Rodolico Alessandro, Cutrufelli Pierfelice, Maccarone Giuliana, Avincola Gabriele, Concerto Carmen, Cunsolo Alfio Luca, Di Francesco Antonio, Furnari Rosaria, Mineo Ludovico, Salerno Federico, Scuto Vincenzo, Tona Ilenia, Petralia Antonino, Signorelli Maria Salvina
Department of Psychiatry and Psychotherapy, TUM School of Medicine and Health, Technical University of Munich, Klinikum Rechts der Isar, 80333 Munich, Germany.
Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy.
J Clin Med. 2024 Oct 21;13(20):6282. doi: 10.3390/jcm13206282.
: Empowerment in medicine and psychiatry involves patients gaining control over health-related decisions, improving treatment adherence, outcomes, and satisfaction. This concept is especially significant in psychiatric care due to the complex challenges of mental health conditions, including stigma and impairment of emotional and cognitive functioning. We aim to investigate the correlations between patient trust, decision-making involvement, symptom severity, and perceived empowerment among individuals with Major Depression. : Patients with Major Depressive Disorder were recruited in the "Policlinico G. Rodolico" psychiatry outpatient clinic from November 2022 to June 2023. Inclusion criteria: ages 18-65, ability to consent, stable condition, psychiatric medication history, and recent consultation. Exclusion criteria: psychotic features, bipolar disorder, substance abuse, high suicide risk, and severe comorbidities. Measures included the User Scale for Measuring Empowerment in Mental Health Services (SESM), Trust in Oncologist Scale (TiOS), Clinical Decision-Making Style for Patients (CDMS-P), and Hamilton Depression Rating Scale (HAM-D). Analysis used Kendall's Tau correlation and Two-One-Sided Tests procedure. : Seventy-three patients completed the study. No relationship was found between decision-making involvement and perceived empowerment (τ = -0.0625; = 0.448), or between trust in psychiatrists and empowerment (τ = 0.0747; = 0.364). An inverse correlation existed between patient involvement in therapy management and trust (τ = -0.2505; = 0.002). Depression severity inversely correlated with empowerment (τ = -0.2762; = <.001), but not with trust or decision-making involvement. : The lack of significant correlations suggests that decision-making involvement and trust alone may not suffice to enhance empowerment. Trust may encourage patient passivity, while skepticism might drive active involvement. Higher empowerment is associated with less depressive symptoms, highlighting its potential connection with patient outcomes.
医学和精神病学中的赋权意味着患者能够掌控与健康相关的决策,提高治疗依从性、治疗效果和满意度。由于心理健康状况面临的复杂挑战,包括耻辱感以及情绪和认知功能受损,这一概念在精神科护理中尤为重要。我们旨在调查重度抑郁症患者的患者信任、决策参与度、症状严重程度和感知赋权之间的相关性。
2022年11月至2023年6月,在“波利克里尼科·G·罗多利科”精神科门诊招募了重度抑郁症患者。纳入标准:年龄18 - 65岁、有同意能力、病情稳定、有精神科用药史且近期有过咨询。排除标准:有精神病性特征、双相情感障碍、药物滥用、高自杀风险和严重合并症。测量工具包括心理健康服务赋权用户量表(SESM)、对精神科医生的信任量表(TiOS)、患者临床决策风格量表(CDMS - P)和汉密尔顿抑郁量表(HAM - D)。分析采用肯德尔tau相关性分析和双单侧检验程序。
73名患者完成了研究。未发现决策参与度与感知赋权之间存在关系(τ = -0.0625;P = 0.448),精神科医生的信任与赋权之间也未发现关系(τ = 0.0747;P = 0.364)。患者参与治疗管理与信任之间存在负相关(τ = -0.2505;P = 0.002)。抑郁严重程度与赋权呈负相关(τ = -0.2762;P = <.001),但与信任或决策参与度无关。
缺乏显著相关性表明,仅决策参与度和信任可能不足以增强赋权。信任可能会助长患者的被动性,而怀疑态度可能会促使其积极参与。更高的赋权与更少的抑郁症状相关,凸显了其与患者治疗效果的潜在联系。