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联络精神科专业人员对综合医院精神疾病患者护理的看法:综合医院环境中精神疾病患者的护理。

Liaison psychiatry professionals' views of general hospital care for patients with mental illness: The care of patients with mental illness in the general hospital setting.

作者信息

Noblett J, Caffrey A, Deb T, Khan A, Lagunes-Cordoba E, Gale-Grant O, Henderson C

机构信息

South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, United Kingdom.

South West London and St George's NHS Trust, Springfield Hospital, London, United Kingdom.

出版信息

J Psychosom Res. 2017 Apr;95:26-32. doi: 10.1016/j.jpsychores.2017.02.004. Epub 2017 Feb 7.

Abstract

OBJECTIVE

Explore the experiences of liaison psychiatry professionals, to gain a greater understanding of the quality of care patients with mental illness receive in the general hospital setting; the factors that affect the quality of care; and their insights on interventions that could improve care.

METHODS

A survey questionnaire and qualitative in depth interviews were used to collect data. Data collection took place at the Royal College of Psychiatrists Faculty of Liaison Psychiatry Annual conference. Qualitative analysis was done using thematic analysis.

RESULTS

Areas of concern in the quality of care of patients with co-morbid mental illness included 'diagnostic overshadowing', 'poor communication with patient', 'patient dignity not respected' and 'delay in investigation or treatment'. Eleven contributing factors were identified, the two most frequently mentioned were 'stigmatising attitudes of staff towards patients with co-morbid mental illness' and 'complex diagnosis'. The general overview of care was positive with areas for improvement highlighted. Interventions suggested included 'formal education' and 'changing the liaison psychiatry team'.

CONCLUSION

The cases discussed highlighted several areas where the quality of care received by patients with co-morbid mental illness is lacking, the consequences of which could be contributing to physical health disparities. It was acknowledged that it is the dual responsibility of both the general hospital staff and liaison staff in improving care.

摘要

目的

探究联络精神病学专业人员的经历,以更深入了解患有精神疾病的患者在综合医院环境中所接受护理的质量;影响护理质量的因素;以及他们对可改善护理的干预措施的见解。

方法

使用调查问卷和定性深入访谈来收集数据。数据收集在皇家精神科医学院联络精神病学系年会上进行。采用主题分析法进行定性分析。

结果

患有合并精神疾病患者的护理质量方面令人担忧的领域包括“诊断掩盖”、“与患者沟通不畅”、“患者尊严未得到尊重”以及“检查或治疗延误”。确定了11个促成因素,最常被提及的两个因素是“工作人员对合并精神疾病患者的污名化态度”和“复杂的诊断”。护理的总体情况是积极的,但也突出了需要改进的领域。建议的干预措施包括“正规教育”和“改变联络精神病学团队”。

结论

所讨论的案例突出了合并精神疾病患者在护理质量方面存在不足的几个领域,其后果可能导致身体健康差异。人们认识到,综合医院工作人员和联络工作人员在改善护理方面负有双重责任。

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