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转变思维模式以创建新的精神卫生护理格局

[Changing Mindsets to Create a New Mental Health Nursing Care Landscape].

作者信息

Yang Cheng-I

机构信息

PhD, RN, Professor, Department of Nursing, Hungkuang University, Taiwan, ROC.

出版信息

Hu Li Za Zhi. 2023 Aug;70(4):4-6. doi: 10.6224/JN.202308_70(4).01.

DOI:10.6224/JN.202308_70(4).01
PMID:37469314
Abstract

Perception of change is a real and profound out come of the recently ended COVID-19 pandemic. The course of this pandemic was unpredictable and subject to change with no clear end in sight. Thus, "uncertainty" became the only certainty in daily life. The realities of the pandemic necessitated that changes and adjustments be made in our physical, psychological, and emotional states as well as life and work styles, which tested everyone's resilience. Change interpreted through Buddha Siddhartha's "Theory of Dependent Origination" is normal and to be expected. The Buddha believed all "conditioned dharmas" in the world (things that can be seen with form) were not created from nothing and could not exist alone. Instead, they must have been formed through a combination of various causal conditions and, once these conditions disappear, must return again to nothingness. Thus, "All dharmas arise due to conditions, and all dharmas cease due to conditions (Sina Buddhism, 2017)". Because of this, the Buddha believed all things and all phenomena to be impermanent and changing (Master Sheng Yen, 2002). According to the Buddha, change is normal and impermanence is permanent. As such, the practice of mental healthcare has not been passively changed by the epidemic, but has always been changing continuously and proactively. The process of treating and restoring to health in patients with mental illness is actually a long and arduous journey, and mental health nurses play a very important role throughout this long process of recovery. We abandon the traditional treatment and care model that only focuses on mental disorders and symptoms, and instead adopt the concept of holistic healthcare (Mandal et al., 2020), which focuses on patient physical, psychological, social and spiritual aspects, helping them achieve whole person wellness (Swanson et al., 2019). Each patient should be regarded as a unique individual not only in terms of their disease diagnosis, symptoms, physical and mental states, understanding, and communications but also in terms of their socioeconomic status, family support, and social resources. Because of this, nursing care plans should not be institutionalized or mechanistic, but rather allow flexibility to address each patient's current condition. Through comprehensive and integrated care and consultation and interdisciplinary teamwork, the psychiatric and mental health nurses work hard to ensure every patient and family member who receives care is satisfied in terms of their physical, psychological, social, and spiritual needs. Another aspect of change is the adoption by mental health nurses of a more active, more professional, larger pattern, and broader vision of their professional services. After all, mental patients may not necessarily fully understand their needs. As mental health professionals, we can develop our professional sensitivity. Moreover, while devoting ourselves to helping patients move towards holistic health and providing holistic care for patients, we should also try our best to detect and pay attention to whether current mental-health-related policies, medical system norms, or usual modes of operation may be ignoring patient needs or increasing the obstacles encountered in the rehabilitation process. In addition, we should try to seek strategies to change the situation, advocate for the health and well-being of patients, and improve the quality and effectiveness of overall mental healthcare. In this issue, four professors respectively discuss issues related to mental health policy, clinical practice, community rehabilitation and employment support, and the expansion of the professional role and service field of mental health nursing. These authors share how the field and functions of mental healthcare can change and evolve along a positive path forward. They not only provide direction and light but also show the results of their efforts.

摘要

对变化的感知是最近结束的新冠疫情带来的真实而深刻的结果。这场疫情的发展不可预测,且不断变化,看不到明确的终点。因此,“不确定性”成了日常生活中唯一确定的事。疫情的现实情况要求我们在身体、心理和情绪状态以及生活和工作方式上做出改变和调整,这考验着每个人的适应能力。用释迦牟尼的“缘起论”来解释,变化是正常且可预期的。佛陀认为世间所有“有为法”(有形态可见的事物)都不是凭空产生的,也不能独自存在。相反,它们必定是通过各种因果条件的组合而形成的,一旦这些条件消失,就必然再次归于虚无。因此,“诸法因缘生,诸法因缘灭(新浪佛学,2017)”。正因如此,佛陀认为所有事物和现象都是无常和变化的(圣严法师,2002)。按照佛陀的说法,变化是正常的,无常是永恒的。因此,精神卫生保健实践并非被动地因疫情而改变,而是一直在持续且主动地变化着。治疗和恢复精神疾病患者健康的过程实际上是一段漫长而艰巨的旅程,精神科护士在这漫长的康复过程中发挥着非常重要的作用。我们摒弃了仅关注精神障碍和症状的传统治疗与护理模式,转而采用整体医疗保健的理念(曼达尔等人,2020),该理念关注患者的身体、心理、社会和精神层面,帮助他们实现全面健康(斯旺森等人,2019)。每个患者都应被视为一个独特的个体,这不仅体现在他们的疾病诊断、症状、身心状态、理解能力和沟通方式上,还体现在他们的社会经济地位、家庭支持和社会资源方面。因此,护理计划不应是制度化或机械的,而应具有灵活性,以应对每个患者的当前状况。通过全面综合的护理、咨询以及跨学科团队合作,精神科和心理健康护士努力确保每一位接受护理的患者及其家庭成员在身体、心理、社会和精神需求方面都能得到满足。变化的另一个方面是精神科护士在其专业服务中采用更积极、更专业、更具宏观性和更广阔视野的方式。毕竟,精神疾病患者不一定能完全理解自己的需求。作为精神卫生专业人员,我们要培养自己的专业敏感性。此外,在致力于帮助患者走向全面健康并为患者提供整体护理的同时,我们还应尽力察觉并关注当前与精神健康相关的政策、医疗系统规范或通常的运作模式是否可能忽视了患者需求,或者增加了康复过程中遇到的障碍。此外,我们应努力寻求改变这种状况的策略,倡导患者的健康和福祉,提高整体精神卫生保健的质量和效果。在本期中,四位教授分别讨论了与精神卫生政策、临床实践、社区康复与就业支持以及精神科护理专业角色和服务领域拓展相关的问题。这些作者分享了精神卫生保健领域和功能如何沿着积极的方向变化和发展。他们不仅提供了方向和指引,还展示了他们的努力成果。

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