Self-management behavior preferences and influencing factors in Chinese patients with recurrent gout:A qualitative study  

痛风复发患者自我管理行为偏好及其影响因素:质性研究

作　　者：Xinyi Hao Aiping Wang Hao Huang Yue Sun Yingying Duan Shanwen Sun 郝鑫懿;王爱平;黄浩;孙月;段莹莹;孙善文

机构地区：[1]Public Service Department,The First Hospital of China Medical University,Shenyang,China [2]Nursing Department,Peking Union Medical College Hospital,Beijing China

出　　处：《International Journal of Nursing Sciences》2024年第5期544-552,共9页国际护理科学（英文）

摘　　要：Objectives: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.Methods: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.Results: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 selfmanagement 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.Conclusion: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.目的探讨痛风复发患者的自我管理行为偏好及其影响因素,为临床护理人员制订提高患者自我管理行为偏好的策略提供理论依据。方法采用半结构式个人访谈收集资料。从2022年10月至2023年3月在辽宁省沈阳市某三级甲等医院痛风专科门诊选取10例痛风复发患者进行调查。采用KJ法(该方法由日本人类学家Kawakita Jiro始创,根据复杂或不明确的观点和事实的相互关系进行总结和整合,从而澄清这些观点或事实之间的关系)对访谈资料进行分析。结果经过5名研究人员的4轮筛选,从最初的132个编码中选出了35个。经过3轮讨论和归纳,确定了复发痛风患者自我管理行为偏好的7个领域:1)痛风知识来源多样,但真假难辨;2)“不疼不管”的消极态度;3)改变根深蒂固的不良日常习惯的挑战;4)“自欺欺人”的乐观情绪;5)因对治愈无望及多次复发习以为常而延迟就医;6)专注于复发时首选镇痛药而忽视长期降尿酸治疗;7)痛风相关病耻感。结论复发性痛风患者的自我管理行为可得到改善,尤其是在就医行为、服药依从性、日常管理和情绪管理方面这4个方面。同时,痛风病耻感、痛风知识真假难辨以及“不痛不管”的消极态度对患者的自我管理行为有显著影响。

关 键 词：BEHAVIOR GOUT KJ method Qualitative research RECURRENT SELF-MANAGEMENT 

分 类 号：R473.5[医药卫生—护理学]