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[患者参与儿童和青少年精神病学——一项范围综述]

[Patient Participation in Child and Adolescent Psychiatry - A Scoping Review].

作者信息

Zerbe Paul-Simon, Röttele Nicole, Körner Mirjam

机构信息

Albert-Ludwigs-Universität Freiburg Deutschland Albert-Ludwigs-Universität Freiburg.

出版信息

Prax Kinderpsychol Kinderpsychiatr. 2020 Nov;69(8):700-719. doi: 10.13109/prkk.2020.69.8.700.

Abstract

The present study deals with the concept of participation in inpatient child- and adolescent mental health care. Aim is to analyse theoretical constructs in the light of a literature review on participation as an important method to implement patient autonomy in the specific context. The potential for conflict of patient autonomy as a greater principle and the absence of literature reviews on the topic make this study essential. The method is a scoping-review. 978 texts from three central databases have been screened for title and abstract, 27 have been included. The results show arguments, barriers and methods of participation. Most of the arguments are utilitarian: positive effects on patients, therapists and the hospital. On the other hand, there are multiple barriers of implementation: willingness of physicians, reticence of patients and systemic barriers. Structures of cooperation, key figures and interactive information brochures have already been used as methods of participation. In conclusion, a contextual concept of participation is proposed: Shared Care Planning. It is meant to be independent from the capacity to give informed consent and underlines the importance of day-to-day issues. It calls for the consideration of the mentioned barriers and a high flexibility of participation methods.

摘要

本研究探讨了儿童和青少年住院精神卫生保健中的参与概念。目的是根据一项关于参与的文献综述来分析理论构建,参与是在特定背景下实现患者自主权的重要方法。患者自主权作为一项更广泛原则存在冲突的可能性,以及缺乏关于该主题的文献综述,使得本研究至关重要。研究方法是范围综述。已对来自三个核心数据库的978篇文本进行了标题和摘要筛选,纳入了27篇。结果显示了参与的论据、障碍和方法。大多数论据是功利主义的:对患者、治疗师和医院有积极影响。另一方面,存在多种实施障碍:医生的意愿、患者的沉默和系统障碍。合作结构、关键人物和交互式信息手册已被用作参与方法。总之,提出了一个参与的情境概念:共享护理计划。它旨在独立于知情同意能力,并强调日常问题的重要性。它要求考虑上述障碍,并要求参与方法具有高度灵活性。

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