School of Health Sciences, University of Tasmania, Sydney, New South Wales, Australia.
Sydney Nursing School, The University of Sydney, Sydney, New South Wales, Australia.
Int J Ment Health Nurs. 2018 Aug;27(4):1266-1272. doi: 10.1111/inm.12474. Epub 2018 May 9.
In adult mental health services, the participation of consumers is essential. The aim of this study was to explore the challenges faced by peer support workers when involving mental health consumers in decision-making about their care and the strategies they employed to overcome these challenges so as to improve mental health consumers' participation in decision-making and recovery. Semi-structured individual interviews were conducted with six peer support workers currently employed in psychiatric hospitals and/or community mental health systems. Thematic analysis identified challenges related to role definition, power imbalance, doctor-centric medical approaches to care, and lack of resources. Strategies to overcome these challenges that were reported, included the following: facilitating meaningful involvement for service users, appropriate use of the lived experience, building relationships and communication, promoting rights and advocacy, and promoting professionalism of peer support workers (PSWs). Nursing staff need ongoing support and education to understand and value the varied roles of PSWs and thereby empower PSWs to engage in enhancing consumer decision-making. The roles of the PSWs should be viewed as complementary, and greater appreciation and understanding of roles would better support recovery-oriented care.
在成人心理健康服务中，消费者的参与至关重要。本研究旨在探讨同伴支持工作者在让精神健康消费者参与他们的护理决策时所面临的挑战，以及他们为克服这些挑战而采用的策略，以提高精神健康消费者在决策和康复中的参与度。采用半结构化个体访谈的方法，对目前在精神病院和/或社区心理健康系统工作的六名同伴支持工作者进行了访谈。主题分析确定了与角色定义、权力失衡、以医生为中心的医疗护理方法以及资源匮乏相关的挑战。报告的克服这些挑战的策略包括：促进服务使用者的有意义参与、适当利用生活经验、建立关系和沟通、促进权利和倡导、以及提升同伴支持工作者的专业性。护理人员需要持续的支持和教育，以理解和重视同伴支持工作者的各种角色，从而使同伴支持工作者能够参与增强消费者决策。同伴支持工作者的角色应被视为互补的，对角色的更多赞赏和理解将更好地支持以康复为导向的护理。
