据分析。

地点

中国重庆市西南医院。

参与者

2023 年 5 月至 6 月期间,采用目的性抽样方法招募了 15 名 AMD 患者。

结果

AMD 患者的社会生态系统一直不积极。在个体层面,影响此类患者营养素养的因素包括缺乏知识、营养自我效能、经济负担、饮食偏好和健康状况。在人际层面,影响患者营养素养的因素包括社会支持和社会角色。在机构层面,相关因素包括医患信任和跨学科团队一致性。最后,在政策层面,一个强有力的因素是政策与实施之间存在巨大差距。

讨论

营养素养侧重于个体在营养知识和行为方面的变化。为了为 AMD 患者的营养素养干预措施的制定提供信息,医务人员应考虑多个角度,可以消除 SEM 在各个层面上的障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/147a/11138290/355e234e4d2c/bmjopen-2023-081468f01.jpg

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