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社区环境中针对重症精神疾病患者的护士主导的治疗参与干预措施。

Nurse-led treatment engagement interventions for persons with severe mental illnesses in community settings.

作者信息

Somanathan Revathi, Gandhi Sailaxmi, Sivakumar T, Manjunatha Narayana

机构信息

Mental Health Nursing, Ramaiah University of Applied Sciences, Bangalore 560054, Karnataka, India.

Department of Nursing, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, Karnataka, India.

出版信息

World J Psychiatry. 2025 Sep 19;15(9):107720. doi: 10.5498/wjp.v15.i9.107720.

Abstract

This review aims to gain a deeper understanding of the current interventions used in high-income and low- and middle-income countries worldwide on treatment engagement among persons with severe mental illnesses. Treatment engagement involves cultivating therapeutic partnerships to address patients' unique needs and challenges. This multifaceted process requires sensitivity, collaboration, and a tailored approach to promote positive outcomes. Effective treatment engagement reduces the chances of relapse and rehospitalization and helps individuals steer through their daily lives and social relationships. Through literature analysis, it was found that individual, situational, and environmental factors affected treatment engagement. Community nurses are crucial in promoting behavioral changes by engaging patients and applying tailor-made interventions. Applying problem-solving, coping skills, and strategies to address factors influencing adherence, motivational interviewing, and telephone follow-ups yielded significant results. The interventions recommended in community settings are tele-aftercare programs and home visits to address issues of dropped-out persons with severe mental illnesses and ensure continuity of treatment. Accessible, non-stigmatizing, non-coercive, informal, and appropriate services are suggested. These interventions can improve treatment engagement, medication adherence, and therapeutic alliance, thereby reducing symptoms and improving patients' quality of life.

摘要

本综述旨在更深入地了解全球高收入国家以及低收入和中等收入国家目前针对重症精神疾病患者治疗参与度所采用的干预措施。治疗参与包括建立治疗伙伴关系,以满足患者的独特需求并应对挑战。这个多方面的过程需要敏感度、协作以及量身定制的方法来促进积极的结果。有效的治疗参与可降低复发和再次住院的几率,并帮助个体应对日常生活和社会关系。通过文献分析发现,个体、情境和环境因素会影响治疗参与度。社区护士在通过与患者互动并应用量身定制的干预措施来促进行为改变方面至关重要。应用解决问题、应对技巧以及策略来处理影响依从性的因素、动机性访谈和电话随访均产生了显著效果。社区环境中推荐的干预措施包括远程后续照护项目和家访,以解决重症精神疾病患者失访问题并确保治疗的连续性。建议提供可及、无歧视、非强制性、非正式且适当的服务。这些干预措施可改善治疗参与度、药物依从性和治疗联盟,从而减轻症状并提高患者的生活质量。

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