Lampridou Smaragda, Saghdaoui Layla Bolton, Reguenga Maria, Davies Alun Huw, Wells Mary
Vascular Surgery Department, Imperial College Healthcare NHS Trust, London, UK; Faculty of Medicine, Department of Surgery & Cancer, Imperial College London, London, UK.
Vascular Surgery Department, Imperial College Healthcare NHS Trust, London, UK; Faculty of Medicine, Department of Surgery & Cancer, Imperial College London, London, UK.
J Vasc Nurs. 2025 Mar;43(1):46-54. doi: 10.1016/j.jvn.2025.01.002. Epub 2025 Jan 23.
Adherence to peripheral arterial disease (PAD) treatment remains low, despite its benefit for secondary disease prevention. Currently, there is no qualitative research exploring why this is the case. This study aimed to explore patients' lived experiences of PAD and its treatment, their motivation to adherence and barriers to non-adherence.
Semi-structured qualitative interviews were conducted with patients with PAD from diverse backgrounds and varying adherence levels. The Perceptions and Practicalities Approach framed the topic guide and guided analysis. Interviews were recorded, transcribed verbatim, and analysed thematically. A public and patient involvement group supported the pilot testing of the topic guide and the data analysis.
Twelve participants (eight men and four women, with an age range between 56 and 78) participated in the study. Six themes were identified: (1) Treatment necessity and effectiveness, (2) Information, (3) Mind-over-matter, (4) Concerns, (5) Physical environment, (6) Social and healthcare professional interactions. Patients perceiving their treatment to be effective were more likely to be adherent. However, some patients did not see themselves as being on treatment as they were not getting better. Participants expressed a lack of support and a need for detailed information and individualised care.
Our findings illustrate that patients' perceptions of treatment effectiveness seem to influence their adherence. To enhance adherence, future research should focus on improving treatment understanding, optimising patient experiences, addressing claudication pain management, and supporting patients to be more motivated to make changes.
尽管外周动脉疾病（PAD）治疗对二级疾病预防有益，但治疗依从性仍然很低。目前，尚无定性研究探讨为何会出现这种情况。本研究旨在探讨患者对PAD及其治疗的生活体验、他们坚持治疗的动机以及不坚持治疗的障碍。
对来自不同背景、依从水平各异的PAD患者进行了半结构化定性访谈。“认知与实践方法”为主题指南提供了框架并指导分析。访谈进行了录音，逐字转录，并进行了主题分析。一个公众和患者参与小组支持了主题指南的试点测试和数据分析。
12名参与者（8名男性和4名女性，年龄在56岁至78岁之间）参与了该研究。确定了六个主题：（1）治疗的必要性和有效性，（2）信息，（3）意志战胜物质，（4）担忧，（5）物理环境，（6）社会和医疗保健专业人员的互动。认为自己的治疗有效的患者更有可能坚持治疗。然而，一些患者认为自己没有接受治疗，因为他们的病情没有好转。参与者表示缺乏支持，需要详细信息和个性化护理。
我们的研究结果表明，患者对治疗效果的认知似乎会影响他们的依从性。为了提高依从性，未来的研究应侧重于提高对治疗的理解、优化患者体验、解决间歇性跛行疼痛管理问题，并支持患者更有动力做出改变。
