Effects of caregivers' perceived stigma and causal beliefs on patients' adherence to antidepressant treatment.
Effects of caregivers' perceived stigma and causal beliefs on patients' adherence to antidepressant treatment.
复制标题
护理人员的耻辱感和因果信念对患者抗抑郁治疗依从性的影响。
DOI：
10.1176/appi.ps.56.5.564
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Meyers,Barnett
中科院分区：
文献类型：
--
作者：
Sher,Iris;McGinn,Lata;Sirey,JoAnne;Meyers,Barnett
在治疗情绪障碍的过程中，不遵守处方药是一个重要的问题。先前提出的依从性模型在识别不依从治疗的患者方面不够准确。本研究采用前瞻性、纵向分析的方法，评估了社会背景在依从性中的重要性。具体而言，本研究评估了照顾者的因果信念抑郁症和他们的看法，对3个月的治疗坚持性之间的患者抑郁症。METHODS五十例重度抑郁症患者和他们的主要照顾者的影响被确定在精神病医院的门诊。抑郁症的原因（无论是认知和态度或医学和生物学）和感知的耻辱之间的照顾者在基线进行了评估，患者的依从性进行了评估，治疗开始后3个月。照顾者将抑郁归因于认知和态度问题显著预测患者依从性降低。然而，病人的依从性的程度没有预测照顾者的归因于医疗和生物原因和照顾者的感知stigm.CONCLUSIONSSThe研究结果强调的重要性，病人的社会环境在确定治疗的依从性和教育照顾者的影响，他们的因果归因对病人的行为的必要性。让照顾者参与治疗可以改善他们对抑郁症患者的态度，从而提高患者的依从性和结果。
OBJECTIVENonadherence to prescribed medications is a significant problem in the treatment of mood disorders. Previously proposed adherence models have not been sufficiently accurate in identifying patients who do not adhere to treatment. This study evaluated the importance of the social context in adherence by using a prospective, longitudinal analysis. Specifically, this study evaluated the effects of caregivers' causal beliefs about depression and their perceptions of stigma on three-month treatment adherence among patients with depression.METHODSFifty patients with major depressive disorder and their primary caregivers were identified at a psychiatric hospital's outpatient clinic. Attributions for the causes of depression (either cognitive and attitudinal or medical and biological) and perceived stigma were assessed among caregivers at baseline, and patients' adherence was evaluated three-months after treatment began.RESULTSData were available for 47 patients at follow-up. Caregivers' attribution of depression to cognitive and attitudinal problems significantly predicted patients' decreased adherence. However, the degree of patients' adherence was not predicted by caregivers' attributions to medical and biological causes and caregivers' perceived stigma.CONCLUSIONSThe findings stress the importance of patients' social environment in determining treatment adherence and the necessity of educating caregivers about the impact that their causal attributions have on patients' behavior. Involving caregivers in treatment may improve their attitude toward patients with depression and, in doing so, enhance patients' adherence and outcome.