Improving Clinician-Patient Communication Alleviates Stigma in Patients With Functional Dyspepsia Receiving Antidepressant Treatment.
Improving Clinician-Patient Communication Alleviates Stigma in Patients With Functional Dyspepsia Receiving Antidepressant Treatment.
复制标题
DOI：
10.5056/jnm20239
复制
发表时间：
2022-01-30
影响因子：
3.4
通讯作者：
Chen SL
中科院分区：
文献类型：
--
作者：
Yan XJ;Qiu HY;Luo QQ;Wang B;Xu P;Ji CF;Chen SL
抗抑郁药对功能性消化不良（FD）患者有效。然而，与FD和抗抑郁药相关的耻辱感可能会影响治疗依从性。本研究旨在探讨可能的沟通策略，以减轻FD患者的耻辱和提高依从性。在这项随机、单中心、单盲试验中，招募了160例开始抗抑郁治疗的FD患者。在开抗抑郁药时，会采取不同的沟通策略。第1组被试被告知大脑是肠道的“总部”，抗抑郁药可作为神经调质通过调节肠道和大脑的功能来缓解FD症状。第2组的参与者被告知抗抑郁药对FD是经验有效的。分析污名评分、药物相关污名、治疗依从性和疗效。抗抑郁治疗8周后，治疗组FD患者病耻感评分下降的比例显著高于对照组（内化病耻感64.10% vs 12.00%;感知病耻感55.13% vs 13.33%; P < 0.01）。第1组的药物相关污名低于第2组（4个问题中有3个问题P < 0.05）。同时，治疗组1患者的治疗依从性（0.71 ± 0.25 vs 0.60 ± 0.25，P < 0.01）和疗效更好。在第1组中，治疗后耻辱评分降低的参与者比评分未降低的参与者表现出更好的治疗依从性和疗效。污名分数的降低与治疗依从性呈正相关。结论通过适当的沟通提高FD患者对疾病及抗抑郁药物的认知，是减轻患者污名化、促进依从性的有效途径。
Antidepressants are effective in patients with functional dyspepsia (FD). However, stigma associated with FD and antidepressants may affect treatment adherence. This study aims to explore possible communication strategies to alleviate stigma and improve adherence in patients with FD. In this randomized, single-center, and single-blind trial, 160 patients with FD initiating antidepressant treatment were recruited. Different communication strategies were performed when prescribing antidepressants. Participants in Group 1 were told that brain is the “headquarters” of gut, and that antidepressants could act as neuromodulators to relieve symptoms of FD through regulating the functions of gut and brain. Participants in Group 2 were told that antidepressants were empirically effective for FD. Stigma scores, medication-related stigma, treatment compliance, and efficacy were analyzed. After 8-week antidepressant treatment, the proportion of patients with FD with decreased stigma scores in Group 1 was significantly higher than in Group 2 (internalized stigma 64.10% vs 12.00%; perceived stigma 55.13% vs 13.33%; P < 0.01). Medication-related stigma was lower in Group 1 than in Group 2 (P < 0.05 for 3 of 4 questions). Concurrently, patients in Group 1 had better treatment compliance (0.71 ± 0.25 vs 0.60 ± 0.25, P < 0.01) and efficacy. In Group 1, participants with decreased post-treatment stigma scores showed better treatment compliance and efficacy than those with non-decreased scores. Decrease in stigma scores positively correlated with treatment compliance. Conclusion Improving knowledge of patients with FD of the disease and antidepressants via proper communication may be an effective way to alleviate stigma and promote adherence.
登录
查看更多内容
影响因子：
12.6
作者：
Tack, Jan;Ly, Huynh Giao;Van Oudenhove, Lukas
通讯作者：
Van Oudenhove, Lukas
影响因子：
1.6
作者：
Luo，Liang;Du，Lijun;Dai，Ning
通讯作者：
Dai，Ning
影响因子：
29.4
作者：
Talley NJ;Locke GR;Saito YA;Almazar AE;Bouras EP;Howden CW;Lacy BE;DiBaise JK;Prather CM;Abraham BP;El-Serag HB;Moayyedi P;Herrick LM;Szarka LA;Camilleri M;Hamilton FA;Schleck CD;Tilkes KE;Zinsmeister AR
通讯作者：
Zinsmeister AR
影响因子：
12.6
作者：
Collins, Joanne;Farrall, Edwina;Andrews, Jane M.
通讯作者：
Andrews, Jane M.
DOI：
10.1016/bs.apha.2015.11.002
发表时间：
2016-01-01
期刊：
PHARMACOLOGICAL MECHANISMS AND THE MODULATION OF PAIN
影响因子：
--
作者：
Johnson, Anthony C.;Greenwood-Van Meerveld, Beverley
通讯作者：
Greenwood-Van Meerveld, Beverley