Gall Sheena H, Atkinson Jacqueline, Elliott Lawrence, Johansen Ron
School of Nursing and Midwifery, University of Dundee, Dundee, UK.
J Adv Nurs. 2003 Feb;41(3):295-305. doi: 10.1046/j.1365-2648.2003.02529.x.
United Kingdom legislation and clinical standards for schizophrenia challenge nurses to re-examine the support that they provide to carers. Nurses are in a key position to provide this support but may lack the necessary skills to do so. The training programme evaluated in the present study aimed to address this problem.
To evaluate change in clinical practice brought about by post-registration training for mental health nurses in supporting carers of people diagnosed with schizophrenia.
DESIGN/METHODS: The study was undertaken in collaboration between the Universities of Dundee and Glasgow, and Tayside National Health Service (NHS) Trust (Scotland). Respondents were nine nurses who completed training and then delivered a planned programme of support to carers. Data on nursing practice were gathered through semi-structured interviews with nurses before training and after providing support. Following the support intervention, carers also commented on the nurses' practice.
Eight of the nine nurses reported changes in practice in five key areas: They built collaborative relationships with carers, developed a carer focused approach to their practice, acknowledged and supported the carer role, and made progress in identifying carer needs and accessing resources to meet these needs. Nurses experienced difficulties supporting carers who had mental health problems or previous negative experiences of services. Those who lacked community experience also found it difficult to adjust to working in a community setting. Although clinical supervision helped them to work through these difficulties, they remain largely unresolved.
Findings from this study indicate that appropriate training may enable nurses to improve the support provided to carers of people diagnosed with schizophrenia. This study represents an important stage in determining the nature of support offered to carers by nurses. While developed to help nurses to meet clinical standards set for schizophrenia in the UK, findings may have clinical significance for nurses in other countries.
英国关于精神分裂症的立法和临床标准促使护士重新审视他们为护理人员提供的支持。护士在提供这种支持方面处于关键地位,但可能缺乏必要的技能。本研究评估的培训项目旨在解决这一问题。
评估注册后针对心理健康护士开展的、旨在支持精神分裂症患者护理人员的培训所带来的临床实践变化。
设计/方法:该研究由邓迪大学、格拉斯哥大学和泰赛德国民保健服务(NHS)信托基金(苏格兰)合作开展。受访者为九名完成培训并随后为护理人员提供了计划好的支持项目的护士。通过在培训前和提供支持后对护士进行半结构化访谈收集护理实践数据。在支持干预之后,护理人员也对护士的实践发表了评论。
九名护士中有八名报告在五个关键领域的实践发生了变化:他们与护理人员建立了合作关系,在实践中形成了以护理人员为中心的方法,认可并支持护理人员的角色,在识别护理人员需求以及获取满足这些需求的资源方面取得了进展。护士在支持有心理健康问题或曾有过负面服务体验的护理人员时遇到困难。那些缺乏社区经验的护士也发现难以适应在社区环境中工作。尽管临床督导帮助他们克服了这些困难,但这些困难在很大程度上仍未得到解决。
本研究结果表明,适当的培训可能使护士能够改善对精神分裂症患者护理人员的支持。这项研究代表了确定护士为护理人员提供的支持性质的一个重要阶段。虽然该研究是为帮助护士达到英国为精神分裂症设定的临床标准而开展的,但研究结果可能对其他国家的护士具有临床意义。