Wainwright Laura D, Glentworth David, Haddock Gillian, Bentley Ros, Lobban Fiona
The Spectrum Centre for Mental Health Research, University of Lancaster, UK.
Psychol Psychother. 2015 Mar;88(1):105-19. doi: 10.1111/papt.12024. Epub 2014 Mar 12.
In the United Kingdom (UK), the government has set out priorities to support relatives and carers. Despite this, many relatives of people experiencing psychosis continue to feel unsupported by mental health services. This may be due to lack of funding, high caseloads for mental health professionals, or due to a lack of understanding of what relatives experience as a result of their family member's psychosis. This research aimed to explore relatives' experiences of supporting a relative in early psychosis.
Thematic analysis was used to conduct an in-depth study of relatives' experiences of supporting a family member in early psychosis.
Eligible individuals were recruited via local National Health Service Early Intervention Teams and other carer support agencies. Four focus groups were conducted, each with a range of five to seven participants.
Four key themes 'reflecting relatives' understanding and management of psychosis were identified: 'Psychosis from the relatives' perspective'; 'Relatives' fight with the mental health 'system'; 'Is anybody listening? Does anyone understand?'; and 'Relatives' coping'. Clinical implications of these themes are discussed.
This study has clear implications for improvement in how relatives are supported in the United Kingdom, such as; clearer guidance for staff about confidentiality, treating relatives as partners in care and providing better quality information for relatives.
Continue to improve the Care Plan Approach process to include relatives as partners in care. Information available about psychosis needs to be clear and, where possible, clarify the processes and protocols by which services operate and how to access appropriate help. Move away from simplistic rules about confidentiality and formalise procedures to allow relatives and carers access to the information they need, without impeding service users' rights. For example, providing additional training for professionals such as Rethink's 'Carers and Confidentiality' online resource (http://www.carersandconfidentiality.org.uk/). Improved support, supervision and training are needed for staff to deal with relatives' distress and the impact of psychosis. Relatives' experiences of services is more positive in specialist Early Interventions Services for psychosis, than in other health service teams.
在英国，政府已明确了支持亲属和照料者的优先事项。尽管如此，许多精神病患者的亲属仍然觉得心理健康服务无法为他们提供支持。这可能是由于资金不足、心理健康专业人员的工作量过大，或者是由于对亲属因家庭成员患精神病而经历的情况缺乏了解。本研究旨在探讨亲属在早期精神病阶段支持亲属的经历。
采用主题分析法对亲属在早期精神病阶段支持家庭成员的经历进行深入研究。
通过当地国民健康服务早期干预团队和其他照料者支持机构招募符合条件的个体。共进行了四个焦点小组，每个小组有五至七名参与者。
确定了四个反映亲属对精神病的理解和管理的关键主题：“亲属视角下的精神病”；“亲属与心理健康‘系统’的斗争”；“有人在听吗？有人理解吗？”；以及“亲属的应对”。讨论了这些主题的临床意义。
本研究对英国改善亲属支持方式具有明确的启示，例如；为工作人员提供更清晰的保密指导，将亲属视为护理伙伴，并为亲属提供更高质量的信息。
继续改进护理计划方法，将亲属纳入护理伙伴。关于精神病的可用信息需要清晰明了，并尽可能阐明服务运作的流程和协议以及如何获得适当帮助。摒弃关于保密的简单规则，规范程序，使亲属和照料者能够获取所需信息，同时不妨碍服务使用者的权利。例如，为专业人员提供额外培训，如“重新思考”组织的“照料者与保密”在线资源（http://www.carersandconfidentiality.org.uk/）。工作人员需要更好的支持、监督和培训，以应对亲属的痛苦和精神病的影响。与其他健康服务团队相比，亲属在专门的精神病早期干预服务中的服务体验更为积极。
