Williams Anne, Fossey Ellie, Farhall John, Foley Fiona, Thomas Neil
Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia.
Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia.
JMIR Ment Health. 2021 Jun 16;8(6):e25998. doi: 10.2196/25998.
e-Mental health resources are increasingly available for people who experience severe mental illness, including those who are users of community mental health services. However, the potential for service users (SUs) living with severe mental illness to use e-mental health resources together with their community mental health workers (MHWs) has received little attention.
This study aims to identify how jointly using an interactive website called Self-Management And Recovery Technology (SMART) in a community mental health context influenced therapeutic processes and interactions between SUs and MHWs from their perspective.
We conducted a qualitative study using a constructivist grounded theory methodology. Data were collected through individual semistructured interviews with 37 SUs and 15 MHWs who used the SMART website together for 2 to 6 months. Data analysis involved iterative phases of coding, constant comparison, memo writing, theoretical sampling, and consultation with stakeholders to support the study's credibility.
A substantive grounded theory, discovering ways to keep life on track, was developed, which portrays a shared discovery process arising from the SU-worker-SMART website interactions. The discovery process included choosing to use the website, revealing SUs' experiences, exploring these experiences, and gaining new perspectives on how SUs did and could keep their lives on track. SUs and MHWs perceived that their three-way interactions were enjoyable, beneficial, and recovery focused when using the website together. They experienced the shared discovery process as relationship building-their interactions when using the website together were more engaging and equal.
Jointly using an e-mental health resource elicited recovery-oriented interactions and processes between SUs and MHWs that strengthened their therapeutic relationship in real-world community mental health services. Further work to develop and integrate this novel use of e-mental health in community mental health practice is warranted.
电子心理健康资源越来越多地提供给患有严重精神疾病的人，包括社区心理健康服务的使用者。然而，患有严重精神疾病的服务使用者（SU）与社区心理健康工作者（MHW）一起使用电子心理健康资源的可能性却很少受到关注。
本研究旨在从服务使用者和社区心理健康工作者的角度，确定在社区心理健康背景下共同使用一个名为自我管理与康复技术（SMART）的交互式网站如何影响治疗过程以及两者之间的互动。
我们采用建构主义扎根理论方法进行了一项定性研究。通过对37名服务使用者和15名社区心理健康工作者进行个人半结构化访谈收集数据，他们共同使用SMART网站2至6个月。数据分析包括编码、持续比较、撰写备忘录、理论抽样以及与利益相关者协商等迭代阶段，以支持研究的可信度。
形成了一个实质性的扎根理论——发现让生活步入正轨的方法，该理论描绘了服务使用者、工作者与SMART网站互动中产生的共同发现过程。这个发现过程包括选择使用网站、揭示服务使用者的经历、探索这些经历，以及获得关于服务使用者如何以及能够让生活步入正轨的新视角。服务使用者和社区心理健康工作者认为，他们一起使用网站时的三方互动是愉快、有益且以康复为重点的。他们将共同发现过程体验为关系建立——他们一起使用网站时的互动更有吸引力且更加平等。
共同使用电子心理健康资源引发了服务使用者和社区心理健康工作者之间以康复为导向的互动和过程，加强了他们在现实世界社区心理健康服务中的治疗关系。有必要进一步开展工作，在社区心理健康实践中开发并整合这种电子心理健康的新用途。
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