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4.
J Nerv Ment Dis ; 192(6): 395-404, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15167402

RESUMO

This study identified factors impacting adherence to human immunodeficiency virus (HIV) therapies in a sample of 46 persons diagnosed with HIV/acquired immune deficiency syndrome and severe mental illness who were receiving care through a day care program in Northern California. Comprehensive descriptions of factors and circumstances that influence adherence behaviors were obtained through critical incident interviews, and a taxonomy of adherence factors was determined. A chi2 analysis that examined differences between patient characteristics and major adherence factors found that planning was more likely to be reported by older persons taking HIV medications over longer periods. Nonwhite persons and those living alone were more apt to rely on the use of reminders and cues. Persons with bipolar disorder reported substantially more incidents of the impact of their symptoms on adherence to HIV therapies than persons with other psychiatric diagnoses. The taxonomy of adherence factors provides important information for developing relevant adherence education programs and an essential foundation for testing compliance interventions.


Assuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Transtornos Mentais/epidemiologia , Cooperação do Paciente , Síndrome da Imunodeficiência Adquirida/psicologia , Adulto , Atitude Frente a Saúde , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , California , Hospital Dia , Escolaridade , Feminino , Infecções por HIV/psicologia , Humanos , Masculino , Transtornos Mentais/psicologia , Cooperação do Paciente/psicologia , Cooperação do Paciente/estatística & dados numéricos , Escalas de Graduação Psiquiátrica , Sistemas de Alerta , Índice de Gravidade de Doença , Fatores Socioeconômicos , Inquéritos e Questionários , Análise e Desempenho de Tarefas
6.
J Psychosoc Nurs Ment Health Serv ; 41(2): 38-49, 2003 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-12613098

RESUMO

A survey was developed to determine whether the rapidly changing context of mental health care has significantly influenced how psychiatric nurses assess and intervene in issues related to medication adherence. A sample of 126 psychiatric nurses working in Veterans Affairs mental health treatment facilities in northern California, Hawaii, and Nevada identified the most effective methods for tracking medication adherence, as well as successful adherence interventions. Despite the challenge imposed by changing work environments, psychiatric nurses use creative and innovative approaches to improve their patients' medication adherence. Interventions for enhancing patient adherence with prescribed regimens are identified. Essential role dimensions related to medication adherence defined by the nurses in this survey included providing medication education, tracking patient adherence, assessing medication effectiveness, providing individualized, tailored adherence interventions, and collaborating with other health care providers in medication planning. Study findings support using nurses to their full potential and highlight nurses' need for more educational opportunities and consultation with experts (e.g., clinical pharmacists).


Assuntos
Transtornos Mentais/tratamento farmacológico , Cooperação do Paciente , Enfermagem Psiquiátrica/métodos , Psicotrópicos/uso terapêutico , Humanos , Transtornos Mentais/epidemiologia , Relações Enfermeiro-Paciente , Cooperação do Paciente/estatística & dados numéricos
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