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心理健康机构中医疗保健专业人员对污名和康复的看法——一项定性研究。

The perspectives of healthcare professionals in mental health settings on stigma and recovery - A qualitative inquiry.

机构信息

Research Division, Institute of Mental Health, 10 Buangkok View, 539747, Singapore, Singapore.

出版信息

BMC Health Serv Res. 2022 Jul 9;22(1):888. doi: 10.1186/s12913-022-08248-z.

Abstract

BACKGROUND

Mental health stigma is one of the most prominent barriers to recovery, and it is widely known that stigma may manifest differentially in different cultures. Healthcare professionals working closely with persons with mental illnesses (PMI) may provide important insights towards stigma that are otherwise unattainable from caregivers and consumers. However, there is a dearth of literature on healthcare professionals' perspectives on this topic. Thus, this study uses a multilevel approach to explore how stigma affects recovery from the perspectives of healthcare professionals that work closely with PMI in Singapore.

METHODS

Semi-structured interviews were conducted with a total of 17 healthcare professionals who were working in mental health settings in Singapore. Participants were recruited via direct email invitation or through snowball sampling. Data collected was analysed with the inductive thematic analysis method. All coding and inter-rater analyses were performed with NVivo.

RESULTS

The current study themes identified stigma-related factors that influence PMI's recovery from the perspectives of healthcare professionals working closely with PMI. These factors were organised into three overarching themes in a multilevel structure. The three themes were classified as Micro Factors (e.g., internalised stigma), Meso Factors (e.g., discrimination of people associated with the stigmatised group), and Macro Factors (e.g., structural stigma and stigma within healthcare settings).

CONCLUSIONS

The findings of this study gave us a greater understanding of how stigma influences recovery in Singapore, which could be used to guide the development and implementation of future policies and strategies to promote recovery. Importantly, our results suggest that improving mental health literacy, addressing cultural misgivings towards mental illness, implementing recovery-oriented practices, and making insurance more accessible for PMI could mitigate the deleterious impact that stigma has on recovery.

摘要

背景

心理健康污名是康复的最大障碍之一,众所周知,污名可能在不同的文化中表现出不同的形式。与精神疾病患者(PMI)密切合作的医疗保健专业人员可能会对污名提供重要的见解,而这些见解是护理人员和消费者无法获得的。然而,关于医疗保健专业人员对此主题的看法的文献却很少。因此,本研究使用多层次方法来探讨污名如何从与新加坡 PMI 密切合作的医疗保健专业人员的角度影响康复。

方法

对 17 名在新加坡精神卫生机构工作的医疗保健专业人员进行了半结构式访谈。通过直接电子邮件邀请或滚雪球抽样的方式招募参与者。使用归纳主题分析方法对收集的数据进行分析。所有编码和内部一致性分析均在 NVivo 中进行。

结果

本研究主题确定了从与 PMI 密切合作的医疗保健专业人员的角度影响 PMI 康复的与污名相关的因素。这些因素以多层次的结构组织成三个总体主题。这三个主题分为微观因素(例如,内化污名)、中观因素(例如,与污名化群体相关的人的歧视)和宏观因素(例如,结构性污名和医疗保健环境中的污名)。

结论

本研究的结果使我们更深入地了解了污名如何影响新加坡的康复,这可以用来指导未来制定和实施促进康复的政策和战略。重要的是,我们的研究结果表明,提高心理健康素养、解决对精神疾病的文化误解、实施以康复为导向的实践以及使 PMI 更容易获得保险,可以减轻污名对康复的不利影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a76/9270770/2d070e9e8ccb/12913_2022_8248_Fig1_HTML.jpg

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