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土耳其自述心力衰竭患者呼吸困难及其管理的描述性定性研究。

Descriptive qualitative study of breathlessness and its management of Turkish individuals with self-reported heart failure.

机构信息

Nursing and Health Care School, University of Glasgow, Glasgow, UK

School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK.

出版信息

BMJ Open. 2024 Nov 14;14(11):e088335. doi: 10.1136/bmjopen-2024-088335.

Abstract

AIMS

To explore the experiences of individuals with heart failure, with a specific focus on elucidating the full spectrum of symptoms experienced and their subjective descriptions of breathlessness and self-management strategies regarding socio-cultural-behavioural context.

DESIGN

Qualitative descriptive study underpinned by critical realism and situation-specific theory of heart failure self-care.

SETTING

Participants from various settings (hospitals and community) in Southeastern Türkiye.

PARTICIPANTS

Adults reporting heart failure and breathlessness.

METHODS

Semi-structured interviews were carried out with 20 individuals (11 women and 9 men). Data were audio-recorded and transcribed. Participants were asked to describe their symptoms, experiences with breathlessness, self-management strategies and health needs from their perspectives. The interview data were analysed using reflexive thematic analysis.

RESULTS

There were a range (31 physical and 7 psycho-social behavioural) of symptoms experienced by participants. This included fatigue, difficulty sleeping, pain (not including chest pain) and fear about death and dying. Based on reflexive thematic analysis of semi-structured interviews, six main themes were identified. First two themes (knowledge and misconception, and experience of breathlessness) were related to breathlessness experience and knowledge. The third theme (culture and religious consideration) highlighted the importance of cultural and religious perspectives in breathlessness regarding Turkish socio-cultural-behavioural context. Themes four (breathlessness self-management/physical) and five (breathlessness self-management/psychological) were identified as self-management strategies for breathlessness. The need for improved health behaviours (improved health behaviours) was also identified.

CONCLUSION

Breathlessness and self-management strategies are affected by individual perspectives in relation to their socio-cultural-behavioural context. Understanding individuals' unique breathlessness experiences regarding their socio-cultural-behavioural context assists in the identification of possible individualised-care strategies to improve their life and care quality in heart failure. We recommend creating a person-centred symptom assessment strategy with reference to culture or transculture guided by nurses. This will help to understand individuals' unique symptom profiles and tailor responses to their needs.

摘要

目的

探讨心力衰竭患者的体验,特别关注阐明所经历的症状全貌及其对呼吸困难的主观描述以及与社会文化行为背景相关的自我管理策略。

设计

以批判现实主义和心力衰竭自我护理情境特定理论为基础的定性描述研究。

地点

土耳其东南部各种环境(医院和社区)中的参与者。

参与者

报告心力衰竭和呼吸困难的成年人。

方法

对 20 名参与者(11 名女性和 9 名男性)进行半结构化访谈。对数据进行录音和转录。要求参与者从自身角度描述他们的症状、呼吸困难体验、自我管理策略和健康需求。使用反思性主题分析对访谈数据进行分析。

结果

参与者经历了一系列(31 种生理和 7 种心理社会行为)症状。这包括疲劳、睡眠困难、疼痛(不包括胸痛)以及对死亡的恐惧。基于对半结构化访谈的反思性主题分析,确定了六个主要主题。前两个主题(知识和误解以及呼吸困难体验)与呼吸困难体验和知识有关。第三个主题(文化和宗教考虑)突出了在土耳其社会文化行为背景下,文化和宗教观点在呼吸困难方面的重要性。主题四(呼吸困难自我管理/身体)和主题五(呼吸困难自我管理/心理)被确定为呼吸困难的自我管理策略。还确定了改善健康行为(改善健康行为)的需求。

结论

呼吸困难和自我管理策略受到个体与社会文化行为背景相关的观点的影响。了解个体在社会文化行为背景下对呼吸困难的独特体验有助于确定可能的个体化护理策略,以改善心力衰竭患者的生活和护理质量。我们建议制定一种以文化或跨文化为指导的以患者为中心的症状评估策略,由护士实施。这将有助于了解个体独特的症状特征,并根据他们的需求调整反应。

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