Adams M W
Swansea University, School of Health Science, Carmarthen, Carmarthenshire, UK.
J Psychiatr Ment Health Nurs. 2008 Mar;15(2):101-8. doi: 10.1111/j.1365-2850.2007.01210.x.
A comorbidity of mental health and substance misuse problems has been associated with deleterious outcomes. In the United Kingdom it has been acknowledged that people with comorbidity have often received poor care, with gaps in service provision suggesting ambivalence towards this issue. Previous reviewing authors have concluded that health professionals hold stereotypical views towards people that misuse substances, but these findings may not be directly comparable to those who work within mental health services. There is however a growing body of evidence concerning this context. The author has reviewed the literature from 1996 to 2006 to ascertain mental health professionals and allied workers attitudes and perceptions towards comorbidity, perceptions on the effectiveness of service systems, and perceptions of personal knowledge and skill in providing effective interventions. The evidence presented mainly pertains to mental health nurses, which reflects their status as the largest discipline within the mental health workforce. Overall attitudes towards comorbidity are mixed, possibly being related to contextual issues of practice and are not necessarily negative. However, there is an almost universal negative perception of deficiencies in service provision and the adequacy of training. Implications for research, development and practice are explored.
心理健康问题与药物滥用问题并存已被证实会产生有害后果。在英国，人们已经认识到，患有合并症的患者往往得到的护理质量较差，服务提供方面的差距表明对这一问题存在矛盾态度。之前的综述作者得出结论，卫生专业人员对药物滥用者持有刻板印象，但这些发现可能无法直接与心理健康服务领域的工作人员的发现相比较。然而，关于这一背景的证据越来越多。作者回顾了1996年至2006年的文献，以确定心理健康专业人员和相关工作人员对合并症的态度和看法、对服务系统有效性的看法，以及对提供有效干预措施的个人知识和技能的看法。所呈现的证据主要涉及心理健康护士，这反映了他们作为心理健康工作人员中最大的专业群体的地位。对合并症的总体态度不一，可能与实践中的背景问题有关，并不一定是负面的。然而，对于服务提供方面的不足和培训的充分性，几乎普遍存在负面看法。本文探讨了对研究、发展和实践的影响。
