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精神分裂症患者使用抗精神病药物时经历的促进因素和障碍的叙事性元综合分析:对医疗保健专业人员的启示。

A narrative meta-synthesis of how people with schizophrenia experience facilitators and barriers in using antipsychotic medication: Implications for healthcare professionals.

机构信息

University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, SE-801 76 Gävle, Sweden.

Northern Stockholm Psychiatry, Section for Affective Disorders, Ward 53, Inpatient care unit for patients with bipolar disorder, SE-112 81 Stockholm, Sweden.

出版信息

Int J Nurs Stud. 2018 Sep;85:7-18. doi: 10.1016/j.ijnurstu.2018.05.003. Epub 2018 May 24.

Abstract

BACKGROUND

It is recognized that people who are diagnosed with schizophrenia often do not fully adhere with their antipsychotic prescription. The vast majority of previous research on the topic of medical adherence is limited to quantitative research methods, and in particular, to determining correlations.

OBJECTIVES

The present review was designed to describe how people who are diagnosed with schizophrenia experience and narrate pharmacological treatment with antipsychotic medication.

DESIGN

A narrative meta-synthesis.

DATA SOURCES/REVIEW METHOD: A search was conducted in three databases, PubMed, CINAHL and PsycINFO, to identify qualitative original research. Nine articles met the criteria for inclusion and were subjected to a qualitative interpretive meta-synthesis.

RESULTS

The findings showed that patients were uninformed about medication but valued talks about medication with professionals. The findings also demonstrated that patients are motivated to take medication in order to gain stability in their life and to be able to participate in life activities and in relationships. Good support, both from relatives and professionals, also motivates them to continue taking medication. The obstacles were side-effects, pressure and compulsion, and rigid organizations.

CONCLUSIONS

We advise professionals to adopt a person-centered approach to healthcare when encountering these patients and to transform the language used to describe patients from terms denoting compliance and adherence to terms denoting cooperation and alliance. Labeling patients as compliant or non-adherent may risk fortifying preconception of patients as static beings and obscure the patients' individual recovery process.

摘要

背景

人们认识到,被诊断为精神分裂症的患者通常无法完全遵守他们的抗精神病药物处方。以前绝大多数关于医学依从性的研究都局限于定量研究方法,特别是确定相关性。

目的

本综述旨在描述被诊断为精神分裂症的人如何体验和叙述他们使用抗精神病药物进行药物治疗的情况。

设计

叙事性元综合。

资料来源/综述方法:在三个数据库 PubMed、CINAHL 和 PsycINFO 中进行了检索,以确定定性的原始研究。有 9 篇文章符合纳入标准,并进行了定性解释性元综合。

结果

研究结果表明,患者对药物治疗缺乏了解,但重视与专业人员讨论药物治疗。研究结果还表明,患者有服药的动机,以获得生活的稳定,并能够参与生活活动和人际关系。良好的支持,来自亲属和专业人员的支持,也激励他们继续服药。障碍是副作用、压力和强迫以及僵化的组织。

结论

我们建议专业人员在遇到这些患者时采取以患者为中心的医疗保健方法,并将用于描述患者的语言从表示依从性和顺应性的术语转变为表示合作和联盟的术语。将患者贴上依从性或不依从性的标签可能会强化患者作为静态存在的观念,并掩盖患者的个体康复过程。

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