School of Health, University of East Anglia, Norwich, UK.
Int J Ment Health Nurs. 2010 Feb;19(1):36-44. doi: 10.1111/j.1447-0349.2009.00649.x.
This paper describes the development of an adherence therapy intervention in schizophrenia and synthesizes the results to date of a collaborative international programme of research. Sticking to treatment is essential to control symptoms and prevent relapse, but as with other long-term conditions, medication adherence is poor. Adherence therapy seeks to facilitate a process of shared decision making, where both parties work towards agreed goals. Central is the theory that when patients make shared choices with a professional they are more likely to stick with them because they are personally owned and meaningful. The results of adherence therapy trials that seek to test this theory are mixed. Outcomes of trials might have been be affected by the point in the patient's illness cycle when therapy was delivered and by sampling bias. Authors of trials of medication management and alliance training packages that aim to equip mental health workers with adherence therapy competencies show considerable promise in improving clinical outcomes. Helping patients manage their medication is central to the work of mental health nurses. We argue that the potential benefits to patients are such that there is sufficient evidence to recommend that all mental health nurses receive medication management training.
本文描述了一种针对精神分裂症的依从性治疗干预措施的发展，并综合了目前一项国际合作研究计划的研究结果。坚持治疗对于控制症状和预防复发至关重要，但与其他长期疾病一样，药物依从性很差。依从性治疗旨在促进共同决策的过程，使双方共同努力实现既定目标。其核心理论是，当患者与专业人员共同做出选择时，他们更有可能坚持这些选择，因为这些选择是他们自己的，并且具有意义。试图检验这一理论的依从性治疗试验的结果喜忧参半。试验结果可能受到治疗开始时患者疾病周期的阶段以及抽样偏差的影响。旨在使精神卫生工作者具备依从性治疗能力的药物管理和联盟培训包的试验的作者，在改善临床结果方面显示出了很大的希望。帮助患者管理他们的药物是精神科护士工作的核心。我们认为，对患者的潜在好处是如此之大，以至于有足够的证据建议所有精神科护士都接受药物管理培训。
