School of Sociology and Social Policy, University of Nottingham, Nottingham, UK.
J Psychiatr Ment Health Nurs. 2011 Nov;18(9):822-32. doi: 10.1111/j.1365-2850.2011.01733.x. Epub 2011 Apr 20.
Assertive outreach services have been central to community mental health policy within the UK. These multidisciplinary teams were established to engage with service users who have severe and enduring mental health problems and have found traditional community services unable to meet their needs. Mental health nurses have a pivotal role in these multidisciplinary teams, yet the nature of these relationships from the perspective of those who work in and receive care is poorly understood. This study set out to explore the nature and meaning of engagement for practitioners and service users within assertive outreach services. A qualitative approach, informed by philosophical hermeneutics, underpinned the study. Participants were recruited from a single assertive outreach team in the UK. To be eligible for the study, mental health practitioners needed to be employed within the assertive outreach team. All service users residing in the community and receiving care from the team were also eligible for inclusion. In total 14 interviews were conducted with mental health practitioners and 13 with service users. Data analysis was informed by Turner's method. Four themes emerged from the data; contact, dialogue, transformation and shared understanding. Meaningful engagement was found to manifest itself through experiences such as providing and receiving practical assistance, having a genuine two-way conversation and valuing the experiences and personal attributes of the other person. The findings indicate that engagement is an active, dynamic and skilled process, which leads practitioners and service users to transform together to create a new relationship.
肯定性外展服务是英国社区心理健康政策的核心。这些多学科团队的成立是为了接触那些患有严重和持久精神健康问题的服务使用者，他们发现传统的社区服务无法满足他们的需求。精神科护士在这些多学科团队中扮演着关键角色，但从从业者和接受护理者的角度来看，这些关系的性质却知之甚少。本研究旨在探讨肯定性外展服务中从业者和服务使用者参与的性质和意义。一种基于哲学解释学的定性方法为该研究提供了依据。参与者是从英国一个单一的肯定性外展团队中招募的。要符合研究条件，精神科从业者必须在肯定性外展团队中工作。所有居住在社区并从团队中接受护理的服务使用者也有资格入选。共有 14 名精神科从业者和 13 名服务使用者接受了访谈。特纳的方法为数据分析提供了信息。数据中出现了四个主题；接触、对话、转变和共同理解。有意义的参与被发现体现在提供和接受实际帮助、进行真正的双向对话以及重视对方的经验和个人特质等方面。研究结果表明，参与是一个积极、动态和熟练的过程，它使从业者和服务使用者共同转变，从而建立新的关系。
