Department of Occupational Therapy, Faculty of Rehabilitation Medicine, College of Health Sciences, University of Alberta, Edmonton, AB T6G 2G4, Canada.
Stepping Stones Behavioral Solutions, LLC, Indianapolis, IN 46205, USA.
Int J Environ Res Public Health. 2021 Dec 21;19(1):9. doi: 10.3390/ijerph19010009.
Recovery orientation is a movement in mental health practice. Although general mental health services have taken the lead in promoting recovery, forensic psychiatric systems have lagged behind because of the need to reconcile recovery principles with the complexities of legal mandates. Advocating recovery and making systemic changes can be challenging because they require seeking a balance between the competing duties to the patient and the public. This paper used a logic model framework to demonstrate a cohabitation program that placed a woman and her newborn infant in a secure forensic rehabilitation unit, and analyzed the key assumptions of recovery upon which it was based.
This was a qualitative program evaluation. Data collection involved individual interviews with the woman, the infant's father, five primary healthcare providers, and five system administrators, and 11 focus groups with unit staff and other patients. Content analysis was used to guide the data analysis and develop the critical components of the program logic model.
A logic model that consists of input (team building, program planning, staff and patient preparation, resource management), output (logistic activities, risk management, mental healthcare, staff/other patient support, discharge preparation), and outcome (individual, provider, system, and society) components was developed.
This study demonstrates a recovery-oriented program for a woman cohabitating with her baby in a secure forensic psychiatric rehabilitation unit. The logic model provided a comprehensive understanding of the way the recovery principles, such as shared decision-making, positive risk-taking, informed choices, and relational security, were implemented.
康复取向是精神卫生实践中的一种运动。尽管一般的精神卫生服务已经率先倡导康复，但由于需要调和康复原则与法律要求的复杂性，法医精神病学系统一直落后。倡导康复和进行系统变革可能具有挑战性，因为这需要在患者和公众的相互竞争的责任之间寻求平衡。本文使用逻辑模型框架展示了一个将妇女及其新生儿安置在安全的法医康复单元的同居项目，并分析了该项目所基于的康复关键假设。
这是一项定性的项目评估。数据收集包括对妇女、婴儿的父亲、五名初级保健提供者和五名系统管理员进行的个人访谈，以及对单位工作人员和其他患者进行的 11 次焦点小组讨论。内容分析用于指导数据分析并开发项目逻辑模型的关键组成部分。
制定了一个包含投入（团队建设、项目规划、员工和患者准备、资源管理）、产出（后勤活动、风险管理、精神保健、员工/其他患者支持、出院准备）和结果（个人、提供者、系统和社会）组成部分的逻辑模型。
本研究展示了一个针对在安全的法医精神病学康复单元中与婴儿同居的妇女的康复导向项目。逻辑模型全面了解了共同决策、积极冒险、知情选择和关系安全等康复原则的实施方式。
