Viora Eka, Maramis Albert, Keliat Budi Anna
Departemen Psikiatri, RS Cipto Mangunkusumo, Jakarta, Indonesia.
Int Rev Psychiatry. 2006 Dec;18(6):559-62. doi: 10.1080/09540260601039959.
Before the tsunami, there was no systematic training provided for General Practitioners (GPs) and nurses in issues related to mental health and psychosocial support in times of disasters. After the tsunami, the Department of Psychiatry, Faculty of Medicine, University of Indonesia in Jakarta was contracted to organize a special two-week intensive training programme on basic psychiatry for 13 GPs from Banda Aceh Mental Hospital. To improve the nursing practice, a Professional Nursing Practice Model (MPKP) has been piloted in two wards in Banda Aceh Mental Hospital. This is a model of best practice for nursing care and management in an open ward system developed by the School of Nursing group and implemented in several mental hospitals in Indonesia. Basic training of GPs located at the primary healthcare level is being carried out based on the existing Ministry of Health curriculum for GPs. It covers 14 conditions listed in the International Classification of Diseases (ICD) Primary Care classification and has been conducted in 11 tsunami-affected districts. Currently, a total of 169 GPs have been trained. In general, there is an increasing interest among primary care doctors in mental health. Currently, community mental healthcare is provided in 11 districts in Aceh and two districts in North Sumatra by 277 Community Mental Health Nurses (CMHN) who have received basic training. Two thousand six hundred and two cases of serious mental disorders (mostly chronic psychosis) have been detected and treated by the CMHN and the doctors in Primary Health Centres (PHC). CMHN can provide a vital link between patients in the community and doctors in PHC. Two years after the earthquake and tsunami in Aceh, psychosocial intervention should continue and mental healthcare should be made available not only at Banda Aceh Mental Hospital, but also general health services, including PHC services.
在海啸发生之前,没有针对全科医生(GPs)和护士开展与灾害时期心理健康及心理社会支持相关问题的系统培训。海啸过后,雅加达印度尼西亚大学医学院精神病学系受委托为班达亚齐精神病院的13名全科医生组织了为期两周的基础精神病学强化培训项目。为改善护理实践,专业护理实践模式(MPKP)已在班达亚齐精神病院的两个病房进行试点。这是护理学院团队开发的开放病房系统中护理和管理最佳实践的模式,并已在印度尼西亚的几家精神病院实施。基于卫生部现有的全科医生课程,正在对基层医疗保健层面的全科医生进行基础培训。培训涵盖《国际疾病分类》(ICD)初级保健分类中列出的14种病症,并已在11个受海啸影响的地区开展。目前,共有169名全科医生接受了培训。总体而言,基层医疗医生对心理健康的兴趣日益浓厚。目前,亚齐的11个区和北苏门答腊的2个区由277名接受过基础培训的社区心理健康护士(CMHN)提供社区心理健康护理。社区心理健康护士和初级卫生保健中心(PHC)的医生已检测并治疗了2602例严重精神障碍病例(大多为慢性精神病)。社区心理健康护士能够在社区患者与初级卫生保健中心的医生之间建立至关重要的联系。在亚齐发生地震和海啸两年后,心理社会干预应继续进行,心理健康护理不仅应在班达亚齐精神病院提供,还应在包括初级卫生保健中心服务在内的一般卫生服务中提供。