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从精神科患者角度看药物治疗与健康控制观念:态度差异

[Pharmacological treatment and health control beliefs from the perspective of psychiatric patients: differences in attitudes].

作者信息

Pogany Laszlo, Lazary Judit

机构信息

Nyírő Gyula Országos Pszichiátriai és Addiktológiai Intézet, Budapest, Hungary.

出版信息

Neuropsychopharmacol Hung. 2019 Dec;21(4):170-178.

Abstract

INTRODUCTION

Patients' attitudes towards psychiatric treatment have an important influence on therapeutic outcome. Health beliefs and the patient's attitude towards the psychiatrist and medical treatment are determined by several factors about which there is only a scarce knowledge. In our study we used the Patient's Health Belief Questionnaire on Psychiatric Treatment, PHBQPT) to assess the beliefs and attitudes of patients suffering from psychiatric disorders.

METHODS

We recruited 115 inpatients from the Nyírő Gyula National Institute of Psychiatry and Addictions. Patients were categorized into 5 classes based on ICD-10 (addictions-F1x; psychotic disorders-F2x; affective disorders-F3x; anxiety disorders-F4x; and personality disorders-F6x). Subjects voluntarily and anonymously completed the PHBQPT questionnaire and answered 4 additional items regarding their opinion about the efficacy of drugs and the placebo effect. We compared the scores of the items and the total scores of subscales of the PHBQPT scale between disorder categories using ANOVA tests.

RESULTS

Total scores did not diff er significantly in our sample compared to those in the publication of the original version of the PHBQPT scale. The most robust diff erences were found between patients with addictions and psychotic patients on the external and internal control subscales. F1x subgroup could also be distinguished from other psychiatric disorders on certain health belief related items. However, patients with personality disorder and affective disorder felt that the efficacy of medications in general was the weakest. The impression that in the drug effect is individually modified in case of a given patient was more frequent in the F1x and F2x groups and rare in the group of subjects with anxiety disorders and personality disorders.

CONCLUSION

The Hungarian version of the PHBQPT can be used in case of Hungarian psychiatric patients; the similarity shown by the results points at the fact that attitude towards treatment is independent of cultural and healthcare system diff erences. Our results highlight that there are variances between different psychiatric disorders in health belief and attitude towards drug treatment. Our study emphasizes the importance of thorough assessment of patients' attitude that is necessary to conceive an effective adherence improving intervention.

摘要

引言

患者对精神科治疗的态度对治疗效果有重要影响。健康信念以及患者对精神科医生和药物治疗的态度由多种因素决定,但对此了解甚少。在我们的研究中,我们使用了《患者精神科治疗健康信念问卷》(PHBQPT)来评估患有精神障碍的患者的信念和态度。

方法

我们从尼勒·久洛国家精神病与成瘾研究所招募了115名住院患者。根据国际疾病分类第十版(ICD - 10)将患者分为5类(成瘾症 - F1x;精神障碍 - F2x;情感障碍 - F3x;焦虑症 - F4x;人格障碍 - F6x)。受试者自愿且匿名完成PHBQPT问卷,并回答了另外4个关于他们对药物疗效和安慰剂效应看法的问题。我们使用方差分析测试比较了不同疾病类别之间PHBQPT量表各项目得分和子量表总分。

结果

与PHBQPT量表原始版本发表的数据相比,我们样本中的总分没有显著差异。在外部和内部控制子量表上,成瘾症患者和精神障碍患者之间的差异最为明显。在某些与健康信念相关的项目上,F1x亚组也可以与其他精神障碍区分开来。然而,人格障碍和情感障碍患者总体上认为药物疗效最弱。认为针对特定患者药物效果会有个体差异的看法在F1x和F2x组中更为常见,而在焦虑症和人格障碍患者组中则很少见。

结论

匈牙利版的PHBQPT可用于匈牙利精神科患者;结果显示的相似性表明,对治疗的态度与文化和医疗保健系统差异无关。我们的结果突出表明,不同精神障碍在健康信念和对药物治疗的态度方面存在差异。我们的研究强调了全面评估患者态度对于构思有效的改善依从性干预措施的重要性。

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