患者参与精神卫生保健：何时会遇到困难？挪威一家精神卫生医院的用户和提供者的定性研究。
Patient participation in mental healthcare: when is it difficult? A qualitative study of users and providers in a mental health hospital in Norway.
机构信息
Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
出版信息
Int J Soc Psychiatry. 2013 Mar;59(2):107-13. doi: 10.1177/0020764011423464. Epub 2011 Oct 18.
BACKGROUND
In western countries, patient participation is requested in policies on mental health services. Participation is built on ideas of democracy and individual responsibility. Mental illness has, however, been characterized by its irrational features.
AIM
To investigate mental health service users' and providers' views on patient participation during episodes of mental illness.
METHODS
Qualitative interview study with 20 users and 25 staff from a mental health hospital in central Norway.
RESULTS
Both users and professionals saw poor illness phases as an obstacle to patient participation. Lack of insight, lack of verbal ability and difficulty cooperating made participation difficult. During such phases, patient participation was redefined. There was a shift in responsibility where professionals took charge through strategies of providing information, motivating patients and reducing choices. Respect and dignity were maintained and not redefined.
CONCLUSIONS
In poor phases of mental illness, patient participation was redefined and weighed against what was perceived to be the patient's best interest.
背景
在西方国家，要求精神卫生服务政策中体现患者参与。参与是基于民主和个人责任的理念。然而，精神疾病的特点是其非理性特征。
目的
调查精神卫生服务使用者和提供者在精神疾病发作期间对患者参与的看法。
方法
对挪威中部一家精神卫生医院的 20 名使用者和 25 名工作人员进行了定性访谈研究。
结果
使用者和专业人员都认为病情不佳是患者参与的障碍。缺乏洞察力、缺乏言语能力和难以合作使得参与变得困难。在这些阶段，患者参与被重新定义。责任发生了转移，专业人员通过提供信息、激励患者和减少选择等策略来负责。尊重和尊严得以维持，而不是重新定义。
结论
在精神疾病的严重阶段，患者参与被重新定义，并与被认为是患者最佳利益的因素进行权衡。
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