Janlöv Ann-Christin, Johansson Linda, Clausson Eva K
Department of Health and Society, Kristianstad University, Kristianstad, Sweden.
Scand J Caring Sci. 2018 Jun;32(2):987-996. doi: 10.1111/scs.12540. Epub 2017 Nov 13.
Mental ill-health among the general population is increasing in Sweden. Primary Health Care (PHC) and Healthcare Centres (HCC), where district nurses (DNs) work, bear the basic responsibility for treatment of mental ill-health, while severe mental ill-health fall under the responsibility of psychiatric specialist care. The increased prevalence of mental ill-health in the community means that DNs increasingly encounter people with mental health problems - not least as a comorbidity. How well DNs are equipped to deal with mental ill-health is currently unclear.
The purpose of this study was to explore district nurses' experience of encountering and dealing with mental ill-health among adult patients at healthcare centres.
A qualitative explorative approach was used to capture the experiences of the phenomena under study.
Individual interviews were conducted with 10 DNs working at six HCCs. The interviews were transcribed and analysed by qualitative content analysis.
The result emerged as several subcategories captured by three categories: (i) having competence - a prerequisite for feeling confident; (ii) nursing mental ill-health requires time and commitment; and (iii) working in an organisation without preparedness, encompassed by the synthesising theme; nursing mental ill-health requires specific competence and organisational support.
Working as a DN requires formal and informal competence when encountering patients with complex health needs. The findings revealed that the DNs could feel insecure regarding how to deal with patients with mental ill-health due to lack of knowledge. Assessment of patients with mental ill-health is time- and energy-consuming and calls for improved teamwork at HCCs as well as effective collaboration with psychiatric specialist care and other care givers. The DNs responsibility to fulfil their work considering the increasing number of mental ill-health among people that seeks help at HCCs needs to be acknowledged and met by the PHC organisation.
瑞典普通人群中的心理健康问题日益增多。地区护士工作的初级卫生保健（PHC）机构和医疗保健中心（HCC）对心理健康问题的治疗负有基本责任，而严重心理健康问题则由精神科专科护理负责。社区中心理健康问题患病率的上升意味着地区护士越来越多地接触到有心理健康问题的人——尤其是作为一种合并症。目前尚不清楚地区护士应对心理健康问题的能力如何。
本研究的目的是探讨地区护士在医疗保健中心遇到并处理成年患者心理健康问题的经历。
采用定性探索性方法来捕捉所研究现象的经历。
对在六个医疗保健中心工作的10名地区护士进行了个人访谈。访谈进行了转录，并通过定性内容分析进行了分析。
结果呈现为三个类别所涵盖的几个子类别：（i）具备能力——感到自信的先决条件；（ii）护理心理健康问题需要时间和投入；（iii）在一个没有准备的组织中工作，综合主题涵盖了这一点；护理心理健康问题需要特定的能力和组织支持。
作为地区护士，在遇到有复杂健康需求的患者时需要具备正式和非正式的能力。研究结果表明，由于缺乏知识，地区护士在如何应对心理健康问题患者方面可能会感到不安全。对心理健康问题患者的评估既耗时又耗精力，需要医疗保健中心改善团队合作，以及与精神科专科护理和其他护理人员进行有效的协作。初级卫生保健组织需要认识到并满足地区护士在医疗保健中心寻求帮助的人群中，心理健康问题日益增多的情况下履行其工作职责的责任。
