Oedegaard Christine Henriksen, Ruano Ana Lorena, Blindheim Anne, Veseth Marius, Stige Brynjulf, Davidson Larry, Engebretsen Ingunn Marie Stadskleiv
Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
Int J Ment Health Syst. 2022 Apr 4;16(1):19. doi: 10.1186/s13033-022-00529-8.
Since 2015, Norwegian Regional Health Authorities have followed new government policy and gradually implemented medication-free services for patients with psychosis. The aim of this qualitative study was to explore the tension between policy and practice, and how health care workers in Bergen reflect on their role in implementing medication-free treatment.
We performed three focus group discussions including 17 therapists working within medication free services, asking about their experiences with this new treatment program. We used Systematic Text Condensation for data analysis. The findings were discussed using Michael Lipsky's theoretical framework on the role public health workers play in policy implementation.
Following Norway's new policy was challenging for the therapists in our study, particularly balancing a patient's needs with treatment guidelines, the legal framework and available resources. Therapists had an overarching wish to help patients through cooperation and therapeutic alliance, but their alliance was sometimes fragile, and the therapists worried about patients' conditions worsening.
Democratization of treatment choices, with the aim of empowering patients in mental health care, challenges the level of professional discretion given that patients and therapists might have conflicting goals. Balancing the desire to help, professional responsibility, the perceived lack of resources, and certain patient choices created conditions that can leave therapists feeling disempowered in and alienated from their work.
N/A.
自2015年以来，挪威地方卫生当局遵循新的政府政策，逐步为精神病患者实施无药物治疗服务。这项定性研究的目的是探讨政策与实践之间的矛盾，以及卑尔根的医护人员如何看待自己在实施无药物治疗中的角色。
我们进行了三次焦点小组讨论，参与讨论的有17名从事无药物治疗服务的治疗师，询问他们对这个新治疗项目的体验。我们使用系统文本浓缩法进行数据分析。研究结果依据迈克尔·利普斯基关于公共卫生工作者在政策实施中所扮演角色的理论框架进行讨论。
在我们的研究中，遵循挪威的新政策对治疗师来说颇具挑战性，尤其是在平衡患者需求与治疗指南、法律框架及可用资源方面。治疗师们有着通过合作与治疗联盟来帮助患者的总体愿望，但他们的联盟有时很脆弱，治疗师们担心患者病情恶化。
治疗选择的民主化旨在增强精神卫生保健中患者的权能，鉴于患者和治疗师可能有相互冲突的目标，这对专业自主权水平构成了挑战。平衡帮助患者的愿望、专业责任、资源匮乏的认知以及患者的某些选择所创造的条件，可能会让治疗师在工作中感到无权且疏离。
无。
