Use of leverage over patients' money to promote adherence to psychiatric treatment
Use of leverage over patients' money to promote adherence to psychiatric treatment
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DOI：
10.1097/01.nmd.0000207368.14133.0c
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发表时间：
2006-04-01
影响因子：
1.9
通讯作者：
Redlich, A
中科院分区：
文献类型：
--
作者：
Appelbaum, PS;Redlich, A
为精神残疾患者管理资金的人经常利用获得资金的机会作为杠杆，以促进坚持治疗。基于对社区精神卫生中心1011名患者的访谈的五个地点的研究数据，本文探索了谁提供资金援助，杠杆使用的预测因素，以及它对患者的影响。相当少数的患者报告说经历过杠杆作用。药物滥用和频繁住院是最强的临床预测因素，表明功能障碍是一个关键决定因素。经历金钱杠杆的患者也可能经历其他形式的杠杆，尽管他们更有可能感到被迫，但他们也更有可能相信金钱杠杆是有效的。作为理财经理，家族成员似乎较少激起负面情绪。货币杠杆的使用频率表明，既需要关注杠杆的公平性，也需要关注将负面影响降至最低的手段。
Persons who handle money for patients with mental disabilities often use access to funds as leverage to promote adherence to treatment. Drawing on data from a five-site study involving interviews of 1011 patients at community mental health centers, this paper explores who provides money assistance, the predictors of leverage use, and its impact on patients. A substantial minority of patients reported having experienced leverage. Substance abuse and frequent hospitalization were the strongest clinical predictors, suggesting that functional impairment is a key determinant. Patients experiencing money leverage were also likely to experience other forms of leverage, and although they were more likely to feel coerced, they were also more likely to believe that money leverage was effective. Family members seemed to provoke fewer negative feelings as money managers. The frequency with which money leverage is used suggests attention is needed to both the fairness of leverage and the means of minimizing negative effects.