van Grieken R A, Schene A H
Tijdschr Psychiatr. 2018;60(9):627-636.
More than two-thirds of all patients suffering from depression experience insufficient improvement despite treatment. Self-management strategies and treatment objectives should be more in line with what patients consider to be helpful. This would improve the treatment efficacy of domains relevant to patients and allow for self-management of depression where possible.
AIM: To explore the patient's perspective on self-management and professional treatment for depression.
METHOD: Predominantly qualitative methods: in-depth individual interviews, concept mapping (mixed method) and a nationwide self-report survey.
RESULTS: Participants generated 50 self-management strategies addressing themes such as engaging in activities (e.g. 'leaving the house regularly'), focus on the diagnosis depression (e.g. 'acceptation') and treatment (e.g. 'trusting the therapist'), remaining socially engaged (e.g. 'informing family about the depression') and good structure and self-care (e.g. 'setting realistic goals'). A lack of clarity and consensus about either the nature of the depression or the content of treatment and a precarious relationship with the professional were perceived as impeding characteristics of treatment.
CONCLUSION: Patients appear to be able to contribute actively and in various ways when managing their own mental health. By exploring the patient's perspectives, professionals could offer treatment established through shared goals.
超过三分之二的抑郁症患者尽管接受了治疗，但病情改善仍不充分。自我管理策略和治疗目标应更符合患者认为有帮助的内容。这将提高与患者相关领域的治疗效果，并在可能的情况下实现抑郁症的自我管理。
探讨患者对抑郁症自我管理和专业治疗的看法。
主要采用定性方法：深入的个人访谈、概念映射（混合方法）和全国性的自我报告调查。
参与者提出了50种自我管理策略，涉及参与活动（如“定期出门”）、关注抑郁症诊断（如“接受”）和治疗（如“信任治疗师”）、保持社交参与（如“告知家人自己患有抑郁症”）以及良好的生活结构和自我护理（如“设定现实目标”）等主题。对抑郁症的性质或治疗内容缺乏清晰认识和共识，以及与专业人员的不稳定关系被视为治疗的阻碍特征。
患者在管理自己的心理健康时似乎能够以各种方式积极做出贡献。通过探索患者的观点，专业人员可以提供基于共同目标的治疗。
