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患者参与精神卫生保健——医护人员的观点:一项综合综述

Patient participation in mental health care - perspectives of healthcare professionals: an integrative review.

作者信息

Jørgensen Kim, Rendtorff Jacob Dahl

机构信息

The Department of Nursing, University College Capital, Hilleroed, Denmark.

Department of Social Sciences and Business, Roskilde University, Roskilde, Denmark.

出版信息

Scand J Caring Sci. 2018 Jun;32(2):490-501. doi: 10.1111/scs.12531. Epub 2017 Sep 22.

Abstract

BACKGROUND

In contemporary Western liberal society, patient participation has become a key goal in psychiatric healthcare treatment. Health professionals must encourage patients to play an active and involved part in their treatment. According to Danish health law, patients have the right to participate in their treatment, and the mental health system therefore needs to be reformed in order to ensure that treatment is based on individual, liberal, values. However, patient participation is not clearly defined, and it is therefore a challenge to transfer it to clinical practice.

AIMS

This integrative review's aims are to explore how professionals perceive the challenges regarding patient participation in the treatment course in mental health care.

DESIGN

An integrative review.

FINDINGS

Seven studies met the inclusion criteria: six employed qualitative methodologies and one utilised a mixed-methods approach. The empirical studies took place in Norway, the UK and Australia, all in a mental health setting. Three themes were identified: 'Patient participation as collaboration between the healthcare professional and patient', 'Challenges to participation' and 'From a professional's perspective - what expectations do patients have when participating in decision-making?'

CONCLUSION

Different synonymous terms describing the patient's active role during treatment - user participation, collaboration, partnership, user involvement and patient participation - are linked to a recovery-oriented approach, shared decision-making, shared ownership and care plans. This integrative review achieves specific knowledge around patient participation, comparing the situation for adult patients with various mental disorders. However, upon reflecting on the included studies, patient participation is not clearly defined, and it is therefore difficult to transfer it to clinical practice.

摘要

背景

在当代西方自由社会,患者参与已成为精神卫生保健治疗的关键目标。卫生专业人员必须鼓励患者积极参与其治疗过程。根据丹麦卫生法,患者有权参与其治疗,因此精神卫生系统需要进行改革,以确保治疗基于个人自由价值观。然而,患者参与并未得到明确界定,因此将其转化为临床实践是一项挑战。

目的

本综合综述的目的是探讨专业人员如何看待精神卫生保健治疗过程中患者参与方面的挑战。

设计

综合综述。

研究结果

七项研究符合纳入标准:六项采用定性方法,一项采用混合方法。实证研究在挪威、英国和澳大利亚进行,均为精神卫生领域。确定了三个主题:“患者参与作为医护人员与患者之间的合作”、“参与的挑战”以及“从专业人员的角度——患者参与决策时有哪些期望?”

结论

描述患者在治疗过程中积极作用的不同同义术语——用户参与、合作、伙伴关系、用户介入和患者参与——与以康复为导向的方法、共同决策、共同所有权和护理计划相关联。本综合综述围绕患者参与获得了具体知识,比较了患有各种精神障碍的成年患者的情况。然而,在对纳入研究进行反思时,患者参与并未得到明确界定,因此难以将其转化为临床实践。

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