Ambikile Joel Seme, Iseselo Masunga K
Department of Clinical Nursing, Muhimbili University of Health & Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
PLOS Glob Public Health. 2023 Jan 24;3(1):e0001518. doi: 10.1371/journal.pgph.0001518. eCollection 2023.
A balance between hospital-based and community-based services is needed to effectively provide mental health services for people with mental illness. As an essential part of community mental health services, home-based care plays an important role in meeting patients' needs, and should, therefore, be appropriately provided. To achieve this, there is a need to understand the challenges faced and take relevant actions to address them. This study aimed to explore challenges to home care and support for people with mental illness in Temeke district, Dar es Salaam. We used a descriptive qualitative study approach to explore challenges to home care and support for people with mental illness among patients, their caregivers, and healthcare providers. The purposeful sampling method was used to recruit participants at Temeke hospital, data was collected using in-depth interviews and focus group discussions, and analysis was performed using a content analysis framework. Four main themes highlighting challenges encountered in the provision of home care and support for individuals with mental illness were revealed. They include poor understanding of mental illness, abandonment of patients' care responsibilities, disputes over preferred treatment, and lack of outreach services for mental health. Participants also provided suggestions to improve home care and support for people with mental illness. Home care for people with mental illness is affected by poor knowledge of the mental illness, social stigma, and lack of outreach visits. There is a need for the provision of health education regarding mental illness, stigma reduction programs, and funding and prioritization for outreach home visits to improve home care and support for people with mental illness. Further research is needed to determine the magnitude of these challenges and factors that can facilitate the provision of support in similar settings.
为了有效地为精神疾病患者提供心理健康服务，需要在基于医院的服务和基于社区的服务之间取得平衡。作为社区心理健康服务的重要组成部分，居家护理在满足患者需求方面发挥着重要作用，因此应适当提供。为了实现这一点，有必要了解所面临的挑战并采取相关行动来应对。本研究旨在探讨达累斯萨拉姆特梅克区为精神疾病患者提供居家护理和支持所面临的挑战。我们采用描述性定性研究方法，探讨患者、其照顾者和医疗服务提供者对精神疾病患者居家护理和支持所面临的挑战。采用目的抽样法在特梅克医院招募参与者，通过深入访谈和焦点小组讨论收集数据，并使用内容分析框架进行分析。揭示了四个突出为精神疾病患者提供居家护理和支持时遇到的挑战的主要主题。它们包括对精神疾病的理解不足、患者护理责任的放弃、对首选治疗的争议以及缺乏心理健康外展服务。参与者还提出了改善对精神疾病患者居家护理和支持的建议。对精神疾病患者的居家护理受到对精神疾病的认知不足、社会耻辱感以及缺乏外展探访的影响。需要提供有关精神疾病的健康教育、减少耻辱感项目，以及为外展家访提供资金并确定其优先次序，以改善对精神疾病患者的居家护理和支持。需要进一步研究以确定这些挑战的严重程度以及在类似环境中能够促进提供支持的因素。
