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专业人士对在地区精神病中心设立专门的短期治疗单位的看法——一项定性研究。

Professionals' perceptions of the establishment of a specialized brief therapy unit in a district psychiatric centre - a qualitative study.

机构信息

Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.

St. Olavs Hospital, Trondheim University Hospital, Nidaros District Psychiatric Centre, Trondheim, Norway.

出版信息

BMC Health Serv Res. 2020 Nov 20;20(1):1056. doi: 10.1186/s12913-020-05926-8.

Abstract

BACKGROUND

Increasing mental health problems and scarce treatment resources put pressure on mental health services to make innovations in service provision, such as developing differentiated services adapted to different needs. One innovation in differentiated service provision is brief or short-term treatment to patients with moderate mental health problems. Implementing a new unit in an organization usually faces many potential barriers and facilitators, and knowledge on how the professionals providing the services perceive the implementation of innovative approaches in mental health services is scarce. The aim of this study was therefore to explore the professionals' perceptions of how the establishment of a specialized brief therapy unit had affected the organization, especially the everyday work in the outpatient clinics.

METHODS

Eleven professionals, five men and six women, took part in individual interviews. All participants were between 40 and 60 years old and had leading or coordinating positions in the organization. Their professional backgrounds were within psychology, nursing and medicine, most of them specialists in their field. Data was analyzed according to Systematic text condensation.

RESULTS

The professionals' experiences represented four main themes: (1) The brief therapy unit was perceived as successful and celebrated. (2) The general outpatient clinics, on the other hand, were described as "forgotten". (3) The establishment process had elucidated different views on treatment in the outpatient clinics - and had set off (4) a discussion regarding the criteria for prioritizing in mental health services.

CONCLUSION

Providing targeted treatment to patients with moderate mental health problems, while having a concurrent aim to solve broader problems in mental health services, entails a discussion regarding resource use and the appropriate level of treatment provision. Professionals should be more involved when innovative efforts are implemented, and the criteria for success must be conceptualized and evaluated. Longitudinal research on the implementation of innovative efforts in the services should include professionals' and service users' perspectives.

摘要

背景

心理健康问题的日益增多和治疗资源的匮乏给精神卫生服务带来了压力,需要在服务提供方面进行创新,例如开发针对不同需求的差异化服务。差异化服务提供方面的一项创新是为中度心理健康问题患者提供简短或短期治疗。在组织中实施新单位通常会面临许多潜在的障碍和促进因素,而关于提供服务的专业人员如何看待精神卫生服务中创新方法的实施的知识却很少。因此,本研究的目的是探讨专业人员对专门的简短治疗单位的建立如何影响组织的看法,特别是对门诊的日常工作的影响。

方法

11 名专业人员,5 名男性和 6 名女性,参加了个人访谈。所有参与者年龄在 40 至 60 岁之间,在组织中担任领导或协调职务。他们的专业背景是心理学、护理和医学,大多数人都是该领域的专家。数据根据系统文本浓缩进行分析。

结果

专业人员的经验代表了四个主要主题:(1)简短治疗单位被认为是成功和值得庆祝的。(2)另一方面,普通门诊被描述为“被遗忘的”。(3)建立过程阐明了门诊治疗的不同观点,并引发了(4)关于精神卫生服务中优先排序标准的讨论。

结论

为中度心理健康问题患者提供有针对性的治疗,同时旨在解决精神卫生服务中的更广泛问题,需要讨论资源的使用和适当的治疗提供水平。在实施创新努力时,应让专业人员更多地参与,并对成功标准进行概念化和评估。对服务中创新努力实施的纵向研究应包括专业人员和服务使用者的观点。

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