Lees David, Procter Nicholas, Fassett Denise
School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia.
Int J Ment Health Nurs. 2014 Aug;23(4):306-15. doi: 10.1111/inm.12061. Epub 2014 Feb 27.
Registered nurses within public mental health services play crucial roles in helping people recover from suicidal crisis. However, there is a lack of understanding of how care is experienced in this context, and available evidence suggests that nurses and consumers are often dissatisfied with the quality of care. There is thus an imperative to generate understanding of needs and experiences of both groups with a view to informing practice development. This article summarizes qualitative findings from a multimethod study undertaken in Australia, which surveyed and interviewed mental health nurses who had recent experience of caring for consumers in suicidal crisis in a hospital setting, and interviewed consumers who had recovered from a recent suicidal crisis. A framework was developed to guide the study and support ethical imperatives; in particular, the promotion of consumer well-being. The findings highlight that therapeutic interpersonal engagement between nurses and consumers was central to quality care. This was particularly noted, as engagement could help reduce consumer isolation, loss of control, distress, and objectification of the delivery of potentially-objectifying common interventions. Of concern, the results indicate a lack of therapeutic engagement from the perspective of both consumers and nurses. Recommendations to promote fuller therapeutic engagement are presented.
公共心理健康服务机构的注册护士在帮助人们从自杀危机中康复方面发挥着关键作用。然而，目前对于在此背景下护理体验的了解不足，现有证据表明护士和患者往往对护理质量不满意。因此，迫切需要了解这两个群体的需求和体验，以便为实践发展提供信息。本文总结了在澳大利亚进行的一项多方法研究的定性结果，该研究对近期在医院环境中护理过自杀危机患者的心理健康护士进行了调查和访谈，并对近期从自杀危机中康复的患者进行了访谈。研究制定了一个框架来指导研究并支持道德要求，特别是促进患者的福祉。研究结果表明，护士与患者之间的治疗性人际互动是高质量护理的核心。这一点尤为显著，因为互动有助于减少患者的孤立感、失控感、痛苦以及在实施可能会使患者物化的常见干预措施时的被物化感。令人担忧的是，结果显示从患者和护士的角度来看，都缺乏治疗性互动。本文提出了促进更充分治疗性互动的建议。
