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精神疾病患者家庭的经历和需求在医学教育指南中是如何体现的?

How are the experiences and needs of families of individuals with mental illness reflected in medical education guidelines?

作者信息

Riebschleger Joanne, Scheid Jeanette, Luz Clare, Mickus Maureen, Liszewski Christine, Eaton Monaca

机构信息

School of Social Work, College of Social Science, Michigan State University, East Lansing, MI 48824, USA.

出版信息

Acad Psychiatry. 2008 Mar-Apr;32(2):119-26. doi: 10.1176/appi.ap.32.2.119.

Abstract

OBJECTIVE

This descriptive study explored the extent that medical education curriculum guidelines contained content about the experiences and needs of family members of people with serious mental illness.

METHODS

Key family-focused-literature themes about the experiences and needs of families of individuals with mental illness were drawn from a review of over 6,000 sources in the mental health practice literature that were identified within a systematic search and thematic development process. The study identified the extent and nature of family-focused key literature themes as reflected in medical education curriculum guidelines for psychiatry and primary care practice specialties of family practice, internal medicine, and pediatrics. An iterative process was used to retrieve and analyze text data drawn from the curriculum guidelines of national accrediting organizations for undergraduate, graduate, and continuing medical education.

RESULTS

The key family-focused themes, as drawn from the mental health practice research literature, were: mental illness stigma; family caregiver burden; information exchange and referral; family stress, coping, and adaptation; family support; crisis response; and family psychoeducation. Two of these seven themes appeared in medical education curriculum guidelines: information exchange and caregiver burden. The most frequently appearing family-focused key literature theme was information exchange. Psychiatry and undergraduate medical education reflected the most family content.

CONCLUSION

It appears that medical education curriculum guidelines have insufficient content about families of people with mental illness. The educational experiences of psychiatrists and primary care physicians may not adequately prepare them for working with family members of their patients. It is recommended that medical education curriculum guidelines incorporate information about family stigma; family/caregiver burden; information exchange; family stress, coping, and adaptation; family support; crisis response; and multiple family group psychoeducation.

摘要

目的

本描述性研究探讨了医学教育课程指南中包含严重精神疾病患者家庭成员经历与需求相关内容的程度。

方法

关于精神疾病患者家庭经历与需求的关键以家庭为中心的文献主题,来自对心理健康实践文献中6000多篇文献的综述,这些文献是在系统检索和主题发展过程中确定的。该研究确定了以家庭为中心的关键文献主题在精神病学以及家庭医学、内科和儿科等初级保健实践专业的医学教育课程指南中的体现程度和性质。采用迭代过程来检索和分析从本科、研究生和继续医学教育的国家认证组织的课程指南中提取的文本数据。

结果

从心理健康实践研究文献中提取的关键以家庭为中心的主题有:精神疾病污名化;家庭照顾者负担;信息交流与转诊;家庭压力、应对与适应;家庭支持;危机应对;以及家庭心理教育。这七个主题中有两个出现在医学教育课程指南中:信息交流和照顾者负担。出现频率最高的以家庭为中心的关键文献主题是信息交流。精神病学和本科医学教育反映的家庭相关内容最多。

结论

医学教育课程指南中关于精神疾病患者家庭的内容似乎不足。精神科医生和初级保健医生的教育经历可能无法充分使他们为与患者家庭成员合作做好准备。建议医学教育课程指南纳入有关家庭污名化;家庭/照顾者负担;信息交流;家庭压力、应对与适应;家庭支持;危机应对;以及多家庭团体心理教育的信息。

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