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亲属的心理健康护理体验、家庭负担和家庭耻辱感:参与患者指定资源小组(RACT)的积极社区治疗是否有影响?

Relatives' Experiences of Mental Health Care, Family Burden and Family Stigma: Does Participation in Patient-Appointed Resource Group Assertive Community Treatment (RACT) Make a Difference?

机构信息

Department of Psychotic Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden.

Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.

出版信息

Issues Ment Health Nurs. 2021 Nov;42(11):1010-1019. doi: 10.1080/01612840.2021.1924322. Epub 2021 Jun 1.

DOI:10.1080/01612840.2021.1924322
PMID:34060978
Abstract

The aim of this exploratory cross-sectional study was to investigate the experiences of relatives of individuals with severe mental illness with and without participation in patient-appointed Resource Group Assertive Community Treatment (RACT). A total of 139 relatives (79 with and 60 without RACT) completed the Family Involvement and Alienation Questionnaire, the Burden Inventory for Relatives of Persons with Psychotic Disturbances, and the family version of the Inventory of Stigmatizing Experiences. We found that relatives participating in RACT experienced a more positive approach from the healthcare professionals, as well as a lower degree of alienation from the provision of care. Relatives who did not participate in RACT were more afraid that their ill next of kin would hurt someone. No other differences in family burden were found. Experiences of family stigmatization were similar in both groups. In conclusion, participating in patient-appointed RACT may contribute to a higher level of satisfaction for relatives in their encounter with healthcare professionals and a more positive alliance. Implementation of RACT in new settings would require adaptation to local conditions to facilitate cooperation between healthcare staff and other relevant services. Staff training focuses on the case manager function and needs assessment, as well as how to create an alliance with the patient and his/her relatives.

摘要

本探索性横断面研究旨在调查经历过患者指定的资源小组(Resource Group)有和没有参与积极社区治疗(Assertive Community Treatment,RACT)的严重精神疾病患者的亲属的体验。共有 139 名亲属(79 名有 RACT,60 名没有 RACT)完成了家庭参与和疏远问卷、精神障碍患者亲属负担量表和家庭版污名体验量表。我们发现,参与 RACT 的亲属感受到医护人员更积极的态度,以及在提供护理方面较少的疏远感。没有参与 RACT 的亲属更担心他们患病的近亲会伤害他人。在家庭负担方面没有发现其他差异。两组的家庭污名体验相似。总之,参与患者指定的 RACT 可能有助于提高亲属在与医护人员接触时的满意度,并建立更积极的联盟。在新环境中实施 RACT 需要适应当地情况,以促进医护人员与其他相关服务之间的合作。员工培训侧重于个案经理的职能和需求评估,以及如何与患者及其亲属建立联盟。

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