Stander Charnelle, Hodkinson Peter, Dippenaar Enrico
Division of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
S Afr J Psychiatr. 2021 Jan 27;27:1545. doi: 10.4102/sajpsychiatry.v27i0.1545. eCollection 2021.
Prehospital emergency care providers are frequently called to assist with the management of mental healthcare users (MHCUs). The no. 17 of 2002 regulates mental healthcare in South Africa, but the act fails to consider the responsibilities of prehospital emergency care providers in the provision of mental healthcare. Rather South African Police Services were given authority over the well-being of a MHCU in the prehospital setting.
To investigate prehospital emergency care providers' understanding of their responsibilities towards MHCUs and the community during the management of behavioural emergencies.
The research was carried out at prehospital emergency care providers from the three main levels of care, currently operational within the boundaries of Pretoria, South Africa.
A grounded theory qualitative study design was chosen using semi-structured focus groups for each level of prehospital emergency care - basic life support (BLS), intermediate life support (ILS) and advanced life support (ALS). Data from each focus group were collected through audio recordings and transcribed and analysed using a framework approach.
A total of 19 prehospital emergency care providers participated; two focus group interviews were performed for each level of care. The BLS focus groups each consisted of two participants. The ILS focus groups consisted of three participants each, and the ALS focus groups consisted of six and three participants. Four key themes were identified: perceptions of behavioural emergencies, responsibilities, understanding of legislation and barriers experienced.
Participants placed high value on their moral and medical responsibilities towards MHCUs, which they described as ensuring the safety of themselves, MHCUs and the community; preventing further harm; and transporting MHCUs to an appropriate healthcare facility. There was a desire for revision of legislation, better education, skill development and awareness of mental healthcare in the prehospital emergency care setting.
院前急救人员经常被召唤协助管理精神卫生保健使用者（MHCUs）。2002年第17号法案对南非的精神卫生保健进行了规范，但该法案没有考虑到院前急救人员在提供精神卫生保健方面的责任。相反，南非警察局被赋予了在院前环境中对MHCU福祉的管辖权。
调查院前急救人员在处理行为紧急情况时对其对MHCUs和社区责任的理解。
该研究在南非比勒陀利亚范围内目前运营的三个主要护理级别的院前急救人员中进行。
选择扎根理论定性研究设计，针对每个院前急救级别——基础生命支持（BLS）、中级生命支持（ILS）和高级生命支持（ALS）——使用半结构化焦点小组。每个焦点小组的数据通过录音收集，并使用框架方法进行转录和分析。
共有19名院前急救人员参与；每个护理级别进行了两次焦点小组访谈。BLS焦点小组每组由两名参与者组成。ILS焦点小组每组由三名参与者组成，ALS焦点小组由六名和三名参与者组成。确定了四个关键主题：对行为紧急情况的看法、责任、对立法的理解以及遇到的障碍。
参与者高度重视他们对MHCUs的道德和医疗责任，他们将其描述为确保自身、MHCUs和社区的安全；防止进一步伤害；以及将MHCUs转运至适当的医疗机构。人们希望修订立法、提供更好的教育、进行技能发展并提高院前急救环境中对精神卫生保健的认识。
