社区心理健康服务中工作人员和患者对未满足需求及治疗联盟的看法。
Staff and patient perspectives on unmet need and therapeutic alliance in community mental health services.
作者信息
Junghan Ulrich M, Leese Morven, Priebe Stefan, Slade Mike
机构信息
University Hospital of Psychiatry, Unit of Community Psychiatry, Laupenstrasse 49, CH-3010 Bern, Switzerland.
出版信息
Br J Psychiatry. 2007 Dec;191:543-7. doi: 10.1192/bjp.bp.107.037978.
BACKGROUND
Therapeutic alliance between clinicians and their patients is important in community mental healthcare. It is unclear whether providing effective interventions influences therapeutic alliance.
AIMS
To assess the impact of meeting previously unmet mental health needs on the therapeutic alliance between patients and clinicians.
METHOD
Secondary analysis of data from a longitudinal study assessing 101 patients and paired staff.
RESULTS
Patient-rated unmet need was negatively associated with patient-rated and staff-rated therapeutic alliance. Staff-rated unmet need was positively associated with patient-rated therapeutic alliance only. Reducing patient-rated unmet need increased patient-rated but not staff-rated therapeutic alliance, even when controlling for other variables. Reducing staff-rated unmet need increased staff-rated but not patient-rated therapeutic alliance, but the effect became insignificant when controlling for other variables.
CONCLUSIONS
Patient-rated therapeutic alliance will be maximised by focusing assessment and interventions on patient-rated rather than staff-rated unmet need.
背景
在社区精神卫生保健中，临床医生与其患者之间的治疗联盟很重要。尚不清楚提供有效的干预措施是否会影响治疗联盟。
目的
评估满足先前未满足的心理健康需求对患者与临床医生之间治疗联盟的影响。
方法
对一项纵向研究的数据进行二次分析，该研究评估了101名患者及配对的工作人员。
结果
患者自评的未满足需求与患者自评及工作人员自评的治疗联盟呈负相关。工作人员自评的未满足需求仅与患者自评的治疗联盟呈正相关。即使在控制其他变量时，减少患者自评的未满足需求会增加患者自评的而非工作人员自评的治疗联盟。减少工作人员自评的未满足需求会增加工作人员自评的而非患者自评的治疗联盟，但在控制其他变量时该效应变得不显著。
结论
通过将评估和干预重点放在患者自评而非工作人员自评的未满足需求上，患者自评的治疗联盟将达到最大化。
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