老年人抑郁症和抑郁症状治疗的传统和叙事做法

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摘要

一项关于老年人抑郁症传统治疗方法的文献分析和评估,将结果的有效性与结合讲故事和反身性写作的叙事实践的治疗计划的益处进行了比较。从2008年开始,优先考虑同行评议的期刊文章,尽管一些早期的信息被用于澄清和基础建设。抑郁症和抑郁症状的个体患者治疗计划的形成和实施受到许多变量的影响,例如:围绕提供者治疗指南的混乱、社会组织背景、组织气氛以及提供者和患者之间存在的对抑郁症的不同定义。患者经常挣扎于自我识别或用语言来描述抑郁症状,而反身性写作的过程是变革性的,可以提高叙事能力,从而增强患者描述自己的能力,有助于自我发现和个人症状意识。临床相遇中存在着权力的不平衡,叙事医学学科的实践和原则可以对加强治疗联盟和治疗效果产生积极影响。患有抑郁症和抑郁症状的老年人生活质量较低,在社区中的工作效率往往较低。传统的以药理学为基础的抑郁症治疗计划是一维的,往往不能解决患者的个人情况和偏好。患有抑郁症和抑郁症状的老年人可以更好地接受治疗计划,其中包括增加联盟、联系、自我意识和自我发现的叙事技巧。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Traditional & narrative practices of treatment for depression and depressive symptoms in older adults
An analysis and evaluation of the literature regarding traditional treatment methods for depression among older adults compared the effectiveness of the results to the benefits of a treatment plan that integrates the narrative practices of storytelling and reflexive writing. Priority was given to peer-reviewed journal articles from 2008 forward, though some earlier information was used for clarification and foundation building. The formation and implementation of individual patient treatment plans for depression and depressive symptoms are impacted by many variables such as: Confusion surrounding provider treatment guidelines, social organizational context, organizational climate and the differing definitions of depression that exist among providers and patients. Patients often struggle to self-identify or put words to depressive symptoms and the process of reflexive writing is transformative and increases narrative competency, which strengthens a patient’s ability to give an account of oneself, aiding in self-discovery and personal symptom awareness. An imbalance of power exists in the clinical encounter and the practices and principles of the discipline of Narrative Medicine can have a positive impact on strengthening the therapeutic alliance and treatment outcomes. Older adults with depression and depressive symptoms have a lower quality of life and often feel less productive in their communities. Traditional pharmacologically based depression treatment plans are one-dimensional and often fail to address personal patient context and preference. Older adults living with diagnosed depression and depressive symptoms can be better served with treatment plans that include narrative techniques that increase alliance, affiliation, self-awareness and self-discovery.  
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