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促进照护途径:一项定性研究报告,探讨了早期精神病诊断的年轻成年患者照顾者的自报需求和应对技能。

Facilitating pathways to care: A qualitative study of the self-reported needs and coping skills of caregivers of young adults diagnosed with early psychosis.

机构信息

Nursing & Healthcare Leadership, University of Washington Tacoma, Tacoma, WA, USA.

Department of Psychosocial & Community Health, University of Washington School of Nursing, Seattle, WA, USA.

出版信息

J Psychiatr Ment Health Nurs. 2020 Aug;27(4):368-379. doi: 10.1111/jpm.12591. Epub 2020 Feb 11.

DOI:10.1111/jpm.12591
PMID:31930633
Abstract

WHAT IS KNOWN ON THE SUBJECT?: In clinical psychiatry and mental health nursing practice, family caregivers are known to provide the bulk of care and play an important role in facilitating recovery outcomes for their loved ones diagnosed with psychosis. Providing services and interventions to family caregivers is as important as to patients in the early stage of psychotic experience for having a beneficial impact on the patients' clinical and social outcomes. Limited qualitative research has focused on family caregivers' subjective views of what they need during the critical period to identify early warning signs and connect their loved ones to professional help as they have no prior experience in caring for persons with psychosis. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Using qualitative analysis of family caregiver focus groups, this manuscript provides readers in clinical nursing practice with an understanding of family caregivers' lived experiences of supporting their loved one diagnosed with early psychosis. Understanding family caregivers' caregiving unmet needs in supporting their loved one diagnosed with early psychosis could inform both the technology-assisted intervention development and nursing practice in improving family-centred care and facilitate self-management practice. IMPLICATIONS FOR MENTAL HEALTH NURSING: Psychiatry and mental health nursing has long been engaged with the health and well-being of individuals with psychosis and supporting their families in the development, evaluation and implementation of innovative approaches to patient and family education. Digital technologies designed to deliver tailored intervention for family caregivers are underdeveloped, and the present study identifies a number of potential features that could comprise technology to meet the needs of this population. ABSTRACT: Introduction Caregivers play a critical role in detecting and managing psychotic symptoms before young people diagnosed with early psychosis present to care. Little is known about the specific needs of caregivers in navigating pathways to care for their loved one. Aim The purpose of this study was to understand the needs of family caregivers and their ways of coping on the pathway to care for early psychosis. Method Twenty family caregivers of individuals diagnosed with early psychosis participated in three focus groups that explored caregiving needs provision for early psychosis. Thematic analysis was conducted. Results We identified four major themes: education and skill training; raising wider awareness, such as police offers and teachers; adopting technologies for coping; and effective coping strategies. Implications for practice These findings provide important insights into caregiving needs and the ways for nurses to address those needs and better equip carers to recognize early symptoms, monitor behaviour changes and navigate care to support people with first-episode psychosis. Nursing researchers can use the information to develop on-demand and tailored family-centred intervention in addressing caregivers' needs in education, increasing awareness of early psychosis and fostering effective coping strategies.

摘要

已知信息:在临床精神病学和精神健康护理实践中,已知家庭照顾者为亲人提供大部分的护理,并在促进亲人的康复结果方面发挥重要作用。为家庭照顾者提供服务和干预与为精神病患者提供服务同样重要,因为这对患者的临床和社会结果都有有益的影响。有限的定性研究集中在家庭照顾者的主观观点上,即他们在精神病体验的早期阶段需要什么,以便识别早期预警信号,并在他们没有照顾精神病患者的经验的情况下,将他们的亲人与专业帮助联系起来。

本文的新增内容:本文通过对家庭照顾者焦点小组的定性分析,为临床护理实践中的读者提供了对家庭照顾者支持被诊断为早期精神病亲人的生活体验的理解。了解家庭照顾者在支持被诊断为早期精神病的亲人方面的未满足的护理需求,可以为技术辅助干预的开发以及改善以家庭为中心的护理和促进自我管理实践的护理实践提供信息。

对精神健康护理的意义:精神病学和精神健康护理长期以来一直致力于关注精神病患者的健康和福祉,并支持他们的家庭制定、评估和实施创新的患者和家庭教育方法。旨在为家庭照顾者提供量身定制的干预措施的数字技术尚未得到充分发展,本研究确定了一些潜在的功能,可以组成满足这一人群需求的技术。

摘要:介绍 照顾者在年轻人被诊断为早期精神病之前,在检测和管理精神病症状方面发挥着关键作用。关于照顾者在为亲人寻求护理途径方面的具体需求知之甚少。目的 本研究的目的是了解家庭照顾者的需求以及他们在寻求早期精神病护理途径时的应对方式。方法 20 名被诊断为早期精神病的个体的家庭照顾者参加了三个焦点小组,探讨了早期精神病护理的需求。进行了主题分析。结果 我们确定了四个主要主题:教育和技能培训;提高更广泛的认识,如警察和教师;采用技术进行应对;以及有效的应对策略。实践意义 这些发现为护理需求提供了重要的见解,为护士提供了满足这些需求的方法,并使照顾者更好地识别早期症状、监测行为变化和为支持首发精神病患者提供护理。护理研究人员可以利用这些信息来开发按需和量身定制的以家庭为中心的干预措施,以满足照顾者在教育、提高对早期精神病的认识和培养有效的应对策略方面的需求。

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