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背景临床试验表明口服抗凝治疗(OAT)自我检测是安全和有效的,但是对于OAT自我检测过程中患者经历的研究很少。对于如何为患者的OAT自我检测提供最优质的训练和帮助,需要进一步研究。目的采集临床试验条件之外的患者OAT自我检测经验的深度信息,探讨如何为此类患者提供最好的帮助。设计和场所选取英格兰患者,针对OAT自我检测进行半结构定性访谈。方法从267例参与OAT自我检测队列研究(CASM)且在12个月的随访后仍坚持进行OAT自我检测的患者中,选取26例进行访谈。访谈话题包括OAT自我检测经历、医疗支持、培训和决策。对访谈结果进行结构性分析。结果患者一般在OAT自我检测初期出现一些问题,但是之后大多为良好经历。与接受医疗专业人员进行的检测相比,受访患者进行了更多的自我检测,其对检测结果加以分析,并针对分析结果采取措施。OAT自我检测的动机是多样的,尤其是在药品剂量建议系统高效且可靠的情况下。受访患者通过自我教育,克服了片段化的健康系统知识和零散的自我检测支持。受访患者的家人和朋友通过学习使用检测仪和OAT剂量调整方法对患者提供帮助。结论更优质、连续性更高的培训和健康服务支持可以帮助OAT自我检测患者克服遇到的一些问题。随着越来越多的患者进行OAT自我检测,此类培训和支持也会越来越重要。
Background Clinical trials have shown that oral anticoagulation (OAT) self-testing is safe and effective, but few studies have been conducted on patients undergoing OAT self-testing. Further research is needed on how to provide the highest quality training and assistance for patient OAT self-testing. Objectives To acquire in-depth information on the patient’s OAT self-test experience outside of clinical trial conditions and to explore ways to provide the best possible help to such patients. Design and site selection of patients in England for semi-structured qualitative interview with OAT self-test. Methods Totally 267 patients were selected from 267 patients who participated in OAT self-test cohort (CASM) and who insisted on OAT self-test after 12 months of follow-up. Interviews included OAT self-testing experiences, medical support, training and decision making. Structural analysis of interview results. Results Patients generally had some problems early in OAT self-examination, but mostly afterwards had good experiences. Patients interviewed conducted more self-tests than did those receiving medical professionals, analyzed the test results and took measures to analyze the results. There are many motivations for OAT self-testing, especially when drug dosage recommendations are efficient and reliable. Interviewed patients overcame fragmented health system knowledge and fragmented self-testing support through self-education. The families and friends of the patients interviewed helped to learn about the use of detector and OAT dose adjustment methods. Conclusion Higher quality, more continuous training and health service support can help OAT self-test patients to overcome some of the problems they encounter. As more and more patients conduct OAT self-tests, such training and support will become increasingly important.