Rose Linda E, Mallinson R Kevin, Walton-Moss Benita
Johns Hopkins University, School of Nursing, Baltimore, MD, USA.
J Nurs Scholarsh. 2004;36(1):39-47. doi: 10.1111/j.1547-5069.2004.04009.x.
To identify barriers to family care in psychiatric settings and to describe family and provider perspectives about what constitutes effective family care.
A qualitative exploratory approach with focus groups. Seventy-eight people participated in 11 focus groups conducted with families, patients, and health professionals.
Families identified poor quality care, conflict with health professionals about treatment, and lack of a role for families in the treatment. African American families also identified isolation of their communities from the mental health care system. Adolescents emphasized their role as caregivers and their needs for support. Health professionals conveyed concerns about system-based barriers, professional practice-based barriers, and family-based barriers to care. Patients stated the need for their families to be better educated about mental illness.
The lack of family care in psychiatric settings is a multifaceted problem. Current health policies do not show endorsement of a family care approach. Responses from families and health professionals indicated conflicting opinions about content of family care. Health professionals reported they often lacked training and resources to deal with complex family issues. Families believed that lengthy and intensive interventions were neither necessary nor desired to address their concerns. Family care can be improved by focusing on building rapport and communicating problems and concerns between families and health professionals.
确定精神科环境中家庭护理的障碍，并描述家庭和提供者对于有效家庭护理构成要素的看法。
采用焦点小组进行定性探索性研究。78人参与了与家庭、患者和卫生专业人员进行的11个焦点小组。
家庭指出护理质量差、与卫生专业人员在治疗问题上存在冲突以及家庭在治疗中缺乏角色。非裔美国家庭还指出其社区与精神卫生保健系统隔离。青少年强调了他们作为照顾者的角色以及对支持的需求。卫生专业人员表达了对基于系统的障碍、基于专业实践的障碍和基于家庭的护理障碍的担忧。患者表示需要让他们的家人更好地了解精神疾病。
精神科环境中缺乏家庭护理是一个多方面的问题。当前的卫生政策未表明对家庭护理方法的认可。家庭和卫生专业人员的回应表明对家庭护理内容存在相互冲突的意见。卫生专业人员报告称，他们常常缺乏处理复杂家庭问题的培训和资源。家庭认为，冗长而密集的干预既无必要，也不符合他们解决问题的意愿。通过专注于建立融洽关系以及在家庭和卫生专业人员之间沟通问题和担忧，可以改善家庭护理。
