Lester Helen, Tait Lynda, England Elizabeth, Tritter Jonathan
Department of Primary Care, University of Birmingham, Edgbaston, Birmingham.
Br J Gen Pract. 2006 Jun;56(527):415-22.
Patient involvement in health care is a strong political driver in the NHS. However in spite of policy prominence, there has been only limited previous work exploring patient involvement for people with serious mental illness.
To describe the views on, potential for, and types of patient involvement in primary care from the perspectives of primary care health professionals and patients with serious mental illness.
Qualitative study consisting of six patient, six health professional and six combined focus groups between May 2002 and January 2003.
Six primary care trusts in the West Midlands, England.
Forty-five patients with serious mental illness, 39 GPs, and eight practice nurses participated in a series of 18 focus groups. All focus groups were audiotaped and fully transcribed. Nvivo was used to manage data more effectively.
Most patients felt that only other people with lived experience of mental illness could understand what they were going through. This experience could be used to help others navigate the health- and social-care systems, give advice about medication, and offer support at times of crisis. Many patients also saw paid employment within primary care as a way of addressing issues of poverty and social exclusion. Health professionals were, however, more reluctant to see patients as partners, be it in the consultation or in service delivery.
Meaningful change in patient involvement requires commitment and belief from primary care practitioners that the views and experiences of people with serious mental illness are valid and valuable.
患者参与医疗保健是英国国家医疗服务体系(NHS)的一个重要政治驱动力。然而,尽管政策上备受关注,但此前探索严重精神疾病患者参与的相关工作却非常有限。
从初级保健健康专业人员和严重精神疾病患者的角度,描述对患者参与初级保健的看法、可能性及类型。
2002年5月至2003年1月期间进行的定性研究,包括六个患者焦点小组、六个健康专业人员焦点小组和六个联合焦点小组。
英国西米德兰兹郡的六个初级保健信托机构。
45名严重精神疾病患者、39名全科医生和8名执业护士参加了一系列18个焦点小组。所有焦点小组都进行了录音并完整转录。使用Nvivo软件更有效地管理数据。
大多数患者认为,只有其他有精神疾病亲身经历的人才能理解他们所经历的一切。这种经历可用于帮助他人在医疗和社会护理系统中找到方向、提供用药建议,并在危机时刻给予支持。许多患者还将在初级保健机构的有偿工作视为解决贫困和社会排斥问题的一种方式。然而,健康专业人员更不愿意将患者视为合作伙伴,无论是在咨询过程中还是在服务提供方面。
患者参与方面的有意义变革需要初级保健从业者的承诺和信念,即严重精神疾病患者的观点和经历是有效且有价值的。