Luigi Mimosa, Rapisarda Filippo, Corbière Marc, De Benedictis Luigi, Bouchard Anne-Marie, Felx Amélie, Miglioretti Massimo, Abdel-Baki Amal, Lesage Alain
Department of Psychiatry and Addictology, University of Montreal, Quebec, Canada.
Department of Psychology, Università degli Studi di Milano-Bicocca, Italy.
Can Med Educ J. 2020 Sep 23;11(5):e62-e73. doi: 10.36834/cmej.61273. eCollection 2020 Sep.
The attitudes of mental health professionals towards consumers' recovery are far more pessimistic than what is needed for the recovery-orientation to truly permeate systems of care. It has become pressing to depict determinants for these attitudes and how they evolve during professionalization. This, in the hopes to adjust not only medical education, but also ongoing training of professionals.
A systematic search of PubMed and PsycINFO databases was conducted, yielding a net 15 303 records. Twenty-two publications from specific educational journals and reference lists were added. Finally, thirty-four full texts were read, from which twenty-two articles were included.
From the reviewed studies emerged five main determinants: profession, education, age, clinical experience, and nature of the contact with consumers. Traditional clinical placements during residency, negative experiences with acute patients, younger age and the professional attitudes of psychiatrists seem to all be determining factors for professionals' pessimistic attitudes towards recovery.
This review found specific determinants for attitudes in recovery and four out of five can be acted upon. For a recovery-orientation to be implemented across our mental health system, we formulate recommendations within the Canadian context for revision of curriculum, recovery-specific training, and operationalisation through state/provincial technical assistance centers.
心理健康专业人员对消费者康复的态度远比康复导向真正渗透到护理系统所需的态度更为悲观。描绘这些态度的决定因素以及它们在专业化过程中如何演变已变得刻不容缓。这样做的目的不仅是为了调整医学教育,也是为了调整专业人员的在职培训。
对PubMed和PsycINFO数据库进行系统检索,共获得15303条记录。另外还补充了来自特定教育期刊和参考文献列表的22篇出版物。最后,阅读了34篇全文,其中22篇文章被纳入研究。
从所审查的研究中得出了五个主要决定因素:职业、教育、年龄、临床经验以及与消费者接触的性质。住院医师培训期间的传统临床实习、与急性病患者的负面经历、较年轻的年龄以及精神科医生的专业态度似乎都是专业人员对康复持悲观态度的决定因素。
本综述发现了康复态度的具体决定因素,并且五个因素中有四个是可以采取行动的。为了在我们的心理健康系统中实施康复导向,我们在加拿大的背景下制定了相关建议,以修订课程、开展针对康复的培训,并通过国家/省级技术援助中心进行实施。