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首页> 外文期刊>BMC Family Practice >From good health to illness with post-infectious fatigue syndrome: a qualitative study of adults’ experiences of the illness trajectory
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From good health to illness with post-infectious fatigue syndrome: a qualitative study of adults’ experiences of the illness trajectory

机译：从身体健康到感染后疲劳综合症的疾病：对成年人疾病轨迹经验的定性研究

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Background Municipal drinking water contaminated with the parasite Giardia lamblia in Bergen, Norway, in 2004 caused an outbreak of gastrointestinal infection in 2500 people, according to the Norwegian Prescription Database. In the aftermath a minor group subsequently developed post-infectious fatigue syndrome (PIFS). Persons in this minor group had laboratory-confirmed parasites in their stool samples, and their enteritis had been cured by one or more courses of antibiotic treatment. The study’s purpose was to explore how the affected persons experienced the illness trajectory and various PIFS disabilities. Methods A qualitative design with in-depth interviews was used to obtain first-hand experiences of PIFS. To get an overall understanding of their perceived illness trajectory, the participants were asked to retrospectively rate their functional level at different points in time. A maximum variation sample of adults diagnosed with PIFS according to the international 1994 criteria was recruited from a cohort of persons diagnosed with PIFS at a tertiary Neurology Outpatient Clinic in Western Norway. The sample comprised 19 women and seven men (mean age 41 years, range 26–59). The interviews were fully transcribed and subjected to a qualitative content analysis. Results All participants had been living healthy lives pre-illness. The time to develop PIFS varied. Multiple disabilities in the physical, cognitive, emotional, neurological, sleep and intolerance domains were described. Everyone more or less dropped out from studies or work, and few needed to be taken care of during the worst period. The severity of these disabilities varied among the participants and during the illness phases. Despite individual variations, an overall pattern of illness trajectory emerged. Five phases were identified: prodromal, downward, turning, upward and chronic phase. All reached a nadir followed by varying degrees of improvement in their functional ability. None regained pre-illness health or personal and professional abilities. Conclusions The needs of persons with this condition are not met. Early diagnosis and interdisciplinary rehabilitation could be beneficial in altering the downward trajectory at an earlier stage, avoiding the most severe disability and optimising improvement. Enhanced knowledge among health professionals, tailored treatment, rest as needed, financial support and practical help would likely improve prognosis.
机译：背景技术根据挪威处方数据库，2004年在挪威卑尔根被寄生虫贾第鞭毛虫（Giardia lamblia）污染的市政饮用水导致2500人暴发了胃肠道感染。善后，一小部分人随后发展为感染后疲劳综合症（PIFS）。少数人群的粪便样本中有实验室确诊的寄生虫，肠炎已通过一或多个疗程的抗生素治疗而治愈。这项研究的目的是探讨受影响者如何经历疾病轨迹和各种PIFS残疾。方法采用定性设计和深入的访谈来获得PIFS的第一手经验。为了全面了解他们的疾病轨迹，要求参与者回顾他们在不同时间点的功能水平。从1994年国际标准诊断为PIFS的成年人的最大变异样本是从挪威西部三级神经病学门诊的一组PIFS诊断者中招募的。样本包括19名女性和7名男性（平均年龄41岁，范围26-59）。采访被完全转录并进行了定性内容分析。结果所有参与者在患病前都过着健康的生活。开发PIFS的时间各不相同。描述了身体，认知，情感，神经，睡眠和不耐受领域的多种残疾。每个人或多或少都退出了学习或工作，在最坏的时期很少有人需要照顾。这些残障的严重程度在参与者之间以及疾病阶段各不相同。尽管存在个体差异，但疾病轨迹的整体模式出现了。确定了五个阶段：前驱阶段，向下阶段，转向阶段，向上阶段和慢性阶段。所有人都达到了最低点，其功能能力得到了不同程度的改善。没有人恢复了病前的健康或个人和专业能力。结论没有满足这种情况的人的需求。早期诊断和跨学科康复可能有助于早期改变下行轨迹，避免最严重的残疾并优化改善。加强卫生专业人员的知识，量身定制的治疗，按需休息，财务支持和实际帮助可能会改善预后。

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