School of Nursing and Midwifery, Victoria University, Melbourne,Victoria, Australia.
Early Interv Psychiatry. 2011 May;5(2):156-62. doi: 10.1111/j.1751-7893.2010.00246.x.
Easy access to first-episode psychosis (FEP) services is critical in reducing the duration of untreated illness. However, primary caregivers can encounter difficulties accessing services on behalf of young people with FEP. This qualitative study describes the lived experience of first time primary caregivers of young adults with FEP, with a focus on examining how they access specialist FEP services.
A qualitative study was undertaken using semi-structured, in-depth interviews with 20 caregivers in Melbourne.
Most carers were women (85%, n = 17) and parents (85%, n = 17). Nearly all lived in the same households as the young people with FEP (90%, n = 18). The mean duration of their involvement with the FEP service was 14.5 months (standard deviation = 8.9). Three competing themes were identified in the data, reflecting caregivers' polarized experiences accessing FEP services. First, general practitioners were regarded as either a resourceful or an unresourceful means of access to FEP services. Second, caregivers often encountered service-focused and carer-focused barriers when initially accessing services. Third, a combination of acquired knowledge, experience with services and caregiver assertiveness enhanced access on subsequent occasions.
This study highlights the important contribution and experience of first-time primary caregivers and the difficulties they face accessing services. The findings suggest access should be influenced more by clinical need and less by caregivers'perseverance. The findings also underline the importance of providing clinical training that acknowledges the needs and contributions of caregivers, as well as interventions that meet the unique challenges faced by first-time caregivers accessing services after the onset of FEP.
便于获得首发精神病(FEP)服务对于减少未治疗疾病的持续时间至关重要。然而,初级照顾者可能难以代表 FEP 的年轻人获得服务。本定性研究描述了首次照顾 FEP 青年的成年照顾者的生活体验,重点是研究他们如何获得专科 FEP 服务。
在墨尔本,采用半结构式深入访谈对 20 名照顾者进行了定性研究。
大多数照顾者为女性(85%,n=17)和父母(85%,n=17)。几乎所有照顾者都与 FEP 年轻人同住(90%,n=18)。他们参与 FEP 服务的平均时长为 14.5 个月(标准差=8.9)。数据中确定了三个相互竞争的主题,反映了照顾者在获得 FEP 服务方面的两极化体验。首先,全科医生被视为获得 FEP 服务的有资源或无资源手段。其次,照顾者在最初获得服务时经常遇到以服务为中心和以照顾者为中心的障碍。第三,通过获得的知识、服务经验和照顾者的坚定性,增强了后续获得服务的能力。
本研究强调了首次初级照顾者的重要贡献和经验,以及他们在获得服务方面面临的困难。研究结果表明,应更多地根据临床需求而不是照顾者的坚持来决定服务的获得。研究结果还强调了提供临床培训的重要性,这种培训既要承认照顾者的需求和贡献,也要满足首次照顾者在 FEP 发病后获得服务时面临的独特挑战。