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护理人员参与护理计划的经历:对参与心理健康服务的促进因素和障碍的质性探索。

Carers' experiences of involvement in care planning: a qualitative exploration of the facilitators and barriers to engagement with mental health services.

作者信息

Cree Lindsey, Brooks Helen L, Berzins Kathryn, Fraser Claire, Lovell Karina, Bee Penny

机构信息

EQUIP, School of Nursing, Midwifery and Social Work, Jean McFarlane Building, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.

School of Healthcare, University of Leeds, ᅟ, Leeds, LS2 9JT, UK.

出版信息

BMC Psychiatry. 2015 Aug 29;15:208. doi: 10.1186/s12888-015-0590-y.

Abstract

BACKGROUND

Formal recognition and involvement of carers in mental health services has been the focus of recent policy and practice initiatives as well as being supported by carers themselves. However, carers still report feeling marginalised and distanced from services. A prominent theme is that that they are not listened to and their concerns are not taken seriously. Compared to service user views, the reasons underpinning carers' dissatisfaction with care-planning procedures have been relatively neglected in the research literature, despite the substantial and significant contribution that they make to mental health services. The aim of the study was to explore carers' experiences of the care planning process for people with severe mental illness.

METHODS

Qualitative interviews and focus groups were undertaken with carers. Data were combined and analysed using framework analysis.

RESULTS

Whilst identifying a shared desire for involvement and confirming a potential role for carers within services, our data highlighted that many carers perceive a lack of involvement in care planning and a lack of recognition and appreciation of their role from health professionals. Barriers to involvement included structural barriers, such as the timing and location of meetings, cultural barriers relating to power imbalances within the system and specific barriers relating to confidentiality.

CONCLUSIONS

This qualitative study led by a researcher who was a carer herself has developed the understanding of the potential role of carers within the care planning process within mental health services, along with the facilitators and barriers to achieving optimal involvement.

摘要

背景

护理人员在精神卫生服务中的正式认可与参与一直是近期政策和实践举措的重点,也得到了护理人员自身的支持。然而,护理人员仍表示感觉被边缘化,与服务脱节。一个突出的问题是,他们的意见不被听取,关切未得到认真对待。尽管护理人员对精神卫生服务做出了重大且显著的贡献,但与服务使用者的观点相比,护理人员对护理计划程序不满的原因在研究文献中相对被忽视。本研究的目的是探讨护理人员对重度精神疾病患者护理计划过程的体验。

方法

对护理人员进行了定性访谈和焦点小组讨论。采用框架分析法对数据进行汇总和分析。

结果

虽然确定了护理人员对参与的共同愿望,并确认了他们在服务中的潜在作用,但我们的数据突出表明,许多护理人员认为自己在护理计划中缺乏参与,且未得到卫生专业人员对其角色的认可和重视。参与的障碍包括结构性障碍,如会议的时间和地点;与系统内权力不平衡相关的文化障碍;以及与保密相关的特定障碍。

结论

这项由身为护理人员的研究人员主导的定性研究,增进了对护理人员在精神卫生服务护理计划过程中的潜在作用的理解,以及对实现最佳参与的促进因素和障碍的理解。

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