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探索精神健康危机后患者对同伴支持的开放式对话和标准护理的体验:定性3个月随访研究

Exploring patients' experience of peer-supported open dialogue and standard care following a mental health crisis: qualitative 3-month follow-up study.

作者信息

Sunthararajah Sailaa, Clarke Katherine, Razzaque Russell, Chmielowska Marta, Brandrett Benjamin, Pilling Stephen

机构信息

Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Research and Development, Goodmayes Hospital, North East London NHS Foundation Trust, Goodmayes, UK; and Department of Clinical, Educational and Health Psychology, University College London, UK.

Department of Clinical, Educational and Health Psychology, University College London, UK.

出版信息

BJPsych Open. 2022 Jul 22;8(4):e139. doi: 10.1192/bjo.2022.542.

Abstract

BACKGROUND

Experience of crisis care may vary across different care models.

AIMS

To explore the experience of care in standard care and 'open dialogue' (a peer-supported community service focused on open dialogue and involving social networks for adults with a recent mental health crisis) 3 months after a crisis.

METHOD

We conducted semi-structured interviews with 11 participants (6 received open dialogue; 5 received treatment as usual (TAU)) in a feasibility study of open dialogue and analysed the data using a three-step inductive thematic analysis to identify themes that (a) were frequently endorsed and (b) represented the experiences of all participants.

RESULTS

Four themes emerged: (a) feeling able to rely on and access mental health services; (b) supportive and understanding family and friends; (c) having a choice and a voice; and (d) confusion and making sense of experiences. Generally, there was a divergence in experience across the two care models. Open dialogue participants often felt able to rely on and access services and involve their family and friends in their care. TAU participants described a need to rely on services and difficulty when it was not met, needing family and friends for support and wanting them to be more involved in their care. Some participants across both care models experienced confusion after a crisis and described benefits of sense-making.

CONCLUSIONS

Understanding crisis care experiences across different care models can inform service development in crisis and continuing mental healthcare services.

摘要

背景

不同护理模式下的危机护理体验可能有所不同。

目的

探讨危机发生3个月后,在标准护理和“开放对话”(一种由同伴支持的社区服务,专注于开放对话,并让社会网络参与到近期有心理健康危机的成年人护理中)中的护理体验。

方法

在一项开放对话的可行性研究中,我们对11名参与者(6名接受开放对话;5名接受常规治疗)进行了半结构化访谈,并使用三步归纳主题分析法对数据进行分析,以确定(a)被频繁认可的主题和(b)代表所有参与者体验的主题。

结果

出现了四个主题:(a)能够依赖并获得心理健康服务;(b)家人和朋友给予支持和理解;(c)有选择权和表达意见的机会;(d)困惑以及对经历的理解。总体而言,两种护理模式的体验存在差异。接受开放对话的参与者通常觉得能够依赖并获得服务,并让家人和朋友参与到他们的护理中。接受常规治疗的参与者表示需要依赖服务,但需求未得到满足时会遇到困难,需要家人和朋友的支持,并希望他们更多地参与到自己的护理中。两种护理模式中的一些参与者在危机后都经历了困惑,并描述了理解经历的益处。

结论

了解不同护理模式下的危机护理体验可为危机及持续心理健康护理服务的发展提供参考。

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