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构建积极身份认同:精神卫生保健系统中同伴工作者的驱动力定性研究。

Constructing a positive identity: A qualitative study of the driving forces of peer workers in mental health-care systems.

机构信息

Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.

Psychiatric Hospital Pittem, Pittem, Belgium.

出版信息

Int J Ment Health Nurs. 2018 Feb;27(1):378-389. doi: 10.1111/inm.12332. Epub 2017 Apr 1.

Abstract

There is growing recognition in mental health for the perspective of individuals with lived experience of mental health problems and mental health service use. As peer workers, these individuals can use their specific experience to benefit and support peers and professional caregivers, and to participate at all levels of mental health-care systems. The aim of the present study was to develop a conceptual framework representing the driving forces of peer workers to fullfil their position in mental health-care systems. A qualitative interview approach was employed using principles of grounded theory. Over a period of 5 months in 2014-2015, semistructured interviews were conducted with 14 peer workers in residential and community mental health-care systems. The emerged conceptual framework reveals that peer workers strive towards constructing a positive identity. This process is powered by driving forces reflecting a desire for normalization and an urge for self-preservation. Peer workers realize a meaningful employment by using their lived experience perspective as an asset, liberating themselves out of restrictive role patterns, and by breaking down stigma and taboo. As a precondition to engage in these normalization processes, peer workers perceive they need to secure their self-preservation by balancing the emergence of adverse emotional fluctuations. The conceptual framework can inform the development of work contexts in which peer workers have an authentic and meaningful contribution, while being offered sufficient support and learning opportunities to manage their well-being.

摘要

在心理健康领域,越来越多的人开始从有心理健康问题和使用心理健康服务经历的个体的角度看待问题。作为同伴工作者,这些个体可以利用他们的特殊经历来造福和支持同伴和专业护理人员,并参与到心理健康护理系统的各个层面。本研究旨在开发一个概念框架,代表同伴工作者在心理健康护理系统中履行其职责的驱动力。采用扎根理论的原则,采用定性访谈方法。在 2014 年至 2015 年的 5 个月期间,对居住在社区和社区心理健康护理系统中的 14 名同伴工作者进行了半结构化访谈。所产生的概念框架表明,同伴工作者努力构建积极的身份认同。这一过程的动力来自于反映出正常化愿望和自我保护冲动的驱动力。同伴工作者通过将自己的生活经历视角作为一种资产来实现有意义的就业,摆脱限制角色模式,并打破污名和禁忌。作为参与这些正常化过程的前提条件,同伴工作者认为他们需要通过平衡负面情绪波动的出现来确保自己的自我保护。该概念框架可以为同伴工作者提供真实而有意义的工作环境的发展提供信息,同时为他们提供足够的支持和学习机会来管理自己的福祉。

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