癫痫青少年参与健康照护行为意向影响因素的质性研究

Qualitative research for the influencing factors of adolescents patients with epilepsy participated in health care

目的以"互动式参与患者安全"理论为框架,了解癫痫青少年参与健康照护行为意向的相关体验和影响因素。方法采用目的抽样法,选择2017年6月-2019年2月在重庆市某三级甲等儿童专科医院就医的14例癫痫青少年为研究对象,通过半结构深入访谈和参与观察法收集数据,根据内容分析法对资料进行分析,提炼主题。结果癫痫青少年参与健康照护行为意向及影响因素包括:个人因素(个性特征、逆境经历、疾病认知、应对技巧);家庭因素(监护人的知识储备、家庭功能状况、家庭的结构);社会因素(医院的联结、学校的联结、家庭的联结)。结论适当的认知准备、挖掘有利的性格特征和逆境经历、专业人员主动干预与自主学习相结合有助于促进癫痫青少年参与健康照护行为;优化家庭支持系统和建立医院、学校和社区的联结为促进癫痫青少年参与健康照护的有效途径。

Objective To explore the influencing factors of adolescents with epilepsy to participate in health care based on the framework of theory of patient participation in patient safety.Methods Personal semi-structured interview and participant observation were adopted to investigate 14 adolescents with epilepsy,and to analyze materials by content analysis method.Themes were extracted.Results Three themes were extracted:Personal Factors(personality characteristics,adversity experience,disease cognition,coping skills);Family factors(knowledge reserve of guardians,family functional status,family structure);Social factors(hospital connections,school connections,family connections).Conclusion To promote participation in health care for adolescents with epilepsy,it is necessary to make appropriate cognitive preparation,explore favorable personality traits and adverse experiences,combine professional intervention and independent learning.Moreover,optimizing family support systems and building links between hospitals schools and communities are effective ways.