Canadian Mental Health Association - Thunder Bay Branch, First Place Clinic & Regional Resource Centre, Thunder Bay, Ontario, Canada.
Early Interv Psychiatry. 2011 Feb;5(1):64-9. doi: 10.1111/j.1751-7893.2010.00255.x.
This part of the Matryoshka project sought to understand the processes with which early intervention in psychosis (EIP) programmes were implemented and developed. The goals were to understand the key influences of programme implementation in the context of rapid EIP service growth and lack of specific provincial guidelines.
Sampling was purposive and data were collected with semi-structured interviews. Five Matryoshka Project programmes were successfully contacted. All interviews were conducted by phone, recorded and transcribed verbatim. Emerging themes were analysed iteratively and discussed among authors. Key themes were validated with participants.
The new EIP services were significantly influenced by the provincial EIP network, advocacy groups and clinical mentors. EIP programme decision makers often relied on each other for guidance. Although the research evidence assisted programme decision makers to develop an effective EIP model for their region, implementation was often shaped by funding constraints. Programmes adapted their EIP models according to funding and local service characteristics. The lack of specific guidelines may have allowed innovation; programme creativity and diversity is consistent with EIP values. Despite the challenges related to geography and staffing, programmes experienced important successes such as partnerships across sectors, quality clinical service and the ability to engage hard-to-serve clientele.
Although important, research evidence played only a secondary role. Relationships among providers and services, coupled with the dedication of front-line staff, were more critical to knowledge exchange than written documents alone. These findings stress the importance of researcher-front-line relationships to the adoption of evidence-informed practice.
该部分的“Matryoshka 项目”旨在了解早期精神病干预 (EIP) 计划的实施和发展过程。目的是了解在快速 EIP 服务增长和缺乏特定省级指南的背景下，项目实施的关键影响因素。
采用目的性抽样，通过半结构化访谈收集数据。成功联系了五个“Matryoshka 项目”。所有访谈均通过电话进行，录音并逐字记录。分析不断出现的主题，并在作者之间进行讨论。关键主题与参与者进行了验证。
新的 EIP 服务受到省级 EIP 网络、倡导团体和临床导师的显著影响。EIP 项目决策者经常相互寻求指导。尽管研究证据有助于决策者为其地区制定有效的 EIP 模式，但实施往往受到资金限制的影响。根据资金和当地服务特点，项目对其 EIP 模式进行了调整。缺乏具体的指导方针可能允许创新；项目的创造性和多样性与 EIP 的价值观一致。尽管存在与地理和人员配备相关的挑战，但项目取得了重要的成功，例如跨部门合作、高质量的临床服务以及能够接触到难以服务的客户群体。
尽管重要，但研究证据仅发挥了次要作用。提供者和服务之间的关系，以及一线工作人员的奉献精神，对于知识交流比书面文件更为关键。这些发现强调了研究人员与一线人员关系对采用循证实践的重要性。
