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一项关于尼加拉瓜初级卫生保健专业人员对年轻人心理健康、自杀问题及寻求帮助的看法的定性研究。

A qualitative study on primary health care professionals' perceptions of mental health, suicidal problems and help-seeking among young people in Nicaragua.

作者信息

Obando Medina Claudia, Kullgren Gunnar, Dahlblom Kjerstin

机构信息

Centre for Demography and Health Research, Nicaraguan National Autonomous University, León, Nicaragua.

出版信息

BMC Fam Pract. 2014 Jul 2;15:129. doi: 10.1186/1471-2296-15-129.

Abstract

BACKGROUND

Mental health problems among young peoples are a growing public health issue around the world. In low- income countries health systems are characterized by lack of facilities, human resources and primary health care is rarely an integrated part of overall health care services. This study aims at exploring how primary health care professionals in Nicaragua perceive young people's mental health problems, suicidal problems and help-seeking behaviour.

METHODS

Twelve in-depth interviews were conducted with nurses and doctors working in primary health care services in León, Nicaragua. A qualitative research design was applied. Data was analysed using thematic analysis approach.

RESULTS

This study revealed that doctors and nurses were reluctant to deal with young people presenting with suicidal problems at the primary health care. This was more likely to stem from feelings of incompetence rather than from negative attitudes. Other barriers in providing appropriate care to young people with mental health problems were identified such as lack of time, lack of privacy, lack of human resources, lack of trained professionals and difficulties in communicating with young people. The primary health care (PHC) professionals suggested different solutions to improve care for young people with suicidal problems.

CONCLUSION

PHC doctors and nurses in Nicaragua felt that providing skilled mental health services to young people was a priority for them but they also identified a number of barriers to be able to do so. They discussed ways to improve young people's willingness to share sensitive issues with them and suggested ways to make PHC more appreciated by young people.

摘要

背景

青少年心理健康问题是全球日益严重的公共卫生问题。在低收入国家,卫生系统的特点是设施匮乏、人力资源短缺,初级卫生保健很少成为整体卫生保健服务的一个有机组成部分。本研究旨在探讨尼加拉瓜的初级卫生保健专业人员如何看待青少年的心理健康问题、自杀问题及求助行为。

方法

对在尼加拉瓜莱昂市从事初级卫生保健服务的护士和医生进行了12次深入访谈。采用定性研究设计。运用主题分析法对数据进行分析。

结果

本研究表明,医生和护士不愿在初级卫生保健机构处理有自杀问题的青少年。这更可能源于能力不足感而非消极态度。还发现了在为有心理健康问题的青少年提供适当护理方面的其他障碍,如时间不足、缺乏隐私、人力资源短缺、缺乏训练有素的专业人员以及与青少年沟通困难。初级卫生保健专业人员提出了不同的解决方案,以改善对有自杀问题青少年的护理。

结论

尼加拉瓜的初级卫生保健医生和护士认为,为青少年提供专业的心理健康服务对他们来说是一个优先事项,但他们也指出了一些阻碍他们这样做的因素。他们讨论了提高青少年与他们分享敏感问题意愿的方法,并提出了让青少年更重视初级卫生保健的方法。

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