Fletcher Justine, Brophy Lisa, Killaspy Helen, Ennals Priscilla, Hamilton Bridget, Collister Laura, Hall Teresa, Harvey Carol
Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
Mind Australia Ltd, Heidelberg, VIC, Australia.
Front Psychiatry. 2019 Oct 24;10:735. doi: 10.3389/fpsyt.2019.00735. eCollection 2019.
Prevention and Recovery Care (PARC) services are relatively new sub-acute residential services that have supported people with mental ill-health in Victoria since 2003. Operated from a partnership model between non-governmental agencies and clinical mental health services, PARC services integrate intensive recovery-focused psychosocial input with clinical mental health care. To describe and contrast the 19 PARC services operating in Victoria at the time of the study, in terms of structures and function, resources, and content and quality of care. Nineteen participants, one representing each PARC, completed two surveys: the first, a purpose-designed survey relating to the government guidelines for PARC services, and the second, the Quality Indicator for Rehabilitative Care. Descriptive analyses highlighted that PARC services have operated in inner-city, urban, and regional areas of Victoria, from between 1 and 14 years. Participants reported that a recovery approach was at the core of service delivery, with a vast array of group and individual programs on offer. Across the state, there was variation in the quality of services according to the Quality Indicator for Rehabilitative Care domains. This study has identified that there is variation in the structure and function, resourcing, and content and quality of care offered across Victoria's PARC services even though, in the main, they are guided by government guidelines. Hence it appears that the services adapt to local needs and changes in service systems occurring over time. The findings indicate emerging evidence that PARCs are providing recovery-oriented services, which offer consumers autonomy and social inclusion, and therefore likely enable a positive consumer experience. The range of individual and group programs is in line with the Victorian guidelines, offering practical assistance, therapeutic activities, and socialization opportunities consistent with consumer preferences. Further research into implementation processes and their impacts on quality of care is warranted concerning this and similar service models.
预防与康复护理（PARC）服务是相对较新的亚急性住院服务，自2003年以来一直在为维多利亚州患有精神疾病的人提供支持。PARC服务由非政府机构与临床心理健康服务机构的合作模式运营，将以康复为重点的强化社会心理投入与临床心理健康护理相结合。描述并对比研究时在维多利亚州运营的19项PARC服务，包括其结构与功能、资源以及护理内容与质量。19名参与者，每人代表一项PARC服务，完成了两项调查：第一项是专门设计的与PARC服务政府指南相关的调查，第二项是康复护理质量指标调查。描述性分析突出显示，PARC服务在维多利亚州的市中心、城市和地区运营，运营时间为1至14年。参与者报告称，康复方法是服务提供的核心，提供了大量的团体和个人项目。根据康复护理质量指标领域，全州的服务质量存在差异。本研究发现，尽管维多利亚州的PARC服务主要遵循政府指南，但在结构与功能、资源以及护理内容与质量方面仍存在差异。因此，这些服务似乎会根据当地需求和服务系统随时间的变化进行调整。研究结果表明有新证据显示，PARC服务正在提供以康复为导向的服务，为消费者提供自主权和社会包容，因此可能会带来积极的消费者体验。个人和团体项目的范围符合维多利亚州的指南，提供了符合消费者偏好的实际帮助、治疗活动和社交机会。有必要针对此服务模式及类似服务模式，对实施过程及其对护理质量的影响进行进一步研究。
