照顾者为双相情感障碍患者提供治疗性患者教育的体验：一项定性研究。
The experience of caregivers providing therapeutic patient education for people living with bipolar disorder: a qualitative study.
机构信息
Psychiatry and Mental Health Department, University Hospital of Nantes, 85 Rue Saint-Jacques, 44093, Nantes Cedex 1, France.
UMR INSERM U1246-SPHERE 'methodS for Patients-Centered Outcomes & HEalth REsearch', University of Nantes, University of Tours, 22 Boulevard Benoni Goullin, 44000, Nantes, France.
出版信息
BMC Psychiatry. 2023 Mar 24;23(1):196. doi: 10.1186/s12888-023-04623-0.
BACKGROUND
Therapeutic patient education (TPE) programs are psycho-educational treatments suggested for all chronic diseases. For several years, these programs have been developing for people living with bipolar disorder. However, to date, only few qualitative studies have explored the experience of caregivers. We wanted to explore the experience of caregivers working in psychiatry as facilitators of a therapeutic education program for people living with bipolar disorder.
METHOD
A single-center qualitative study was carried out. We conducted an inductive exploration, examining the content of the discourse produced in a focus group of eight caregivers in therapeutic education. The corpus was transcribed manually and a thematic analysis was conducted by two authors in a blinded fashion before combining.
RESULTS
Four dimensions and twenty themes were identified: i) facilitators' pleasant experiences of the TPE sessions with a secure climate and a sense of belonging to a group, ii) being a TPE facilitator with a new horizontal and collaborative posture valuing the experiential knowledge, iii) the role of the TPE sessions with knowledge provision, empowerment and destigmatization, and iv) perceived changes in patients with an appeasement, the awareness of a shared experience, openness to others, a phenomenon of identification to peers and a new commitment.
CONCLUSIONS AND IMPLICATIONS FOR PRACTICE
The observations noted overlap with the elements of the personal recovery well known CHIME framework (Connectedness, Hope, positive Identity, Meaning in life and Empowerment). Therapeutic education is a developing form of psychosocial rehabilitation care: through the mobilization of a new attitude of caring, the facilitation of TPE programs could be a lever for changing the posture of caregivers in favor of supporting the personal recovery of people with bipolar disorder. These results would need to be confirmed by further studies.
背景
治疗性患者教育（TPE）计划是为所有慢性病患者推荐的心理教育治疗方法。多年来，这些计划一直在为双相情感障碍患者开发。然而，迄今为止，只有少数定性研究探讨了照顾者的体验。我们想探讨在精神病学中作为双相情感障碍患者治疗教育计划的促进者的照顾者的体验。
方法
进行了一项单中心定性研究。我们进行了归纳性探索，检查了在 TPE 焦点小组的 8 名照顾者的话语内容。手动转录语料库，并由两位作者在组合前进行盲法主题分析。
结果
确定了四个维度和二十个主题：i）TPE 会议促进者的愉快体验，具有安全的氛围和归属感，ii）作为 TPE 促进者，具有新的横向和协作姿态，重视经验知识，iii）TPE 会议的作用，提供知识、赋权和去污名化，iv）患者的感知变化，安抚、共享经验的意识、对他人的开放、对同伴的认同现象和新的承诺。
结论和对实践的影响
观察到的结果与众所周知的 CHIME 框架（联系、希望、积极的身份认同、生活意义和赋权）的个人康复要素重叠。治疗性教育是一种发展中的心理社会康复护理形式：通过调动一种新的关怀态度，促进 TPE 计划可以成为改变照顾者立场以支持双相情感障碍患者个人康复的杠杆。这些结果需要通过进一步的研究来证实。
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