生活方式讨论有助于类风湿关节炎的自我管理：一项关于患者认知的定性研究
Lifestyle discussions facilitate self-management in RA: a qualitative study of patients' perceptions.
作者信息
Drake Af Hagelsrum Klara, Larsson Ingrid, Bremander Ann, Einarsson Jon T, Lindqvist Elisabet, Mogard Elisabeth
机构信息
Section of Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
School of Health and Welfare, Halmstad University, Halmstad, Sweden.
出版信息
BMC Rheumatol. 2024 Nov 29;8(1):65. doi: 10.1186/s41927-024-00433-3.
BACKGROUND
Healthy lifestyle habits (regular physical activity, a healthy diet, no smoking and non-hazardous alcohol consumption) alongside pharmacological treatment can lower the risk of cardiovascular diseases and improve symptoms and quality of life in patients with rheumatoid arthritis (RA). Therefore, healthcare professionals in rheumatology care are urged to discuss lifestyle habits with all patients. The aim of this study was to explore patients' perceptions of lifestyle discussions in early rheumatology care.
METHODS
Individual interviews were conducted with 20 patients with RA, 14 women and six men, aged 23 to 77 years, and with a mean disease duration of 2.4 years. All lifestyle discussions were performed during the first year with RA. A qualitative content analysis was performed.
RESULTS
An overarching theme emerged, exploring how patients with RA perceived lifestyle discussions as facilitating self-management. Three categories illustrated this: (1) the usefulness of lifestyle discussions depended on the individual patient's preferences and prioritization for lifestyle support; (2) the design of lifestyle discussions should be based on a person-centred approach, incorporating personalized lifestyle information and providing structured and recurrent support; (3) the outcomes of lifestyle discussions should contribute to enhanced knowledge and motivation for making healthy lifestyle changes.
CONCLUSION
Lifestyle discussions in early rheumatology care should, according to patients with RA, be based on a person-centred approach, be tailored to each patient's preferences and needs, and have outcomes focusing on patient support for healthy lifestyle changes, all essential elements to facilitate self-management. The present findings can be used to guide the development and implementation of more person-centred lifestyle approaches targeted to facilitate lifestyle changes and benefit cardiovascular disease risk management in early rheumatology care.
背景
健康的生活方式习惯（定期体育锻炼、健康饮食、不吸烟和适量饮酒）与药物治疗相结合，可以降低心血管疾病的风险，并改善类风湿关节炎（RA）患者的症状和生活质量。因此，风湿病护理领域的医护人员被敦促与所有患者讨论生活方式习惯。本研究的目的是探讨患者对早期风湿病护理中生活方式讨论的看法。
方法
对20例RA患者进行了个体访谈，其中14名女性和6名男性，年龄在23至77岁之间，平均病程为2.4年。所有生活方式讨论均在确诊RA的第一年进行。进行了定性内容分析。
结果
出现了一个总体主题，探讨了RA患者如何将生活方式讨论视为有助于自我管理。三个类别说明了这一点：（1）生活方式讨论的有用性取决于个体患者对生活方式支持的偏好和优先级；（2）生活方式讨论的设计应基于以人为本的方法，纳入个性化的生活方式信息，并提供结构化和反复的支持；（3）生活方式讨论的结果应有助于增强做出健康生活方式改变的知识和动力。
结论
根据RA患者的说法，早期风湿病护理中的生活方式讨论应以以人为本的方法为基础，根据每个患者的偏好和需求进行调整，并且结果应侧重于患者对健康生活方式改变的支持，所有这些都是促进自我管理的关键要素。本研究结果可用于指导开发和实施更以人为本的生活方式方法，以促进生活方式改变，并有利于早期风湿病护理中的心血管疾病风险管理。
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