Deans C, Soar R
University of Ballarat and Ballarat Health Services, University of Ballarat, Ballarat, Victoria, Australia.
J Psychiatr Ment Health Nurs. 2005 Jun;12(3):268-74. doi: 10.1111/j.1365-2850.2005.00830.x.
This paper identifies and describes the experiences of 13 rural mental health professionals who care for clients diagnosed with a mental illness and a coexisting alcohol and other drug disorder (dual diagnosis). Dual diagnosis is a common problem which is often poorly understood and managed by mental health professionals. The effect of excessive substance use on a person's mental well-being can present as a diagnostic challenge as each condition may mask symptoms of the other. The authors utilized a phenomenological approach to discover the experiences of a group of mental health professionals working in rural communities in Victoria, Australia. Caring for clients diagnosed with dual diagnosis was found to be a complex and stressful role that involved high levels of skill and knowledge. Despite the fact that health professionals in rural areas are expected to deliver the most appropriate care to individuals with a dual diagnosis, a number of these rural health professionals have limited preparation and experience in dealing with arising clinical diagnosis issues. Clinicians experience frustration, resentment and powerlessness in their attempt to understand their clients' drug misuse whilst simultaneously endeavouring to provide a quality mental health service.
本文识别并描述了13位农村心理健康专业人员的经历,这些专业人员负责照料被诊断患有精神疾病且同时患有酒精及其他药物紊乱(双重诊断)的患者。双重诊断是一个常见问题,心理健康专业人员往往对此理解不足且处理不当。过度使用物质对一个人的心理健康产生的影响可能会带来诊断挑战,因为每种情况可能会掩盖另一种情况的症状。作者采用现象学方法,去探寻在澳大利亚维多利亚州农村社区工作的一组心理健康专业人员的经历。结果发现,照料被诊断为双重诊断的患者是一项复杂且压力巨大的工作,需要高水平的技能和知识。尽管农村地区的卫生专业人员预计要为双重诊断患者提供最合适的护理,但其中一些农村卫生专业人员在处理出现的临床诊断问题方面准备有限且经验不足。临床医生在试图理解患者药物滥用情况的同时,又努力提供高质量的心理健康服务,他们感到沮丧、不满和无力。