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为何服务使用者选择非药物精神治疗:一项基于使用者叙述的混合方法研究

Why Service Users Choose Medication-Free Psychiatric Treatment: A Mixed-Method Study of User Accounts.

作者信息

Standal Kari, Solbakken Ole Andre, Rugkåsa Jorun, Martinsen Astrid Ringen, Halvorsen Margrethe Seeger, Abbass Allan, Heiervang Kristin Sverdvik

机构信息

District Psychiatric Center Nedre Romerike, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.

Department of Psychology, University of Oslo, Oslo, Norway.

出版信息

Patient Prefer Adherence. 2021 Jul 23;15:1647-1660. doi: 10.2147/PPA.S308151. eCollection 2021.

Abstract

PURPOSE

Medication has been a central part of treatment for severe mental disorders in Western medicine since the 1950s. In 2015, Norwegian Health Authorities decided that Norwegian health regions must have treatment units devoted to medication-free mental health treatment to enhance service users' freedom of choice. The need for these units has been controversial. The aim of this study was to examine why service users choose medication-free services. This article examines what purpose these units serve in terms of the users' reasons for choosing this service, what is important for them to receive during the treatment, and what factors lay behind their concerns in terms of medication-related views and experiences.

METHODS

Questionnaires were answered by 46 participants and 5 participants were interviewed in a mixed-method design integrated with a concurrent triangulation strategy applying thematic analysis and descriptive statistics.

RESULTS

Negative effects of medications and unavailable alternatives to medication in ordinary health care were important reasons for wanting medication-free treatment. Medication use may conflict with personal values, attitudes, and beliefs.

CONCLUSION

This study broadens the understanding of why the demand for separate medication-free units has arisen. The findings may contribute to making medication-free treatment an option in mental health care in general. To this end, clinicians are advised to communicate all treatment alternatives to service users and to be mindful of the effect of power imbalances in their interactions with them.

摘要

目的

自20世纪50年代以来,药物治疗一直是西医治疗严重精神障碍的核心组成部分。2015年,挪威卫生当局决定,挪威各卫生区域必须设有专门用于无药物心理健康治疗的治疗单元,以增强服务使用者的选择自由。对这些单元的需求一直存在争议。本研究的目的是调查服务使用者选择无药物治疗服务的原因。本文探讨了这些单元在使用者选择该服务的原因方面所起的作用,他们在治疗期间接受什么对其很重要,以及在药物相关观点和经历方面,他们的担忧背后有哪些因素。

方法

46名参与者回答了问卷,并对5名参与者进行了访谈,采用混合方法设计,并结合应用主题分析和描述性统计的同步三角验证策略。

结果

药物的负面影响以及普通医疗保健中缺乏药物替代方案是希望接受无药物治疗的重要原因。药物使用可能与个人价值观、态度和信仰相冲突。

结论

本研究拓宽了对为何出现对单独的无药物治疗单元需求的理解。这些发现可能有助于使无药物治疗成为一般心理健康护理中的一种选择。为此,建议临床医生向服务使用者传达所有治疗选择,并在与他们互动时留意权力不平衡的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f005/8315812/d3a6571cd21c/PPA-15-1647-g0001.jpg

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