Hlongwa Esther N, Sibiya Maureen N
KwaZulu-Natal College of Nursing, Pietermaritzburg.
Curationis. 2019 Aug 21;42(1):e1-e9. doi: 10.4102/curationis.v42i1.1847.
Since the publication of the White Paper for the Transformation of the Health System in South Africa in 1997, which included Policy on Integration of Mental Health Care into primary health care (PHC), there has been an emphasis on the promotion of health as well as the re-engineering of PHC to include the integration of mental health care into PHC. Although South Africa has made significant advances at the level of health-related policy development and legislation in trying to bring the country in line with international trends, there have been challenges with regard to implementation of policies, including that of integration of mental health care into PHC.
The aim of this study was to determine the challenges affecting the implementation of the Policy on Integration of Mental Health Care into PHC in KwaZulu-Natal (KZN) province of South Africa and to seek possible solutions.
A qualitative exploratory descriptive design was used to determine the challenges affecting the implementation of the Policy on Integration of Mental Health Care into PHC in KZN. The sample consisted of 42 participants of whom 4 were PHC managers, 6 were operational managers and 22 were professional nurses who were directly involved in implementing the policy at the operational level.
The challenges identified included lack of training in mental healthcare services for staff working in PHC, unavailability of mental health policies, inadequate resources, poor communication between management and staff, lack of skills among PHC nurses in identifying signs of mental illness and misdiagnosis of patients.
Considering the challenges pertaining to PHC nurses' abilities and skills to implement the Policy on Integration of Mental Health Care into PHC, PHC-trained nurses should engage in lifelong learning and be encouraged to develop their knowledge, skills and competence throughout their professional lives.
自1997年南非《卫生系统转型白皮书》发布以来,其中包括将精神卫生保健纳入初级卫生保健(PHC)的政策,一直强调促进健康以及对初级卫生保健进行重新设计,以将精神卫生保健纳入初级卫生保健。尽管南非在卫生相关政策制定和立法层面取得了重大进展,试图使该国与国际趋势接轨,但在政策实施方面仍存在挑战,包括将精神卫生保健纳入初级卫生保健的政策实施。
本研究的目的是确定影响南非夸祖鲁 - 纳塔尔省(KZN)将精神卫生保健纳入初级卫生保健政策实施的挑战,并寻求可能的解决方案。
采用定性探索性描述性设计来确定影响KZN将精神卫生保健纳入初级卫生保健政策实施的挑战。样本包括42名参与者,其中4名是初级卫生保健管理人员,6名是运营管理人员,22名是直接参与在运营层面实施该政策的专业护士。
确定的挑战包括初级卫生保健工作人员缺乏精神卫生保健服务培训、精神卫生政策不可用、资源不足、管理层与工作人员之间沟通不畅、初级卫生保健护士识别精神疾病症状的技能不足以及对患者的误诊。
考虑到与初级卫生保健护士实施将精神卫生保健纳入初级卫生保健政策的能力和技能相关的挑战,接受过初级卫生保健培训的护士应进行终身学习,并鼓励他们在整个职业生涯中发展自己的知识、技能和能力。