The Research Collaboration Psychiatric Centre, University of Copenhagen, DK-3400 Hillerød, Denmark.
Center for Quality and Development, Department of Social Health, Rudersdal Kommune, DK-3460 Birkerød, Denmark.
Int J Environ Res Public Health. 2021 Mar 24;18(7):3352. doi: 10.3390/ijerph18073352.
This study aimed to explore how healthcare professionals and users could perceive user involvement in the handover between mental health hospitals and community mental healthcare, drawing on the discourse analysis framework from Fairclough.
A qualitative research design with purposive sampling was adopted. Five audio-recorded focus group interviews with nurses, users and other health professionals were explored using Fairclough's discourse analysis framework. Ethical approval: The study was designed following the ethical principles of the Helsinki Declaration and Danish Law. Each study participant in the two intersectoral sectors gave their informed consent after verbal and written information was provided.
This study has shown how users can be subject to paternalistic control despite the official aims that user involvement should be an integral part of the care and treatment offered. As evidenced in discussions by both health professionals and the users themselves, the users were involved in plans with the handover on conditions determined by the health professionals who were predominantly focused on treating diseases and enabling the users to live a life independent of professional help.
Our results can contribute to dealing with the challenges of incorporating user involvement as an ideology in the handover between mental health hospitals and community mental health. There is a need to start forming a common language across sectors and, jointly, for professionals and users to draw up plans for intersectoral care.
本研究旨在探讨医护人员和使用者如何看待用户在精神卫生医院和社区精神卫生保健交接中的参与，借鉴 Fairclough 的话语分析框架。
采用有目的抽样的定性研究设计。对护士、使用者和其他卫生专业人员进行了五次录音焦点小组访谈，采用 Fairclough 的话语分析框架进行了探讨。伦理批准：本研究设计遵循《赫尔辛基宣言》和丹麦法律的伦理原则。两个跨部门的每一位研究参与者在口头和书面信息提供后，均表示同意。
本研究表明，尽管用户参与应成为所提供护理和治疗的一个组成部分，但用户仍可能受到家长式控制。正如卫生专业人员和使用者本人的讨论所表明的那样，使用者是在卫生专业人员决定的条件下参与交接计划的，而卫生专业人员主要侧重于治疗疾病，并使使用者能够独立于专业帮助生活。
我们的研究结果可以为应对将用户参与纳入精神卫生医院和社区精神卫生保健交接作为一种理念所面临的挑战做出贡献。需要开始在各部门之间形成共同语言，并且专业人员和使用者共同制定跨部门护理计划。
