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荷兰非典型溶血性尿毒症综合征患者的生活:患者及家属视角

Living with Atypical Hemolytic Uremic Syndrome in the Netherlands: Patient and Family Perspective.

作者信息

Bouwmeester Romy N, Engel Leonie J, Altena Wim, Renette Caroline, van Daelen Clim, van Kempen Evy, de Wildt Renée, van de Kar Nicole C A J

机构信息

Radboud University Medical Center, Amalia Children's Hospital, Department of Pediatric Nephrology, Nijmegen, Netherlands.

Dutch Kidney Patients Association, Bussum, Netherlands.

出版信息

Kidney Int Rep. 2024 Apr 27;9(7):2189-2197. doi: 10.1016/j.ekir.2024.04.047. eCollection 2024 Jul.

Abstract

INTRODUCTION

Atypical hemolytic uremic syndrome (aHUS) poses a significant health challenge due to its rarity and severity within the spectrum of thrombotic microangiopathy. Despite efforts to optimize and personalize health care for patients with aHUS, understanding the individual experiences, needs, and desires of patients with aHUS and their relatives remains limited.

METHODS

Here, we present a nationwide, exploratory, qualitative interview study with a direct content analysis approach. In-depth interviews and a 6-week evaluation were audio-recorded and conducted using a semistructured topic guide, based on the Institute for Positive Health (IPH) model.

RESULTS

Analysis of 10 interviews involving 6 patients with aHUS and 13 relatives revealed the prevalence of long-term disease symptoms in adult patients, notably fatigue, which significantly impacted daily functioning. Moreover, the resilience demonstrated by patients and their relatives was noteworthy; however, the acute phase of aHUS and the unpredictable nature of disease recurrence could profoundly affect mental well-being. The emotional toll of aHUS is pervasive, with feelings of fear, guilt, and trauma persisting across disease phases in both patients and relatives. Challenges in medical care, including delays in diagnosis and the need for personalized and uniform protocols, were highlighted. Support was deemed crucial, indicating the necessity for enhancements in the accessibility to comprehensible disease information and psychological counseling. Finally, complexities surrounding genetic testing and carriership were discussed.

CONCLUSION

This study underscores the profound, enduring, and multifaced impact of aHUS. The insights gleaned from the experiences and needs of patients with aHUS and their relatives could lay the foundation for development and implementation of more personalized innovations in aHUS health care.

摘要

引言

非典型溶血尿毒综合征(aHUS)在血栓性微血管病范围内因其罕见性和严重性而构成重大的健康挑战。尽管已努力为aHUS患者优化和个性化医疗保健,但对aHUS患者及其亲属的个人经历、需求和愿望的了解仍然有限。

方法

在此,我们采用直接内容分析法进行了一项全国性的探索性定性访谈研究。基于积极健康研究所(IPH)模型,使用半结构化主题指南进行了深入访谈和为期6周的评估,并进行了录音。

结果

对涉及6名aHUS患者和13名亲属的10次访谈的分析显示,成年患者中长期疾病症状普遍存在,尤其是疲劳,这对日常功能有显著影响。此外,患者及其亲属所表现出的恢复力值得注意;然而,aHUS的急性期和疾病复发的不可预测性可能会深刻影响心理健康。aHUS的情感代价是普遍存在的,恐惧、内疚和创伤感在患者和亲属的疾病各阶段都持续存在。突出了医疗保健方面的挑战,包括诊断延迟以及对个性化和统一方案的需求。支持被认为至关重要,这表明有必要加强获取易懂的疾病信息和心理咨询的机会。最后,讨论了基因检测和携带者身份相关的复杂性。

结论

本研究强调了aHUS的深刻、持久和多方面的影响。从aHUS患者及其亲属的经历和需求中获得的见解可为aHUS医疗保健中更个性化创新的开发和实施奠定基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a06a/11284443/3391edc09116/ga1.jpg

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