住院病人对精神科治疗的态度:定量研究综述

Raymond M. Weinstein
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引用次数: 16

摘要

从住院病人的角度来看,文献中关于精神治疗的大部分可用数据都来自定性研究。通过观察、非正式访谈或伪装成病人,社会科学家在很大程度上以不利的方式描述了医院的治疗和病人对它的态度。相对而言,很少有科学家从患者中抽取有代表性的样本,用客观测试或有效的量表正式询问他们的治疗情况,并以统计格式显示结果。本报告是对这一定量研究的回顾,特别考虑到确定患者对治疗的好感程度。结果表明,在44个不同的样本中,有34个(77%)患者持积极态度。总的来说,患者对精神病院的治疗比在自己的机构接受治疗的态度更有利。医院类型和学习时间对患者观点的影响可以忽略不计。有限的数据表明,由于住院治疗,态度有所改善,或至少没有恶化。比较病人和工作人员态度的研究报告了不一致的结果。对总体治疗态度测量的内容分析显示,患者对医院的治疗价值、对医疗问题的帮助、限制、活动和家庭成员的参与持积极态度,对患者政府和医患关系持消极态度,对患者的自由和责任持矛盾态度。对特定治疗态度的内容分析表明,个体、职业、环境、身体、娱乐和活动治疗被患者认为是积极的,团体治疗则是消极的,药物治疗和电痉挛疗法则是矛盾的。社会变量对患者反应的有利性影响最小,精神变量的影响稍大。对这些结果,特别是关于定性和定量数据之间的差异,提出了解释。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Attitudes toward psychiatric treatment among hospitalized patients: A review of quantitative research

Much of the data available in the literature dealing with psychiatric treatment from the point of view of hospitalized patients stem from qualitative research. Via observations, informal interviews, or masquerading as patients, social scientists have described hospital treatment and patients' attitudes toward it largely in unfavorable terms. Relatively few scientists have taken representative samples of patients, questioned them formally about treatment with objective tests or validated scales, and displayed the findings in statistical format. The present report is a review of this body of quantitative research, with special consideration given to ascertaining patients' degree of favorableness toward treatment. Results indicate that in 34 of the 44 different samples reviewed, or 77%, patients espoused favorable attitudes. Patients proved to be more favorable in their attitude toward treatment at psychiatric hospitals generally than the treatment they received at their own institution. Type of hospital and time of study had a negligible impact on patients' views. Limited data suggest that attitudes improve, or at least do not worsen, as a consequence of hospitalization. Studies that compared patient and staff attitudes reported inconsistent findings. A content analysis of the attitude measures for treatment in general revealed that patients are positive toward the hospital's therapeutic value, assistance with medical problems, restrictions, activities, and involvement of family members, negative toward its patient government and staff/patient relations, and ambivalent toward its patient freedoms and responsibilities. The content analysis of attitudes pertaining to specific therapies disclosed that indvidual, occupational, milieu, physical, recreational, and activity therapies are perceived positively by patients, group therapies negatively, and medication and ECT in an ambivalent manner. Social variables minimally affected the favorableness of patients' responses, and the impact of psychiatric variables was somewhat greater. Interpretations of these results, particularly in regard to the discrepancy between qualitative and quantitative data, are offered.

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