La Trobe Rural Health School, Bendigo Health Care Group, Bendigo, Victoria, Australia.
Int J Ment Health Nurs. 2015 Feb;24(1):38-48. doi: 10.1111/inm.12095. Epub 2014 Nov 14.
The present study describes participants' perspectives of the meaning of recovery-oriented care in developing services for people with psychosocial disability associated with mental illness. Participants were involved in a 12-month cooperative inquiry action-research group from August 2012 to July 2013, with six consumers, four clinicians, and a carer. A major finding was the importance of the facilitation of dialogue that acknowledged the asymmetrical power differences between participants. Thematically-analysed data identified an overarching global theme: 'I want services to hear me'. The theme reflected a shared view that participation is important in service development. Actions included mapping the integration of consumer participation within a mental health service and developing workshops to support change. Addressing the asymmetrical power relationship inherent in traditional mental health design is important. Using participatory processes, structural discrimination is revealed, and tensions associated with clinical mental health services and psychiatric practice can be discussed. A partnership approach to service development enables the social determinants of health to be addressed more effectively, as well as supporting individual recovery. These approaches create the potential for genuine transformational change. Approaches that support coproduction and codesign have the potential to enable solutions.
本研究描述了参与者对以精神疾病相关的心理社会残疾人为服务对象的康复导向护理的意义的看法。参与者参与了一个为期 12 个月的合作式探究行动研究小组,从 2012 年 8 月至 2013 年 7 月,有 6 名消费者、4 名临床医生和 1 名照顾者。一个主要发现是促进对话的重要性,承认参与者之间存在不对称的权力差异。通过主题分析数据确定了一个总体主题:“我希望服务能听到我的声音”。这一主题反映了一个共同的观点,即参与是服务发展的重要组成部分。行动包括在精神卫生服务中整合消费者参与的情况,并制定支持变革的研讨会。解决传统精神卫生设计中固有的权力不对称关系很重要。使用参与性过程,可以揭示与临床精神卫生服务和精神病学实践相关的紧张关系。以伙伴关系为基础的服务发展方法能够更有效地解决健康的社会决定因素,并支持个人康复。这些方法为真正的变革性变革创造了潜力。支持共同生产和共同设计的方法有可能使解决方案成为可能。