青春期哮喘患儿自我管理影响因素的描述性质性研究  

Influencing factors of self-management in adolescents with asthma:a descriptive qualitative study

作　　者：何旭东 陈翔宇 尼码旺堆 胡扬帆 杨颖 段红梅[1] He Xudong;Chen Xiangyu;Nimawangdui;Hu Yangfan;Yang Ying;Duan Hongmei(School of Nursing,Beijing University of Chinese Medicine,Beijing 100029,China;Nursing Department,Children's Hospital,Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]北京中医药大学护理学院,北京100029 [2]首都儿科研究所附属儿童医院护理部,北京100020

出　　处：《中华现代护理杂志》2024年第1期7-13,共7页Chinese Journal of Modern Nursing

摘　　要：目的了解青春期哮喘患儿对影响疾病自我管理因素的观点,为改善哮喘患儿自我管理提供依据并提出改进建议。方法本研究为描述性质性研究。于2023年2—6月,通过目的抽样方法,招募在首都儿科研究所附属儿童医院哮喘门诊就诊的10~17岁青春期哮喘患儿。围绕自我管理及其影响因素进行一对一半结构化访谈,并采用主题分析法对访谈资料进行主题分析。结果共纳入17例青春期哮喘患儿,年龄(13.00±2.03)岁,病程(5.00±2.85)年。经过分析,访谈资料包括自我管理的促进因素和阻碍因素2个方面。其中,促进因素编码为3个主题及7个亚主题,包括哮喘患儿的个人管理意识(责任感、依从意识);社会支持(家长照护和补偿、教师和同学支持、病友互动);健康教育(医护健康指导、学校健康宣传)。阻碍因素编码为3个主题及6个亚主题,包括疾病认知(需求竞争、重视度);社交环境(人际互动、物理环境);医疗保健服务(医疗服务可及性、学校相关医疗资源)。结论青春期哮喘患儿的自我管理受多种因素影响,个人管理意识、社会支持和健康教育可促进哮喘患儿的自我管理,而疾病认知、社交环境和医疗保健服务方面的不利因素会阻碍哮喘患儿的自我管理。医护人员应制定和开展针对哮喘患儿自我管理的赋能方案,通过调动多渠道医疗资源、给予多维度全程赋能并帮助哮喘患儿构建多元人际支持网络系统等方式,促进青春期哮喘患儿实现有效的健康管理过渡。Objective To explore the views of adolescents with asthma on factors affecting disease self-management,so as to provide a basis for improving self-management of asthma children,and propose improvement suggestions.Methods This study was a descriptive qualitative study.From February to June 2023,10 to 17 year old children with asthma were recruited at the Asthma Clinic of the Children's Hospital affiliated to Capital Institute of Pediatrics through purposive sampling.One-on-one semi-structured interviews were conducted around self-management and its related factors,and the thematic analysis was used to analyse interview materials.Results A total of 17 adolescents with asthma,aged(13.00±2.03)years,with a course of disease of(5.00±2.85)years,were included.The interview materials included two aspects,namely facilitators and barriers of self-management.The facilitators were coded into three themes and seven sub-themes,including the individual management awareness of children with asthma(sense of responsibility,compliance awareness),social support(parental care and compensation,teacher and classmate support,patient interaction),and health education(health guidance from doctors and nurses,school health propaganda).Barriers were encoded into three themes and six sub-themes,including disease cognition(demand competition,importance),social environment(interpersonal interaction,physical environment),and healthcare services(accessibility of medical services,school related medical resources).Conclusions The self-management of adolescents with asthma is affected by multiple factors.Individual management awareness,social support,and health education can promote self-management in children with asthma,while unfavorable factors in disease cognition,social environment,and healthcare services can hinder self-management in children with asthma.Medical and nursing staff should develop and implement empowerment plans for self-management of asthma children,by mobilizing multi-channel medical resources,providing multi-dimensional full

关 键 词：哮喘 青春期 儿童 自我管理 质性研究 

分 类 号：R725.6[医药卫生—儿科]