Reflecting on patient-generated photographs of the pediatric renal transplant experience.
Reflecting on patient-generated photographs of the pediatric renal transplant experience.
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DOI：
10.1111/petr.13896
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发表时间：
2021-05
影响因子：
1.3
通讯作者：
Snyder J
中科院分区：
文献类型：
--
作者：
Pollack AH;Snyder J
不良的自我管理有助于降低青少年和青年期肾移植存活率。为患者提供自我反思工具，以帮助探索“我的经历正常吗？”可能有助于缓解这些挑战。我们探索照片启发，一种定性的方法，其中图像被用来提示个人谈论他们的个人经验和价值观，使儿科移植受者及其家人深入了解他们的经验和他们在移植后面临的挑战。来自西雅图儿童医院的儿童肾移植受者和一名家庭成员提交了5张照片，展示了他们的移植故事，这些照片在半结构化访谈中用作提示。访谈记录，转录，并使用主题分析进行分析。24名个体（13名患者：年龄7-21岁，11名父母）完成了研究。由照片产生的对话比常规的临床遭遇更深入地涵盖了主题，从而为患者及其家人提供了更多的反思机会。这些照片引发了关于四个新兴主题的对话：（a）意义建构;（B）过渡和代理;（c）社会互动和社区参与;（d）障碍和障碍。照片启发产生了一个丰富的数据集，描述了一系列儿科肾移植经验，帮助医生获得丰富和细致入微的了解日常生活和临床环境以外的患者的经验。作为一种临床干预措施，照片诱导可能为解决以前未被认识到的可改变的风险因素提供新的机会，提高移植物存活率和健康相关的生活质量。
Poor self-management contributes to reduced renal allograft survival during adolescence and young adulthood. Providing patients with self-reflection tools to help explore the question “Is my experience normal?” may help mitigate these challenges. We explore Photograph-elicitation, a qualitative method where images are used to prompt individuals to talk about their personal experiences and values, engages pediatric transplant recipients and their families to generate insight into their experiences and the challenges they face after transplant. Pediatric renal transplant recipients and one family member from Seattle Children’s Hospital submitted 5 photographs showcasing their transplant story, which were used as prompts during semi-structured interviews. Interviews were recorded, transcribed, and analyzed using thematic analysis. Twenty-four individuals (13 patients: ages 7–21, and 11 parents) completed the study. Conversations generated by the photographs covered topics in more depth than a routine clinical encounter leading to more opportunities for reflection by patients and their family. The photographs generated conversations on four emergent themes: (a) sensemaking; (b) transitions and agency; (c) social interactions and community engagement; and (d) barriers and obstacles. Photograph elicitation generated a rich dataset describing a range of pediatric renal transplant experiences helping physicians gain a rich and nuanced understanding of the daily lives and experiences of their patients outside the clinical setting. Photograph elicitation, as a clinical intervention, may provide new opportunities to address previously unrecognized modifiable risk factors, improving graft survival and health-related quality of life.
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