Badger Frances, Nolan Peter
University of Birmingham.
Nurs Stand. 2006;20(52):35-40. doi: 10.7748/ns2006.09.20.52.35.c4492.
To identify how depression is managed in primary care settings and examine patients' perspectives on their care and the impact medication had on their recovery. This article specifically addresses patients' accounts of the influences on medication concordance.
A total of 60 patients from four primary care centres who had a recent episode of depression were interviewed using a semi-structured questionnaire and a framework analysis to identify recurring themes. Participants had largely recovered from their illness.
Many factors influenced patients' decisions to take and continue prescribed antidepressants and four broad themes were identified. These were: the role and relationship with health practitioners; factors related to the illness; beliefs about and experiences of medication for depression; and the wider context of depression.
Concordance with antidepressants is multifactorial and may change over time in the same patient. Influences on concordance may be positive or negative and the combined effects are highly individual and dependent on circumstances. Nurses involved in medication management should encourage discussion of the likely impact of, and patients' attitudes toward, medication.
确定在初级保健机构中抑郁症是如何得到治疗的，并考察患者对其治疗的看法以及药物对其康复的影响。本文特别探讨患者关于影响药物依从性的描述。
使用半结构化问卷对来自四个初级保健中心的60名近期患有抑郁症的患者进行访谈，并采用框架分析法来确定反复出现的主题。参与者在很大程度上已从疾病中康复。
许多因素影响患者决定服用并持续服用处方抗抑郁药，共确定了四大主题。这些主题分别是：与医疗从业者的角色及关系；与疾病相关的因素；对抑郁症药物的看法及用药经历；以及抑郁症的更广泛背景。
抗抑郁药的依从性受多因素影响，且在同一患者身上可能随时间变化。对依从性的影响可能是积极的或消极的，其综合效应高度因人而异且取决于具体情况。参与药物管理的护士应鼓励讨论药物可能产生的影响以及患者对药物的态度。
