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“医疗体系确实让我屡屡失望”:一项针对加拿大库欣综合征女性医疗体验的定性研究。

"The healthcare system did fail me repeatedly": a qualitative study on experiences of healthcare among Canadian women with Cushing's syndrome.

机构信息

Department of Psychology, University of Victoria, 3800 Finnerty Rd, Victoria, BC, V8P 5C2, Canada.

Educational Psychology and Leadership Studies, University of Victoria, 3800 Finnerty Rd, Victoria, BC, V8P 5C2, Canada.

出版信息

BMC Prim Care. 2024 Sep 5;25(1):329. doi: 10.1186/s12875-024-02580-5.

Abstract

BACKGROUND

As a rare endocrine disorder, Cushing's Syndrome (Cushing's) is characterized by numerous symptoms and a non-specific presentation, leading to a delay to diagnosis for patients with this disease. To date, research examining the lived experiences of patients with Cushing's in healthcare is absent in the literature. This preliminary inquiry into the healthcare experiences of women with Cushing's aimed to examine the utility of this line of inquiry to support the patient centered care of individuals with Cushing's.

METHODS

Seven women from across Canada with endogenous Cushing's participated in the study. Semi-structured interviews were conducted examining participants' healthcare and body-related experiences with Cushing's. Results pertaining to healthcare experiences were analyzed for the current study using reflexive thematic analysis.

RESULTS

Four themes emerged whereby women with Cushing's experienced (1) a lack of patient centered care, characterized by provider miscommunication and medical gaslighting; (2) a misunderstanding of their symptoms as related to weight gain; (3) weight stigma in healthcare encounters; and (4) a shift in their quality of care following diagnosis.

CONCLUSIONS

The results highlight the importance of patient centered care as well as the negative impact of commonly reported barriers to patient centered care. Cushing's specific barriers to patient centered care may include weight stigma as well as the rare incidence of Cushing's. Further research is needed to better understand the healthcare experiences of people with Cushing's in Canada.

摘要

背景

作为一种罕见的内分泌疾病,库欣综合征(Cushing's)的特点是症状繁多且表现不具特异性,导致患者的诊断出现延误。迄今为止,针对库欣患者在医疗保健方面的生活体验的研究在文献中尚属空白。本研究初步探讨了库欣患者的医疗保健体验,旨在考察这一研究方向对支持以患者为中心的库欣患者护理的实用性。

方法

本研究纳入了来自加拿大各地的 7 名患有内源性库欣综合征的女性参与者。采用半结构式访谈,考察了参与者与库欣相关的医疗和身体体验。本研究对与医疗保健体验相关的结果采用反思性主题分析进行了分析。

结果

出现了 4 个主题,即库欣患者经历了(1)缺乏以患者为中心的护理,表现为提供者沟通不畅和医疗误导;(2)对其症状与体重增加相关的误解;(3)在医疗保健接触中存在体重污名化;以及(4)诊断后护理质量的转变。

结论

研究结果强调了以患者为中心的护理的重要性,以及常见的以患者为中心的护理障碍的负面影响。库欣特有的以患者为中心的护理障碍可能包括体重污名化以及库欣病的罕见发病率。需要进一步研究以更好地了解加拿大库欣患者的医疗保健体验。

相似文献

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Psychiatric phenomenology in Cushing's disease.库欣病中的精神现象学。
Pharmacopsychiatry. 1992 Jul;25(4):192-8. doi: 10.1055/s-2007-1014405.

本文引用的文献

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Memorable Messages About Fat Bodies Before, During, and After Pregnancy.怀孕前后关于胖身体的难忘信息。
Health Commun. 2023 Dec;38(13):3069-3079. doi: 10.1080/10410236.2022.2131982. Epub 2022 Oct 5.
6
Defining and implementing patient-centered care: An umbrella review.定义并实施以患者为中心的护理:一项综合综述。
Patient Educ Couns. 2022 Jul;105(7):1679-1688. doi: 10.1016/j.pec.2021.11.004. Epub 2021 Nov 16.

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