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秘鲁严重精神障碍患者护理与康复连续性项目实施情况的定性研究 秘鲁针对严重精神障碍患者的护理与康复连续性项目实施情况的定性研究

[Qualitative study of the implementation of the Continuity of Care and Rehabilitation Program for people with severe mental disorders in PeruEstudo qualitativo sobre a implementação do Programa de Continuidade de Cuidados e Rehabilitação para pessoas com transtornos mentais graves no Peru].

作者信息

Diez-Canseco Francisco, Rojas-Vargas Jefferson, Toyama Mauricio, Mendoza María, Cavero Victoria, Maldonado Humberto, Caballero July, Cutipé Yuri

机构信息

CRONICAS Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia Lima Perú CRONICAS Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Perú.

Dirección de Salud Mental Ministerio de Salud del Perú Dirección de Salud Mental, Ministerio de Salud del Perú.

出版信息

Rev Panam Salud Publica. 2020 Dec 14;44:e134. doi: 10.26633/RPSP.2020.134. eCollection 2020.

DOI:10.26633/RPSP.2020.134
PMID:33337443
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7737645/
Abstract

OBJECTIVE

Describe the implementation of the Continuity of Care and Rehabilitation Program (PCC-R) in community mental health centers (CSMCs, Spanish acronym) in Peru.

METHODS

Qualitative study of the implementation of the PCC-R in four CSMCs in Lima and La Libertad, Peru. Forty-two individual semi-structured interviews were conducted, as well as a focus group with five participants, for a total of 47 informants, including users, family members, and professionals involved in the design, implementation, and monitoring of the program.

RESULTS

The PCC-R is a key program for community mental health services in Peru and it enjoys broad acceptability. Providers and users report satisfaction with its results; however, the program lacks a policy document specifying its objectives, organization, and activities. This would explain the variability in its implementation. The PCC-R has limitations in terms of management of financial and human resources, and it is necessary to improve training and supervision. There is consensus on the need, usefulness, and viability of developing a system to monitor the PCC-R. Good practices and suggestions are presented with a view to addressing these challenges.

CONCLUSIONS

The PCC-R is a flagship program for the CSMCs and for the mental health reform in Peru. It has achieved broad acceptability among providers and users. Its implementation combines successes and difficulties, with pending tasks that include developing a policy document, improving resource management, strengthening training and supervision, and implementing a monitoring system for continuous improvement of the program.

摘要

目的

描述秘鲁社区心理健康中心(西班牙语首字母缩写为CSMCs)中连续性护理与康复项目(PCC-R)的实施情况。

方法

对秘鲁利马和拉利伯塔德的四个社区心理健康中心实施PCC-R的情况进行定性研究。进行了42次个人半结构化访谈,并组织了一个由五名参与者组成的焦点小组,共有47名信息提供者,包括项目设计、实施和监测过程中的使用者、家庭成员及专业人员。

结果

PCC-R是秘鲁社区心理健康服务的关键项目,具有广泛的可接受性。提供者和使用者对其结果表示满意;然而,该项目缺乏明确其目标、组织和活动的政策文件。这可以解释其实施过程中的差异。PCC-R在财务和人力资源管理方面存在局限性,有必要改进培训和监督。对于开发一个监测PCC-R的系统的必要性、实用性和可行性存在共识。针对这些挑战提出了良好做法和建议。

结论

PCC-R是社区心理健康中心以及秘鲁心理健康改革的旗舰项目。它在提供者和使用者中获得了广泛的接受度。其实施既有成功之处也有困难,有待完成的任务包括制定政策文件、改善资源管理、加强培训和监督以及实施一个监测系统以持续改进该项目。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de61/7737645/ffc78a1754d8/rpsp-44-e134_Figure1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de61/7737645/ffc78a1754d8/rpsp-44-e134_Figure1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de61/7737645/ffc78a1754d8/rpsp-44-e134_Figure1.jpg

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