Treatment Acceptance and Adherence in HIV Disease: Patient Identity and the Perceived Impact of Physician-Patient Communication.

Treatment acceptance and adherence in HIV disease: patient identity and the perceived impact of physician-patient communication.

Filed under: Addiction Rehab

Patient Prefer Adherence. 2012; 6: 893-903
Laws MB, Rose GS, Bezreh T, Beach MC, Taubin T, Kogelman L, Gethers M, Wilson IB

Studies have found that physician-patient relationships and communication quality are related to medication adherence and outcomes in HIV care. Few qualitative studies exist of how people living with HIV experience clinical communication about their self-care behavior. Eight focus groups with people living with HIV in two US cities were conducted. Participants responded to a detailed discussion guide and to reenactments of actual physician-patient dialogue about antiretroviral adherence. The 82 participants were diverse in age, sex, and ethnicity. Most had been living with HIV for many years and had stable relationships with providers. They appreciated providers who knew and cared about their personal lives, who were clear and direct about instructions, and who were accessible. Most had struggled to overcome addiction, emotional turmoil, and/or denial before gaining control over their lives and becoming adherent to medications. They made little or no causal attribution for their transformation to any outside agency, including their providers. They generally saw medication adherence as a function of autonomous motivation. Successful coping with HIV with its prevalent behavioral comorbidities, stigma, and other challenges requires a transformation of identity and internalization of motivation to maintain health. Effective methods for clinicians to support such development are needed.
HubMed – addiction

Novel Insights into Depression and Antidepressants: A Synergy Between Synaptogenesis and Neurogenesis?

Filed under: Addiction Rehab

Curr Top Behav Neurosci. 2012 Dec 28;
Bambico FR, Belzung C

Major depressive disorder has been associated with manifold pathophysiological changes. These include metabolic abnormalities in discreet brain areas; modifications in the level of stress hormones, neurotransmitters, and neurotrophic factors; impaired spinogenesis and synaptogenesis in crucial brain areas, such as the prefrontal cortex and the hippocampus; and impaired neurogenesis in the hippocampus. Antidepressant therapy facilitates remission by reversing most of these disturbances, indicating that these dysfunctions may participate causally in depressive symptomatology. However, few attempts have been made to integrate these different pathophysiologies into one model. The present chapter endeavors (1) to review the extant literature in the field, with particular focus on the role of neurogenesis and synaptogenesis in depression; (2) and to suggest a possible interplay between these two processes, as well as, describe the ways by which improving both neurogenesis and synaptogenesis may enable effective recovery by acting on a larger neuronal network.
HubMed – addiction

Understanding addiction.

Filed under: Addiction Rehab

Am J Nurs. 2013 Jan; 113(1): 12
Pickett J

HubMed – addiction

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