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精神病患者的感知健康控制与反抗:对药物依从性的影响。

Psychiatric Patients' Perceived Health Control and Reactance: Implications for Medication Adherence.

作者信息

De Las Cuevas Carlos

机构信息

Department of Internal Medicine, Dermatology and Psychiatry, Universidad de La Laguna, San Cristóbal de La Laguna, Canary Islands, Spain.

Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, San Cristóbal de La Laguna, Canary Islands, Spain.

出版信息

Patient Prefer Adherence. 2023 Jul 8;17:1591-1601. doi: 10.2147/PPA.S417608. eCollection 2023.

Abstract

Adherence to prescribed treatment is a major challenge in psychiatry, with non-adherence rates estimated to be as high as 50%. Two factors that have been suggested to influence medication adherence in psychiatric patients are perceived health control and psychological reactance. Perceived health control refers to the belief that one can control their own health outcomes, while psychological reactance refers to the negative response that occurs when individuals perceive their freedom or autonomy to be threatened. The aim of this review is to explore the possible relevance and interaction of perceived health control and psychological reactance in the adherence of psychiatric patients to their treatment. Several studies have suggested that higher levels of perceived health control are associated with better medication adherence, while higher levels of psychological reactance are associated with poorer adherence. Moreover, it has been suggested that patients with high levels of perceived health control may be more likely to experience psychological reactance if they feel that their autonomy is threatened by the treatment regimen. Taken together, these findings suggest that perceived health control and psychological reactance may interact to influence medication adherence in psychiatric patients. Future research could explore ways to enhance patients' perceived health control while minimizing psychological reactance in order to improve treatment adherence in this population.

摘要

坚持规定的治疗是精神病学中的一项重大挑战,据估计不坚持治疗的比率高达50%。已被认为会影响精神病患者药物治疗依从性的两个因素是感知到的健康控制和心理抗拒。感知到的健康控制是指相信自己能够控制自身的健康结果,而心理抗拒是指当个体感觉到自己的自由或自主权受到威胁时所产生的负面反应。本综述的目的是探讨感知到的健康控制和心理抗拒在精神病患者坚持治疗方面可能存在的相关性及相互作用。多项研究表明,较高水平的感知到的健康控制与更好的药物治疗依从性相关,而较高水平的心理抗拒则与较差的依从性相关。此外,有人提出,感知到的健康控制水平较高的患者,如果他们觉得自己的自主权受到治疗方案的威胁,可能更有可能经历心理抗拒。综合来看,这些发现表明,感知到的健康控制和心理抗拒可能相互作用,从而影响精神病患者的药物治疗依从性。未来的研究可以探索如何增强患者的感知到的健康控制,同时将心理抗拒降至最低,以便提高这一人群的治疗依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0dc/10337681/3701b50949bf/PPA-17-1591-g0001.jpg

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