lived experience

生活经验
  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    对于患有注意力缺陷/多动障碍(ADHD)的成年人如何进行锻炼知之甚少,导致缺乏支持这一人口的建议。我们旨在探讨患有ADHD的成年人在诊断前后如何将运动作为管理工具,以及个人如何以及为什么会遇到与运动依赖相关的问题。15名被诊断为ADHD的活跃成年人参加了半结构化访谈。确定了三个总体主题:(a)锻炼是ADHD的必要条件,反映出在正式的多动症诊断之前需要锻炼,并将锻炼用作诊断后的管理工具;(b)目标和成就,反映锻炼模式如何围绕实现目标的需要;和(c)活动或锻炼:过山车之旅,涵盖了锻炼旅程的起伏。本文强调了运动对成年人管理ADHD的重要性,以及如何鼓励和支持这一点。
    Little is known about how adults with attention-deficit/hyperactivity disorder (ADHD) experience exercise, resulting in a lack of recommendations for supporting this population. We aimed to explore how adults with ADHD experience exercise as a management tool before and after diagnosis and how and why individuals experience issues related to exercise dependence. Fifteen active adults with a diagnosis of ADHD participated in semistructured interviews. Three overarching themes were identified: (a) exercise as a necessity for ADHD, reflecting the need to exercise before a formal ADHD diagnosis, and use of exercise as a management tool postdiagnosis; (b) goals and achievements to live by, reflecting how exercise patterns revolved around a need to make progress toward targets; and (c) activity or exercise: a roller coaster journey, covering the ups and downs of exercise journeys. This article highlights the importance of exercise for adults to manage ADHD and how this can be encouraged and supported.
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  • 文章类型: Journal Article
    心力衰竭患者很难识别和识别身体感觉的变化,尽管症状监测很重要。人们对心力衰竭患者从恶化到恢复的身体体验方式知之甚少。我们旨在描述从恶化到恢复的心力衰竭的生活身体体验。对7例心力衰竭恶化的重症监护病房患者进行了参与式观察和访谈。本纳的解释现象学被用于分析。确定了四个主要主题:无功能的身体成为关注的中心和对象;在被要求住院之前意识到身体的变化;中心关注转移到日常生活,身体成为背景;并且在身体中具有死亡的感觉,不再起作用或恢复后身体虚弱。这项研究发现,心力衰竭患者在恶化和康复过程中经历了快速变化,因此意识清醒并担心自己的身体变化。此外,他们的身体康复后,直到他们出院,他们通过心力衰竭恶化期间的身体经历来看待他们的日常生活。心力衰竭的身体体验,在日常生活中缺乏意识,在从急性加重中恢复后的这段时期内,通过讲故事使其有意识,并且可以成为随后的自我保健探索的基础。
    Patients with heart failure have difficulty recognizing and identifying changes in bodily sensations, despite the importance of symptom monitoring. The way patients with heart failure experience their bodies from exacerbation to recovery is poorly understood. We aimed to describe the lived bodily experience of heart failure from exacerbation to recovery. Participatory observations and interviews were conducted in seven patients admitted to the intensive care unit with worsening heart failure. Benner\'s interpretive phenomenology was used for analysis. Four major themes were identified: a non-functional body becomes the central concern and an object; being conscious of bodily changes before hospitalization when asked; the central concern shifted to daily life and the body becomes the background; and having a feeling of death in the body that no longer functions or a weakened body after recovery. This study found that patients with heart failure were conscious and concerned about their bodies changing as they underwent rapid changes during exacerbations and recovery. In addition, immediately after their bodies recovered and until they were discharged from the hospital, they looked toward their daily lives through their bodily experiences during heart failure exacerbation. The lived bodily experience of heart failure, which is less conscious in daily life, is made conscious through storytelling in the period immediately following recovery from an acute exacerbation and can be the basis for subsequent self-care exploration.
