Deegan Patricia E, Carpenter-Song Elizabeth, Drake Robert E, Naslund John A, Luciano Alison, Hutchison Shari L
Dr. Deegan is with Pat Deegan Ph.D. & Associates, L.L.C., Byfield, Massachusetts (e-mail:
Psychiatr Serv. 2017 Aug 1;68(8):771-775. doi: 10.1176/appi.ps.201600418. Epub 2017 Apr 3.
Discordance between psychiatric care providers' and clients' goals for medication treatment is prevalent and is a barrier to person-centered care. Power statements-short self-advocacy statements prepared by clients in response to a two-part template-offer a novel approach to help clients clarify and communicate their personal goals for using psychiatric medications. This study described the power statement method and examined a sample of power statements to understand clients' goals for medication treatment.
More than 17,000 adults with serious mental illness at 69 public mental health clinics had the option to develop power statements by using a Web application located in the clinic waiting areas. A database query determined the percentage of clients who entered power statements into the Web application. The authors examined textual data from a random sample of 300 power statements by using content analysis.
Nearly 14,000 (79%) clients developed power statements. Of the 277 statements in the sample deemed appropriate for content analysis, 272 statements had responses to the first part of the template and 230 had responses to the second part. Clients wanted psychiatric medications to help control symptoms in the service of improving functioning. Common goals for taking psychiatric medications (N=230 statements) were to enhance relationships (51%), well-being (32%), self-sufficiency (23%), employment (19%), hobbies (15%), and self-improvement (10%).
People with serious mental illness typically viewed medications as a means to pursue meaningful life goals. Power statements appear to be a simple and scalable technique to enhance clients' communication of their goals for psychiatric medication treatment.
精神科护理提供者与患者在药物治疗目标上的不一致很普遍，这是以人为本护理的障碍。权力陈述——患者根据两部分模板编写的简短自我倡导陈述——提供了一种新颖的方法，以帮助患者阐明并传达他们使用精神科药物的个人目标。本研究描述了权力陈述方法，并检查了一组权力陈述样本，以了解患者的药物治疗目标。
69家公共精神卫生诊所的17000多名患有严重精神疾病的成年人可以选择通过使用位于诊所候诊区的网络应用程序来制定权力陈述。数据库查询确定了在网络应用程序中输入权力陈述的患者百分比。作者通过内容分析检查了从300份权力陈述的随机样本中获取的文本数据。
近14000名（79%）患者制定了权力陈述。在样本中被认为适合进行内容分析的277份陈述中，272份陈述对模板的第一部分做出了回应，230份陈述对第二部分做出了回应。患者希望精神科药物有助于控制症状，以改善功能。服用精神科药物的常见目标（N = 230份陈述）是改善人际关系（51%）、幸福感（32%）、自给自足（23%）、就业（19%）、爱好（15%）和自我提升（10%）。
患有严重精神疾病的人通常将药物视为追求有意义生活目标的手段。权力陈述似乎是一种简单且可扩展的技术，可增强患者对其精神科药物治疗目标的沟通。
