학술논문

A Focus Group Study of Self-Management in Patients With Glomerular Disease
Document Type
article
Source
Kidney International Reports. 7(1)
Subject
Health Services and Systems
Health Sciences
Behavioral and Social Science
Health Services
Clinical Research
Management of diseases and conditions
7.1 Individual care needs
Good Health and Well Being
focus groups
glomerulonephritis
personal autonomy
self-management
therapeutic alliance
Biomedical and clinical sciences
Health sciences
Language
Abstract
IntroductionPatients with glomerular disease experience symptoms that impair their physical and mental health while managing their treatments, diet, appointments and monitoring general and specific indicators of health and their illness. We sought to describe the perspectives of patients and their care partners on self-management in glomerular disease.MethodsWe conducted 16 focus groups involving adult patients with glomerular disease (n = 101) and their care partners (n = 34) in Australia, Hong Kong, the United Kingdom, and United States. Transcripts were analyzed thematically.ResultsWe identified the following 4 themes: empowered in autonomy (gaining confidence through understanding, taking ownership of disease and treatment, learning a positive health approach); overwhelmed by compounding treatment burdens (financially undermined and depleted, demoralized by side effects and harms, frustrated by fragmented and inflexible care, fear of possible drug harms); striving for stability and normalcy (making personal sacrifices, maximizing life participation, attentiveness to bodily signs, avoiding precarious health states, integrating medicines into routines); and necessity of health-sustaining relationships (buoyed by social support, fulfilling meaningful responsibilities, sharing and normalizing experiences, seeking a trusting and respectful alliance).ConclusionPatients with glomerular disease and their care partners value their capacity for autonomy and disease ownership, stability of their health, and relationships that support self-management. Strategies directed at strengthening these factors may increase self-efficacy and improve the care and outcomes for patients with glomerular disease.