Barriers and facilitators to self-management of asthma in adolescents: An interview study to inform development of a novel intervention
Barriers and facilitators to self-management of asthma in adolescents: An interview study to inform development of a novel intervention
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DOI：
10.1111/cea.13141
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发表时间：
2018-08-01
影响因子：
6.1
通讯作者：
Roberts, G.
中科院分区：
文献类型：
--
作者：
Holley, S.;Walker, D.;Roberts, G.
背景和结论尽管已有20年的文献描述了青少年哮喘自我管理的障碍，但缺乏成功的、基于临床的干预措施来解决这一重要问题。鉴于以前的一些研究的局限性，我们进行了一项研究，旨在获得更广泛的了解障碍和促进因素，以自我管理的哮喘的青少年，而不仅仅是坚持治疗，和三角他们的意见与他们的父母和医疗保健professionals.MethodsFocus小组和访谈分别进行了28青少年哮喘年龄在12-18岁，14名医护人员和12名家长。焦点小组和访谈录音，并从每个参与者组的成绩单进行了分析，分别使用归纳专题分析。我们三角形的三个角度，通过比较的主题，出现了从每个analysis. ResultsAdolescents '，家长'和医疗保健专业人员的意见，总结成10个相关的主题，包括遗忘和例程，知识，尴尬和信心，沟通与医疗保健专业人员，触发器，支持在学校，冷漠和承担责任。我们发现，青少年，父母和医疗保健专业人员提出了类似的障碍和促进自我管理和我们的结果提供了进一步验证以前的研究结论和临床相关性我们的研究强调，医疗保健专业人员可能需要考虑一系列的心理和背景问题影响青少年的能力，有效地自我管理他们的哮喘，特别是，他们如何实施常规治疗，以及青少年对自己的病情和治疗的理解。至关重要的是，医疗保健专业人员需要考虑如何传达这些信息，并确保他们促进开放，包容，双向协商。从这个更全面的理解，我们已经制定了干预策略，医疗保健专业人员可以利用，使青少年改善他们的哮喘自我管理。
Background and ObjectiveDespite literature that spans twenty years describing the barriers to asthma self-management in adolescents, successful, clinically based interventions to address this important issue are lacking. Given the limitations of some of the previous studies, we conducted a study that aimed to gain a broader insight into barriers and facilitators to self-management of asthma by adolescents, not just adherence to treatment, and triangulated their views with those of their parents and healthcare professionals.MethodsFocus groups and interviews were conducted separately for 28 adolescents with asthma aged 12-18 years, 14 healthcare professionals and 12 parents. Focus groups and interviews were audio-recorded, and transcripts from each participant group were analysed separately using inductive thematic analysis. We triangulated the three perspectives by comparing themes that had emerged from each analysis.ResultsAdolescents', parents' and healthcare professionals' views were summarized into ten related themes that included forgetting and routines, knowledge, embarrassment and confidence, communication with healthcare professionals, triggers, support at school, apathy and taking responsibility. We found that adolescents, parents and healthcare professionals raised similar barriers and facilitators to self-management and our results provide further validation for previous studies.Conclusion and Clinical RelevanceOur study highlights that healthcare professionals may need to consider a range of psychological and contextual issues influencing adolescents' ability to effectively self-manage their asthma, in particular, how they implement treatment routines and the understanding that adolescents have of their condition and treatments. Crucially, healthcare professionals need to consider how this information is communicated and ensure they facilitate open, inclusive, two-way consultations. From this more comprehensive understanding, we have developed interventional strategies that healthcare professionals can utilize to empower adolescents to improve their asthma self-management.