Cusack E, Killoury F, Nugent L E
HSE, Dublin North, Quality and Clinical Care Directorate, Swords, Dublin, Ireland.
Department of Psychiatry, University Hospital Limerick, Limerick, Ireland.
J Psychiatr Ment Health Nurs. 2017 Mar;24(2-3):93-104. doi: 10.1111/jpm.12347. Epub 2016 Nov 18.
WHAT IS KNOWN ON THE SUBJECT?: Nationally and internationally there has been a movement away from the traditional medical model towards a more holistic recovery-oriented approach to mental health care delivery. At every level of service provision the emphasis is firmly on recovery and on facilitating active partnership working and involvement of service users, their carers and family members. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to identify on a national level specific areas of care that are addressed most or least by psychiatric and mental health nurses in care planning for mental health service users in Ireland. In addition, this is the first study to identify nationally how the recovery approach is being implemented by psychiatric and mental health nurses in relation to current recovery-orientated policy. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental healthcare staff require more education on the recovery concept and this needs to be multidisciplinary team wide. Further research is required to establish how best to develop a shared approach to working with service users and their families within the mental healthcare environment. Further investigation is required to help determine how funding could be allocated appropriately for education and training and service development nationally.
Introduction The restructuring of national mental health policy to an integrated recovery ethos demands a clarification in the psychiatric/mental health nurse's role, skills and competencies. Aim/Question To explore the psychiatric/mental health nurse's role and identify skills, competencies and supports required to adopt recovery-orientated policy in practice. Method An exploratory mixed methods study in multiple health services in Ireland with N = 1249 psychiatric/mental health nurses. Data collection used a survey, focus groups and written submissions. Data analysis used descriptive statistics and thematic analysis. Results The medical profession use a symptom-focused approach to mental healthcare delivery. Nurses viewed this as a primary inhibitor to recovery-orientated practice. Professional development in prevention and earlier intervention within primary care environments requires development. Nurses require research support to measure the effectiveness of the mental health interventions they provide. Implications and conclusion The effective implementation of the recovery approach requires a multitude of strategies and narrative threads in an overall medical assessment. Nurses need support from medics in providing consistency of assessments/documentation of required psychosocial interventions. A greater range of specialist services provided by nurses including psychosocial interventions and health promotion is fundamental to quality care and improving service user outcomes in primary care.
关于该主题已知的信息有哪些?在国内和国际上,都出现了从传统医学模式转向更全面的以康复为导向的心理健康护理模式的趋势。在服务提供的各个层面,重点都坚定地放在康复上,以及促进积极的伙伴关系合作和服务使用者、他们的护理人员及家庭成员的参与。本文对现有知识的补充是什么?这是第一项在国家层面确定爱尔兰精神科和心理健康护士在为心理健康服务使用者制定护理计划时最常或最少涉及的具体护理领域的研究。此外,这是第一项在全国范围内确定精神科和心理健康护士如何根据当前以康复为导向的政策实施康复方法的研究。对实践有何影响?精神卫生保健人员需要在康复概念方面接受更多教育,而且这需要在多学科团队范围内进行。需要进一步研究以确定如何最好地制定一种与服务使用者及其家庭在精神卫生保健环境中合作的共享方法。需要进一步调查以帮助确定如何在全国范围内为教育、培训和服务发展适当分配资金。
引言 将国家心理健康政策重组为综合康复理念需要明确精神科/心理健康护士的角色、技能和能力。目的/问题 探讨精神科/心理健康护士的角色,并确定在实践中采用以康复为导向的政策所需的技能、能力和支持。方法 在爱尔兰的多个卫生服务机构中进行一项探索性混合方法研究,涉及N = 1249名精神科/心理健康护士。数据收集采用问卷调查、焦点小组和书面意见。数据分析采用描述性统计和主题分析。结果 医学专业在提供心理健康护理时采用以症状为重点的方法。护士们认为这是以康复为导向的实践的主要障碍。需要发展初级保健环境中预防和早期干预方面的专业发展。护士需要研究支持来衡量他们提供的心理健康干预措施的有效性。影响和结论 康复方法的有效实施需要在整体医学评估中采用多种策略和叙述线索。护士在提供所需心理社会干预措施的评估/记录的一致性方面需要医生的支持。护士提供的更广泛的专科服务,包括心理社会干预和健康促进,对于初级保健中的优质护理和改善服务使用者的结果至关重要。