2型糖尿病患者运动决策体验的质性研究

戴璇; 李珍; 秦月兰; 熊茂; 陶美伊

PDF(2030 KB)

湖南师范大学学报医学版 ›› 2024, Vol. 21 ›› Issue (3) : 179-183.

护理学

2型糖尿病患者运动决策体验的质性研究

戴璇, 李珍, 秦月兰, 熊茂, 陶美伊

作者信息 +

A qualitative study of the exercise decision-making experience of patients with type 2 diabetes mellitus

DAI Xuan, LI Zhen, QIN YueLan, XIONG Mao, TAO MeiYi

Author information +

文章历史 +

摘要

目的: 了解2型糖尿病患者运动决策的真实体验,为针对性制定决策辅助方案提供依据。方法: 采用现象学研究方法,通过目的抽样法对13例2型糖尿病住院患者进行半结构式访谈,运用Colaizzi分析法对访谈资料进行分析。结果: 归纳得出3个主题和8个亚主题：运动决策需求的差异较明显（决策认知差异、决策参与程度不一致、决策行为受情境约束）、运动决策支持不系统（低效的信息支持、缺位的情感支持、医患沟通不充分、时间和经济的压力、同伴效应的导向）运动决策结果不明确。结论: 医护人员应针对2型糖尿病患者的不同需求,提供有效的决策支持,改善其决策体验,鼓励患者参与运动决策,提高运动依从性。

Abstract

Objective To understand the real-life experience of exercise decision-making in people with type 2 diabetes to inform the development of targeted decision-aid programs. Methods A phenomenological research method was used to conduct semi-structured interviews with 13 inpatients with type 2 diabetes mellitus, and Colaizzi analysis was used to analyze the interview data. Results Three themes and eight sub-themes were summarized: Exercise decision-making needs are differ significantly (decision-making cognitive differences, inconsistent decision-making participation, situational constraints on decision-making behavior), and exercise decision-making support is unsystematic (ineffective informational support, absent emotional support, Inadequate communication between healthcare professionals and patients, time and financial pressures, and peer effect orientation) Exercise decision-making outcomes are not clear. Conclusion Healthcare professionals should provide effective decision support to improve the decision-making experience for the different needs of patients with type 2 diabetes mellitus, encourage patients to participate in exercise decision-making, and improve exercise adherence.

导出引用

戴璇, 李珍, 秦月兰, 熊茂, 陶美伊. 2型糖尿病患者运动决策体验的质性研究[J]. 湖南师范大学学报医学版. 2024, 21(3): 179-183

DAI Xuan, LI Zhen, QIN YueLan, XIONG Mao, TAO MeiYi. A qualitative study of the exercise decision-making experience of patients with type 2 diabetes mellitus[J]. Journal of Hunan Normal University(Medical Science). 2024, 21(3): 179-183

