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界定“照顾者”的定义及其在住院精神卫生保健中所扮演的角色:一项针对患者、照顾者及临床医生的焦点小组研究。

Defining what a 'carer' is and the role they play in in-patient mental healthcare: A focus group study with patients, carers and clinicians.

作者信息

Dirik Aysegul, Kaselionyte Justina, Giacco Domenico, Priebe Stefan

机构信息

Unit for Social & Community Psychiatry, (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, UK.

出版信息

BJPsych Open. 2020 Aug 18;6(5):e89. doi: 10.1192/bjo.2020.70.

Abstract

BACKGROUND

The value of carer involvement has been extensively researched and promoted. However, the field lacks exploration of conceptual issues, which might help to explain why there are widespread difficulties in putting policy into practice in this area, as implementation rates remain low internationally.

AIMS

This qualitative study explored patients', carers' and clinicians' perspectives on the role of carers in mental healthcare, particularly with regards to in-patient settings.

METHOD

Sixteen focus groups were conducted with patients, carers and clinicians who have current or previous experience of in-patient settings. A thematic analysis was conducted on the transcripts, exploring two key domains: (a) what a 'carer' is, and (b) how the 'carer' role is described within the context of the hospital environment.

RESULTS

Participants diverged in their opinions of what the 'carer' role entails, and the perceived helpfulness of it. Issues unique to the in-patient setting were identified, such as the role of the hospital environment in enabling or being a barrier to carer involvement. These differing perspectives and contextual factors had an impact on the position of carers in the hospital setting, as they could be viewed as helpful, a hindrance or as passive visitors, depending on the perspectives of clinicians.

CONCLUSIONS

More clarity and agreement is needed between patients, carers and clinicians in terms of how the 'carer' role is defined. This has the potential to improve carers' experience of involvement in hospital settings.

摘要

背景

照顾者参与的价值已得到广泛研究和推广。然而,该领域缺乏对概念性问题的探索,这或许有助于解释为何在将政策付诸实践方面存在广泛困难,因为国际上的实施率仍然很低。

目的

这项定性研究探讨了患者、照顾者和临床医生对照顾者在精神卫生保健中的作用的看法,特别是在住院环境方面。

方法

对有当前或既往住院经历的患者、照顾者和临床医生进行了16个焦点小组访谈。对访谈记录进行了主题分析,探讨了两个关键领域:(a)“照顾者”是什么,以及(b)在医院环境背景下如何描述“照顾者”的角色。

结果

参与者对“照顾者”角色的内涵及其感知的帮助程度意见不一。确定了住院环境特有的问题,例如医院环境在促进或阻碍照顾者参与方面的作用。这些不同的观点和背景因素对照顾者在医院环境中的地位产生了影响,因为根据临床医生的观点,他们可能被视为有帮助的、有阻碍的或被动的访客。

结论

患者、照顾者和临床医生之间需要在如何定义“照顾者”角色方面更加明确和达成一致。这有可能改善照顾者在医院环境中的参与体验。

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