Leendertse Pien, Hirzalla Fadi, van den Berg David, Castelein Stynke, Mulder Cornelis Lambert
Emergis, Institute for Mental Healthcare, Kloetinge, Netherlands.
Department of Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands.
Front Psychiatry. 2023 Jan 4;13:1051446. doi: 10.3389/fpsyt.2022.1051446. eCollection 2022.
The objective of this study was to gain insight into patients' experiences of how personal recovery (PR) is facilitated or hindered in the context of an early episode psychosis setting (Soteria). We thereby aimed to contribute to the understanding of how care settings may promote or hinder the process of PR in people with (acute) psychosis.
This study used a qualitative method, consisting of semi-structured in-depth interviews with people who had been admitted to a Soteria house in the Netherlands. Interview transcripts were analyzed following the Grounded Theory approach.
Five themes emerged from the data illustrating how Soteria facilitated or impeded PR. The experience of togetherness in contact with staff and peers, feeling at home, and being active facilitated PR, while the emphasis put on medication by staff was experienced as hindering, and attention to spirituality was missed.
In addition to the literature that identified factors associated with PR in psychosis, the current study gives a sense of how this can be put into practice. By offering treatment within a normalizing, holding environment, with emphasis on equality, close contact, optimism, active structured days, open-mindedness toward spirituality, and the role of medication, PR can be facilitated without detracting from guideline-based treatment aimed at symptomatic recovery. Similarities with existing concepts are discussed.
本研究的目的是深入了解在早期精神病发作环境(索泰里亚模式)中,患者在个人康复(PR)过程中是如何得到促进或受到阻碍的。我们旨在为理解护理环境如何促进或阻碍(急性)精神病患者的PR进程做出贡献。
本研究采用定性方法,包括对入住荷兰索泰里亚之家的患者进行半结构化深度访谈。访谈记录按照扎根理论方法进行分析。
数据中出现了五个主题,说明了索泰里亚模式如何促进或阻碍PR。与工作人员和同伴接触时的团结感、有家的感觉以及积极参与促进了PR,而工作人员对药物治疗的强调被认为是一种阻碍,并且对精神层面的关注缺失。
除了已确定的与精神病患者PR相关因素的文献外,本研究还展示了如何将其付诸实践。通过在一个正常化、包容的环境中提供治疗,强调平等、密切接触、乐观态度、有组织的活跃日程、对精神层面的开放态度以及药物治疗的作用,可以在不影响基于指南的症状恢复治疗的情况下促进PR。文中还讨论了与现有概念的相似之处。