协调专门护理以帮助黑人家族应对早期精神病的独特途径：初步报告。
The unique pathways to coordinate specialty care for Black families navigating early psychosis: A preliminary report.
机构信息
Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; Washington State Center for Excellence in Early Psychosis, WA, USA.
Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA.
出版信息
Schizophr Res. 2023 Mar;253:54-59. doi: 10.1016/j.schres.2021.11.004. Epub 2021 Nov 23.
BACKGROUND
Aversive pathways to coordinated specialty care (CSC) for first episode psychosis have been linked to the extended duration of untreated psychosis, limited engagement, and treatment outcomes. Yet there has been very limited research that has solely explored the unique pathways to care among Black families in the U.S. This study utilized qualitative methods to explore the pathways to CSC among Black individuals experiencing their first episode of psychosis and their family members.
METHODS
Individuals who were or are enrolled in CSC programs and/or their family members were recruited to participate in semi-structured qualitative interviews. Qualitative interviews were used to characterize events and experiences prior to the initiation of CSC. All interviews were transcribed verbatim and analyzed using a qualitative descriptive approach.
RESULTS
A total of 14 participants were recruited to complete semi-structured interviews. Findings revealed that during prodromal phase participants noticed changes in social functioning, identified prior childhood experiences that were viewed as traumatic, and sought very little help from formal sources. After the onset of psychosis, the majority of participants highlighted the importance of family members in the initiation of care, yet also expressed difficulties navigating services and engaging with clinical staff, contributing to further delays to the initiation of CSC.
CONCLUSIONS
Finding from this study sheds light on understanding known disparities in utilization of services and potentially identifies areas that can be leveraged to improve the experiences for Black families seeking CSC.
背景
对于首次出现精神病症状的患者，采用令人不快的途径来协调专科护理（CSC）与未治疗精神病的持续时间延长、参与度有限以及治疗结果有关。然而，针对美国黑人家庭的独特护理途径，仅有非常有限的研究进行了探索。本研究采用定性方法，探讨了首次出现精神病症状的黑人个体及其家庭成员接受 CSC 的途径。
方法
参与 CSC 计划或其家庭成员的个人被招募来参加半结构化的定性访谈。定性访谈用于描述启动 CSC 之前的事件和经历。所有访谈都逐字转录，并使用定性描述方法进行分析。
结果
共招募了 14 名参与者完成半结构化访谈。研究结果表明，在前驱期，参与者注意到社会功能的变化，确定了之前被视为创伤的童年经历，并很少向正式来源寻求帮助。精神病发作后，大多数参与者强调了家庭成员在启动护理方面的重要性，但也表达了在服务方面的困难和与临床工作人员的参与，这导致 CSC 的启动进一步延迟。
结论
本研究的结果揭示了对服务利用方面已知差异的理解，并可能确定了可以利用的领域，以改善寻求 CSC 的黑人家庭的体验。
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