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让有精神疾病亲身经历的人参与一项协作式照护模式可行性研究。

Engaging a person with lived experience of mental illness in a collaborative care model feasibility study.

作者信息

Vojtila Lenka, Ashfaq Iqra, Ampofo Augustina, Dawson Danielle, Selby Peter

机构信息

Nicotine Dependence Clinic, Centre for Addiction and Mental Health, 175 College Street, Toronto, ON, M5T1P, Canada.

Addictions Research Program, Centre for Addiction and Mental Health, Toronto, Canada.

出版信息

Res Involv Engagem. 2021 Jan 8;7(1):5. doi: 10.1186/s40900-020-00247-w.

Abstract

Researchers have explored different types of treatment to help people with a mental illness with other problems they might be experiencing, such as their health condition and quality of life. Care models that involve many different health care providers working together to provide complete physical and mental health care are becoming popular. There has been a push from the research community to understand the value of including people with lived experience in such programs. While research suggests that people with lived experience may help a patient's treatment, there is little evidence on including them in a team based program. This paper describes how our research team included a person with lived experience of psychosis in both the research and care process. We list some guiding principles we used to work through some of the common challenges that are mentioned in research. Lastly, experiences from the research team, lessons learned, and a personal statement from the person with lived experience (AA) are provided to help future researchers and people with lived experience collaborate in research and healthcare. Background In our current healthcare system, people with a mental illness experience poorer physical health and early mortality in part due to the inconsistent collaboration between primary care and specialized mental health care. In efforts to bridge this gap, hospitals and primary care settings have begun to take an integrated approach to care by implementing collaborative care models to treat a variety of conditions in the past decade. The collaborative care model addresses common barriers to treatment, such as geographical distance and lack of individualized, evidence-based, measurement-based treatment. Person(s) with lived experience (PWLE) are regarded as 'experts by experience' in the scope of their first-hand experience with a diagnosis or health condition. Research suggests that including PWLE in a patient's care and treatment has significant contributions to the patient's treatment and overall outcome. However, there is minimal evidence of including PWLE in collaborative care models. This paper describes the inclusion of a PWLE in a research study and collaborative care team for youth with early psychosis. Aims To discuss the active involvement of a PWLE on the research and collaborative care team and to describe the research team's experiences and perspectives to facilitate future collaborations. Method This paper describes the inclusion of a PWLE on our research team. We provide a selective review of the literature on several global initiatives of including PWLE in different facets of the healthcare system. Additionally, we outline multiple challenges of involving PWLE in research and service delivery. Examples are provided on how recruitment and involvement was facilitated, with the guidance of several principles. Lastly, we have included a narrative note from the PWLE included in our study, who is also a contributing author to this paper (AA), where she comments on her experience in the research study. Conclusion Including PWLE in active roles in research studies and collaborative care teams can enhance the experience of the researchers, collaborative care team members, and PWLE. We showcase our method to empower other researchers and service providers to continue to seek guidance from PWLE to provide more comprehensive, collaborative care with better health outcomes for the patient, and a more satisfying care experience for the provider.

摘要

研究人员探索了不同类型的治疗方法,以帮助患有精神疾病的人解决他们可能面临的其他问题,比如他们的健康状况和生活质量。涉及许多不同医疗服务提供者共同努力提供全面身心健康护理的护理模式正变得越来越普遍。研究界一直在推动了解将有实际生活经验的人纳入此类项目的价值。虽然研究表明有实际生活经验的人可能有助于患者的治疗,但几乎没有证据表明将他们纳入基于团队的项目中。本文描述了我们的研究团队如何在研究和护理过程中纳入了一位有精神病实际生活经验的人。我们列出了一些指导原则,用于应对研究中提到的一些常见挑战。最后,提供了研究团队的经验、吸取的教训以及有实际生活经验的人(AA)的个人陈述,以帮助未来的研究人员和有实际生活经验的人在研究和医疗保健中进行合作。背景 在我们当前的医疗系统中,患有精神疾病的人身体健康较差且过早死亡,部分原因是初级保健和专业精神卫生保健之间缺乏协调合作。为了弥合这一差距,在过去十年中,医院和初级保健机构已开始采取综合护理方法,通过实施协作护理模式来治疗各种病症。协作护理模式解决了治疗中的常见障碍,如地理距离以及缺乏个性化、基于证据、基于测量的治疗。有实际生活经验的人(PWLE)在其对某种诊断或健康状况的第一手经验范围内被视为“经验专家”。研究表明,将有实际生活经验的人纳入患者的护理和治疗对患者的治疗及总体结果有重大贡献。然而,几乎没有证据表明将有实际生活经验的人纳入协作护理模式中。本文描述了将一名有实际生活经验的人纳入针对早期精神病青年的研究和协作护理团队的情况。目的 讨论有实际生活经验的人在研究和协作护理团队中的积极参与,并描述研究团队的经验和观点,以促进未来的合作。方法 本文描述了将一名有实际生活经验的人纳入我们的研究团队的情况。我们对关于将有实际生活经验的人纳入医疗系统不同方面的几个全球倡议的文献进行了选择性综述。此外,我们概述了让有实际生活经验的人参与研究和服务提供的多个挑战。提供了在若干原则的指导下促进招募和参与的示例。最后,我们纳入了我们研究中包含的有实际生活经验的人的叙述性记录,她也是本文的共同作者(AA),她在其中评论了自己在研究中的经历。结论 将有实际生活经验的人积极纳入研究和协作护理团队可以提升研究人员、协作护理团队成员以及有实际生活经验的人的体验。我们展示我们的方法,以促使其他研究人员和服务提供者继续向有实际生活经验的人寻求指导,从而为患者提供更全面、协作性更好的护理,实现更好的健康结果,并为提供者带来更令人满意的护理体验。

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