慢性病患者治疗负担的概念分析

Conceptual analysis of treatment burden in patients with chronic disease

目的分析并阐明慢病患者治疗负担的概念内涵。方法系统检索PubMed、Embase、Web of Science、Cochrane、中国知网、维普、万方、中国生物医学数据库中治疗负担的相关文献,检索时限为建库至2023年4月10日,采用Rodgers概念分析法进行分析。结果共纳入47篇文献,慢病患者治疗负担包括动态的过程、多维度的概念、主客观负担3个概念属性;前因包括人口学因素、疾病与治疗因素、健康素养、心理因素、自我效能以及社会支持系统;后果包括依从性降低、生活质量下降、负性情绪、恶性循环、医疗资源利用不当等。常用测量工具包括治疗负担量表、患者治疗和自我管理体验量表、慢性病共存治疗负担问卷、老年慢病共存患者治疗负担量表。结论通过对慢性病患者治疗负担的概念分析,有助于提高医护人员认识,并为治疗负担在我国的进一步研究提供理论指导。

Objective To analyze and clarify the concept and connotation of treatment burden of chronic disease patients.Methods The Literature related to treatment burden in PubMed,Embase,Web of Science,Cochrane,CNKI,VIP,Wanfang,and China Biomedical Literature Service System were systematically searched,and the search time was from the database establishment to April 2023,and Rodgers conceptual analysis method was used for analysis.Results A total of 47 literatures were included,and the treatment burden of chronic disease patients included 3 conceptual attributes:Dynamic process,multi-dimensional concept,and subjective burden and objective burden.The antecedents included demographic factors,disease and treatment factors,health literacy,psychological factors,self-efficacy,and social support system;Consequences included reduced adherence,reduced quality of life,negative emotion,vicious cycle,and improper use of medical resources.Common measuring tools included treatment burden scale,patient treatment and self-management experience scale,chronic disease co-existing treatment burden questionnaire,and elderly chronic disease co-existing treatment burden scale.Conclusion Through the conceptual analysis of treatment burden,it is helpful to improve the awareness of medical staff,and provide theoretical guidance for further research of treatment burden in China.