Pogany Laszlo, Lazary Judit
National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.
Janos Szentagothai Doctoral School of Neuroscience, Budapest, Hungary.
Front Psychiatry. 2021 Apr 29;12:537309. doi: 10.3389/fpsyt.2021.537309. eCollection 2021.
Although there is accumulating evidence on the potential influencing factors of medication adherence, the knowledge about patients' attitudes and beliefs toward treatment is only partly utilized in adherence-improving strategies. Several internal and external factors determining adherence have been described regarding many chronic somatic diseases but in recent research, insight on psychiatric patients has been exclusively lacking. As a result, there is a scarcity of effective adherence-improving interventions. Identification of any specific differences or similarities between the attitudes toward treatment of psychiatric and non-psychiatric patients would help to support adherent behavior. We recruited 189 participants from four departments of general psychiatry (GEN PSYCH, = 106), addictology (ADDICT, = 42) and somatic diseases (NON PSYCH, = 41). The Patient's Health Belief Questionnaire on Psychiatric Treatment (PHBQPT) was performed to assess the patients' attitude toward drug treatment, perceived health locus of control, and psychological reactance. The most robust difference of the PHBQT scores occurred between the GEN PSYCH and ADDICT subgroups. ADDICT patients scored significantly higher on the internal and external health locus of control and on the Psychological Reactance subscale as well. While GEN PSYCH subjects provided higher scores on the Positive Aspect of Medication compared to ADDICT persons. Interestingly, the only difference between the GEN PSYCH and NON-PSYCH groups was the more pronounced mistrust in physicians in the case of psychiatric patients. Our data suggest that mistrust toward medication does not differ in psychiatric and non-psychiatric samples, while the acceptance of the doctor's competency may be stronger in the non-psychiatric sample. The analysis of these factors provides information which could help us better understand this important issue and to develop more efficient interventions for improving adherence.
尽管关于药物依从性的潜在影响因素的证据越来越多,但在改善依从性的策略中,关于患者对治疗的态度和信念的知识仅得到了部分利用。关于许多慢性躯体疾病,已经描述了一些决定依从性的内部和外部因素,但在最近的研究中,完全缺乏对精神科患者的深入了解。因此,缺乏有效的改善依从性的干预措施。识别精神科和非精神科患者对治疗态度上的任何具体差异或相似之处,将有助于支持依从行为。我们从普通精神病学(GEN PSYCH,n = 106)、成瘾学(ADDICT,n = 42)和躯体疾病(NON PSYCH,n = 41)四个科室招募了189名参与者。进行了《精神科治疗患者健康信念问卷》(PHBQPT)以评估患者对药物治疗的态度、感知的健康控制点和心理抗拒。PHBQT分数最显著的差异出现在GEN PSYCH和ADDICT亚组之间。ADDICT患者在内部和外部健康控制点以及心理抗拒子量表上的得分也显著更高。而与ADDICT患者相比,GEN PSYCH受试者在药物治疗积极方面的得分更高。有趣的是,GEN PSYCH组和NON-PSYCH组之间唯一的差异是,精神科患者对医生的不信任更为明显。我们的数据表明,精神科和非精神科样本对药物的不信任没有差异,而非精神科样本对医生能力的接受度可能更强。对这些因素的分析提供了有助于我们更好地理解这一重要问题并制定更有效干预措施以提高依从性的信息。