Villena Amelia, Hurtado María M, Gómez Clara, Amor Gisela, Vega Amanda, Morales-Asencio José Miguel
Mental Health Unit, Regional University Hospital of Málaga, Málaga, Spain.
Faculty of Health Sciences, Universidad de Málaga, Málaga, Spain.
J Psychiatr Ment Health Nurs. 2025 Feb;32(1):203-214. doi: 10.1111/jpm.13095. Epub 2024 Aug 20.
WHAT IS KNOWN ON THE SUBJECT?: Patients do not always receive enough information about their diagnosis and their perceived participation in decision-making about their treatment is low. Some participants reported feeling very uncertain when the physician invited them to choose between these options. Others users expressed their satisfaction with the trend away from paternalistic attitudes in the health system. There is a trend towards pharmacological prescription as a first approximation. This contrasts with the recommendations of scientific organizations based on evidence and cost-effectiveness studies on the offer of psychological interventions as the first option. The user groups pointed out that active coping, based on exposure to anxiety-generating situations, made a significant contribution to alleviating their anxiety disorders. However, some of those interviewed rejected this type of intervention. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Users diagnosed with anxiety disorders miss more information about the disorder and participation in its treatment. Opposite positions coexist in terms of participation in the choice of treatment. Pharmacological treatment is most commonly the first option offered. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study is an example in itself of the involvement of users in the healthcare process, and therefore placing them at the centre of attention, as reflected in healthcare policies and clinical practice guidelines. It promotes the identification of needs that users diagnosed of anxiety disorders may have, with the aim of putting in place, from healthcare professionals and health services, the necessary supports adapted to these. Mental health nurses are well-positioned to offer support and guidance during the process of involvement and shared decision-making.
INTRODUCTION: An essential aspect of mental health treatment and recovery is the degree of involvement by health service users in the process.
AIM/QUESTION: Explore the values, demands and preferences of persons diagnosed with anxiety disorders, their participation in the treatment provided, and the response of the health system in this regard.
A qualitative study was conducted, with 51 participants. Nine focus groups and four in-depth interviews took place.
Three broad categories were identified: (1) diagnosis; (2) treatment options offered and shared decision-making; and (3) coping with the disorder. Sometimes patients do not receive enough information to cover their needs. A trend towards drug prescription as a first approach was observed, while active coping based on exposure to anxiogenic situations was indicated as the most effective option.
Shared decision-making is a necessary aspect of treatment, and the therapeutic process should be adapted to match the service user's preferences, values and needs.
This research identifies the needs of patients diagnosed with anxiety disorders and promotes, therefore, from healthcare professionals and services, the provision of measures to meet these needs.
关于该主题已知的信息有哪些？：患者并不总是能获得关于其诊断的足够信息，并且他们感觉自己对治疗决策的参与度较低。一些参与者报告说，当医生邀请他们在这些选项之间进行选择时，他们感到非常不确定。其他用户对医疗系统中家长式态度的转变表示满意。有一种将药物处方作为首选方法的趋势。这与科学组织基于证据和成本效益研究提出的将心理干预作为首选的建议形成对比。用户群体指出，基于暴露于引发焦虑的情境的积极应对方式，对缓解他们的焦虑症有显著贡献。然而，一些受访者拒绝这种干预方式。本文对现有知识的补充有哪些？：被诊断患有焦虑症的用户缺乏更多关于该疾病及其治疗参与方面的信息。在治疗选择的参与方面存在相反的立场。药物治疗最常作为首选提供。对实践有哪些启示？：本研究本身就是用户参与医疗过程的一个例子，因此将他们置于关注的中心，这在医疗政策和临床实践指南中有所体现。它促进了对被诊断患有焦虑症的用户可能存在的需求的识别，目的是让医疗专业人员和医疗服务机构提供适应这些需求的必要支持。心理健康护士在参与和共同决策过程中处于提供支持和指导的有利位置。
引言：心理健康治疗和康复的一个重要方面是医疗服务用户在这一过程中的参与程度。
目的/问题：探讨被诊断患有焦虑症的人的价值观、需求和偏好，他们对所提供治疗的参与情况，以及医疗系统在这方面的反应。
进行了一项定性研究，有51名参与者。开展了9个焦点小组和4次深入访谈。
确定了三大类：（1）诊断；（2）提供的治疗选择和共同决策；（3）应对该疾病。有时患者没有得到足够满足其需求的信息。观察到有一种将药物处方作为首选方法的趋势，而基于暴露于引发焦虑的情境的积极应对方式被认为是最有效的选择。
共同决策是治疗的一个必要方面，治疗过程应根据服务用户的偏好、价值观和需求进行调整。
本研究确定了被诊断患有焦虑症的患者的需求，因此促进医疗专业人员和服务机构提供满足这些需求的措施。
