Carrick Rachael, Mitchell Annie, Powell Richard A, Lloyd Keith
School of Psychology, University of Exeter, Exeter, UK.
Psychol Psychother. 2004 Mar;77(Pt 1):19-33. doi: 10.1348/147608304322874236.
Antipsychotic medication is integral to the treatment of severe and enduring mental health problems (e.g. schizophrenia). Such medication is associated with significant adverse side effects that can affect treatment adherence. To date there have been few attempts to analyse qualitatively service users' experience of taking antipsychotic medication. This study, conducted in Exeter, South West England, investigates the subjective experience of side effects of antipsychotic medication to gain a greater understanding of service users' experiences and to gain insights into adherence issues. Data were analysed using a variant of grounded theory (Glaser and Strauss, 1967) and a model of the experience of taking antipsychotic medication was constructed. The interview schedule was then refined and further interviews (including a focus group) were conducted among a diverse sample recruited from local day centres. Results indicated that people taking antipsychotic medication do not see side effects and symptoms as separate issues. Instead, they describe drugs as 'good' or 'terrible'-an indication of the total impact of their treatment. The model constructed reflects this, having the core concept of Well-being: that is, normality of function, feeling and appearance to the outside world. Major themes relating to this core category were managing treatment, evaluating treatment and understanding of the situation. Implications for medication adherence and clinical practice, including drug choice, are discussed, and the doctor-patient relationship is also considered.
抗精神病药物是治疗严重且持久的心理健康问题(如精神分裂症)不可或缺的一部分。这类药物会产生显著的不良副作用,可能影响治疗依从性。迄今为止,很少有人尝试对服务使用者服用抗精神病药物的体验进行定性分析。这项在英格兰西南部埃克塞特进行的研究,调查了抗精神病药物副作用的主观体验,以更深入地了解服务使用者的经历,并洞察依从性问题。数据采用扎根理论的一种变体(格拉泽和施特劳斯,1967年)进行分析,并构建了服用抗精神病药物体验的模型。然后对访谈提纲进行了完善,并在从当地日间护理中心招募的多样化样本中进行了进一步访谈(包括焦点小组访谈)。结果表明,服用抗精神病药物的人并不将副作用和症状视为 separate issues。相反,他们将药物描述为“好”或“糟糕”——这表明了治疗的总体影响。构建的模型反映了这一点,其核心概念是幸福感:即功能、感觉和对外界外观的正常状态。与这一核心类别相关的主要主题是管理治疗、评估治疗和对情况的理解。讨论了对药物依从性和临床实践(包括药物选择)的影响,同时也考虑了医患关系。