Qualitative research-enhanced understanding of patients' beliefs: Results of focus groups with low-income, urban, African American adults with asthma
Qualitative research-enhanced understanding of patients' beliefs: Results of focus groups with low-income, urban, African American adults with asthma
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DOI：
10.1067/mai.2003.1459
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发表时间：
2003-05-01
影响因子：
14.2
通讯作者：
Apter, AJ
中科院分区：
文献类型：
--
作者：
George, M;Freedman, TG;Apter, AJ
背景：质性研究是了解患者健康信念和态度的重要研究方法。这些信念和态度被认为是低收入城市少数民族对药物治疗依从性低和随之而来的哮喘发病率高负担的部分解释。目的：本研究的目的是探讨低收入群体对吸入性皮质类固醇（ICS）依从性的障碍、对哮喘及其治疗的健康信念以及对提供者和临床研究的看法。对15名患有持续性哮喘的低收入、城市、非洲裔美国成年人进行了三个重点小组的研究。这些焦点小组会议录音，逐字转录，并通过使用定性分析techniques.Results：健康信念，影响依从性包括患者的依赖，他们的评估哮喘控制的健康提供者和关注ICS治疗的不良影响。社会义务和保险公司的批准政策以及限制性处方集也对依从性产生了不利影响。尽管对医疗机构的不信任显而易见，但成员们普遍表示愿意参与非药物临床研究，并相信研究是有益的。然而，他们有强烈的偏好，在哪里应该进行research.Conclusions：虽然存在障碍，ICS坚持在患者人群中，其中许多可以解决在患者与临床医生的互动。定性研究是一个重要的工具，制定假设，提高ICS的坚持，然后可以在未来通过使用定量研究方法进行测试。
Background: Qualitative research is an important research methodology for understanding the health beliefs and attitudes of patients. These beliefs and attitudes have been proposed as partial explanations for low adherence to medical therapy and the consequent high burden of morbidity from asthma among low-income urban minorities.Objective: The purpose of this study was to explore barriers to adherence to inhaled corticosteroids (ICSs), health beliefs regarding asthma and its treatment, and opinions about providers and clinical research among low-income groups.Methods: Three focus groups were conducted with 15 low-income, urban, African American adults with persistent asthma. These focus group sessions were audiotaped, transcribed verbatim, and coded by using qualitative analytic techniques.Results: Health beliefs that influenced adherence included patients' reliance on their assessment of asthma control over that of the health provider and concern over the adverse effects of ICS therapy. Adherence was also adversely affected by social obligations and insurers' approval policies and restricted formularies. Although mistrust of the medical establishment was evident, members generally expressed a willingness to participate in nonpharmacologic clinical research and the belief that research was beneficial. However, they had strong preferences for where the research should be conducted.Conclusions: Although barriers exist to ICS adherence in patient populations, many of these can be addressed during patient-clinician interactions. Qualitative research is an important tool for formulating hypotheses for improving ICS adherence that can then be tested in the future by using quantitative research methods.