PDF(Pubmed)
Abstract：
UNASSIGNED: In Canada, one out of five people lives with chronic pain, a condition frequently co-occurring with other chronic illnesses. As with most chronic illnesses, successful engagement in symptom management is key. In the context of multiple illnesses, self-management involves daily prioritization of symptoms and conditions and decision-making, which can be challenging. Self-management of chronic illnesses can require more complex competence and tasks to address the different implications of each condition.
UNASSIGNED: Our research objective was to explore types and processes of self-management symptom prioritization among adults living with chronic pain and other chronic illnesses.
UNASSIGNED: This research was carried out as part of a larger study that adopted an explanatory sequential mixed-methods design. This study focused more specifically on the qualitative part of the study.
UNASSIGNED: Participants recruited for the qualitative component took part in a semi-structured individual interview online or in-person at the center hospitalier de l\'Université de Montréal.
UNASSIGNED: In total, 25 participants were interviewed, including 18 women and 7 men.
UNASSIGNED: To participate in the qualitative part of the study, participants were selected from the larger study and were eligible if they were 18 years old or older and experiencing pain for more than 3 months and had at least one other chronic illness for which they were receiving treatment or engaged in symptom management. Semi-structured interviews were conducted in-person or virtually and were transcribed verbatim. Reflexive thematic analysis was used to explore patients\' narratives, and an open and iterative approach was adopted to code interviews and generate themes.
UNASSIGNED: The first theme, focus on symptom prioritization, showed different prioritization processes, including prioritizing a dominant illness, prioritizing multiple illnesses to avoid undesirable consequences, and finally absence of or automatic processes of prioritization. In the second theme, we identified several characteristics of an illness, in this case chronic pain that made it a self-management priority: uncontrollable and disabling nature, omnipresence, unpredictability, unpleasantness, and invisibility to others. In the last theme, we highlighted that some psychosocial factors influenced levels of engagement in self-management and prioritization processes, including social support and the patient-physician relationship.
UNASSIGNED: Chronic pain was the medical condition most often prioritized by participants in their self-management tasks. Because of its characteristics, it was the medical condition that had the most negative impact on day-to-day functioning.
UNASSIGNED: Our research objective was to explore types and processes of self-management symptom prioritization among adults living with chronic pain and other chronic illnesses.
UNASSIGNED: This research was carried out as part of a larger study that adopted an explanatory sequential mixed-methods design. This study focused more specifically on the qualitative part of the study.
UNASSIGNED: Participants recruited for the qualitative component took part in a semi-structured individual interview online or in-person at the center hospitalier de l\'Université de Montréal.
UNASSIGNED: In total, 25 participants were interviewed, including 18 women and 7 men.
UNASSIGNED: To participate in the qualitative part of the study, participants were selected from the larger study and were eligible if they were 18 years old or older and experiencing pain for more than 3 months and had at least one other chronic illness for which they were receiving treatment or engaged in symptom management. Semi-structured interviews were conducted in-person or virtually and were transcribed verbatim. Reflexive thematic analysis was used to explore patients\' narratives, and an open and iterative approach was adopted to code interviews and generate themes.
UNASSIGNED: The first theme, focus on symptom prioritization, showed different prioritization processes, including prioritizing a dominant illness, prioritizing multiple illnesses to avoid undesirable consequences, and finally absence of or automatic processes of prioritization. In the second theme, we identified several characteristics of an illness, in this case chronic pain that made it a self-management priority: uncontrollable and disabling nature, omnipresence, unpredictability, unpleasantness, and invisibility to others. In the last theme, we highlighted that some psychosocial factors influenced levels of engagement in self-management and prioritization processes, including social support and the patient-physician relationship.
UNASSIGNED: Chronic pain was the medical condition most often prioritized by participants in their self-management tasks. Because of its characteristics, it was the medical condition that had the most negative impact on day-to-day functioning.
摘要：
■在加拿大，五分之一的人患有慢性疼痛，一种经常与其他慢性疾病同时发生的疾病。和大多数慢性病一样，成功参与症状管理是关键.在多种疾病的背景下，自我管理涉及症状和状况的日常优先排序和决策，这可能是具有挑战性的。慢性病的自我管理可能需要更复杂的能力和任务来解决每种疾病的不同影响。
我们的研究目标是探索患有慢性疼痛和其他慢性疾病的成年人自我管理症状优先排序的类型和过程。
■这项研究是作为一项较大研究的一部分进行的，该研究采用了解释性的顺序混合方法设计。这项研究更具体地集中在研究的定性部分。
为定性部分招募的参与者在蒙特利尔大学中心医院在线或面对面地参加了半结构化的个人访谈。
■总共，25名参与者接受了采访，包括18名女性和7名男性。
■要参与研究的定性部分，参与者从较大的研究中选出,如果他们年龄在18岁或以上,并且疼痛时间超过3个月,并且至少有一种其他慢性疾病正在接受治疗或参与症状管理,则他们符合研究条件.半结构化访谈是亲自或虚拟进行的，并逐字记录。反思主题分析用于探索患者的叙述，并采用了开放和迭代的方法来编码访谈和生成主题。
■第一个主题，专注于症状优先排序，显示了不同的优先级过程，包括优先考虑显性疾病，优先考虑多种疾病，以避免不良后果，最后是缺少或自动进行优先级排序的过程。在第二个主题中，我们确定了疾病的几个特征，在这种情况下，慢性疼痛使其成为自我管理的优先事项：无法控制和致残的性质，无所不在，不可预测性,不愉快,和对他人的隐形。在最后一个主题中，我们强调，一些社会心理因素影响了自我管理和优先过程的参与程度，包括社会支持和医患关系。
慢性疼痛是参与者在自我管理任务中最常优先考虑的医疗状况。由于其特点,对日常功能产生负面影响的是医疗条件。
我们的研究目标是探索患有慢性疼痛和其他慢性疾病的成年人自我管理症状优先排序的类型和过程。
■这项研究是作为一项较大研究的一部分进行的，该研究采用了解释性的顺序混合方法设计。这项研究更具体地集中在研究的定性部分。
为定性部分招募的参与者在蒙特利尔大学中心医院在线或面对面地参加了半结构化的个人访谈。
■总共，25名参与者接受了采访，包括18名女性和7名男性。
■要参与研究的定性部分，参与者从较大的研究中选出,如果他们年龄在18岁或以上,并且疼痛时间超过3个月,并且至少有一种其他慢性疾病正在接受治疗或参与症状管理,则他们符合研究条件.半结构化访谈是亲自或虚拟进行的，并逐字记录。反思主题分析用于探索患者的叙述，并采用了开放和迭代的方法来编码访谈和生成主题。
■第一个主题，专注于症状优先排序，显示了不同的优先级过程，包括优先考虑显性疾病，优先考虑多种疾病，以避免不良后果，最后是缺少或自动进行优先级排序的过程。在第二个主题中，我们确定了疾病的几个特征，在这种情况下，慢性疼痛使其成为自我管理的优先事项：无法控制和致残的性质，无所不在，不可预测性,不愉快,和对他人的隐形。在最后一个主题中，我们强调，一些社会心理因素影响了自我管理和优先过程的参与程度，包括社会支持和医患关系。
慢性疼痛是参与者在自我管理任务中最常优先考虑的医疗状况。由于其特点,对日常功能产生负面影响的是医疗条件。
