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在中东欧,多学科社区精神卫生团队的医护人员提供社区精神卫生保健的经验:RECOVER-E 项目的观察性干预研究。

Experiences of healthcare staff providing community-based mental healthcare as a multidisciplinary community mental health team in Central and Eastern Europe findings from the RECOVER-E project: an observational intervention study.

机构信息

Department of General Practice and Health Services Research, Heidelberg University Hospital, Marsilius Arcades, West Tower, Im Neuenheimer Feld 130, 69120, Heidelberg, Germany.

Clinic for Psychiatry and Psychological Medicine, Zagreb University Hospital Centre, Kišpatićeva ul. 12, 10000, Zagreb, Croatia.

出版信息

BMC Psychiatry. 2021 Oct 24;21(1):525. doi: 10.1186/s12888-021-03542-2.

Abstract

BACKGROUND

Community Mental Health Teams (CMHTs) deliver healthcare that supports the recovery of people with mental illness. The aim of this paper was to explore to what extent team members of five CMHTs newly implemented in five countries perceived that they had introduced aspects of the recovery-oriented, strength-based approach into care after a training week on recovery-oriented practice. In addition, it evaluated what the team members' perceptions on their care roles and their level of confidence with this role were.

METHOD

An observational intervention study using a quantitative survey that was administered among 52 health professionals (21 Nurses, 13 Psychiatrists, 9 Psychologists, 8 Social Workers) and 14 peer workers including the Recovery Self-Assessment Tool Provider Version (RSA-P), the Team Member Self-Assessment Tool (TMSA), and demographic questions was conducted. The measures were self-reported. Descriptive statistics were used to calculate the means and standard deviations for continuous variables and frequencies and percentages for categorical variables (TMSA tool and demographic data). The standard technique to calculate scale scores for each subscale of the RSA-P was used. Bivariate linear regression analyses were applied to explore the impact of predictors on the subscales of the RSA-P. Predictors with significant effects were included in multiple regression models.

RESULT

The RSA-P showed that all teams had the perception that they provide recovery-oriented practice to a moderately high degree after a training week on recovery-oriented care (mean scores between 3.85-4.46). Health professionals with fewer years of professional experience perceived more frequently that they operated in a recovery-oriented way (p = 0.036, B = - 0.268). Nurses and peer workers did not feel confident or responsible to fulfil specific roles.

CONCLUSION

The findings suggest that a one-week training session on community-based practices and collaborative teamwork may enhance recovery-oriented practice, but the role of nurses and peer workers needs further attention.

TRIAL REGISTRATION

Each trial was registered before participant enrolment in the clinicaltrials.gov database: Croatia, Zagreb (Trial Reg. No. NCT03862209 ); Montenegro, Kotor (Trial Reg. No. NCT03837340 ); Romania, Suceava (Trial Reg. No. NCT03884933 ); Macedonia, Skopje (Trial Reg. No. NCT03892473 ); Bulgaria, Sofia (Trial Reg. No. NCT03922425 ).

摘要

背景

社区心理健康团队(CMHT)提供支持精神疾病患者康复的医疗服务。本文旨在探讨在接受一周的以康复为导向的实践培训后,五个新设立的国家/地区的五个 CMHT 的团队成员在多大程度上认为他们已经将以康复为导向、以优势为基础的方法引入了护理中。此外,本文还评估了团队成员对其护理角色的看法及其对该角色的信心水平。

方法

采用观察性干预研究,对 52 名卫生专业人员(21 名护士、13 名精神科医生、9 名心理学家、8 名社会工作者)和 14 名同伴工作者进行了定量调查,使用了康复自我评估工具提供者版本(RSA-P)、团队成员自我评估工具(TMSA)以及人口统计问题。该措施是自我报告的。使用描述性统计来计算连续变量的平均值和标准差以及分类变量(TMSA 工具和人口统计数据)的频率和百分比。为每个 RSA-P 子量表计算量表分数的标准技术。应用双变量线性回归分析来探讨预测因子对 RSA-P 子量表的影响。具有显著影响的预测因子被纳入多元回归模型。

结果

RSA-P 显示,在接受一周的以康复为导向的护理培训后,所有团队都认为他们以中等高度提供以康复为导向的实践(平均得分在 3.85-4.46 之间)。专业经验较少的卫生专业人员更频繁地认为他们以康复为导向的方式运作(p=0.036,B=-0.268)。护士和同伴工作者对履行特定角色没有信心或责任感。

结论

研究结果表明,为期一周的社区实践和协作团队工作培训课程可能会增强以康复为导向的实践,但需要进一步关注护士和同伴工作者的角色。

试验注册

每个试验都在 clinicaltrials.gov 数据库中进行了注册,在参与者入组之前:克罗地亚,萨格勒布(试验注册号 NCT03862209);黑山,科托尔(试验注册号 NCT03837340);罗马尼亚,苏恰瓦(试验注册号 NCT03884933);马其顿,斯科普里(试验注册号 NCT03892473);保加利亚,索非亚(试验注册号 NCT03922425)。

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