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  • 文章类型: Journal Article
    国家痴呆症战略是指导为痴呆症患者提供适当支持的政府政策。这些策略,通过广泛的利益相关者参与开发,应该适合一个国家的文化和人口需求。采用混合方法进行调查设计,这项研究探讨了威尔士(英国)痴呆症行动计划(2018-2022)的目标,诊断,和诊断后支持,并评估这些是否正在实现。Further,它试图从痴呆症患者及其照顾者那里获得关于未来如何改善他人体验的洞察力,预计下一次行动计划的发展。受访者包括71人,受典型和罕见类型的痴呆症影响,生活在农村和城市地区。研究结果表明,积极和消极的经验,反映服务提供的“邮政编码彩票”。受访者提出了可实现的改进建议,这最终可能具有成本效益,并减轻正式服务的压力。本文报道的发现与其他国家痴呆症患者的报道一致,表明它们与威尔士以外的决策者的相关性。
    National dementia strategies are government policies that guide the provision of appropriate support for people living with dementia. These strategies, developed through extensive stakeholder engagement, should be tailored to the cultural and demographic needs of a country. Using a mixed methods survey design, this study explored the aims of the Dementia Action Plan (2018-2022) for Wales (UK) around assessment, diagnosis, and post-diagnostic support, and assessed whether these are being realized. Further, it sought to gain insight from people living with dementia and their carers around how the experience may be improved for others in the future, as the development of the next iteration of the Action Plan is anticipated. Respondents included 71 people, affected by typical and rarer types of dementia, living in both rural and urban areas. Findings suggest both positive and negative experiences, reflecting a \'postcode lottery\' of service provision. Attainable recommendations for improvement were made by respondents, which would ultimately likely be cost-effective and reduce strain on formal services. The findings reported in this paper concur with those reported by people living with dementia in other countries, indicating their relevance for policymakers beyond Wales.
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  • 文章类型: Journal Article
    长QT综合征(LQTS),一种可以导致猝死的罕见心脏病,在不列颠哥伦比亚省北部的原住民社区中非常普遍。在有5500人的Gitxsan社区中,估计125人中有1人受到影响,主要是由于KCNQ1中的新型致病变体p.V205M。在过去的十年里,通过一项基于社区的研究,超过800名Gitxsan个体接受了LQTS基因检测和咨询。尽管对LQTS的生物学基础进行了大量研究,很少有研究探索LQTS家庭的生活经历,尤其是土著居民。这项研究的目的是更好地了解LQTS在该群落中的遗传确认的影响,以及这种情况对个人的影响,他们的家人,和社区。与当地研究顾问委员会和谈话圈子协商后,进行了一项定性研究,传统的土著形式进行讨论,举行。属于同一家族的四个人参加了谈话圈。本文通过一个Gitxsan家族的反思,介绍了LQTS和遗传诊断的多代影响。LQTS影响身份和家庭关系,包括父母和孩子之间的关系,兄弟姐妹,甚至是大家庭成员。笑声和幽默在应对中起着重要的作用。这个Gitxsan家族的家庭关系在管理LQTS诊断中至关重要。这种多代人的观点提供了对家庭结构和动态的关键见解,可以为遗传咨询和临床护理提供信息。由于文化安全是有经验的,因此由接受服务的人定义,听取土著人民的观点和偏好对于提供文化知情护理至关重要。
    Long QT syndrome (LQTS), a rare cardiac condition that can lead to sudden death, is highly prevalent in First Nations communities of northern British Columbia. In the Gitxsan community of 5500, an estimated 1 in 125 individuals are affected, primarily due to the novel pathogenic variant p.V205M in KCNQ1. Over the past decade, more than 800 Gitxsan individuals received genetic testing and counseling for LQTS through a community-based study. Despite the substantial research characterizing the biological underpinnings of LQTS, there are few studies exploring the lived experiences of families with LQTS, especially those of Indigenous peoples. The goal of this study was to gain a greater understanding of the impact of the genetic confirmation of LQTS in this community, and the impact the condition has on individuals, their families, and the community. A qualitative study was developed in consultation with a local research advisory board and a Talking Circle, a traditional Indigenous format for discussion, was held. Four people who belonged to the same kindred group attended the Talking Circle. This article presents the multigenerational impact that LQTS and genetic diagnosis have through the reflections of one Gitxsan family. LQTS affects identity and family relationships, including those between parents and children, siblings, and even extended family members. Laughter and humor played an important part in coping. The role of family relationships for this Gitxsan family was seen to be critical in managing an LQTS diagnosis. This multigenerational perspective provides key insights into family structure and dynamics which can inform genetic counseling and clinical care. As cultural safety is experienced and therefore defined by the person receiving services, listening to the perspectives and preferences of Indigenous peoples is essential to the delivery of culturally informed care.
