Patient experience after kidney transplant: a conceptual framework of treatment burden
Patient experience after kidney transplant: a conceptual framework of treatment burden
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DOI：
10.1186/s41687-019-0095-4
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发表时间：
2019-01-30
影响因子：
2.7
通讯作者：
Eton, David T.
中科院分区：
文献类型：
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作者：
Lorenz, Elizabeth C.;Egginton, Jason S.;Eton, David T.
背景肾移植受者面临终身的药物治疗、健康监测和医疗预约。这种涉及管理个人健康的工作及其对福祉的影响被称为治疗负担。过度的治疗负担会对依从性和生活质量产生不利影响。本研究的目的是建立一个肾移植后治疗负担的概念框架。对来自三个马约诊所移植中心的肾移植受者（n = 27）进行定性访谈。一个半结构化的访谈指南，最初开发的慢性疾病患者和肾移植的背景下量身定制的。在两个焦点组（n = 16）中确认了肾移植后治疗负担的主题。结果分析证实了肾移植后治疗负担的三个主要主题：1）患者必须做的工作，以照顾他们的健康（例如，参加医疗预约，服用药物），2）加剧感觉负担的挑战/压力源（例如，财务问题，卫生系统障碍）3）负担的影响（例如，社会活动限制）。结论：患者描述了大量的工作涉及照顾他们的肾移植。个人、人际和系统相关因素加剧了这一工作。该框架将被用作患者报告的治疗负担措施的基础，以促进肾移植后更好的护理。
Background Kidney transplant recipients face a lifelong regimen of medications, health monitoring and medical appointments. This work involved in managing one's health and its impact on well-being are referred to as treatment burden. Excessive treatment burden can adversely impact adherence and quality of life. The aim of this study was to develop a conceptual framework of treatment burden after kidney transplantation. Qualitative interviews were conducted with kidney transplant recipients (n = 27) from three Mayo Clinic transplant centers. A semi-structured interview guide originally developed in patients with chronic conditions and tailored to the context of kidney transplantation was utilized. Themes of treatment burden after kidney transplantation were confirmed in two focus groups (n = 16). Results Analyses confirmed three main themes of treatment burden after kidney transplantation: 1) work patients must do to care for their health (e.g., attending medical appointments, taking medications), 2) challenges/stressors that exacerbate felt burden (e.g., financial concerns, health system obstacles) 3) impacts of burden (e.g., role/social activity limitations). Conclusions Patients describe a significant amount of work involved in caring for their kidney transplants. This work is exacerbated by individual, interpersonal and system-related factors. The framework will be used as a foundation for a patient-reported measure of treatment burden to promote better care after kidney transplantation.