Patel M X, DE Zoysa N, Baker D, David A S
Division of Psychological Medicine, Institute of Psychiatry and GKT School of Medicine, De Crespigny Park, London, UK.
J Psychiatr Ment Health Nurs. 2005 Apr;12(2):237-44. doi: 10.1111/j.1365-2850.2004.00826.x.
Utilization of long-acting antipsychotic injections (depots) shows wide regional variation. In many countries, community psychiatric nurses (CPNs) administer depots but their concerns and attitudes regarding these drugs are seldom considered. We aimed to investigate attitudes and knowledge towards depots in a cross-sectional survey of CPNs in London, and compare them with those of psychiatrists obtained in a previous study. Three subscales of a depot attitude/knowledge questionnaire were used with additional items which referred to aspects of the CPN role. Participants were 70 CPNs who attended an academic meeting. Most CPNs reported that they were involved in treatment decisions (78%) although some CPNs seldom asked their patients about side effects (19%) and felt that they did not have sufficient time for consultations (23%) or training (23%). Several CPNs believed that depots are old fashioned (34%) and stigmatizing (44%). Compared to psychiatrists, CPNs believed more that depots compromised patient autonomy (28%, P = 0.003) and were coercive (42%, P < 0.001). Familiarity with depots and their knowledge of side effects were positively associated with favourable attitudes. CPNs have several strongly endorsed attitudes towards depot medication. Interprofessional group differences also exist which may undermine the treatment process. Training/refresher courses about depots should highlight systematic treatment decision-making and side effect monitoring which, in turn, may improve professionals' attitudes, knowledge and clinical monitoring of depots.
长效抗精神病药物注射剂（长效针剂）的使用存在广泛的地区差异。在许多国家，社区精神科护士负责管理长效针剂，但他们对这些药物的担忧和态度很少被考虑。我们旨在通过对伦敦社区精神科护士的横断面调查，研究他们对长效针剂的态度和知识，并将其与之前一项研究中精神科医生的态度和知识进行比较。使用了长效针剂态度/知识问卷的三个子量表，并增加了与社区精神科护士角色相关的项目。参与者是70名参加学术会议的社区精神科护士。大多数社区精神科护士报告说他们参与治疗决策（78%），尽管一些社区精神科护士很少询问患者副作用情况（19%），并且觉得他们没有足够时间进行咨询（23%）或接受培训（23%）。一些社区精神科护士认为长效针剂过时（34%）且有污名化作用（44%）。与精神科医生相比，社区精神科护士更认为长效针剂损害了患者自主权（28%，P = 0.003）且具有强制性（42%，P < 0.001）。对长效针剂的熟悉程度及其副作用知识与积极态度呈正相关。社区精神科护士对长效针剂治疗有几种强烈认可的态度。不同专业群体之间也存在差异，这可能会破坏治疗过程。关于长效针剂的培训/进修课程应强调系统的治疗决策和副作用监测，这反过来可能会改善专业人员对长效针剂的态度、知识和临床监测。