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  • 文章类型: Journal Article
    PatientsLikeMe(PLM)等面向患者的在线平台为具有各种诊断的个人提供了一个分享经验和建立社区的场所,尽管它们可能不能代表更大的患者群体。这可能限制了普遍性,并引发了人们对错误信息传播的担忧,强调知情使用和医疗保健提供者参与的必要性。
    Online patient-oriented platforms such as PatientsLikeMe (PLM) offer a venue for individuals with various diagnoses to share experiences and build community, though they may not be representative of the larger patient population. This potentially limits generalizability and raises concerns about the spread of misinformation, emphasizing the need for informed use and health care provider engagement.
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  • 文章类型: Journal Article
    背景:罕见疾病包括影响一小部分人口的各种衰弱,有时甚至危及生命的疾病,构成了重大的公共卫生挑战。尽管它们很少,大约70%的这些疾病困扰着儿童,然而,有限的研究集中在他们的经验上。这项研究旨在深入了解患有罕见疾病的儿童面临的日常挑战。
    方法:我们对11名被诊断患有一系列罕见疾病的儿童和年轻人(7-16岁)进行了半结构化的一对一访谈,有目的地从爱尔兰的三级儿科医疗机构采样。我们分析了采访记录,主题是归纳设计的。
    结果:确定了两个主题:“对罕见疾病的知识和理解”和“适应与感觉不同”。“这些主题出现在各种环境中——家庭,医院,学校,和社会环境——来说明罕见疾病对参与者日常生活的影响。开发了一个概念框架来说明儿童的知识,经验,在罕见的疾病背景下,情绪塑造了他们的身份。
    结论:我们的分析揭示了参与者的归属感和他们不同的意识之间的复杂相互作用,受其罕见状况或疾病的表现和要求的影响。他们身份的这种双重性在社会环境中最为明显,参与者感受到他们罕见疾病最显著的影响。了解这种相互作用揭示了患有罕见疾病的儿童面临的独特社会挑战。提高对这些情况的认识可以减轻这些孩子的社会挑战,为那些患有罕见疾病的人培养一个更具包容性的社会。
    BACKGROUND: Rare diseases encompass a diverse group of debilitating and sometimes life-threatening conditions that affect a small percentage of the population, posing a significant public health challenge. Despite their rarity, around 70% of these diseases afflict children, yet limited research has focused on their experiences. This study aimed to gain insights into the day-to-day challenges children living with rare diseases face.
    METHODS: We conducted semistructured one-to-one interviews with 11 children and young people (7-16 years) diagnosed with a range of rare diseases, purposively sampled from a tertiary pediatric healthcare setting in Ireland. We analyzed the interview transcripts, and themes were devised inductively.
    RESULTS: Two themes were identified: \"Knowledge and Understanding of Rare Diseases\" and \"Fitting in Versus Feeling Different.\" These themes emerged across various settings-the home, hospital, school, and social environments-to illustrate the impact of rare diseases on the participants\' daily lives. A conceptual framework was developed to illustrate how the children\'s knowledge, experiences, and emotions shape their identity in a rare disease context.
    CONCLUSIONS: Our analysis revealed a complex interplay between the participants\' sense of belonging and their awareness of being different, influenced by the manifestations and demands of their rare conditions or illnesses. This duality in their identity was most pronounced in social settings, where the participants felt the most significant impact of their rare diseases. Understanding this interplay sheds light on the unique social challenges children with rare medical conditions face. Raising awareness about these conditions could mitigate these children\'s social challenges, fostering a more inclusive society for those with rare diseases.