中图分类号： R47

参考文献

[1] SUN H, SAEEDI P, KARURANGA S, et al.IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045[J]. Diabetes Research Clinical Practice, 2022, 183: 109119.
[2] GERARDO G, MANUEL J M, GERARDO J G, et al.Treatment burden and perceptions of glucose-lowering therapy among people living with diabetes.[J]. Primary care diabetes, 2022, 16(4): 568-573.
[3] 付洋洋, 郭舜, 廖立宏.2型糖尿病运动干预方案研究[J]. 体育科技文献通报, 2023, 31(09): 243-246.
[4] 曾琪茜. 2型糖尿病患者共享决策参与现状及影响因素研究[D]. 南宁: 广西中医药大学, 2023.
[5] VICKERS J A . Decisional Conflict, Regret, and the Burden of Rational Decision Making[J]. Medical Decision Making, 2017, 37(1): 3-5.
[6] 邢乃芳, 姚丹, 王璐杉, 等. 育龄期女性乳腺癌患者生育决策真实体验的Meta整合[J]. 中国护理管理, 2023, 23(05): 719-724.
[7] 陈小芳. 冠状动脉介入治疗患者感知参与治疗决策现状及其对服药依从性的影响研究[D]. 沈阳: 中国医科大学, 2022.
[8] 钱瑜, 刘欢, 赵中晶, 等. 共享决策干预对前路颈椎间盘切除融合术患者预后的影响[J]. 中国护理管理, 2023, 23(06): 834-838.
[9] 张欣, 尹卫, 刘巧艳, 等. 妊娠期糖尿病患者血糖管理决策体验的纵向质性研究[J]. 护理学报, 2023, 30(12): 22-26.
[10] 惠静, 樊一桦, 李春岭, 等. 共享决策在慢性病治疗中的应用进展——以糖尿病为例[J]. 医学与哲学, 2020, 41(10): 21-24.
[11] 马娟娟, 贾红红, 张慧. 医患共同决策对2型糖尿病患者自我管理效果的Meta分析[J]. 护理学杂志, 2023, 38(20): 44-48.
[12] 周闯, 刘欢欢, 苏国锋. 心理治疗失败的青少年抑郁症患者治疗体验的质性研究[J]. 深圳中西医结合杂志, 2023, 33(19): 119-121.
[13] 李峥, 刘宇. 护理学研究方法[M]. 北京: 人民卫生出版社, 2018.
[14] 刘明. Colaizzi七个步骤在现象学研究资料分析中的应用[J]. 护理学杂志, 2019, 34(11): 90-92.
[15] 贠妍卉, 乔够梅, 程魏弟, 等. 膀胱肿瘤患者灌注化疗决策过程的现象学研究[J]. 中西医结合护理 (中英文), 2020, 6(09): 54-58.
[16] 钟华梅, 王兆红. 我国大陆居民体育锻炼参与决策及体育锻炼时间的影响因素研究——基于2016年中国劳动力动态调查数据的实证研究[J]. 首都体育学院学报, 2023, 35(03): 307-316.
[17] 何清新, 夏文芳. 医患共同决策面临的问题及解决方法探索[J]. 医学与哲学, 2023, 44(05): 18-20+67.
[18] 罗思佳. 具身认知理论在高中地理教学中的应用研究[D]. 哈尔滨: 哈尔滨师范大学, 2022.
[19] 张文雨, 张静静, 郭唱, 等. 育龄期女性癌症患者生育力保存决策体验质性研究的Meta整合[J]. 中华护理杂志, 2023, 58(12): 1504-1511.
[20] DING J, WANG J, WU P, et al.Identification of psychological stressors in cancer patients based on a computer decision support nursing system[J]. Am J Transl Res, 2022, 14(10): 6953-6963.
[21] 王旭兰, 刘小青, 魏慧萍. 剖宫产后瘢痕妊娠阴道试产风险决策现状调查及影响因素分析[J]. 齐鲁护理杂志, 2022, 28(12): 76-80.
[22] 梁嘉宁. 中国家庭生育影响因素研究[D]. 长春: 吉林大学, 2023.
[23] REED P, WHITTALL C M, OSBORNE L A, et al.Impact of Strength and Nature of Patient Health Values on Compliance and Outcomes for Physiotherapy Treatment for Pelvic Floor Dysfunction[J]. Urology, 2019, 136: 95-99.
[24] 朱行策, 刘智勇, 董钟昕, 等. 我国慢性病患者决策参与影响因素质性研究的系统评价[J]. 护理学杂志, 2022, 37(09): 10-16.
[25] 徐霞, 王慧芬, 孔笑晓. 以医患共享决策模式为基础的干预方案在糖尿病酮症患者中的应用[J]. 齐鲁护理杂志, 2022, 28(17): 92-95.
[26] 赵子韩, 强万敏, 王书蕊, 等. 乳腺癌患者术前决策体验的质性研究[J]. 护士进修杂志, 2021, 36(16): 1531-1535.
[27] MAKWERO M, MUULA A S, ANYANWU F C, et al.An insight into patients' perspectives on barriers affecting participation in shared decision making among patients with diabetes mellitus in Malawi[J]. BMC Primary Care, 2022, 23(1): 1-8.
[28] 吴秀梅, 彭美芳, 缪景霞, 等. 社会支持对癌症患者医患共同决策的影响: 医患关系与医疗决策参与期望的链式多重中介作用[J]. 重庆医学, 2022, 51(21): 3771-3776.
[29] LI Z, JIN Y, LU C, et al.Effects of patient decision aids in patients with type 2 diabetes mellitus: A systematic review and meta‐analysis[J]. Int J Nurs Pract, 2021, 27(6): e12914.
[30] YU C H, MEDLEG F, CHOI D, et al.Integrating shared decision-making into primary care: lessons learned from a multi-centre feasibility randomized controlled trial[J]. BMC Med Inform Decis Mak, 2021, 21(1): 1-12.
[31] 周如华, 顾则娟, 徐晶晶, 等. 决策辅助工具在糖尿病管理中的研究进展[J]. 实用临床医药杂志, 2022, 26(12): 144-148.
[32] SHUBROOK J H, RADIN M, ALI S N, et al.Preference for Type2 Diabetes Therapies in the United States: A Discrete Choice Experiment[J]. Adv Ther, 2022, 39(9): 4114-4130.