青少年1型糖尿病患者向成人医疗过渡期自我管理面临困境的质性研究  

A qualitative study of self-management dilemmas in adolescents with type 1 diabetes mellitus transitioning to adult medical care

作　　者：吴景 刘春妍[2] 黄咏琪 丁如 黄晴茵[3] 卢咏梅[1] Wu Jing;Liu Chunyan;Huang Yongqi;Ding Ru;Huang Qingyin;Lu Yongmei(School of Nursing,Guangzhou University of Traditional Chinese Medicine,Guangzhou 510006,China;Endocrinology,Shenzhen Children′s Hospital,Shenzhen 518026,China;Endocrinology,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学护理学院,广州510006 [2]深圳市儿童医院内分泌科,深圳518026 [3]广州中医药大学第一附属医院内分泌科,广州510405

出　　处：《中国实用护理杂志》2024年第31期2455-2461,共7页Chinese Journal of Practical Nursing

基　　金：广东省研究生教育创新计划(2022JGXM037)。

摘　　要：目的探究青少年1型糖尿病患者向成人医疗过渡期间自我管理面临的困境,为医务人员开展过渡期自我管理干预提供参考。方法运用描述性质性研究方法,于2023年8—12月以目的抽样法对广州中医药大学第一附属医院和深圳市儿童医院内分泌科符合纳入排除标准的青少年1型糖尿病患者进行深度访谈,采用定向内容分析法对资料进行归纳分析。结果共纳入12例青少年1型糖尿病患者接受访谈,男6例,女6例,年龄12~18岁。针对青少年1型糖尿病患者向成人医疗过渡期的自我管理面临的困境,归纳为4个主题和10个亚主题:疾病管理困境(疾病管理意识薄弱、疾病相关知识与能力不足、疾病管理依从性较低、日常活动受限)、角色适应困难(医疗角色过渡感知缺乏、家庭角色过渡困难、社会角色适应不良)、负性情绪应对无力、社会支持体系不完善(学校支持匮乏、社会组织可及性有限、社会经济支持不足)。结论青少年1型糖尿病患者在向成人医疗过渡期间疾病自我管理面临多重困境,医务人员应重视过渡期自我管理教育,提高患者过渡期自我管理意识和参与能力,制订过渡准备计划,构建情感支持网络,完善社会保障体系,帮助青少年1型糖尿病患者掌握自我管理方法,成功向成人期过渡。ObjectiveExploring the dilemmas faced by adolescents with type 1 diabetes mellitus in self-management during the transition to adult healthcare,to inform healthcare professionals in the delivery of transitional care interventions.MethodsUsing descriptive qualitative research methods,in-depth interviews were conducted from August to December 2023 to adolescents with type 1 diabetes mellitus(selected by objective sampling)who met the inclusion and exclusion criteria in the Department of Endocrinology of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine and the Shenzhen Children′s Hospital,and the data were analysed inductively using directed content analysis.ResultsA total of 12 adolescents with type 1 diabetes mellitus were included for interview,6 males and 6 females,aged 12-18 years.The self-management dilemmas for adolescents with type 1 diabetes in the transition to adult healthcare can be summarised into 4 themes and 10 sub-themes:disease management dilemmas(weak awareness of disease management,insufficient disease-related knowledge and competence,low adherence to disease management,and restriction of daily activities),role adaptation difficulties(lack of perceived transition to the healthcare role,difficulty in transitioning to the family role,and maladaptation to the social role),negative emotions Inadequate social support system(lack of school support,limited accessibility of social organisations,insufficient socio-economic support).ConclusionsAdolescents with type 1 diabetes mellitus face multiple dilemmas in disease self-management during the transition to adult healthcare,and healthcare professionals should pay attention to transition self-management education,improve patients′awareness of transition self-management and their ability to participate in it,formulate a transition preparation plan,build an emotional support network,and improve the social security system,so as to help juvenile patients with type 1 diabetes master the method of self-management and make

关 键 词：定性研究 糖尿病 1型 青少年 过渡期 自我管理 

分 类 号：R473.5[医药卫生—护理学]