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康复导向的精神科医院心理健康原则:服务使用者、家属和工作人员如何看待实践的实现。

Recovery-oriented mental health principles in psychiatric hospitals: How service users, family members and staff perceive the realization of practices.

机构信息

Department of Nursing Science, University of Turku, Turku, Finland.

Department of Nursing, Manchester Metropolitan University, Manchester, UK.

出版信息

J Adv Nurs. 2023 Jul;79(7):2732-2743. doi: 10.1111/jan.15506. Epub 2022 Nov 21.

Abstract

AIMS

The aim of the study was to describe and compare how recovery-oriented mental health principles have been realized in Finnish psychiatric hospitals from the viewpoint of different stakeholders (service users, family members and staff).

DESIGN

A multimethod research design was adopted to combine both quantitative and qualitative descriptive methods.

METHODS

A total of 24 focus group interviews were conducted with service users (n = 33), family members (n = 3) and staff (n = 53) on 12 psychiatric Finnish hospital wards (October 2017). The interview topics were based on six recovery-oriented principles (WHO QualityRights Tool Kit, 2012). A quantitative deductive analysis was conducted to describe and compare the realization of the recovery-oriented principles between three stakeholder groups. A qualitative deductive content analysis was used to describe participants' perceptions of the realization of recovery-oriented principles in practice. The GRAMMS guideline was used in reporting.

RESULTS

Out of six recovery-oriented principles, 'Dignity and respect' was found to have been realized to the greatest extent on the psychiatric wards. The most discrepancy between the participant groups was seen in the 'Evaluation of recovery'. Service users and family members found the realization of the practices of all principles to be poorer than the staff members did. Wide variation was also found at the ward level between perceptions among participants, and descriptions of the realization of the principles in psychiatric hospital practice.

CONCLUSION

Perceptions about the realization of recovery-oriented principles in practice in Finnish psychiatric hospitals vary between different stakeholder groups. This variation is linked to differing ward environments.

IMPACT

More research is needed to understand the factors associated with variation in perceptions of recovery principles.

PATIENT OR PUBLIC CONTRIBUTION

Service users and family members participated in this study.

摘要

目的

本研究旨在从不同利益相关者(服务使用者、家属和工作人员)的角度描述和比较芬兰精神病院如何实现以康复为导向的精神卫生原则。

设计

采用多方法研究设计,结合定量和定性描述方法。

方法

2017 年 10 月,在 12 家芬兰精神病院的病房中,对 33 名服务使用者、3 名家属和 53 名工作人员进行了总共 24 次焦点小组访谈。访谈主题基于 6 项以康复为导向的原则(世卫组织质量权利工具包,2012 年)。进行了定量演绎分析,以描述和比较三个利益相关者群体对以康复为导向的原则的实现情况。采用定性演绎内容分析法描述参与者对以康复为导向的原则在实践中的实现情况的看法。报告中使用了 GRAMMS 指南。

结果

在 6 项以康复为导向的原则中,“尊严和尊重”在精神病病房中得到了最大程度的实现。在不同的利益相关者群体之间,“康复评估”的差异最大。服务使用者和家属认为所有原则的实践实现程度比工作人员差。在病房层面上,参与者之间的看法以及对精神病院实践中原则实现情况的描述也存在很大差异。

结论

不同利益相关者群体对芬兰精神病院实践中以康复为导向的原则的实现情况的看法存在差异。这种差异与不同的病房环境有关。

影响

需要进一步研究以了解与康复原则感知差异相关的因素。

患者或公众贡献

服务使用者和家属参与了这项研究。

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