Jenssen T, Mørch W T
Oslo Vernepleierhøgskole.
Tidsskr Nor Laegeforen. 1990 May 20;110(13):1721-7.
A proposal for deinstitutionalization of the mentally retarded in Norway passed the Norwegian Storting in May 1988. The Ministry of Health and Social Affairs has prepared guidelines for planning and implenting this reform. On 1 January 1991 the responsibility for providing the necessary services was transferred to the municipalities. Many problems have to be solved in order to ensure that the life of each mentally retarded person is qualitatively improved after normalization and integration into society. In July 1989 the Ministry of Health and Social Affairs issued a document which assumed that necessary specialists and special services for the mentally retarded already exist, and are being used. Our study has questioned this assumption as being incorrect or incomplete. We interviewed persons in charge of the system of health care in all 19 Norwegian counties. Our conclusions are as follows: The mentally retarded do receive specialist services in various areas of somatic medicine. Their needs as regards psychiatric care are not taken care of by psychiatric specialists in hospitals or at out-patient facilities. Data shows that the system of institutionalized health care for the mentally retarded provides unique services which are best described as systematically applied behaviour analyses. Such special competence is often lacking in the Norwegian health services otherwise. In order to ensure that the mentally retarded will receive the best possible care, this competence must be integrated into the future system of care. It is most importance to consider these problems without delay. This article also discusses organizing special training and treatment for the mentally retarded themselves and special training for the persons providing the care.
1988年5月，挪威一项关于智障人士去机构化的提案在挪威议会获得通过。卫生和社会事务部已制定了规划和实施这项改革的指导方针。1991年1月1日，提供必要服务的责任移交给了各市镇。为确保每个智障人士在正常化并融入社会后生活质量得到提高，有许多问题必须解决。1989年7月，卫生和社会事务部发布了一份文件，该文件假定已经存在针对智障人士的必要专家和特殊服务，并且正在得到使用。我们的研究对这一假设提出了质疑，认为它不正确或不完整。我们采访了挪威所有19个郡的医疗保健系统负责人。我们的结论如下：智障人士在躯体医学的各个领域确实接受了专家服务。他们在精神科护理方面的需求并未得到医院或门诊设施的精神科专家的关注。数据显示，针对智障人士的机构化医疗保健系统提供了独特的服务，最好将其描述为系统应用的行为分析。而挪威其他医疗服务中往往缺乏这种特殊能力。为确保智障人士能得到尽可能好的护理，这种能力必须融入未来的护理体系。刻不容缓地考虑这些问题至关重要。本文还讨论了为智障人士自身组织特殊培训和治疗，以及为护理人员组织特殊培训的问题。
