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探索 COPD 患者的认知和期望:个性化治疗干预的扎根理论方法。

Exploring perceptions and expectations of COPD patients: A grounded theory approach for personalized therapeutic interventions.

机构信息

IRCCS Fondazione Don Carlo Gnocchi, Milan (MI), Italy.

Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.

出版信息

Chron Respir Dis. 2024 Jan-Dec;21:14799731241268262. doi: 10.1177/14799731241268262.

Abstract

This study aimed to investigate the dynamic patterns of perception and expectations among COPD patients. Conducted at the Heart-Respiratory Rehabilitation Unit, IRCCS Fondazione Don Carlo Gnocchi, in Milan, Italy, the research involved 28 participants (16 males; mean age 72.8 ± 9.9) in face-to-face interviews. Utilizing a Grounded Theory approach, complemented by clinical data, recorded, and transcribed interviews underwent enhancement through the integration of two pictorial tools. The central theme that emerged was a profound sense of responsibility toward their condition, perceived as a significant threat to life. Key symptoms, such as shortness of breath, coupled with negative expectations about their condition, contributed to depressive mood and avoidance behaviors. A notable proportion ( = 17; 60.71%) of participants struggled to envision a positive future, expressing a pervasive sense of hopelessness, which significantly influenced their health behaviors and adherence to medical recommendations. Conversely, individuals who felt supported and optimistic about treatment efficacy exhibited more positive expectations and adopted proactive coping strategies. Recognizing the dynamic nature of patients' perceptions and negative illness expectations is essential to create personalized therapeutic interventions and meet the specific needs of COPD patients, ultimately improving the overall effectiveness of their care journey.

摘要

本研究旨在探究 COPD 患者的感知和期望的动态模式。该研究在意大利米兰的 IRCCS Fondazione Don Carlo Gnocchi 心脏-呼吸康复科进行,共纳入 28 名参与者(16 名男性;平均年龄 72.8±9.9 岁)进行面对面访谈。研究采用扎根理论方法,结合临床数据,对记录和转录的访谈进行了增强,整合了两种图像工具。出现的核心主题是对自己病情的深刻责任感,将其视为对生命的重大威胁。主要症状,如呼吸急促,加上对病情的负面预期,导致抑郁情绪和回避行为。相当一部分(=17;60.71%)的参与者难以想象美好的未来,表达出普遍的绝望感,这对他们的健康行为和对医疗建议的依从性有重大影响。相比之下,那些对治疗效果感到支持和乐观的人则表现出更积极的期望和采取积极的应对策略。认识到患者感知和负面疾病预期的动态性质对于制定个性化的治疗干预措施和满足 COPD 患者的特定需求至关重要,最终可以提高他们整个护理旅程的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6e5/11380127/108ae318f1dd/10.1177_14799731241268262-fig1.jpg

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