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精神健康从业者在社区精神卫生环境中与服务使用者互动的体验:定性证据的系统评价和主题综合。

Mental health practitioner experiences of engaging with service users in community mental health settings: A systematic review and thematic synthesis of qualitative evidence.

机构信息

Division of Health Research, Lancaster University, Lancaster, UK.

Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK.

出版信息

J Psychiatr Ment Health Nurs. 2020 Dec;27(6):807-820. doi: 10.1111/jpm.12628. Epub 2020 Apr 1.

Abstract

WHAT IS KNOWN ON THE SUBJECT?: Engagement is regarded as important and beneficial for service users and mental health services A universal definition of engagement is not yet fully agreed upon. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Based upon their experience, mental health staff use varied engagement approaches to fit with the changeable and unique needs of people who use services (service users). Mental health staff demonstrate qualities such as persistence and adaptability to successfully engage with service users. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Irrespective of professional background, the role of community mental health staff is not restricted to any single approach. Practical help and social support are as seen as important as clinical treatment to establish successful engagement. Little is known about the engagement experiences of mental health staff working in early intervention settings as most studies in this review focused on the perspectives of staff based in assertive outreach or community mental health teams. There is a need to further understand staff experiences of engagement with service users in early intervention settings. Role descriptions and expectations of community mental health workers should account for the wide-ranging flexible approach required in order to deliver appropriate interventions. This may involve a focus on engagement in training programmes. ABSTRACT: Introduction Effective mental health care is dependent on engaging service users, but some individuals do not actively attend appointments, and may stop engaging with mental health services. Quantitative studies reveal some salient factors that seem to predict engagement, but these studies miss the nuances of good clinical practice in this area. A number of qualitative studies of health professionals' experiences and understanding of effective engagement have been published. Aim This review aimed to systematically identify, evaluate and synthesize results from these studies with a view to informing effective practice in this area. Methods Electronic databases MEDLINE, EMBASE, CINAHL, PsychINFO and AMED were searched (PROSPERO systematic review protocol registry (www.crd.york.ac.uk/prospero/; ID CRD42017083976). Of 799 records, ten papers met the inclusion criteria. All papers were subjected to quality appraisal based on the CASP checklist and data systematically extracted. A thematic synthesis of included studies examining mental health practitioners' experiences of engagement in community mental health settings was conducted. Results Mental health practitioners see engaging service users as depending upon complex, multi-dimensional phenomena which should include individualized person-centred approaches as well as practical, social and clinical support. Mental health practitioners demonstrate qualities such as determination and adaptability to establish and maintain engagement with service users. Implications for practice As a core aspect of nurse education, registered mental health nurses and other professionals would benefit from systematic guidance regarding engagement strategies. Most studies in this review focused on assertive outreach or community mental health teams, more clarification is needed of practitioner's engagement experiences in early intervention settings.

摘要

已知信息

  • 参与被认为对服务使用者和精神健康服务有益;

  • 参与的普遍定义尚未完全达成一致。

本研究增加的信息

  • 根据他们的经验,精神健康工作人员使用各种参与方法来适应服务使用者不断变化和独特的需求(服务使用者);

  • 精神健康工作人员表现出坚持不懈和适应性等素质,以成功与服务使用者接触;

  • 无论专业背景如何,社区精神健康工作人员的角色都不仅限于任何单一的方法,实际帮助和社会支持与临床治疗一样重要,以建立成功的参与。

研究意义

  • 很少有人了解在早期干预环境中工作的精神健康工作人员的参与经验,因为本综述中的大多数研究都集中在坚定的外展或社区精神健康团队工作人员的观点上;

  • 需要进一步了解社区精神健康工作者与早期干预环境中的服务使用者的参与经验,社区精神健康工作者的角色描述和期望应该考虑到提供适当干预所需的广泛灵活方法;

  • 这可能涉及在培训计划中关注参与。

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