Mental Health Unit, Regional University Hospital, 29009 Málaga, Spain.
Faculty of Heath Sciences, University of Málaga, 29071 Málaga, Spain.
Int J Environ Res Public Health. 2023 Mar 5;20(5):4614. doi: 10.3390/ijerph20054614.
The mental health recovery model is based on shared decision making, in which patients' preferences and perceptions of the care received are taken into account. However, persons with psychosis usually have very few opportunities to participate in this process. The present study explores the experiences and perceptions of a group of patients with psychosis-in some cases longstanding, in others more recently diagnosed-concerning their participation in the decisions taken about the approach to their condition and about the attention received from healthcare professionals and services. For this purpose, we performed a qualitative analysis of the outcomes derived from five focus groups and six in-depth interviews (36 participants). Two major themes, with five sub-themes, were identified: shared decision-making (drug-centred approach, negotiation process, and lack of information) and the care environment and styles of clinical practice as determinants (aggressive versus person-centred environments, and styles of professional practice). The main conclusions drawn are that users want to participate more in decision making, they want to be offered a range of psychosocial options from the outset and that their treatment should be based on accessibility, humanity and respect. These findings are in line with the guidelines for clinical practice and should be taken into account in the design of care programmes and the organisation of services for persons with psychosis.
心理健康康复模式基于共同决策，其中考虑到患者对所接受护理的偏好和看法。然而，精神病患者通常几乎没有机会参与这一过程。本研究探讨了一组精神病患者的经验和看法，他们的患病经历有的较为长久，有的则较为新近确诊，涉及他们对自身病情处理方式的决策以及对医疗保健专业人员和服务的关注的参与程度。为此，我们对五个焦点小组和六个深度访谈（36 名参与者）的结果进行了定性分析。确定了两个主要主题，包括五个子主题：共同决策（以药物为中心的方法、协商过程和缺乏信息）和护理环境及临床实践风格作为决定因素（积极与以患者为中心的环境以及专业实践风格）。得出的主要结论是，用户希望更多地参与决策，他们希望从一开始就提供一系列心理社会选择，并且他们的治疗应该基于可及性、人性化和尊重。这些发现与临床实践指南一致，应在为精神病患者设计护理方案和组织服务时加以考虑。
