Badger Frances, Nolan Peter
School of Health Sciences, University of Birmingham, Birmingham, UK.
J Clin Nurs. 2007 Mar;16(3A):25-34. doi: 10.1111/j.1365-2702.2006.01581.x.
The aim of the study was to understand how people treated for depression in primary care perceived the care they received. The focus was specifically on ascertaining their perceptions of what had helped during their treatment, their understanding of the factors to which they attributed their recovery, and their reflections on their experience of depression.
Although knowledge of the factors that promote recovery from depression is growing, personal accounts of attributions of recovery are largely absent from the literature. Identifying and understanding people's accounts of their recovery is particularly important for practitioners involved in medication management and prescribing.
A purposeful sample of 60 people who had accessed primary care and been prescribed medication because of depressive symptoms was interviewed using a semistructured approach. Interviews explored people's experiences of accessing and using primary care, their assessments of care offered, experiences of medication management and their attributions of recovery.
Recovery from depression was characterized by its multifactorial nature, and two-thirds of the participants felt that medication had contributed to their recovery. Factors in recovery changed with the passage of time and many perceived personal strengths as important to recovery. Practitioners who acknowledged and encouraged people's roles in recovery and supported multifaceted care were perceived by users as caring and offering holistic, individualized care.
People with depression are keen to regard their recovery as multifactorial and to have their own roles in recovery acknowledged. Preferences for a 'portfolio' of care, the components of which change as recovery progresses, were evident.
Practitioners involved in prescribing and medication management for depression must aim to explore patients' beliefs about appropriate treatments and recovery. Addressing these can potentially promote treatment concordance and enhance recovery from depression by establishing and sustaining therapeutic relationships.
本研究旨在了解在初级保健机构接受抑郁症治疗的患者如何看待他们所接受的护理。具体重点在于确定他们对治疗过程中有所帮助的因素的看法、对康复归因因素的理解以及对抑郁症经历的反思。
尽管促进抑郁症康复的因素的相关知识不断增加，但文献中基本没有关于康复归因的个人叙述。对于参与药物管理和处方开具的从业者来说，识别和理解人们对康复的叙述尤为重要。
采用半结构化方法，对60名因抑郁症状就诊于初级保健机构并已开具药物处方的患者进行了有目的抽样访谈。访谈探讨了人们获得和使用初级保健的经历、对所提供护理的评估、药物管理经历以及康复归因。
抑郁症康复具有多因素性质，三分之二的参与者认为药物对他们的康复有帮助。康复因素随时间而变化，许多人认为个人优势对康复很重要。那些认可并鼓励人们在康复中发挥作用且支持多方面护理的从业者，被患者视为关心患者并提供全面、个性化护理的人。
抑郁症患者渴望将他们的康复视为多因素的，并希望自己在康复中的作用得到认可。明显存在对“护理组合”的偏好，其组成部分会随着康复进程而变化。
参与抑郁症处方开具和药物管理的从业者必须致力于探索患者对适当治疗和康复的信念。解决这些问题可能会通过建立和维持治疗关系来促进治疗依从性并增强抑郁症的康复。
