School of Nursing and Midwifery, Medical Biology Centre, Queens University, Belfast, UK.
Krongold Clinic, Faculty of Education, Monash University, Clayton, Victoria, Australia.
Int J Ment Health Nurs. 2019 Feb;28(1):140-151. doi: 10.1111/inm.12503. Epub 2018 Jun 27.
Family-focused practice improves outcomes for families where parents have a mental illness. However, there is limited understanding regarding the factors that predict and enable these practices. This study aimed to identify factors that predict and enable mental health nurses' family-focused practice. A sequential mixed methods design was used. A total of 343 mental health nurses, practicing in 12 mental health services (in acute inpatient and community settings), throughout Ireland completed the Family Focused Mental Health Practice Questionnaire, measuring family-focused behaviours and other factors that impact family-focused activities. Hierarchical multiple regression identified 14 predictors of family-focused practice. The most important predictors noted were nurses' skill and knowledge, own parenting experience, and work setting (i.e. community). Fourteen nurses, who achieved high scores on the questionnaire, subsequently participated in semistructured interviews to elaborate on enablers of family-focused practice. Participants described drawing on their parenting experiences to normalize parenting challenges, encouraging service users to disclose parenting concerns, and promoting trust. The opportunity to visit a service user's home allowed them to observe how the parent was coping and forge a close relationship with them. Nurses' personal characteristics and work setting are key factors in determining family-focused practice. This study extends current research by clearly highlighting predictors of family-focused practice and reporting how various enablers promoted family-focused practice. The capacity of nurses to support families has training, organizational and policy implications within adult mental health services in Ireland and elsewhere.
以家庭为中心的实践可以改善父母患有精神疾病的家庭的治疗效果。然而，对于能够预测和促进这些实践的因素，人们的理解有限。本研究旨在确定预测和促进精神科护士以家庭为中心实践的因素。采用了顺序混合方法设计。共有 343 名精神科护士在爱尔兰的 12 个精神卫生服务机构（急性住院和社区环境）中从事实践，他们完成了以家庭为中心的精神卫生实践问卷，该问卷测量了以家庭为中心的行为以及影响以家庭为中心活动的其他因素。层次多重回归确定了 14 个以家庭为中心实践的预测因素。注意到的最重要的预测因素是护士的技能和知识、自身的育儿经验以及工作环境（即社区）。在问卷上获得高分的 14 名护士随后参加了半结构化访谈，以详细阐述以家庭为中心实践的促进因素。参与者描述了利用自己的育儿经验来使育儿挑战正常化，鼓励服务使用者披露育儿问题，并促进信任。有机会访问服务使用者的家，可以让他们观察父母的应对方式，并与他们建立密切的关系。护士的个人特征和工作环境是决定以家庭为中心实践的关键因素。本研究通过明确强调以家庭为中心实践的预测因素，并报告各种促进因素如何促进以家庭为中心的实践，扩展了当前的研究。爱尔兰和其他地方的成人精神卫生服务机构在培训、组织和政策方面都需要考虑护士支持家庭的能力。
