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      Health Literacy Needs of Acute Pancreatitis Patients During the Diagnosis and Treatment Process Under the Lens of the Timing It Right Theory: A Qualitative Study

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          Abstract

          Background

          The incidence and recurrence rate of acute pancreatitis (AP) continues to increase worldwide. The risk of AP attack and recurrence is closely related to the patient’s health literacy. Previous studies have shown that AP patients had low levels of health literacy. Understanding patients’ experience in AP’s diagnosis and treatment process and their health literacy needs might significantly improve their health status.

          Objective

          This study aims to understand the experience of acute pancreatitis (AP) patients in the diagnostic and treatment process and explore their health literacy needs at various phases of this process.

          Methods

          This study utilized a qualitative approach based on Timing It Right theory. A purposive sampling strategy was employed to select 31 participants diagnosed with AP at various phases of the diagnosis and treatment process. These patients were selected from the Pancreatitis Treatment Centers of two tertiary hospitals in Eastern China. Subsequently, semi-structured in-depth interviews were conducted with the selected participants. The qualitative data was analyzed using the Colaizzi’s method.

          Results

          The themes of AP patients’ experiences and health literacy needs at various phases of the diagnosis and treatment process were presented as follows. 1. Diagnosis phase: inability to obtain disease information, psychological support seeking, and change unhealthy lifestyle; 2. Hospitalization phase: disease treatment information needs and medical professionals’ healthcare. 3. Discharge Preparation phase: fear of recurrence, individualized healthy lifestyle instruction. 4. Home Recovery phase: self-management, continuous healthcare needs, and family support.

          Conclusion

          AP patients’ HL needs and health-related problems vary during the diagnosis and treatment process. Medical professionals should comprehend AP patients’ changing needs and individual differences, provide continuous healthcare, and involve families in patient management. These factors support patients’ long-term self-management and preserve their overall health.

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          Most cited references33

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            Acute pancreatitis

            Acute pancreatitis is an unpredictable and potentially lethal disease. The prognosis mainly depends on the development of organ failure and secondary infection of pancreatic or peripancreatic necrosis. In the past 10 years, treatment of acute pancreatitis has moved towards a multidisciplinary, tailored, and minimally invasive approach. Despite improvements in treatment and critical care, severe acute pancreatitis is still associated with high mortality rates. In this Seminar, we outline the latest evidence on diagnostic and therapeutic strategies for acute pancreatitis.
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              New insights into acute pancreatitis

              The incidence of acute pancreatitis continues to increase worldwide, and it is one of the most common gastrointestinal causes for hospital admission in the USA. In the past decade, substantial advancements have been made in our understanding of the pathophysiological mechanisms of acute pancreatitis. Studies have elucidated mechanisms of calcium-mediated acinar cell injury and death and the importance of store-operated calcium entry channels and mitochondrial permeability transition pores. The cytoprotective role of the unfolded protein response and autophagy in preventing sustained endoplasmic reticulum stress, apoptosis and necrosis has also been characterized, as has the central role of unsaturated fatty acids in causing pancreatic organ failure. Characterization of these pathways has led to the identification of potential molecular targets for future therapeutic trials. At the patient level, two classification systems have been developed to classify the severity of acute pancreatitis into prognostically meaningful groups, and several landmark clinical trials have informed management strategies in areas of nutritional support and interventions for infected pancreatic necrosis that have resulted in important changes to acute pancreatitis management paradigms. In this Review, we provide a summary of recent advances in acute pancreatitis with a special emphasis on pathophysiological mechanisms and clinical management of the disorder.
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                Author and article information

                Journal
                Patient Prefer Adherence
                Patient Prefer Adherence
                ppa
                Patient preference and adherence
                Dove
                1177-889X
                26 February 2024
                2024
                : 18
                : 507-517
                Affiliations
                [1 ]Hepatobiliary and Pancreatic Center, Clinical Medical College, Yangzhou University , Yangzhou, Jiangsu, People’s Republic of China
                [2 ]School of Nursing & Public Health, Yangzhou University , Yangzhou, Jiangsu, People’s Republic of China
                [3 ]Department of Gastroenterology, Affiliated Hospital of Nantong University , Nantong, Jiangsu, People’s Republic of China
                [4 ]School of Health and Wellness, Panzhihua University , Panzhihua, Sichuan, People’s Republic of China
                [5 ]Medical College of Yangzhou University , Yangzhou, Jiangsu, People’s Republic of China
                Author notes
                Correspondence: Weiwei Chen, Tel +86 18051062900, Email cww1984@126.com
                Article
                444955
                10.2147/PPA.S444955
                10906671
                38433996
                5979216b-3de8-4c34-9603-38425883b815
                © 2024 Su et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 26 October 2023
                : 13 February 2024
                Page count
                Figures: 0, Tables: 3, References: 33, Pages: 11
                Funding
                Funded by: National Natural Science Foundation of China, open-funder-registry 10.13039/501100001809;
                Funded by: 333 High-level Talents Training Project of Jiangsu Province;
                Funded by: Foundation Project of Medicine College of Yangzhou University;
                The National Natural Science Foundation of China (Grant No. 82004291); The 333 High-level Talents Training Project of Jiangsu Province; The Foundation Project of Medicine College of Yangzhou University (Grant No. SBLC22005, SBHL22015).
                Categories
                Original Research

                Medicine
                acute pancreatitis,timing it right,health literacy need,qualitative study
                Medicine
                acute pancreatitis, timing it right, health literacy need, qualitative study

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