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以个体康复为导向的社区心理卫生保健:一个发展项目的定性评估。

Personal-recovery-oriented community mental healthcare: qualitative evaluation of a developmental project.

机构信息

Research Group Social Psychiatry and Mental Health Nursing, Hogeschool Arnhem Nijmegen University of Applied Science, Schinveld, The Netherlands

MET ggz, Roermond, Limburg, The Netherlands.

出版信息

BMJ Open. 2020 Jun 4;10(6):e035709. doi: 10.1136/bmjopen-2019-035709.

Abstract

OBJECTIVES

Mental healthcare is commonly aimed at reducing symptoms in individual service users. When only symptomatic recovery is addressed, not all service users experience sufficient recovery, and when care is aimed only at individuals (instead of the neighbourhood), not all people in need of mental healthcare are reached. This study evaluated a project that aimed to improve mental healthcare in a neighbourhood, by improving healthcare providers' outreach to the residents living in the neighbourhood, by improving collaboration among healthcare providers and focussing on the residents' personal recovery. This project was carried out by several public health services. It aimed to change the goal of mental healthcare provided in the neighbourhood from symptom reduction to personal recovery.

DESIGN

The study included qualitative focus groups and inductive content analysis.

SETTING

Primary and secondary mental healthcare that healthcare workers from different healthcare services provided.

PARTICIPANTS

The evaluation was conducted through three focus group interviews with services users, their friends and relatives, neighbourhood residents, neighbourhood representatives and the healthcare services that were involved ( = 24).

RESULTS

Evaluation indicated that the most valued part of the project was the utilisation of peer workers at the initiation of mental healthcare. Improved communication among healthcare providers that the project fostered was also highly regarded. The aim of the project to align it with existing initiatives in the neighbourhood was also considered important, although it was difficult to achieve.

CONCLUSIONS

The project did not find a panacea for recovery-oriented community mental healthcare. A variety of its components did, however, contribute to the mental health of the community residents.

摘要

目的

精神卫生保健通常旨在减轻个体服务使用者的症状。当仅关注症状的恢复时,并非所有服务使用者都能获得足够的康复,而当护理仅针对个人(而不是社区)时,并非所有需要精神保健的人都能得到照顾。本研究评估了一个旨在通过改善医疗服务提供者对居住在社区中的居民的服务范围、改善医疗服务提供者之间的合作以及关注居民的个人康复来改善社区精神卫生保健的项目。该项目由多个公共卫生服务部门实施。其目的是将社区中提供的精神卫生保健的目标从减少症状转变为个人康复。

设计

本研究包括定性焦点小组和归纳内容分析。

设置

初级和二级精神卫生保健,由来自不同医疗服务的医疗工作者提供。

参与者

通过与服务使用者、他们的朋友和亲戚、社区居民、社区代表以及参与的医疗服务部门(=24 人)进行的三次焦点小组访谈,对评估进行了评估。

结果

评估表明,该项目最有价值的部分是在精神卫生保健开始时利用同伴工作人员。项目促进的医疗服务提供者之间更好的沟通也受到高度重视。该项目旨在与社区内现有的举措保持一致的目标也被认为很重要,尽管实现这一目标具有挑战性。

结论

该项目并未为面向康复的社区精神卫生保健提供灵丹妙药。然而,该项目的各种组成部分确实有助于社区居民的精神健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2553/7279651/053313fb05c5/bmjopen-2019-035709f01.jpg

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