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精神健康急救危机角色扮演:药剂师与有真实体验的模拟患者之间的互动:讨论记录的主题分析

Mental Health First Aid crisis role-plays between pharmacists and simulated patients with lived experience: a thematic analysis of debrief.

机构信息

Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia.

Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, Australia.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2023 Sep;58(9):1365-1373. doi: 10.1007/s00127-023-02443-x. Epub 2023 Mar 16.

Abstract

PURPOSE

Healthcare professionals, including pharmacists, can recognise and assist people experiencing mental health crises. Despite this, little is known about how pharmacists assist and engage with people presenting with signs and symptoms of mental health crises. This study aimed to (i) examine pharmacists' mental health crisis assessment language during simulated patient role-plays (SPRPs) and (ii) explore participants' experiences of participating in SPRPs of Mental Health First Aid (MHFA) scenarios.

METHODS

Fifty-nine MHFA-trained pharmacy staff participated in audio-recorded SPRPs of three crisis scenarios enacted by a mental health consumer educator (MHCE). Post-SPRP, pharmacy staff members (including role-playing and observing participants), engaged in reflective debrief discussions with the facilitator and MHCEs. Debrief discussions were transcribed verbatim and analysed using inductive thematic analysis and suicide assessment language was explored.

RESULTS

The majority of role-playing pharmacists asked about suicidal ideation using appropriate, direct language (n = 8). Qualitative analyses of debrief discussions yielded four themes: (i) Relationship with the consumer, (ii) Verbal and non-verbal communication, (iii) Challenges with crisis assessment, which included difficulties associated with initiating conversations about suicide and mania, and (iv) Reflective learning.

CONCLUSION

While pharmacists demonstrated the appropriate suicide assessment language post-MHFA training, pharmacists felt uncomfortable initiating conversations around suicide and lacked confidence during crisis assessments. SPRPs provided pharmacists with opportunities to reflect on and practice MHFA skills in a safe learning environment. Future research exploring how MHFA training and SPRPs impact pharmacists' ability to provide MHFA in real-world settings is warranted.

摘要

目的

包括药剂师在内的医疗保健专业人员能够识别和帮助经历心理健康危机的人。尽管如此,人们对药剂师如何协助和参与出现心理健康危机迹象和症状的人知之甚少。本研究旨在:(i) 检查药剂师在模拟患者角色扮演 (SPRPs) 中进行心理健康危机评估的语言;(ii) 探讨参与者参与心理健康急救 (MHFA) 情景 SPRP 的体验。

方法

59 名接受过 MHFA 培训的药房工作人员参与了由心理健康消费者教育者 (MHCE) 扮演的三个危机情景的录音 SPRP。在 SPRP 之后,药房工作人员(包括角色扮演和观察参与者)与主持人和 MHCE 进行了反思性讨论。讨论记录被逐字转录,并使用归纳主题分析进行分析,探索自杀评估语言。

结果

大多数角色扮演药剂师使用适当、直接的语言询问自杀意念(n=8)。对反思讨论的定性分析产生了四个主题:(i) 与消费者的关系,(ii) 言语和非言语沟通,(iii) 危机评估挑战,包括与自杀和躁狂相关的对话启动困难,以及 (iv) 反思性学习。

结论

尽管药剂师在接受 MHFA 培训后表现出了适当的自杀评估语言,但药剂师在围绕自杀问题展开对话时感到不自在,并且在危机评估时缺乏信心。SPRPs 为药剂师提供了在安全的学习环境中反思和实践 MHFA 技能的机会。未来的研究探索 MHFA 培训和 SPRPs 如何影响药剂师在现实环境中提供 MHFA 的能力是有必要的。

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