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治疗抵抗的概念化与测量:糖尿病患者治疗抵抗问卷

Conceptualization and measurement of resistance to treatment: the resistance to treatment questionnaire for people with diabetes.

作者信息

Mishali M, Vaknin Y S, Omer H, Heymann A D

机构信息

Department of Psychology, Tel Aviv University, Tel Aviv, Israel.

出版信息

Fam Pract. 2007 Dec;24(6):610-5. doi: 10.1093/fampra/cmm057. Epub 2007 Sep 28.

Abstract

OBJECTIVE

This research describes the process of building a tool which allows assessment of resistance to treatment and its intensity among patients with diabetes.

METHODS

This study was undertaken in Maccabi Health care Services a preferred provider health care organization. This is a multistage study using both qualitative and quantitative methods. A semi-structured interview using 14 key questions identified the reasons for resistance to treatment among 64 people with diabetes. A questionnaire was built based on these themes and then validated with a further 123 people with diabetes. A further validation was undertaken comparing our questionnaire with that of Kavookjian.

RESULTS

This resulted in a four theme, 40-item questionnaire which can be administered in about 10 minutes. Resistance patterns and their intensity were different in each patient. This resistance questionnaire identifies the core reasons for non-compliance: lack of faith or dissatisfaction with the treatment or with the medical team, emotional reasons, specific problems or constraints and factors connected to despair and failure.

CONCLUSIONS

We present a tool 'The Resistance to Treatment Questionnaire' which may be used by medical personnel to identify the barriers to treatment for each individual and in turn improve patient compliance to treatment.

摘要

目的

本研究描述了构建一种工具的过程,该工具可用于评估糖尿病患者的治疗抵抗情况及其强度。

方法

本研究在麦卡比医疗保健服务机构(一家首选的医疗保健服务组织)开展。这是一项采用定性和定量方法的多阶段研究。通过使用14个关键问题进行的半结构化访谈,确定了64名糖尿病患者治疗抵抗的原因。基于这些主题编制了一份问卷,随后又对另外123名糖尿病患者进行了验证。还将我们的问卷与卡武基安的问卷进行了进一步验证。

结果

由此产生了一份包含四个主题、40个条目的问卷,大约10分钟即可完成作答。每位患者的抵抗模式及其强度各不相同。这份抵抗问卷确定了不遵医嘱的核心原因:对治疗或医疗团队缺乏信心或不满、情绪原因、特定问题或限制以及与绝望和失败相关的因素。

结论

我们提出了一种工具——“治疗抵抗问卷”,医务人员可使用该工具识别每位患者的治疗障碍,进而提高患者的治疗依从性。

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