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“看,我很健康,我心态积极,我会没事的,非常感谢”:应对丙型肝炎治疗与不切实际的乐观态度

"Look, I'm fit, I'm positive and I'll be all right, thank you very much": coping with hepatitis C treatment and unrealistic optimism.

作者信息

Treloar Carla, Hopwood Max

机构信息

National Centre in HIV Social Research, University of New South Wales, Australia.

出版信息

Psychol Health Med. 2008 May;13(3):360-6. doi: 10.1080/13548500701477532.

Abstract

Hepatitis C treatment is known to produce significant physical and psychiatric side-effects. Healthcare workers in hepatitis C treatment clinics focus on preparing people to cope with these side-effects. Unrealistic optimism, or judging oneself to be at low risk of negative events, has been implicated in contributing to practices that place health at risk and to delays in seeking help or facilitating coping with negative events. In the context of hepatitis C treatment, patients with overly optimistic expectations of their ability to cope with treatment-related side-effects are less prepared for their impact and therefore may be more likely to discontinue treatment. In this exploratory qualitative study, data from semi-structured interviews with 20 people undergoing hepatitis C treatment and six healthcare workers at three hepatitis C treatment clinics in Sydney, Australia were explored for the presence of unrealistic optimism and also the impact that this had on patients' processing of information pre-treatment and management of side-effects during treatment. The concept of unrealistic optimism was evident in both patients' and healthcare workers' interview transcripts. Patients' descriptions of their preparation for hepatitis C treatment included references to delays in seeking help for depressive symptoms attributable to unrealistic optimism. Healthcare workers also discussed their observations of the effects of unrealistic optimism on patients' coping strategies. Data from this study contribute to an understanding of unrealistic optimism and its impact on the experience of hepatitis C treatment side-effects, patients' coping styles and potential for delays in seeking help. Unrealistic optimism should be explored as part of pre-treatment assessments for hepatitis C treatment and considered throughout treatment to avoid delays in help seeking.

摘要

已知丙型肝炎治疗会产生显著的身体和精神副作用。丙型肝炎治疗诊所的医护人员专注于帮助人们做好应对这些副作用的准备。不切实际的乐观态度,即认为自己遭遇负面事件的风险较低,已被认为会导致将健康置于危险境地的行为,以及寻求帮助或应对负面事件时的延迟。在丙型肝炎治疗的背景下,对自身应对与治疗相关副作用能力抱有过度乐观期望的患者,对这些副作用的影响准备不足,因此可能更有可能中断治疗。在这项探索性定性研究中,对澳大利亚悉尼三家丙型肝炎治疗诊所的20名接受丙型肝炎治疗的患者和6名医护人员进行了半结构化访谈,探讨了不切实际的乐观态度的存在情况,以及这对患者治疗前信息处理和治疗期间副作用管理的影响。不切实际的乐观概念在患者和医护人员的访谈记录中都很明显。患者对丙型肝炎治疗准备情况的描述包括提到由于不切实际的乐观态度而延迟寻求对抑郁症状的帮助。医护人员也讨论了他们观察到的不切实际的乐观态度对患者应对策略的影响。这项研究的数据有助于理解不切实际的乐观态度及其对丙型肝炎治疗副作用体验、患者应对方式和寻求帮助延迟可能性的影响。在丙型肝炎治疗的治疗前评估中应探索不切实际的乐观态度,并在整个治疗过程中加以考虑,以避免寻求帮助的延迟。

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