Trostle J A, Hauser W A, Susser I S
Cult Med Psychiatry. 1983 Mar;7(1):35-56. doi: 10.1007/BF00249998.
Studies of patient compliance with medical regimens reveal that one-quarter to one-half of patients act at variance with their physician's suggestions. Using anthropological methods of long-term participant observation, seven epileptic patients were intensively studied for ten months in a variety of social contexts, including visits to health resources. Their conceptions of proper management of epilepsy were elicited, and their communication of these conceptions to providers of health care was observed. Although most of these patients were noncompliant, no single pattern of noncompliance encompassed their behavior as a group, and some of them had more than one drug consumption strategy. Furthermore, some patients were found to be noncompliant with biomedical regimens, yet actively and consistently pursuing alternative regimens. A range of such alternative therapies were identified both for low-income and middle-income patients. These case histories suggest that patients actively assess the quality of care given by their providers of health care. From the patient's point of view, biomedical strategies form one facet of many coping mechanisms in the management of epilepsy.
对患者遵守医疗方案情况的研究表明，四分之一到二分之一的患者行为与医生的建议不符。采用长期参与观察的人类学方法，对七名癫痫患者在包括就诊等各种社会背景下进行了为期十个月的深入研究。了解了他们对癫痫正确治疗的观念，并观察了他们将这些观念传达给医疗服务提供者的情况。尽管这些患者中的大多数不遵守医嘱，但作为一个群体，他们的不遵守行为并没有单一的模式，而且其中一些患者有不止一种用药策略。此外，还发现一些患者不遵守生物医学方案，但积极且持续地寻求替代方案。针对低收入和中等收入患者都确定了一系列这样的替代疗法。这些病例记录表明，患者会积极评估医疗服务提供者给予的护理质量。从患者的角度来看，生物医学策略只是癫痫治疗中众多应对机制的一个方面。
