晚期肾病患者心肌梗死的治疗决策:一项定性研究方案

IF 3.9 2区 社会学 Q1 SOCIAL SCIENCES, INTERDISCIPLINARY
Jemima Scott, Lucy E. Selman, Fergus J. Caskey, Thomas Johnson, Yoav Ben-Shlomo, Pippa K. Bailey
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引用次数: 0

摘要

背景:慢性肾脏疾病(CKD)患者在心肌梗死(MI)后的发病率和死亡率明显高于一般人群。尽管如此,与没有肾脏疾病的患者相比,他们接受侵入性治疗和指导药物治疗的可能性更小。目前尚不清楚为什么存在这种治疗差异,以及它是否反映了高风险CKD人群平等和适当的护理机会。目的:目的是(1)了解慢性肾病患者在心肌梗死后的管理决策是如何制定的,以及如何与之一起制定的;(2)描述最近在英国接受心肌梗死治疗的慢性肾病患者的经历。方法:我们将从英国3-5家NHS医院信托中招募15-20名CKD合并既往心肌梗死患者和15-20名参与治疗决策的临床工作人员。有目的的抽样将用于确保参与者在年龄、性别、种族以及相关的职业或肾损害程度方面的多样性。我们将按照为患者和临床工作人员制定的灵活主题指南进行半结构化访谈。采访将被录音和抄写。文本分析将使用布劳恩和克拉克的主题分析中概述的六个步骤,在解释主义和建构主义的方法下进行。分析将主要是归纳的。我们将用代码标记文本部分,以反映语义或潜在的含义,并将相似的代码聚类在一起,以派生我们将定义和命名的主题。我们将制作一份报告,包括CKD患者心肌梗死治疗决策的核心主题,用数据和分析评论的例子来说明,并展示我们的研究在文献和更广泛的背景下所处的位置。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment Decision-Making in Myocardial Infarction for People With Advanced Kidney Disease: Protocol for a Qualitative Study
Background: People with chronic kidney disease (CKD) have significantly higher morbidity and mortality following myocardial infarction (MI) than the general population. Despite this, they are less likely to receive invasive management and guideline-directed medications than those without kidney disease. It is unclear why this treatment variation exists and whether or not it reflects equal and appropriate access to care for the high-risk CKD population. Aims: The aims are to (1) understand how management decisions following an MI are made for, and with, people with CKD, and (2) describe the experiences of people with CKD who have recently received MI care in England. Method: We will recruit 15–20 patients with CKD and previous MI, and 15–20 clinical staff who are involved in treatment decision-making, from 3–5 NHS hospital trusts in the UK. Purposive sampling will be used to ensure diversity in participants with respect to age, gender, ethnicity and, where relevant, profession or degree of kidney impairment. We will undertake semi-structured interviews following flexible topic guides developed for patients and clinical staff. Interviews will be audio-recorded and transcribed. Transcripts will be analysed using the six steps outlined in Braun and Clarke’s thematic analysis, within an interpretivist, constructionist approach. Analysis will be primarily inductive. We will label sections of text with codes to reflect semantic or latent meaning and cluster similar codes together to derive themes which we will define and name. We will produce a report comprising themes central to MI treatment decision-making in people with CKD, illustrated with examples of data and analytic commentary, and demonstrate where our research stands within the context of the literature and wider context.
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来源期刊
International Journal of Qualitative Methods
International Journal of Qualitative Methods SOCIAL SCIENCES, INTERDISCIPLINARY-
CiteScore
6.90
自引率
11.10%
发文量
139
审稿时长
12 weeks
期刊介绍: Journal Highlights Impact Factor: 5.4 Ranked 5/110 in Social Sciences, Interdisciplinary – SSCI Indexed In: Clarivate Analytics: Social Science Citation Index, the Directory of Open Access Journals (DOAJ), and Scopus Launched In: 2002 Publication is subject to payment of an article processing charge (APC) Submit here International Journal of Qualitative Methods (IJQM) is a peer-reviewed open access journal which focuses on methodological advances, innovations, and insights in qualitative or mixed methods studies. Please see the Aims and Scope tab for further information.
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