Perkins Amorette, Ridler Joseph, Browes Daniel, Peryer Guy, Notley Caitlin, Hackmann Corinna
Department of Research and Development, Norfolk and Suffolk NHS Foundation Trust, Hellesdon Hospital, Norwich, UK; Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK.
Department of Research and Development, Norfolk and Suffolk NHS Foundation Trust, Hellesdon Hospital, Norwich, UK.
Lancet Psychiatry. 2018 Sep;5(9):747-764. doi: 10.1016/S2215-0366(18)30095-6. Epub 2018 Apr 18.
Receiving a mental health diagnosis can be pivotal for service users, and it has been described in both positive and negative terms. What influences service-user experience of the diagnostic process is unclear; consequently, clinicians report uncertainty regarding best practice. This Review aims to understand and inform diagnostic practice through a comprehensive synthesis of qualitative data on views and experiences from key stakeholders (service users, clinicians, carers, and family). We searched five databases and identified 78 papers for inclusion, originating from 13 countries and including 2228 participants. Eligible papers were assessed for quality, and data were coded and then developed into themes, which generated a model representing factors to consider for clinicians conveying, and individuals receiving, mental health diagnoses. Themes included disclosure, information provision, collaboration, timing, stigma, and functional value of diagnosis for recovery. Variations between different stakeholders and clinical contexts are explored. Findings support an individualised, collaborative, and holistic approach to mental health diagnosis.
获得心理健康诊断对服务使用者而言可能至关重要,对此既有积极的描述,也有消极的描述。目前尚不清楚是什么影响了服务使用者对诊断过程的体验;因此,临床医生表示在最佳实践方面存在不确定性。本综述旨在通过全面综合关键利益相关者(服务使用者、临床医生、护理人员和家庭成员)关于观点和经历的定性数据,来理解并为诊断实践提供参考。我们检索了五个数据库,确定了78篇纳入论文,这些论文来自13个国家,包括2228名参与者。对符合条件的论文进行质量评估,对数据进行编码,然后形成主题,从而生成一个模型,该模型代表了临床医生在传达心理健康诊断以及个人接受诊断时需要考虑的因素。主题包括诊断结果的披露、信息提供、协作、时机、污名以及诊断对康复的功能价值。还探讨了不同利益相关者和临床背景之间的差异。研究结果支持采用个性化、协作性和整体性的方法进行心理健康诊断。