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以患者为中心的护理与治疗联盟。

Person-Centered Care and the Therapeutic Alliance.

作者信息

Hamovitch Emily K, Choy-Brown Mimi, Stanhope Victoria

机构信息

McSilver Institute for Poverty Policy and Research, New York University, 41 East 11th Street, 7th Floor, New York, NY, 10003, USA.

Silver School of Social Work, New York University, 1 Washington Square N, New York, NY, 10003, USA.

出版信息

Community Ment Health J. 2018 Oct;54(7):951-958. doi: 10.1007/s10597-018-0295-z. Epub 2018 Jun 12.

Abstract

Person-centered care has been gaining prominence in behavioral health care, and service planning has shifted towards "person-centered care planning" (PCCP), where individuals, in partnership with providers, identify life goals and interventions. A strong therapeutic alliance has been identified as key to a person-centered approach, but little is known about how the therapeutic relationship influences person-centered processes and outcomes. Using an explanatory sequential mixed methods design, this study investigated: (1) the association between the therapeutic alliance and PCCP, and (2) how the therapeutic relationship influences the process and outcomes of PCCP. Quantitative analyses found that a strong working alliance predicted greater personcenteredness. Qualitative analyses revealed two central themes: (1) the importance of connection, continuity, and calibration of the relationship to set the right conditions for PCCP, and (2) PCCP as a vehicle for engagement. Findings demonstrated that the therapeutic alliance is inextricably linked to the PCCP process, each influencing the other.

摘要

以患者为中心的护理在行为健康护理中日益受到重视,服务规划已转向“以患者为中心的护理规划”(PCCP),即个体与提供者合作,确定生活目标和干预措施。强大的治疗联盟已被确定为以患者为中心方法的关键,但对于治疗关系如何影响以患者为中心的过程和结果却知之甚少。本研究采用解释性序列混合方法设计,调查了:(1)治疗联盟与PCCP之间的关联,以及(2)治疗关系如何影响PCCP的过程和结果。定量分析发现,强大的工作联盟预示着更高的以患者为中心程度。定性分析揭示了两个核心主题:(1)关系的连接、连续性和校准对于为PCCP设定正确条件的重要性,以及(2)PCCP作为参与的载体。研究结果表明,治疗联盟与PCCP过程紧密相连,二者相互影响。

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