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双相情感障碍 II 型患者和家属在治疗决策方面的观点和体验的定性探索。

A qualitative exploration of patient and family views and experiences of treatment decision-making in bipolar II disorder.

机构信息

a School of Psychology.

b Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), University of Sydney , New South Wales , Australia.

出版信息

J Ment Health. 2018 Feb;27(1):66-79. doi: 10.1080/09638237.2016.1276533. Epub 2017 Jan 13.

DOI:10.1080/09638237.2016.1276533
PMID:28084845
Abstract

BACKGROUND

Treatment decision-making in bipolar II disorder (BPII) is challenging, yet the decision support needs of patients and family remain unknown.

AIM

To explore patient and family perspectives of treatment decision-making in BPII.

METHOD

Semistructured, qualitative interviews were conducted with 28 patients with BPII-diagnosis and 13 family members with experience in treatment decision-making in the outpatient setting. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Participant demographics, clinical characteristics and preferences for patient decision-making involvement were assessed.

RESULTS

Four inter-related themes emerged: (1) Attitudes and response to diagnosis and treatment; (2) Influences on decision-making; (3) The nature and flow of decision-making; (4) Decision support and challenges. Views differed according to patient involvement preferences, time since diagnosis and patients' current mood symptoms.

CONCLUSIONS

This is the first known study to provide in-depth patient and family insights into the key factors influencing BPII treatment decision-making, and potential improvements and challenges to this process. Findings will inform the development of BPII treatment decision-making resources that better meet the informational and decision-support priorities of end users.

DECLARATION OF INTEREST

This research was partly funded by a Postgraduate Research Grant awarded to the first author by the University of Sydney. No conflicts of interest declared.

摘要

背景

双相情感障碍 II 型(BPII)的治疗决策具有挑战性,但患者和家属的决策支持需求仍不清楚。

目的

探讨 BPII 患者和家属的治疗决策观点。

方法

采用半结构式定性访谈方法,对 28 名 BPII 门诊患者和 13 名有治疗决策经验的家属进行访谈。访谈进行录音,逐字转录,并使用框架方法进行主题分析。评估了参与者的人口统计学、临床特征和对患者参与决策的偏好。

结果

出现了四个相互关联的主题:(1)对诊断和治疗的态度和反应;(2)对决策的影响;(3)决策的性质和流程;(4)决策支持和挑战。根据患者参与偏好、诊断后时间和患者当前情绪症状的不同,观点也有所不同。

结论

这是首次深入了解影响 BPII 治疗决策的关键因素的患者和家属研究,以及对这一过程的潜在改进和挑战。研究结果将为 BPII 治疗决策资源的开发提供信息,这些资源能更好地满足最终用户的信息和决策支持需求。

利益声明

这项研究部分由悉尼大学授予第一作者的研究生研究基金资助。无利益冲突声明。

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