PDF(Pubmed)
Abstract：
BACKGROUND: Treatment pressures encompass communicative strategies that influence mental healthcare service users\' decision-making to increase their compliance with recommended treatment. Persuasion, interpersonal leverage, inducements, and threats have been described as examples of treatment pressures. Research indicates that treatment pressures are exerted not only by mental healthcare professionals but also by relatives. While relatives play a crucial role in their family member\'s pathway to care, research on the use of treatment pressures by relatives is still scarce. Likewise, little is known about other strategies relatives may use to promote the treatment compliance of their family member with a serious mental health condition. In particular, no study to date has investigated this from the perspective of relatives of people with a serious mental health condition.
OBJECTIVE: The aim of this study was to answer the following research questions: Which types of treatment pressures do relatives use? Which other strategies do relatives use to promote the treatment compliance of their family member with a serious mental health condition? How do treatment pressures relate to these other strategies?
METHODS: Eleven semi-structured interviews were conducted with relatives of people with a serious mental health condition in Germany. Participants were approached via relatives\' self-help groups and flyers in a local psychiatric hospital. Inclusion criteria were having a family member with a psychiatric diagnosis and the family member having experienced formal coercion. The data were analyzed using grounded theory methodology.
RESULTS: Relatives use a variety of strategies to promote the treatment compliance of their family member with a serious mental health condition. These strategies can be categorized into three general approaches: influencing the decision-making of the family member; not leaving the family member with a choice; and changing the social or legal context of the decision-making process. Our results show that the strategies that relatives use to promote their family member\'s treatment compliance go beyond the treatment pressures thus far described in the literature.
CONCLUSIONS: This qualitative study supports and conceptually expands prior findings that treatment pressures are not only frequently used within mental healthcare services but also by relatives in the home setting. Mental healthcare professionals should acknowledge the difficulties faced and efforts undertaken by relatives in seeking treatment for their family member. At the same time, they should recognize that a service user\'s consent to treatment may be affected and limited by strategies to promote treatment compliance employed by relatives.
OBJECTIVE: The aim of this study was to answer the following research questions: Which types of treatment pressures do relatives use? Which other strategies do relatives use to promote the treatment compliance of their family member with a serious mental health condition? How do treatment pressures relate to these other strategies?
METHODS: Eleven semi-structured interviews were conducted with relatives of people with a serious mental health condition in Germany. Participants were approached via relatives\' self-help groups and flyers in a local psychiatric hospital. Inclusion criteria were having a family member with a psychiatric diagnosis and the family member having experienced formal coercion. The data were analyzed using grounded theory methodology.
RESULTS: Relatives use a variety of strategies to promote the treatment compliance of their family member with a serious mental health condition. These strategies can be categorized into three general approaches: influencing the decision-making of the family member; not leaving the family member with a choice; and changing the social or legal context of the decision-making process. Our results show that the strategies that relatives use to promote their family member\'s treatment compliance go beyond the treatment pressures thus far described in the literature.
CONCLUSIONS: This qualitative study supports and conceptually expands prior findings that treatment pressures are not only frequently used within mental healthcare services but also by relatives in the home setting. Mental healthcare professionals should acknowledge the difficulties faced and efforts undertaken by relatives in seeking treatment for their family member. At the same time, they should recognize that a service user\'s consent to treatment may be affected and limited by strategies to promote treatment compliance employed by relatives.
摘要：
背景：治疗压力包括影响心理健康服务使用者决策的沟通策略，以提高他们对推荐治疗的依从性。说服,人际杠杆，诱因,和威胁已被描述为治疗压力的例子。研究表明，治疗压力不仅由精神保健专业人员施加，而且由亲属施加。虽然亲戚在他们的家庭成员的道路上发挥着至关重要的作用，关于亲属使用治疗压力的研究仍然很少。同样，关于亲属可能使用的其他策略，以促进其家庭成员的治疗依从性与严重的心理健康状况知之甚少。特别是,迄今为止，还没有一项研究从精神健康状况严重的人的亲属的角度进行调查。
目的：这项研究的目的是回答以下研究问题：亲属使用哪些类型的治疗压力？亲属使用哪些其他策略来提高其患有严重心理健康状况的家庭成员的治疗依从性？治疗压力与这些其他策略有何关系？
方法：对德国患有严重心理健康状况的人的亲属进行了11次半结构化访谈。参与者通过亲戚自助小组和传单在当地精神病医院接触。纳入标准是有一个患有精神病的家庭成员和经历过正式胁迫的家庭成员。数据采用扎根理论方法进行分析。
结果：亲属使用多种策略来提高其患有严重心理健康状况的家庭成员的治疗依从性。这些策略可以分为三种一般方法：影响家庭成员的决策；不让家庭成员做出选择；并改变决策过程的社会或法律背景。我们的结果表明，亲属用来促进其家庭成员的治疗依从性的策略超出了迄今为止文献中描述的治疗压力。
结论：这项定性研究支持并在概念上扩展了先前的发现，即治疗压力不仅在精神保健服务中经常使用，而且在家庭环境中的亲属也经常使用。精神保健专业人员应该承认亲属在为其家庭成员寻求治疗时面临的困难和努力。同时,他们应该认识到，服务用户对治疗的同意可能会受到亲属采用的促进治疗依从性的策略的影响和限制。
目的：这项研究的目的是回答以下研究问题：亲属使用哪些类型的治疗压力？亲属使用哪些其他策略来提高其患有严重心理健康状况的家庭成员的治疗依从性？治疗压力与这些其他策略有何关系？
方法：对德国患有严重心理健康状况的人的亲属进行了11次半结构化访谈。参与者通过亲戚自助小组和传单在当地精神病医院接触。纳入标准是有一个患有精神病的家庭成员和经历过正式胁迫的家庭成员。数据采用扎根理论方法进行分析。
结果：亲属使用多种策略来提高其患有严重心理健康状况的家庭成员的治疗依从性。这些策略可以分为三种一般方法：影响家庭成员的决策；不让家庭成员做出选择；并改变决策过程的社会或法律背景。我们的结果表明，亲属用来促进其家庭成员的治疗依从性的策略超出了迄今为止文献中描述的治疗压力。
结论：这项定性研究支持并在概念上扩展了先前的发现，即治疗压力不仅在精神保健服务中经常使用，而且在家庭环境中的亲属也经常使用。精神保健专业人员应该承认亲属在为其家庭成员寻求治疗时面临的困难和努力。同时,他们应该认识到，服务用户对治疗的同意可能会受到亲属采用的促进治疗依从性的策略的影响和限制。
