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不是你想要的故事?评估一个概念框架的契合度,该框架描述了心理健康康复叙事。

Not the story you want? Assessing the fit of a conceptual framework characterising mental health recovery narratives.

机构信息

School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK.

Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2020 Mar;55(3):295-308. doi: 10.1007/s00127-019-01791-x. Epub 2019 Oct 25.

Abstract

PURPOSE

Narratives of recovery have been central to the development of the recovery approach in mental health. However, there has been a lack of clarity around definitions. A recent conceptual framework characterised recovery narratives based on a systematic review and narrative synthesis of existing literature, but was based on a limited sample. The aims of this study were to assess the relevance of the framework to the narratives of more diverse populations, and to develop a refined typology intended to inform narrative-based research, practice and intervention development.

METHOD

77 narrative interviews were conducted with respondents from four under-researched mental health sub-populations across England. Deductive and inductive analysis was used to assess the relevance of the dimensions and types of the preliminary typology to the interview narratives.

RESULTS

Five or more dimensions were identifiable within 97% of narratives. The preliminary typology was refined to include new definitions and types. The typology was found not to be relevant to two narratives, whose narrators expressed a preference for non-verbal communication. These are presented as case studies to define the limits of the typology.

CONCLUSION

The refined typology, based on the largest study to date of recovery narratives, provides a defensible theoretical base for clinical and research use with a range of clinical populations. Implications for practice include ensuring a heterogeneous selection of narratives as resources to support recovery, and developing new approaches to supporting non-verbal narrative construction.

摘要

目的

在心理健康领域,康复叙事一直是康复方法发展的核心。然而,对于定义一直缺乏明确性。最近的一个概念框架基于对现有文献的系统回顾和叙事综合,以有系统的方式来描述康复叙事,但该框架的基础是有限的样本。本研究的目的是评估该框架对于更多样化的人群的叙事的相关性,并开发一个经过改进的分类法,旨在为基于叙事的研究、实践和干预措施的发展提供信息。

方法

在英格兰,对四个研究不足的心理健康亚人群进行了 77 次叙述性访谈。采用演绎和归纳分析来评估初步分类法的维度和类型对访谈叙事的相关性。

结果

97%的叙述中可以识别出五个或更多的维度。初步分类法得到了进一步的细化,包括新的定义和类型。研究发现,初步分类法不适用于两个叙述者的情况,他们更喜欢非言语交流。这些案例研究被用来定义分类法的局限性。

结论

基于迄今为止对康复叙事进行的最大研究,该经过改进的分类法为具有一系列临床人群的临床和研究应用提供了一个合理的理论基础。对实践的启示包括确保作为支持康复的资源的叙事具有多样性,以及开发支持非言语叙事构建的新方法。

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