McCann Terence V, Bamberg John
Centre for Chronic Disease, College of Health and Biomedicine (Discipline of Nursing), Victoria University, Melbourne, Victoria, Australia.
J Clin Nurs. 2016 Jun;25(11-12):1634-43. doi: 10.1111/jocn.13165. Epub 2016 Mar 30.
The purpose of our paper was to explore primary caregivers' experience of the way public mental health nurses and other mental health clinicians responded to them as primary carers of older adults with mental illness.
As populations age, the prevalence of mental illness in older adults will increase and the burden of care placed on family carers will intensify. While family carers are essential to the well-being and quality of life of older adults with mental illness, they frequently experience marginalisation from clinicians.
An interpretative phenomenological analysis approach was used to inform data collection and analysis.
Individual, semistructured, audio-recorded qualitative interviews were conducted with a purposive sample of 30 primary carers.
Two themes were abstracted from the data highlighting carers' contrasting satisfaction with, and delivery of culturally competent care by, clinicians. A third theme, strategies for enhancing carers' experience of care, incorporated carers' suggestions about ways to strengthen their experience of caring.
Although some primary carers had favourable experiences with clinicians, most were dissatisfied and this, in turn, clouded their overall experience of caring.
Our findings have implications for the provision of education, ongoing support for, and building the cultural competence of, clinicians about working with carers. They also highlight the need for a change in organisational and practice culture to encompass mutual respect and partnership with carers within the context of the providing person-centred care for carers and older adults with mental illness.
我们撰写本文的目的是探究主要照顾者对于公共心理健康护士及其他心理健康临床医生作为老年精神疾病患者主要照顾者时，对他们的回应方式的体验。
随着人口老龄化，老年人群中精神疾病的患病率将会上升，家庭照顾者的护理负担也会加重。虽然家庭照顾者对于患有精神疾病的老年人的幸福和生活质量至关重要，但他们经常受到临床医生的边缘化对待。
采用解释现象学分析方法指导数据收集与分析。
对30名主要照顾者进行了有目的抽样的个人半结构化录音定性访谈。
从数据中提炼出两个主题，突出了照顾者对临床医生提供的具有文化胜任力的护理的满意度差异。第三个主题，即提升照顾者护理体验的策略，纳入了照顾者关于增强其护理体验方式的建议。
尽管一些主要照顾者与临床医生有良好的经历，但大多数人不满意，这反过来又影响了他们整体的护理体验。
我们的研究结果对为临床医生提供与照顾者合作的教育、持续支持以及培养文化胜任力具有启示意义。它们还强调了需要改变组织和实践文化，以便在为照顾者和患有精神疾病的老年人提供以患者为中心的护理背景下，包含对照顾者的相互尊重和建立伙伴关系。
