van Grieken Roos A, Kirkenier Anneloes C E, Koeter Maarten W J, Nabitz Udo W, Schene Aart H
Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Department of Research, Arkin, Amsterdam, The Netherlands.
Health Expect. 2015 Oct;18(5):1339-48. doi: 10.1111/hex.12112. Epub 2013 Aug 2.
Self-management appears to be a promising approach in the case of depression, which helps to stimulate patients' autonomy. However, a good and systematic description of the concept self-management from the patients' perspective, to our knowledge, has not yet been performed.
To determine: (i) what strategies patients think they can use themselves to recover from depression, (ii) which main themes of self-management strategies can be detected, and (iii) which of these strategies patients perceive as being most helpful.
We used concept mapping to explore the experiences of patients who recently recovered from a depressive episode. Patients generated self-management strategies in focus group discussions. The strategies were clustered on a two-dimensional concept map by a hierarchical cluster analysis.
Patients generated 50 strategies that formed eight clusters: (i) proactive attitude towards depression and treatment, (ii) daily life strategies and rules, (iii) explanation of disease to others, (iv) remaining socially engaged, (v) engaging in activities, (vi) structured attention to oneself, (vii) contact with fellow sufferers, and (viii) other. Behavioural and cognitive strategies and a proactive attitude towards treatment were considered as the most helpful.
From the patients' perspective, there is a wide range of self-management strategies that they can use - and perceive as helpful- to contribute to their own recovery. Professionals could encourage patients to take an active role in achieving recovery. Further research could open new roads to improve patients' active contributions to current treatments for depression.
自我管理在抑郁症治疗中似乎是一种很有前景的方法，有助于激发患者的自主性。然而，据我们所知，尚未从患者角度对自我管理这一概念进行全面系统的描述。
确定：（i）患者认为自己可用来从抑郁症中康复的策略；（ii）可检测到的自我管理策略的主要主题；（iii）患者认为哪些策略最有帮助。
我们采用概念映射法来探究近期从抑郁发作中康复的患者的经历。患者在焦点小组讨论中提出自我管理策略。通过层次聚类分析将这些策略聚类到二维概念图上。
患者提出了50种策略，形成了八个类别：（i）对抑郁症和治疗持积极态度；（ii）日常生活策略和规则；（iii）向他人解释病情；（iv）保持社交参与；（v）参与活动；（vi）有组织地关注自己；（vii）与其他患者接触；（viii）其他。行为和认知策略以及对治疗的积极态度被认为是最有帮助的。
从患者角度来看，有多种自我管理策略可供他们使用，并且他们认为这些策略有助于自身康复。专业人员可鼓励患者在康复过程中发挥积极作用。进一步的研究可为改善患者对当前抑郁症治疗的积极贡献开辟新途径。
