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[严重精神障碍中的家庭依从性]

[Family adherence in serious mental disorder].

作者信息

Martín Padilla Ernesto, Obando Posada Diana, Sarmiento Medina Pedro

机构信息

Facultad de Psicología, Universidad de La Sabana, Chía, Colombia.

Facultad de Psicología, Universidad de La Sabana, Chía, Colombia.

出版信息

Aten Primaria. 2018 Nov;50(9):519-526. doi: 10.1016/j.aprim.2017.06.010. Epub 2017 Oct 9.

Abstract

OBJECTIVE

Identify attitudes and behaviors that evidence and characterize family adherence to treatment in patients with severe mental disorder.

DESIGN

Qualitative descriptive, from an interpretative social approach.

LOCATION

Chia, Colombia, with professionals in the psychiatric and geriatric settings.

PARTICIPANTS

Twelve professionals in psychiatry, nursing and psychology, with experience in care of patients with serious mental disorder and their families.

METHOD

Intentional sampling. Twelve semi-structured interviews were carried out. The analysis strategy was made from the procedures of constant comparison and open coding of the grounded theory. As validation strategies, triangulation was done between researchers and methods, as interviews and results survey.

RESULTS

Two categories of family adherence were defined: family and treatment (treatment cooperation, knowledge about the disease and attention to the disease evolution), and family attitudes towards the patient (patient's care, patient's promotion of autonomy, and affective attachment with the patient). A third category showed aspects that diminished family adherence, such as lack or distortion of information regarding mental disorder, or family and patient endurance attitudes.

CONCLUSIONS

Participants agree about the relevance of the construct named «family adherence», which describes the behaviors and attitudes of the family regarding the treatment of patients with severe mental disorder. Family adherence can be seen as active participation behavior, but also as a process of strengthening relationships, which can reduce the burden and suffering on family members, caregivers and patients.

摘要

目的

识别重度精神障碍患者家庭坚持治疗的证据及特征的态度和行为。

设计

基于解释性社会方法的定性描述。

地点

哥伦比亚基亚,涉及精神病学和老年病学领域的专业人员。

参与者

12名精神病学、护理学和心理学专业人员,具有照顾重度精神障碍患者及其家庭的经验。

方法

立意抽样。进行了12次半结构化访谈。分析策略基于扎根理论的持续比较和开放编码程序。作为验证策略,在研究人员和方法之间进行三角验证,如访谈和结果调查。

结果

定义了两类家庭坚持治疗的情况:家庭与治疗(治疗合作、对疾病的了解以及对疾病进展的关注),以及家庭对患者的态度(对患者的照顾、促进患者自主性以及与患者的情感依恋)。第三类展示了降低家庭坚持治疗的方面,如关于精神障碍的信息缺乏或歪曲,或家庭和患者的忍耐态度。

结论

参与者认同名为“家庭坚持治疗”这一概念的相关性,该概念描述了家庭在重度精神障碍患者治疗方面的行为和态度。家庭坚持治疗可被视为积极参与行为,也可视为加强关系的过程,这可以减轻家庭成员、护理人员和患者的负担与痛苦。

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