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  • 文章类型: Journal Article
    背景:骨关节炎的美好生活:丹麦(GLA:D™),基于证据的教育和运动计划,旨在保守治疗膝关节和髋关节骨关节炎(OA),已被证明可以通过减轻疼痛使参与者受益,改善功能,和生活质量。GLA:D数据库中的标准化报告可以衡量自我报告和基于绩效的结果。关于参与者对这个项目的看法的定性研究很少,重要的是要了解参与者对该计划的益处的看法是否与报告的定量结果一致。
    方法:我们对2017年1月至2018年12月在艾伯塔省参加GLA:D计划的个人进行了半结构化电话采访,加拿大。使用解释性描述方法和主题分析对数据进行了分析,以确定与参与者感知到的GLA:D计划收益相关的紧急主题和子主题。我们使用NVivoPro软件分析数据。使用成员检查和括号来确保分析的严谨性。
    结果:30名参与者接受了采访(70%为女性,57%的农村,73%的膝关节OA)。大多数参与者认为该计划对他们有利。分析中出现了两个主题:健康和自我效能感。参与者认为该计划有益于他们的健康,特别是在缓解疼痛方面,以及机动性的改善,力量,和整体福祉。参与者认为该计划通过提高进行锻炼和日常活动的信心来促进自我效能感,从而使他们受益。以及意识,以及控制他们OA症状的动机。20%的参与者认为该计划没有任何好处,因为他们的疼痛增加,感觉他们的OA太严重而无法参与。
    结论:GLA:D项目被认为对大多数参与者有益,这项研究还确定了因素(例如,严重OA,极度痛苦),为什么一些参与者没有经历有意义的改善。在经历严重OA的个体之前进行GLA:D计划的早期干预可以帮助增加从参与中受益的参与者数量。
    结论:随着GLA:D计划在各个司法管辖区扩展,该计划的提供者可能会考虑在疾病进展的早期招募,并针对轻度和中度OA患者.
    BACKGROUND: The Good Life with osteoArthritis: Denmark (GLA:D™), an evidence-based education and exercise program designed for conservative management of knee and hip osteoarthritis (OA), has been shown to benefit participants by reducing pain, improving function, and quality of life. Standardized reporting in the GLA:D databases enabled the measurement of self-reported and performance-based outcomes. There is a paucity of qualitative research on the participants\' perceptions of this program, and it is important to understand whether participants\' perceptions of the benefits of the program align with reported quantitative findings.
    METHODS: We conducted semi-structured telephone interviews with individuals who participated in the GLA:D program from January 2017 to December 2018 in Alberta, Canada. Data were analyzed using an interpretive description approach and thematic analysis to identify emergent themes and sub-themes associated with participants perceived benefits of the GLA:D program. We analyzed the data using NVivo Pro software. Member checking and bracketing were used to ensure the rigour of the analysis.
    RESULTS: 30 participants were interviewed (70% female, 57% rural, 73% knee OA). Most participants felt the program positively benefited them. Two themes emerged from the analysis: wellness and self-efficacy. Participants felt the program benefited their wellness, particularly with regard to pain relief, and improvements in mobility, strength, and overall well-being. Participants felt the program benefited them by promoting a sense of self-efficacy through improving the confidence to perform exercise and routine activities, as well as awareness, and motivation to manage their OA symptoms. Twenty percent of participants felt no benefits from the program due to experiencing increased pain and feeling their OA was too severe to participate.
    CONCLUSIONS: The GLA:D program was viewed as beneficial to most participants, this study also identified factors (e.g., severe OA, extreme pain) as to why some participants did not experience meaningful improvements. Early intervention with the GLA:D program prior to individuals experiencing severe OA could help increase the number of participants who experience benefits from their participation.
    CONCLUSIONS: As the GLA:D program expands across jurisdictions, providers of the program may consider recruitment earlier in disease progression and targeting those with mild and moderate OA.
