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以患者为中心的心理健康照护:实施的挑战。

Person-centred mental health care: the challenge of implementation.

出版信息

Epidemiol Psychiatr Sci. 2012 Jun;21(2):139-44. doi: 10.1017/S2045796012000078.

Abstract

Within mental health care, 'person-centredness' has been generally interpreted to convey a holistic approach with an attitude of respect for the individual and his/her unique experience and needs. Although it has been possible to demonstrate that professionals can acquire such skills through training, the impact on clinical outcomes has been more difficult to demonstrate in randomized controlled trials. Indeed what is becoming increasingly apparent in the literature is the need to acknowledge and address the degree of complexity that exists within the health care system that militates against achieving satisfactory implementation and outcomes from person-centred mental health care. In addressing this, we must develop and work with more sophisticated and three-dimensional models of 'patient-centredness' that engage with not only what happens in the consulting room (the relationship between individual service users and healthcare professionals), but also addresses the problems involved in achieving person-centredness through modifying the way that services and organizations work, and finally by engaging families and communities in the delivery of health care. A truly meaningful concept of 'people-centredness' encompasses how the views of the population are taken into consideration not only in healthcare but also in health and social care policy, and wider society too.

摘要

在精神卫生保健领域,“以患者为中心”通常被解释为一种整体方法,体现出对个体及其独特体验和需求的尊重。尽管已经有可能证明专业人员可以通过培训获得这些技能,但在随机对照试验中更难证明其对临床结果的影响。事实上,文献中越来越明显的是,需要承认和解决医疗保健系统中存在的一定程度的复杂性,这些复杂性不利于实现令人满意的以患者为中心的精神卫生保健的实施和结果。为了解决这个问题,我们必须开发并使用更复杂和三维的“以患者为中心”模型,不仅要考虑咨询室中发生的事情(服务使用者和医疗保健专业人员之间的关系),还要通过改变服务和组织的工作方式来解决实现以患者为中心的问题,最后还要让家庭和社区参与医疗保健服务。“以患者为中心”的真正有意义的概念包括如何不仅在医疗保健中,而且在卫生和社会保健政策以及更广泛的社会中考虑民众的意见。

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