Gault Iris
Joint Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, London, UK.
Health Soc Care Community. 2009 Sep;17(5):504-13. doi: 10.1111/j.1365-2524.2009.00847.x. Epub 2009 Apr 27.
This paper reports on a qualitative study analyzing service-user (SU) and carer perspectives on medication compliance and their experience of compulsory treatment. Eleven SUs and eight carers were interviewed. The research is set against the background of changes to mental health legislation in England, in the form of Supervised Community Treatment. This signals a change in community mental health practice and urges a reconsideration of concepts such as compliance, concordance and coercion. These concepts are discussed in the context of legislative changes and in relation to the perspectives of service-SUs and carers. Five themes emerged from qualitative interview data, analysed using an adapted form of grounded theory: loss of credible identity, playing the game, medicalization, therapeutic competence and incompetence and increased control. The findings suggest that SUs are initially reluctant to comply with mental health treatment, but do eventually accept the need for treatment; they also stress the significance of respectful relationships with professionals and the importance of communicative competence.
本文报道了一项定性研究，该研究分析了服务使用者（SU）和护理人员对药物治疗依从性的看法以及他们接受强制治疗的经历。对11名服务使用者和8名护理人员进行了访谈。这项研究以英国心理健康立法的变化为背景，即社区治疗令。这标志着社区心理健康实践的转变，并促使人们重新审视诸如依从性、一致性和强制性等概念。这些概念将在立法变化的背景下，并结合服务使用者和护理人员的观点进行讨论。通过对定性访谈数据进行分析，采用一种改编形式的扎根理论，得出了五个主题：可信身份的丧失、敷衍了事、医学化、治疗能力与无能力以及控制的增加。研究结果表明，服务使用者最初不愿意接受心理健康治疗，但最终确实认识到治疗的必要性；他们还强调了与专业人员建立尊重关系的重要性以及沟通能力的重要性。
