Matsuoka Sumiko
Department of Nursing, Konan Women's University, Kobe, Japan.
Int J Ment Health Nurs. 2021 Apr;30(2):563-573. doi: 10.1111/inm.12822. Epub 2020 Dec 6.
Transforming to recovery-oriented care is an urgent issue in community psychiatric nursing in Japan. Because traditional psychiatry is still influential, nurses are required to possess cultural sensitivity to objectively view conflicts between values when providing recovery-oriented care. If recovery-oriented care based on cultural sensitivity is clarified, it would help nurses providing recovery-oriented care in non-recovery-oriented environments. Therefore, this study aimed to clarify recovery-oriented nursing care based on cultural sensitivity in community psychiatric nursing in Japan. A semi-structured interview with 21 community psychiatric nurses and participant observations for seven of them were performed. A qualitative description was undertaken to analyse the data. The relationships between categories were examined. The study conforms to the COREQ checklist. Through the analysis, six categories were revealed: 1. Continuously reflecting on one's own practice and the influence of the traditional mental health culture; 2. Constructing a partnership with clients to uphold their rights and responsibilities; 3. Having client-centred dialogue to help them enjoy life and grow; 4. Supporting clients' lives and strengthening their self-management; 5. Working as a team to achieve clients' wishes, which includes some risks, and 6. Maintaining a relationship between clients and the people who care for them. Category 1 was central and enclosed by categories 2, 3 and 4. Categories 5 and 6 were located outside of categories 1 to 4. The results showed cultural sensitivity enables recovery-oriented care even in non-recovery-oriented environments and include recognizing the traditional mental health culture, understanding clients' experiences and accepting other's values.
向以康复为导向的护理模式转变是日本社区精神科护理中的一个紧迫问题。由于传统精神病学仍具有影响力,护士在提供以康复为导向的护理时,需要具备文化敏感性,以便客观地看待价值观之间的冲突。如果基于文化敏感性的以康复为导向的护理得以明确,将有助于护士在非康复导向的环境中提供以康复为导向的护理。因此,本研究旨在阐明日本社区精神科护理中基于文化敏感性的以康复为导向的护理。对21名社区精神科护士进行了半结构式访谈,并对其中7名护士进行了参与观察。采用定性描述方法对数据进行分析。研究了类别之间的关系。本研究符合COREQ清单。通过分析,揭示了六个类别:1. 不断反思自己的实践以及传统心理健康文化的影响;2. 与服务对象建立伙伴关系,维护他们的权利和责任;3. 进行以服务对象为中心的对话,帮助他们享受生活并成长;4. 支持服务对象的生活并加强他们的自我管理;5. 作为团队开展工作以实现服务对象的愿望,这其中存在一些风险;6. 维持服务对象与照顾他们的人之间的关系。类别1处于核心位置,被类别2、3和4围绕。类别5和6位于类别1至4之外。结果表明,文化敏感性即使在非康复导向的环境中也能实现以康复为导向的护理,包括认识传统心理健康文化、理解服务对象的经历以及接受他人的价值观。