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  • 文章类型: Journal Article
    体位性心动过速综合征(PoTS),有时也写为“POTS”,是自主神经失调(自主神经系统功能障碍)和体位不耐受(站立时会导致症状恶化)的一种形式。本文探讨了现有文献中有关PoTS患者与医疗保健提供者之间的互动以及PoTSies与周围人群之间个体水平的互动的生活经验。我的标题包含“咸”这个词,因为它可以用来描述沮丧的感觉,同时也反映了许多(但不是全部)PoTS患者被告知要消耗额外的钠以最大程度地减少症状时建议的特定饮食变化。COVID-19被认为导致PoTS患病率增加,因此这一主题与当代讨论和辩论特别相关。在这篇社会学文章中,我指的不仅是关于患有PoTS的生活经验的现有研究,而且还涉及相关的其他慢性疾病的研究。通过自动/传记和理论分析探索以下主题:未诊断和未验证;(在)可见;诊断的影响;恢复和期望;社区。自动/传记反射,我包括了与我的晕厥经历相关的互动分析,COVID-19和自主神经障碍,因为我自己也被诊断出患有PoTS,据认为,COVID-19病毒已大大加剧了这种情况。这项研究是社会学的,而不是医学或心理,并得出了迄今为止已知的与PoTS一起生活的生活经历的结论,以及关于未知事物的讨论,因为目前缺乏关于患有PoTS及其合并症的个人生活经历的研究。
    Postural orthostatic Tachycardia Syndrome (PoTS), sometimes also written as \'POTS\', is a form of dysautonomia (dysfunction of the autonomic nervous system) and orthostatic intolerance (which causes symptoms to be worsened when standing). This paper explores the extant literature on the lived experiences of those living with PoTS in relation to interactions between patients and healthcare providers as well as interactions at the level of the individual between PoTSies and those around them. My title contains the word \'salty\' because it can be used to describe the feeling of being frustrated, while also reflecting a specific dietary change recommended to many (but not all) PoTS patients when they are told to consume additional sodium to minimise symptoms. COVID-19 is thought to have led to an increased prevalence of PoTS so this topic is particularly relevant to contemporary discussions and debates. In this sociological article, I refer not only to existing research on the lived experiences of having PoTS but also that of other chronic illnesses when relevant. The following themes are explored through auto/biographical and theoretical analysis: Undiagnosed and Invalidated; (In)Visible; Impacts of Diagnosis; Recovery and Expectations; Community. Reflecting auto/biographically, I have included analysis of interactions related to my lived experiences of presyncope, COVID-19 and dysautonomia, as I have been diagnosed with PoTS myself, which is thought to have been significantly exacerbated by the COVID-19 virus. This research is sociological, rather than medical or psychological, and conclusions are drawn about what is known so far about the lived experiences of living with PoTS, as well as discussion about what remains unknown, as there is currently a paucity of research on the lived experiences of individuals with PoTS and its comorbidities.
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  • 文章类型: Journal Article
    家庭护理模式可以成为确保健康和就地老龄化目标在卫生政策议程中普遍存在的有效机制。然而,很少考虑这些模型对生活在社会和环境不安全条件下的人的相关性和实用性。这标志着在私人住宅中提供原位护理服务的假设,以及家庭护理开发过程中缺乏这样的群体。这项研究旨在利用老年人在无家可归(OH)的经历和偏好,年长的爱尔兰旅行者(OT),和专业利益相关者共同制定基于证据的包容性家庭护理政策建议。该研究采用了参与式方法,涉及将生活经验证据整合到多利益相关者的共同生产过程中。方法包括:五个单独的OH焦点组,OT和服务提供商(n=30);两个由焦点小组参与者共同参与的咨询论坛;以及对OH(n=27)和OT(n=22)和成年人的49次生命历程访谈。研究结果表明,这些群体在护理方面仍然存在巨大差距,资源限制和立法限制对专业利益相关者占上风。提出并讨论了基于这些经验和群体偏好的包容性家庭护理政策建议。
    Homecare models can be effective mechanisms in securing wellbeing and ageing-in-place goals prevalent in health policy agendas. However, the relevance and utility of these models for those living in socially and environmentally insecure conditions has rarely been considered. This is marked by an assumption of in-situ care delivery in private dwellings, and the absence of such groups from homecare development processes. This study aims to harnesses the experiences and preferences of older people in homelessness (OH), older Irish Travellers (OT), and professional stakeholders in an evidence-based co-production of policy recommendations for inclusive homecare provision. The study employed a participatory approach involving the integration of lived experience evidence in a multistakeholder co-production process. Methods comprised: five separate focus groups with OH, OT and service providers (n = 30); two consultative forums involving focus group participants together; and 49 life-course interviews with OH (n = 27) and OT (n = 22) and adults. Findings demonstrate that sizeable gaps in care remain for these groups, and that resource constraints and legislative restrictions prevail for professional stakeholders. Co-produced policy recommendations for inclusive homecare provision based on these experiences and group preferences are presented and discussed.
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