症状特征、知觉因果归因及影响自我照顾行为的环境因素:慢性疾病成人生态日常评估研究
2024/05/28
摘要
目的：了解症状对自我保健的影响，指导患者教育，改善症状控制。本研究考察了关节炎、哮喘、慢性阻塞性肺病、糖尿病或心力衰竭患者的症状特征、因果归因和影响自我护理的环境因素。
方法：有症状慢性疾病的成人(n=81)参加了一项纵向观察研究。通过生态日常评估，参与者在两周内每天两次描述一种症状，并对其频率、严重程度、困扰程度、持续时间、原因和自我护理进行评分。
结果：最常见的症状是疲劳和呼吸短促。疼痛、疲劳和关节僵硬是最严重和最麻烦的。大多数参与者进行主动自我照顾，但那些疲劳和疼痛的参与者进行被动自我照顾(即休息或什么都不做)，特别是当症状不频繁、轻微、有点麻烦、转瞬即逝的时候。在使用被动自我照顾的人群中，思想、感觉和对他人隐瞒症状的愿望干扰了自我照顾。
结论：大多数患有慢性疾病的成年人在控制症状方面发挥积极作用，但有些人隐瞒或忽视症状，直到频率、严重程度、麻烦程度或持续时间增加。
Symptom characteristics, perceived causal attributions, and contextual factors influencing self-care behaviors: An ecological daily assessment study of adults with chronic illness
B. Riegel, S. D. Page, S. Aryal, C. S. Lee, A. Belfiglio, K. E. Freedland, et al.
Abstract
OBJECTIVE:Insights into how symptoms influence self-care can guide patient education and improve symptom control. This study examined symptom characteristics, causal attributions, and contextual factors influencing self-care of adults with arthritis, asthma, chronic obstructive pulmonary disease, diabetes, or heart failure.
METHODS:Adults (n=81) with a symptomatic chronic illness participated in a longitudinal observational study. Using Ecological Daily Assessment, participants described one symptom twice daily for two weeks, rating its frequency, severity, bothersomeness, duration, causes, and self-care.
RESULTS:The most frequent symptoms were fatigue and shortness of breath. Pain, fatigue, and joint stiffness were the most severe and bothersome. Most participants engaged in active self-care, but those with fatigue and pain engaged in passive self-care (i.e., rest or do nothing), especially when symptoms were infrequent, mild, somewhat bothersome, and fleeting. In people using passive self-care, thoughts, feelings, and the desire to conceal symptoms from others interfered with self-care.
CONCLUSION:Most adults with a chronic illness take an active role in managing their symptoms but some conceal or ignore symptoms until the frequency, severity, bothersomeness, or duration increases
目的：了解症状对自我保健的影响，指导患者教育，改善症状控制。本研究考察了关节炎、哮喘、慢性阻塞性肺病、糖尿病或心力衰竭患者的症状特征、因果归因和影响自我护理的环境因素。
方法：有症状慢性疾病的成人(n=81)参加了一项纵向观察研究。通过生态日常评估，参与者在两周内每天两次描述一种症状，并对其频率、严重程度、困扰程度、持续时间、原因和自我护理进行评分。
结果：最常见的症状是疲劳和呼吸短促。疼痛、疲劳和关节僵硬是最严重和最麻烦的。大多数参与者进行主动自我照顾，但那些疲劳和疼痛的参与者进行被动自我照顾(即休息或什么都不做)，特别是当症状不频繁、轻微、有点麻烦、转瞬即逝的时候。在使用被动自我照顾的人群中，思想、感觉和对他人隐瞒症状的愿望干扰了自我照顾。
结论：大多数患有慢性疾病的成年人在控制症状方面发挥积极作用，但有些人隐瞒或忽视症状，直到频率、严重程度、麻烦程度或持续时间增加。
（中日友好医院呼吸与危重症医学科 李春晓 摘译 林江涛 审校）
（Patient Education and Counseling 2024 Vol. 123 DOI: ARTN 10822710.1016/j.pec.2024.108227）
（Patient Education and Counseling 2024 Vol. 123 DOI: ARTN 10822710.1016/j.pec.2024.108227）
Symptom characteristics, perceived causal attributions, and contextual factors influencing self-care behaviors: An ecological daily assessment study of adults with chronic illness
B. Riegel, S. D. Page, S. Aryal, C. S. Lee, A. Belfiglio, K. E. Freedland, et al.
Abstract
OBJECTIVE:Insights into how symptoms influence self-care can guide patient education and improve symptom control. This study examined symptom characteristics, causal attributions, and contextual factors influencing self-care of adults with arthritis, asthma, chronic obstructive pulmonary disease, diabetes, or heart failure.
METHODS:Adults (n=81) with a symptomatic chronic illness participated in a longitudinal observational study. Using Ecological Daily Assessment, participants described one symptom twice daily for two weeks, rating its frequency, severity, bothersomeness, duration, causes, and self-care.
RESULTS:The most frequent symptoms were fatigue and shortness of breath. Pain, fatigue, and joint stiffness were the most severe and bothersome. Most participants engaged in active self-care, but those with fatigue and pain engaged in passive self-care (i.e., rest or do nothing), especially when symptoms were infrequent, mild, somewhat bothersome, and fleeting. In people using passive self-care, thoughts, feelings, and the desire to conceal symptoms from others interfered with self-care.
CONCLUSION:Most adults with a chronic illness take an active role in managing their symptoms but some conceal or ignore symptoms until the frequency, severity, bothersomeness, or duration increases
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有无哮喘的阿尔茨海默症的发病率和患病率：一项医疗保险队列研究
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