Sripada Rebecca K, Bowersox Nicholas W, Ganoczy Dara, Valenstein Marcia, Pfeiffer Paul N
VA Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC), 2800 Plymouth Road Bldg 16, Ann Arbor, MI, 48109, USA.
VA Ann Arbor Health Care System, Ann Arbor, MI, USA.
Community Ment Health J. 2016 Aug;52(6):662-6. doi: 10.1007/s10597-015-9929-6. Epub 2015 Aug 29.
The objective of this study was to assess whether the constructs of self-determination theory-autonomy, competence, and relatedness-are associated with adherence to outpatient follow-up appointments after psychiatric hospitalization. 242 individuals discharged from inpatient psychiatric treatment within the Veterans Health Administration completed surveys assessing self-determination theory constructs as well as measures of depression and barriers to treatment. Medical records were used to count the number of mental health visits and no-shows in the 14 weeks following discharge. Logistic regression models assessed the association between survey items assessing theory constructs and attendance at mental healthcare visits. In multivariate models, none of the self-determination theory factors predicted outpatient follow-up attendance. The constructs of self-determination theory as measured by a single self-report survey may not reliably predict adherence to post-hospital care. Need factors such as depression may be more strongly predictive of treatment adherence.
本研究的目的是评估自我决定理论的构成要素——自主性、能力和关联性——是否与精神病住院后门诊随访预约的依从性相关。242名在退伍军人健康管理局接受住院精神治疗后出院的个体完成了调查，评估自我决定理论的构成要素以及抑郁和治疗障碍的测量指标。病历被用于统计出院后14周内心理健康就诊次数和未就诊次数。逻辑回归模型评估了评估理论构成要素的调查项目与精神保健就诊出勤率之间的关联。在多变量模型中，自我决定理论的因素均未预测门诊随访出勤率。通过单一自我报告调查测量的自我决定理论构成要素可能无法可靠地预测出院后护理的依从性。诸如抑郁等需求因素可能更能强烈预测治疗依从性。
