Attitudes regarding the collaborative practice model and treatment adherence among individuals with bipolar disorder
Attitudes regarding the collaborative practice model and treatment adherence among individuals with bipolar disorder
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DOI：
10.1016/j.comppsych.2004.10.007
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发表时间：
2005-07-01
影响因子：
7.3
通讯作者：
Jenkins, J
中科院分区：
文献类型：
--
作者：
Sajatovic, M;Davies, M;Jenkins, J
一个新兴的文献表明，一个合作的护理模式，其中患者是积极的管理者，他们的疾病在一个支持性的社会环境，是一个有益的方法，为个人与双相情感障碍。在双相情感障碍患者中，治疗的一个方面往往是次优的，那就是治疗的依从性。建立一个理想的合作模式，可能会提供一个机会，以提高个人之间的治疗依从性与双相情感障碍。本文介绍了患者对协作护理模式的态度以及双相情感障碍患者在协作护理模式下如何看待治疗依从性的定性探索结果。所有参与者都积极参加了社区精神卫生中心的门诊治疗，并参与了一项评估生活目标计划的更大研究，一个手动驱动的结构化团体心理治疗的双相情感障碍，是基于合作的实践模式。生活目标计划旨在帮助个人更有效地参与双相情感障碍的管理，并改善他们的社会和工作相关问题。询问了个人对有效的客户-提供者关系要素的看法。在社区精神卫生诊所接受双相情感障碍治疗的患者确定了12个关键因素，他们认为这些因素是与精神卫生保健提供者积极合作的关键因素。作者围绕3个新兴主题对这些要素进行了概念化：以病人为中心的品质，以提供者为中心的品质，和以病人为中心的品质。双相情感障碍患者认为理想的合作模式是这样的，在这种模式中，个人有特定的责任，如参加约会和分享信息，而提供者同样具有特定的责任，例如与当前的“最新技术”处方实践保持同步并成为一个好的倾听者。治疗依从性被确定为在协作模式的更大背景下的自我管理责任。在这项研究中，双相情感障碍患者在患者与提供者的关系中，特别是在患者可能更有症状和更受损害的时候，非常强调干预成分。重要的是，临床医生和护理提供者在设计或评估旨在提高治疗依从性的服务时，收集与患者对患者-提供者关系的感知相关的信息。爱思唯尔公司出版
An emerging literature suggests that a collaborative care model, in which patients are active managers of their illness within a supportive social environment, is a beneficial approach for individuals with bipolar disorder. One aspect of treatment that is often suboptimal among individuals with bipolar disorder is treatment adherence. Establishing an ideal collaborative model may offer an opportunity to enhance treatment adherence among individuals with bipolar disorder. This paper presents results from a qualitative exploration of patients' attitudes towards the collaborative care model and how individuals with bipolar disorder perceive treatment adherence within the context of the collaborative care model.All participants were actively enrolled in outpatient treatment at a Community Mental Health Center and part of a larger study that evaluated the Life Goals Program, a manual-driven structured group psychotherapy for bipolar disorder that is based on the collaborative practice model. The Life Goals Program is designed to assist individuals to participate more effectively in the management of their bipolar illness and to improve their social and work-related problems. Individuals were queried regarding their opinions on the ingredients for an effective client-provider relationship. Quantitative data were collected on baseline treatment adherence as well.Individuals treated for bipolar disorder in a community mental health clinic identified 12 key elements that they felt were critical ingredients to a positive collaborative experience with their mental health care provider. The authors conceptualized these elements around 3 emerging themes: patient-centered qualities, provider-centered qualities, and interactional qualities.Individuals with bipolar disorder perceived the ideal collaborative model as one in which the individual has specific responsibilities such as coming to appointments and sharing information, whereas the provider likewise has specific responsibilities such as keeping abreast of current "state-of-the-art" prescribing practices and being a good listener. Treatment adherence was identified as a self-managed responsibility within the larger context of the collaborative model. Individuals with bipolar disorder in this study placed substantial emphasis on the interactional component within the patient-provider relationship, particularly with respect to times when the individual may be more symptomatic and more impaired. It is important that clinicians and care providers gather information related to patients' perceptions of the patient-provider relationship when designing or evaluating services aimed at enhancing treatment adherence. Published by Elsevier Inc.