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一项探索急性心理健康病房中“保留治疗空间”护理干预措施的患者观点的定性研究。

A qualitative study exploring the patients' perspective from the 'Reserved Therapeutic Space' nursing intervention in acute mental health units.

机构信息

Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L´Hospitalet de Llobregat, Spain.

Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain.

出版信息

Int J Ment Health Nurs. 2021 Jun;30(3):783-797. doi: 10.1111/inm.12848. Epub 2021 Feb 17.

Abstract

This study aimed to explore the perspective of people who had experienced treatment as patients at acute mental health units, regarding an intervention model to improve therapeutic relationships in the units, which had been previously designed by the nurses. The study participants were people linked to collectives for social activism in mental health. Six focus groups were held. The results were classified into three themes: (a) the meaning of a space to enable the establishment of a therapeutic relationship, (b) the procedures to implement the space, and (c) the difficulties to overcome to establish the space. For the participants, the Reserved Therapeutic Space intervention was perceived as a space where they could share expectations and needs with the nurses, considering it as both valid and useful to improve the therapeutic relationship in acute units. For the participants, the intervention should be structured in three stages: orientation, follow-up, and discharge. The content of the intervention should be proposed by the patients based on their needs and concerns. The barriers identified for carrying out the intervention were the lack of relational competence, the violation of rights, and the lack of accessibility of nurses. The facilitating elements were the availability of nurses, active listening, and empathy. The resulting intervention model includes realities of both groups, providing insights for nurses to initiate a space with patients and improve their therapeutic relationship. This intervention model could be used by managers to test its effectiveness.

摘要

本研究旨在探讨曾在急性精神卫生病房接受治疗的患者对先前由护士设计的改善病房治疗关系的干预模式的看法。研究参与者是与心理健康社会行动团体有关联的人。共进行了六次焦点小组。结果分为三个主题:(a)为建立治疗关系而启用的空间的意义,(b)实施该空间的程序,以及(c)为建立该空间而克服的困难。对于参与者来说,保留治疗空间干预被视为一个可以与护士分享期望和需求的空间,他们认为这对改善急性病房的治疗关系既有效又有用。对于参与者来说,干预应该分为三个阶段:定位、随访和出院。干预的内容应该根据患者的需求和关注点由患者提出。实施干预的障碍包括缺乏关系能力、侵犯权利和护士缺乏可及性。促进因素包括护士的可用性、积极倾听和同理心。由此产生的干预模式包含了两组的现实情况,为护士与患者建立空间并改善他们的治疗关系提供了见解。该干预模式可由管理者进行测试,以评估其有效性。

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