School of Social Policy & Practice, University of Pennsylvania, USA.
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA.
Int J Soc Psychiatry. 2022 May;68(3):610-618. doi: 10.1177/0020764021992807. Epub 2021 Feb 7.
The increasing prevalence of mental illness and low treatment rate presents a pressing public health issue in China. Pervasive stigma is a significant barrier to mental health recovery and community inclusion. In particular, stigmatizing or supportive attitudes held by healthcare providers could either perpetuate or mitigate self-stigma of people with mental illness. Moreover, mental health resources are unevenly distributed in China, with most of them concentrated in urban centers and provincial capitals. This study explores healthcare providers' attitudes toward mental illness and the challenges they faced at work in a rural Chinese county.
Four focus groups were conducted with 36 healthcare providers from a three-tier mental healthcare system in a rural county in southwestern China. Focus group discussions were recorded and transcribed verbatim. The team employed a conventional content analysis approach for data analysis. All transcripts were double-coded by three bilingual team members who are native Chinese speakers. Coding discrepancies were resolved by consensus.
Healthcare providers recruited from the county, township, and village levels varied in educational background, professional qualification, and experience of working with people with mental illness. Five thematic categories identified across four groups include (1) barriers to mental healthcare delivery, (2) keys to mental health recovery, (3) providers' attitudes toward providing care, (4) providers' perception toward patients and family members, and (5) providers' perception of training needs.
This is a unique study that included healthcare providers from a three-tier healthcare system. Findings signal the importance of understanding healthcare practitioners' experiences and views to inform the design of training initiatives in rural or low-resource communities.
在中国，精神疾病的患病率不断上升，治疗率低，这是一个紧迫的公共卫生问题。普遍存在的污名化是精神健康康复和社区融入的一个重大障碍。特别是，医疗保健提供者持有的污名化或支持性态度可能会加剧或减轻精神疾病患者的自我污名化。此外，中国的精神卫生资源分布不均，大部分集中在城市中心和省会城市。本研究探讨了中国农村县级医疗机构中医疗保健提供者对精神疾病的态度以及他们在工作中面临的挑战。
在中国西南部的一个农村县，从三级精神卫生保健系统中招募了 36 名医疗保健提供者，进行了 4 个焦点小组讨论。将讨论内容录制并逐字转录。团队采用传统的内容分析方法进行数据分析。所有的转录本都由三名双语团队成员进行双编码，这三名团队成员都是以中文为母语的人。通过共识解决编码差异。
从县级、乡镇级和村级招募的医疗保健提供者在教育背景、专业资格和与精神疾病患者合作经验方面存在差异。四个小组共确定了五个主题类别，包括（1）精神卫生保健服务提供的障碍，（2）精神健康恢复的关键，（3）提供者提供护理的态度，（4）提供者对患者和家庭成员的看法，以及（5）提供者对培训需求的看法。
这是一项独特的研究，包括了来自三级医疗保健系统的医疗保健提供者。研究结果表明，了解医疗保健从业者的经验和观点对于在农村或资源匮乏的社区设计培训计划非常重要。
