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'我们都在同一条船上':一项关于在儿童和青少年心理健康服务 (CAMHS) 中参与患者和公众时作为'专家'的体验的阐释现象学分析研究。

'We're all in the same boat': An Interpretative Phenomenological Analysis study of experiences of being an 'expert' during patient and public involvement within Child and Adolescent Mental Health Services (CAMHS).

机构信息

Manchester Metropolitan University, Manchester, UK.

Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.

出版信息

Health Expect. 2021 Apr;24(2):421-430. doi: 10.1111/hex.13183. Epub 2021 Feb 2.

Abstract

BACKGROUND

Patient and Public involvement (PPI) has rapidly evolved into a key component in shaping the delivery of health services. However, little is known about what it is like to participate in involvement procedures that include representatives of multiple groups and in the context of developing new interventions for Child and Adolescent Mental Health Services (CAMHS).

OBJECTIVE

This study explored participants' experiences of PPI, following attending a 'consensus conference', during which their views were sought in relation to the development of a proposed staff-based intervention and key questions about its design and implementation.

DESIGN

Qualitative, semi-structured interview study.

SETTING AND PARTICIPANTS

Six participants, including service users and various frontline clinical staff team members, who had experience of CAMHS were present at the consensus conference and then asked about their experiences of being involved via semi-structured interviews. The data were analysed using Interpretative Phenomenological Analysis (IPA). Young people, carers and frontline staff have been involved in the design and implementation throughout the broader programme of work of which this study forms part, although these groups were not directly involved in the design and implementation of this paper.

RESULTS

Three key narratives were present: (a) Previous Experiences Driving Expectations, (b) 'We are all in the same boat' and (c) The Realization of Multiple Identities. The results suggest that PPI involvement is a complex process that may be driven by positive/negative expectations, but that individuals value learning about others and recognizing different perspectives while reaching shared goals in improving services.

DISCUSSION AND CONCLUSION

This study demonstrates the complexity of experience that service users and clinical staff face when engaging in involvement activities in CAMHS. The findings demonstrate the value in engaging multiple stakeholder groups while also highlighting the importance of proper consideration of the procedures involved and facilitators of engagement.

摘要

背景

患者和公众参与(PPI)已迅速成为塑造医疗服务提供方式的关键组成部分。然而,对于参与包括多个群体代表的参与程序以及在为儿童和青少年心理健康服务(CAMHS)开发新干预措施的背景下的参与程序,我们知之甚少。

目的

本研究探讨了参与者在参加“共识会议”后的 PPI 体验,在该会议上,他们就拟议的基于员工的干预措施的发展以及有关其设计和实施的关键问题征求了意见。

设计

定性、半结构化访谈研究。

设置和参与者

六名参与者,包括服务使用者和各种一线临床工作人员,他们在共识会议上就参与情况进行了半结构化访谈,然后就参与情况进行了访谈。使用解释现象学分析(IPA)对数据进行了分析。年轻人、照顾者和一线工作人员在更广泛的工作方案中参与了设计和实施,尽管这些群体没有直接参与本论文的设计和实施。

结果

存在三个关键叙述:(a)以前的经验驱动期望,(b)“我们都在同一条船上”,(c)多重身份的实现。结果表明,PPI 参与是一个复杂的过程,可能是由积极/消极的期望驱动的,但个人重视了解他人和认识不同的观点,同时实现改善服务的共同目标。

讨论与结论

本研究表明,服务使用者和临床工作人员在参与 CAMHS 中的参与活动时所面临的体验的复杂性。研究结果证明了让多个利益相关者群体参与的价值,同时也强调了适当考虑所涉及的程序和促进参与的重要性。

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