服务提供者对以康复为导向的精神卫生系统改革的经验和看法。
Service providers' experiences and perspectives on recovery-oriented mental health system reform.
机构信息
Douglas Mental Health University Institute, Canada.
出版信息
Psychiatr Rehabil J. 2012 Spring;35(4):289-96. doi: 10.2975/35.4.2012.289.296.
Abstract
OBJECTIVE
With the use of a qualitative approach, this study focuses on service providers' experiences and perspectives on recovery-oriented reform.
METHODS
Nine focus groups were conducted with a sample of 68 service providers recruited from three Canadian sites.
RESULTS
Three major themes were identified: 1) positive attitudes towards recovery-oriented reform; 2) skepticism towards recovery-oriented reform; and 3) challenges associated with implementing recovery-oriented practice. These challenges pertained to conceptual uncertainty and consistency around the meanings of recovery; application of recovery-oriented practice with certain populations and in certain contexts; bureaucratization of recovery-oriented tools; limited leadership support; and, societal stigma and social exclusion of persons with mental illnesses.
CONCLUSIONS AND IMPLICATIONS FOR PRACTICE
The findings point towards challenges that might arise as system planners move ahead in their efforts toward implementing recovery within the mental health system. In this regard, we offer several recommendations for the planning of organizational and educational practices that support the implementation of recovery-oriented practice.
摘要
目的
本研究采用定性方法，关注服务提供者在以康复为导向的改革方面的经验和观点。
方法
从加拿大的三个地点招募了 68 名服务提供者，对他们进行了 9 次焦点小组讨论。
结果
确定了三个主要主题：1）对以康复为导向的改革的积极态度；2）对以康复为导向的改革的怀疑态度；3）实施以康复为导向的实践所面临的挑战。这些挑战涉及到对康复的概念的不确定性和一致性；在某些情况下和某些人群中应用以康复为导向的实践；以康复为导向的工具的官僚化；有限的领导支持；以及社会对精神疾病患者的污名化和社会排斥。
结论和对实践的启示
研究结果指出了在系统规划者努力在精神卫生系统中实施康复的过程中可能出现的挑战。在这方面，我们提出了一些建议，用于规划组织和教育实践，以支持实施以康复为导向的实践。
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