Manchester Mental Health and Social Care Trust, United Kingdom.
J Affect Disord. 2013 Mar 5;145(3):315-23. doi: 10.1016/j.jad.2012.08.009. Epub 2012 Aug 24.
Psychosocial assessment is a central aspect of managing self-harm in hospitals, designed to encompass needs and risk, and to lead to further care. However, little is known about service user experiences of assessment, or what aspects of assessment service users value. The aim of this study was to explore service user experiences of assessment, and examine the short-term and longer-term meanings of assessment for service users.
Interpretative phenomenological analysis was applied to 13 interviews with service users following hospital attendance, and seven follow-up interviews conducted 3 months later.
Few participants had a clear understanding of assessment's purpose. Assessment had the potential to promote or challenge hope, dependent on whether it was experienced as accepting or critical. If follow-up care did not materialise, this reinforced hopelessness and promoted disengagement from services.
The study sample was small and the participants heterogeneous in terms of self-harm history, method and intent, which may limit the transferability of the findings to other settings. Only self-report data on clinical diagnosis were collected.
This was the first study to utilise an in-depth qualitative approach to investigate service user experiences of assessment and follow-up. The findings suggest that re-conceptualising psychosocial assessment as primarily an opportunity to engage service users therapeutically may consequently affect how health services are perceived. In order to maintain benefits established during the hospital experience, follow-up needs to be timely and integrated with assessment.
心理社会评估是医院管理自残行为的一个核心方面，旨在涵盖需求和风险，并为进一步的护理提供指导。然而，对于服务使用者对评估的体验，或者服务使用者看重评估的哪些方面，我们知之甚少。本研究旨在探讨服务使用者对评估的体验，并考察评估对服务使用者的短期和长期意义。
采用解释性现象学分析方法，对 13 名在医院就诊后接受访谈的服务使用者和 7 名在 3 个月后进行的随访访谈进行了分析。
很少有参与者对评估的目的有明确的了解。评估有可能促进或挑战希望，这取决于它是被视为接受还是批评。如果没有跟进护理，这将加剧无望感，并促使服务使用者脱离服务。
研究样本较小，参与者在自残史、方法和意图方面存在异质性，这可能限制研究结果在其他环境中的可转移性。仅收集了关于临床诊断的自我报告数据。
这是第一项利用深入定性方法调查服务使用者对评估和随访体验的研究。研究结果表明，重新将心理社会评估主要概念化为与服务使用者进行治疗性接触的机会，可能会影响人们对卫生服务的看法。为了保持在医院体验中建立的益处，随访需要及时并与评估相结合。
