Understanding the Perspectives and Experiences of Patients with Acute Severe Ulcerative Colitis in the Hospital: A Qualitative Analysis.

Autor: Romain D; Department of Internal Medicine, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA., Larson C; Department of Internal Medicine, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA., Kathuria P; Department of Internal Medicine, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA., Aintabi D; Department of Medicine, Trinity Health, Ann Arbor, Ypsilanti, MI, USA., Tedesco N; Department of Internal Medicine, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.; Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, MI, USA., Saunyama Q; Department of Internal Medicine, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.; Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, MI, USA., DeJonckheere M; Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA.; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA., Bishu S; Department of Internal Medicine, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.; Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, MI, USA., Cohen-Mekelburg S; Department of Internal Medicine, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.; Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, MI, USA.; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.; VA Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, MI, USA., Higgins PDR; Department of Internal Medicine, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.; Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, MI, USA., Berinstein JA; Department of Internal Medicine, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA. jberinst@med.umich.edu.; Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, MI, USA. jberinst@med.umich.edu.; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA. jberinst@med.umich.edu.
Jazyk: angličtina
Zdroj: Digestive diseases and sciences [Dig Dis Sci] 2024 Sep 18. Date of Electronic Publication: 2024 Sep 18.
DOI: 10.1007/s10620-024-08633-0
Abstrakt: Introduction: Acute severe ulcerative colitis (ASUC) is a life-treating presentation of ulcerative colitis (UC) that requires prompt initiation of treatment to avoid complication. Unfortunately, outcomes for ASUC are suboptimal, with as many as 20-30% of patients requiring colectomy. This can be challenging for patients and highlights the need to understand patient experiences and perspectives navigating ASUC.
Methods: A qualitative descriptive study utilizing semi-structured interviews was conducted to understand perspectives and experiences of patients navigating ASUC. Adult patients hospitalized for ASUC between January 2017 and March 2024 were eligible. Interviews were conducted both retrospectively among patients with a recent hospitalization and prospectively among patients within 24 h of hospitalization for ASUC. Interviews were analyzed using a well-established hybrid inductive-deductive approach.
Results: Thirty-four patients (44.2% response rate) hospitalized for ASUC were interviewed. Hybrid thematic analysis uncovered five major themes: (1) the pervasive impact of UC on QoL and mental health, (2) challenges associated with navigating uncertainty, (3) prioritizing colon preservation, (4) bridging the divide between outpatient expectations and inpatient realities, and (5) balancing rapid symptom improvement with steroid safety. Our findings advocate for transparent approach to care, emphasizing the need for effective communication, education, and better alignment with patient values and expectations.
Conclusion: Five key themes were identified, each with significant implications for developing a more patient-centered approach to ASUC care. These themes captured meaningful insight into patient perceptions and experiences, identifying multiple areas for actionable interventions to improve care.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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