The impact of psychosocial factors on experience of illness and mental health service use.
The impact of psychosocial factors on experience of illness and mental health service use.
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心理社会因素对疾病体验和心理健康服务使用的影响。
DOI：
10.1097/jgp.0b013e318182550b
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Sirey,JoAnne
中科院分区：
文献类型：
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作者：
Sirey,JoAnne
精神病学中的精神疾病是一个由疾病、症状和治疗组成的世界。在对患有精神疾病的老年人进行临床干预时，临床医生努力提供足够的药物和心理治疗干预措施，以减轻痛苦并促进康复。然而，我们经常面临老年人未充分利用心理健康服务和不遵守所提供干预措施的双重挑战。正是这些挑战促使我们超越症状和治疗需求，关注更广泛的个体背景。心理社会因素影响老年人是否寻求和接受心理健康干预措施。这些因素在坚持干预措施以及最终抑郁症的结果方面发挥着重要作用。同样，对精神疾病的态度和信念可以促进受苦个体的恢复能力或加剧症状。在对国家心理健康研究所优先事项的概述中，有证据表明人们对个人观点和心理社会因素的影响重新产生了兴趣。 NIMH 提供的临床愿景概述了医学研究的四个“P”；它们是预测、先发制人、个性化和参与（http://www.nimh.nih.gov/about/strategic-planning-reports/index.shtml）。个性化研究就是突出“个体的生物、环境、社会因素”。这一新的重点可能会为人们更多地关注精神疾病的个人和心理观点铺平道路。当我们考虑老年人获得和使用（或缺乏）服务或治疗时，我们可以认为他们的选择部分是由促进或阻碍优质护理的社会心理因素驱动的。
Mental illness in psychiatry is a world of diseases, symptoms and treatment. When conducting clinical interventions with older adults who have a mental illness, clinicians strive to provide adequate pharmacologic and psychotherapeutic interventions to alleviate suffering and promote recovery. Yet we are frequently faced with the duel challenges of underutilization of mental health services by older adults and nonadherence to the interventions offered. It is these challenges that spur us to look beyond symptoms and the need for treatments to the broader context of the individual. Psychosocial factors influence whether older adults seek and accept mental health interventions. These factors play a powerful role in adherence to interventions, and ultimately, depression outcomes. Similiarly, attitudes and beliefs about mental illness can promote resilience or exacerbate symptoms in a suffering individual.In an overview of the priorities for the National Institute of Mental Health there is evidence of a renewed interest in the individual perspective and the impact of psychosocial factors. The clinical vision offered by NIMH outlines the four “Ps” of medical research; they are prediction, pre-emption, personalize, and participation (http://www. nimh. nih. gov/about/strategic-planning-reports/index. shtml). To personalize research is to highlight “the individual biological, environment, and social factors”. This new emphasis may path the way for greater attention to the personal and psychological perspectives on mental illness. When we consider older persons’ access and use (or lack thereof) of services or treatments, we can view their choices as driven in part by social-psychological factors that either facilitate or hinder quality care.