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治疗关系与非自愿治疗令:服务使用者在病房与医护人员的互动

Therapeutic relationships and involuntary treatment orders: service users' interactions with health-care professionals on the ward.

作者信息

Wyder Marianne, Bland Robert, Blythe Andrew, Matarasso Beth, Crompton David

机构信息

School of Social Work and Human Services, University of Queensland, Brisbane, Queensland, Australia.

出版信息

Int J Ment Health Nurs. 2015 Apr;24(2):181-9. doi: 10.1111/inm.12121. Epub 2015 Jan 28.

Abstract

There is increasing evidence that an involuntary hospital admission and treatment can undermine the therapeutic relationship. While good relationships with staff are important factors influencing long-term recovery, there is little information on how people experience their relationships with staff while under an involuntary treatment order (ITO). Twenty-five involuntary inpatients were interviewed about their experiences of an ITO. The interviews were analysed by a general inductive approach. Participants described the following themes: (i) the ITO admission was a daunting and frightening experience; (ii) staff behaviours and attitudes shaped their experiences in hospital; (iii) importance of staff listening to their concerns; (iv) importance of having a space to make sense of their experiences; (v) importance of staff ability to look beyond their illness and diagnosis; and (vi) importance of staff working in partnership. These findings highlight that when using recovery principles, such as an empathic engagement with the patients' lived experience, forging partnerships with patients in treatment decision-making to enhance agency, an involuntary treatment order does not have to limit the ability to establish positive relationships.

摘要

越来越多的证据表明,非自愿住院治疗可能会破坏治疗关系。虽然与工作人员建立良好关系是影响长期康复的重要因素,但对于人们在非自愿治疗令(ITO)下与工作人员的关系体验却知之甚少。对25名非自愿住院患者进行了关于他们接受ITO经历的访谈。采用一般归纳法对访谈进行分析。参与者描述了以下主题:(i)接受ITO住院是一次令人生畏和恐惧的经历;(ii)工作人员的行为和态度塑造了他们在医院的经历;(iii)工作人员倾听他们担忧的重要性;(iv)拥有一个空间来理解他们经历的重要性;(v)工作人员超越他们的疾病和诊断去看待问题的能力的重要性;以及(vi)工作人员合作的重要性。这些发现表明,在运用康复原则时,比如对患者的生活经历进行共情参与、在治疗决策中与患者建立伙伴关系以增强自主性,非自愿治疗令不一定会限制建立积极关系的能力。

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