Hao Xinyi, Wang Aiping, Huang Hao, Sun Yue, Duan Yingying, Sun Shanwen
Public Service Department, The First Hospital of China Medical University, Shenyang, China.
Nursing Department, Peking Union Medical College Hospital, Beijing China.
Int J Nurs Sci. 2024 Oct 10;11(5):544-552. doi: 10.1016/j.ijnss.2024.10.001. eCollection 2024 Nov.
This study aimed to explore the preferences and influencing factors of self-management behaviors in patients with recurrent gout and provide a theoretical basis for developing targeted strategies to improve self-management preferences.
A total of 10 patients with recurrent gout were recruited from the gout specialist outpatient clinic at a tertiary hospital in Shenyang, Liaoning Province, China. Semi-structured interviews were conducted with these patients, and the Kawakita Jiro (KJ) method was used to analyze the interview data.
After four rounds of screening by five researchers, 35 codes were selected from an initial 132. After three rounds of discussion and induction, the KJ method identified seven domains of self-management behavior preferences in patients with recurrent gout: 1) extensive knowledge of gout, yet difficulty in distinguishing between accurate and inaccurate information; 2) a passive attitude of "no pain, no management"; 3) the challenge of changing entrenched daily habits; 4) the optimistic but unrealistic belief of "self-delusion"; 5) a tendency to seek medical attention late due to hopelessness of cure and familiarity with recurrences; 6) preference for analgesics for gout recurrences while neglecting long-term urate-lowering therapy (ULT); and 7) gout-related stigma.
The results of this study showed that the self-management behavior of patients with recurrent gout could be improved, especially in the aspects of medical seeking behavior, medication compliance, daily management and emotional management. At the same time, we found that gout stigma, difficulty in distinguishing true and false knowledge of gout and negative attitude of "ignoring pain" were significantly associated with self-management behavior.
本研究旨在探讨复发性痛风患者自我管理行为的偏好及影响因素,为制定针对性策略以提高自我管理偏好提供理论依据。
从中国辽宁省沈阳市某三级医院的痛风专科门诊招募了10例复发性痛风患者。对这些患者进行了半结构式访谈,并采用川喜田二郎(KJ)法分析访谈数据。
经过5名研究人员四轮筛选,从最初的132个编码中选取了35个。经过三轮讨论和归纳,KJ法确定了复发性痛风患者自我管理行为偏好的七个领域:1)对痛风有广泛了解,但难以区分准确和不准确的信息;2)“不痛就不管理”的消极态度;3)改变根深蒂固的日常习惯的挑战;4)“自我欺骗”的乐观但不现实的信念;5)由于治愈无望和对复发的熟悉而倾向于延迟就医;6)痛风复发时偏爱使用镇痛药,而忽视长期降尿酸治疗(ULT);7)痛风相关的耻辱感。
本研究结果表明,复发性痛风患者的自我管理行为可以得到改善,尤其是在就医行为、用药依从性、日常管理和情绪管理方面。同时,我们发现痛风耻辱感、难以区分痛风的真假知识以及“忽视疼痛”的消极态度与自我管理行为显著相关。