Shared decision making and medication management in the recovery process
Shared decision making and medication management in the recovery process
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DOI：
10.1176/appi.ps.57.11.1636
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发表时间：
2006-11-01
影响因子：
3.8
通讯作者：
Drake, Robert E.
中科院分区：
文献类型：
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作者：
Deegan, Patricia E.;Drake, Robert E.
精神卫生专业人员通常将严重精神疾病患者的药物管理概念化为增加依从性或依从性的策略。作者认为，依从性是一个不充分的概念，因为它未能捕捉到自主客户的动态复杂性，这些客户必须在几年或几十年的时间里学习管理疾病的决策冲突。依从性植根于医疗家长主义，与以人为本的护理和循证医学的原则不一致。使用药物是一个积极的过程，涉及复杂的决策和通过决策冲突的机会。它需要两个专家之间的伙伴关系：客户和从业者。共同决策为他们提供了一个模型，以评估在诊断为严重精神障碍后恢复生活的背景下治疗的优点和缺点。
Mental health professionals commonly conceptualize medication management for people with severe mental illness in terms of strategies to increase compliance or adherence. The authors argue that compliance is an inadequate construct because it fails to capture the dynamic complexity of autonomous clients who must navigate decisional conflicts in learning to manage disorders over the course of years or decades. Compliance is rooted in medical paternalism and is at odds with principles of person-centered care and evidence-based medicine. Using medication is an active process that involves complex decision making and a chance to work through decisional conflicts. It requires a partnership between two experts: the client and the practitioner. Shared decision making provides a model for them to assess a treatment's advantages and disadvantages within the context of recovering a life after a diagnosis of a major mental disorder.