摘要
背景面对老年慢性病患病率高、多种慢性病共存形势带来的严峻挑战,社区共病老年人的健康问题亟待关注。共病管理模式正不断被探索实践,疾病体验作为来自患者自我报告的健康信息有望成为“以患者为中心”社区共病管理模式的重点内容。目的 深入了解社区共病老年人居家的真实疾病体验,为社区共病老年人的个性化健康管理和支持策略提供依据。方法 采用目的抽样法、最大差异化抽样于2022年8—9月在郑州市某社区卫生服务中心所管辖的4个社区中抽取符合条件的访谈对象,基于信息饱和的原则最终纳入20例研究对象。在研究目的、文献回顾及专家咨询结果的基础上初步拟定访谈提纲,预访谈2例后确定最终访谈提纲。以现象学研究方法为指导,对研究对象进行半结构式访谈。采用Golaizzi分析法分析资料。结果 共提炼出4个主题和11个亚主题,主要有长期存在的症状困扰(身体功能障碍、疲劳、睡眠障碍、疼痛)、负性心理体验(对未来生活的无助感和担忧、社会价值感和自我认同感降低、社交活动改变的孤独感)、与共病和谐共存的积极心态(感恩知足、积极适应)、困境下的期望(希望功能改善、寻求多方社会支持)。结论 身体功能障碍、睡眠障碍、疲劳、疼痛是社区共病老年人最关注的健康困扰,社区共病老年人的症状管理和多元社会支持有待加强。未来有望采用多维数据进行动态化健康评估,探索共病的共性和个体性规律,实现社区共病的精准管理及干预。
Background In the face of the serious challenges posed by the high prevalence of chronic diseases among the elderly and the coexistence of multiple chronic diseases,the health problems of community-dwelling elderly people' with multimorbidity require urgent attention.The comorbidity management model is being explored and practiced.Disease experience,as self-reported health information from patients,is expected to become a key component of the patient-centered community multimorbidity management model.Objective This study aimed to gain a deeper understanding of the real disease experience of community-dwelling elderly people with multimorbidity and provide a basis for personalized health management and supportive strategies of the group.Methods This study used purposive sampling and maximum difference sampling to select eligible interviewees from four communities under the jurisdiction of a community health service center in Zhengzhou City from August to September in 2022.Based on the principle of information saturation,20 subjects were ultimately included.Based on the research objective,literature review,and expert consultation results,the preliminary interview outline was formulated,and the final interview outline was determined after interviewing 2 patients.Semi-structured interviews were conducted with the study participants,guided by the phenomenological research methodology.Golaizzi analysis was used to analyse the data.Results Four themes and eleven sub-themes had been extracted from this study,including mainly long-standing symptomatic distress (physical dysfunction,fatigue,sleep disorders,and pain),negative psychological experiences(feelings of helplessness and worry about future life,reduced sense of social value and self-identity,and loneliness with altered social activities),positive mindset of coexisting harmoniously with multimorbidity(being grateful for being satisfied,and positively adapting),and aspirations in times of adversity(hoping for improvement in functioning,and seeking multi-directional s
作者
赵婷
张艳
吴兰心
孟李雪
刘莉
ZHAO Ting;ZHANG Yan;WU Lanxin;MENG Lixue;LIU Li(School of Nursing and Health,Zhengzhou University,Zhengzhou 450001,China)
出处
《中国全科医学》
CAS
北大核心
2024年第25期3143-3149,共7页
Chinese General Practice
基金
国家自然科学基金资助项目(71874162)。
关键词
慢性病
慢性病共病
患者报告结局评价
老年人
疾病体验
质性研究
Chronic disease
Multiple chronic conditions
Patient reported outcome measures
Aged
Illness experience
Qualitative studies
