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医疗保健专业人员对心理健康服务提供的看法:一项在六个欧洲国家开展的焦点小组试点研究。

Healthcare professionals' perspectives on mental health service provision: a pilot focus group study in six European countries.

作者信息

Triliva Sofia, Ntani Spyridoula, Giovazolias Theodoros, Kafetsios Konstantinos, Axelsson Malin, Bockting Claudi, Buysse Ann, Desmet Mattias, Dewaele Alexis, Hannon Dewi, Haukenes Inger, Hensing Gunnel, Meganck Reitske, Rutten Kris, Schønning Viktor, Van Beveren Laura, Vandamme Joke, Øverland Simon

机构信息

1Department of Psychology, University of Crete, 74100 Rethymno, Crete, Greece.

2Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.

出版信息

Int J Ment Health Syst. 2020 Mar 6;14:16. doi: 10.1186/s13033-020-00350-1. eCollection 2020.

Abstract

BACKGROUND

The mental healthcare treatment gap (mhcGAP) in adult populations has been substantiated across Europe. This study formed part of MentALLY, a research project funded by the European Commission, which aimed to gather qualitative empirical evidence to support the provision of European mental healthcare that provides effective treatment to all adults who need it.

METHODS

Seven focus groups were conducted with 49 health professionals (HPs), including psychologists, psychiatrists, social workers, general practitioners, and psychiatric nurses who worked in health services in Belgium, Cyprus, Greece, the Netherlands, Norway and Sweden. The focus group discussions centered on the barriers and facilitators to providing quality care to people with mild, medium, and severe mental health problems. Analyses included deductively and inductively driven coding procedures. Cross-country consensus was obtained by summarizing findings in the form of a fact sheet which was shared for triangulation by all the MentALLY partners.

RESULTS

The results converged into two overarching themes: (1) Minding the treatment gap: the availability and accessibility of Mental Health Services (MHS). The mhcGAP gap identified is composed of different elements that constitute the barriers to care, including bridging divides in care provision, obstacles in facilitating access via referrals and creating a collaborative 'chain of care'. (2) Making therapeutic practice relevant by providing a broad-spectrum of integrated and comprehensive services that value person-centered care comprised of authenticity, flexibility and congruence.

CONCLUSIONS

The mhcGAP is comprised of the following barriers: a lack of funding, insufficient capacity of human resources, inaccessibility to comprehensive services and a lack of availability of relevant treatments. The facilitators to the provision of MHC include using collaborative models of primary, secondary and prevention-oriented mental healthcare. Teamwork in providing care was considered to be a more effective and efficient use of resources. HPs believe that the use of e-mental health and emerging digital technologies can enhance care provision. Facilitating access to a relevant continuum of community-based care that is responsive coordinated and in line with people's needs throughout their lives is an essential aspect of optimal care provision.

摘要

背景

欧洲成年人群体中的精神卫生保健治疗差距(mhcGAP)已得到证实。本研究是“MENTALLY”项目的一部分,该项目由欧盟委员会资助,旨在收集定性实证证据,以支持提供能为所有有需要的成年人提供有效治疗的欧洲精神卫生保健服务。

方法

与49名卫生专业人员(包括心理学家、精神科医生、社会工作者、全科医生以及在比利时、塞浦路斯、希腊、荷兰、挪威和瑞典的卫生服务机构工作的精神科护士)进行了7次焦点小组讨论。焦点小组讨论围绕为轻度、中度和重度精神健康问题患者提供优质护理的障碍和促进因素展开。分析包括演绎和归纳驱动的编码程序。通过以情况说明书的形式总结研究结果获得跨国共识,所有“MENTALLY”项目合作伙伴都共享该情况说明书以进行三角验证。

结果

研究结果归纳为两个总体主题:(1)关注治疗差距:精神卫生服务(MHS)的可获得性和可及性。所确定的mhcGAP差距由构成护理障碍的不同要素组成,包括弥合护理提供方面的差距、通过转诊促进获得护理的障碍以及建立协作性的“护理链”。(2)通过提供广泛的综合和全面服务使治疗实践具有相关性,这些服务重视以患者为中心的护理,包括真实性、灵活性和一致性。

结论

mhcGAP包括以下障碍:资金不足、人力资源能力不足、无法获得综合服务以及缺乏相关治疗方法。提供精神卫生保健的促进因素包括采用初级、二级和预防导向的精神卫生保健协作模式。提供护理时的团队合作被认为是更有效和高效地利用资源。卫生专业人员认为,使用电子精神卫生和新兴数字技术可以改善护理提供。促进获得相关的基于社区的连续性护理,这种护理具有响应性、协调性且符合人们一生的需求,是提供最佳护理的一个重要方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d44/7060571/3a70618d0059/13033_2020_350_Fig1_HTML.jpg

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