Kauppi Kaisa, Hätönen Heli, Adams Clive E, Välimäki Maritta
Department of Nursing Science, University of Turku, Finland.
J Adv Nurs. 2015 Apr;71(4):777-88. doi: 10.1111/jan.12567. Epub 2014 Nov 14.
To explore patients' and mental healthcare professionals' perceptions of supportive and restrictive indicators of adherence to treatment in patients with mental health problems.
People with mental health problems may have difficulties adhering to their treatment, causing relapses and hospitalizations. It is, therefore, important to learn more about how patients' treatment adherence can be supported and what jeopardizes adherence.
A descriptive qualitative study.
Nine focus groups and semi-structured interviews were conducted in Finland during 2010-2011. The patients (n = 19) were recruited from patient associations and the healthcare professionals (n = 42) from healthcare organizations. The data were analysed using inductive content analysis.
Participants agreed that treatment adherence can be supported. Suggestions focused on treatment planning mindful of both patient involvement and needs. A structured daily routine helps patients manage their everyday issues and further facilitates adherence. On the other hand, patients found that their adherence was affected by factors related to the mental health system, including arrangements for follow-up care, access to services, the receptiveness of providers to meet patient needs and a disconnect time between hospital and community life.
Patient adherence should already be taken into account when treatment is planned. The content of treatment should be individually designed according to the patient's activities of daily life. In addition, stressing the importance of medication and listening to the patient's opinions and experiences of taking medication may improve the patient's willingness to adhere.
探讨患者及精神卫生保健专业人员对精神健康问题患者坚持治疗的支持性和限制性指标的看法。
精神健康问题患者在坚持治疗方面可能存在困难,导致病情复发和住院。因此,进一步了解如何支持患者坚持治疗以及哪些因素会危及治疗依从性非常重要。
一项描述性定性研究。
2010 - 2011年期间在芬兰进行了9个焦点小组和半结构化访谈。患者(n = 19)从患者协会招募,医疗保健专业人员(n = 42)从医疗保健机构招募。采用归纳性内容分析法对数据进行分析。
参与者一致认为治疗依从性可以得到支持。建议集中在治疗规划上,要兼顾患者的参与度和需求。结构化的日常生活有助于患者处理日常事务,进而促进治疗依从性。另一方面,患者发现他们的依从性受到与精神卫生系统相关因素的影响,包括后续护理安排、服务获取、提供者满足患者需求的接受程度以及医院与社区生活之间的脱节时间。
在制定治疗计划时就应考虑患者的依从性。治疗内容应根据患者的日常生活活动进行个性化设计。此外,强调药物治疗的重要性并倾听患者对服药的意见和体验可能会提高患者坚持治疗的意愿。