印度尼西亚精神障碍患者获得心理健康服务的障碍与促进因素：一项定性研究。
Barriers and facilitators to access mental health services among people with mental disorders in Indonesia: A qualitative study.
作者信息
Munira Lafi, Liamputtong Pranee, Viwattanakulvanid Pramon
机构信息
College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.
College of Health Sciences, VinUniversity, Vietnam.
出版信息
Belitung Nurs J. 2023 Apr 18;9(2):110-117. doi: 10.33546/bnj.2521. eCollection 2023.
BACKGROUND
The care and treatment management of people with mental health problems has become a prominent global concern in recent years that requires consistent attention. However, the literature suggests that only a small percentage of individuals with mental health problems in Indonesia receive the necessary mental health care. Therefore, it is crucial to explore this gap.
OBJECTIVE
This study aimed to explore barriers and facilitators that affect access to mental health services among people with mental health disorders in Indonesia.
METHODS
The study employed a qualitative descriptive design and focused on individuals with depression, anxiety, or bipolar disorder. Data were collected through in-depth interviews conducted via WhatsApp chat with 90 participants aged 18-32, who were purposively selected from Sumatra, Java, Kalimantan, and Papua Islands in Indonesia between January and June 2022. Thematic analysis was used to analyze the data.
RESULTS
The barriers to accessing mental health services included: 1) uneasy access to mental healthcare facilities, 2) stigma, lack of social support, and delay in receiving proper treatment, and 3) expensive treatment costs without national health insurance membership. Importantly, the facilitators to access mental health services included: 1) national health insurance membership, 2) support from spouse, family, and closest friends and its association with mental health literacy, and 3) self-help.
CONCLUSION
The widespread distribution of mental health knowledge is recommended among healthcare providers, including public health practitioners and primary care nurses, to enhance their mental health literacy and competencies while rendering services to individuals with mental disorders. Additionally, efforts should be made to educate and promote awareness among caregivers and communities to reduce the stigma faced by those with mental disorders.
背景
近年来，心理健康问题患者的护理和治疗管理已成为一个突出的全球关注点，需要持续关注。然而，文献表明，印度尼西亚只有一小部分心理健康问题患者获得了必要的心理健康护理。因此，探索这一差距至关重要。
目的
本研究旨在探讨影响印度尼西亚心理健康障碍患者获得心理健康服务的障碍和促进因素。
方法
本研究采用定性描述性设计，重点关注抑郁症、焦虑症或双相情感障碍患者。通过2022年1月至6月期间在WhatsApp上与90名年龄在18 - 32岁之间的参与者进行深入访谈收集数据，这些参与者是从印度尼西亚的苏门答腊岛、爪哇岛、加里曼丹岛和巴布亚岛有目的地选取的。采用主题分析法对数据进行分析。
结果
获得心理健康服务的障碍包括：1）难以获得心理健康护理设施；2）耻辱感、缺乏社会支持以及接受适当治疗的延迟；3）没有国家医疗保险会员资格时治疗费用昂贵。重要的是，获得心理健康服务的促进因素包括：1）国家医疗保险会员资格；2）配偶、家人和最亲密朋友的支持及其与心理健康素养的关联；3）自助。
结论
建议在医疗保健提供者中广泛传播心理健康知识，包括公共卫生从业者和初级保健护士，以提高他们在为精神障碍患者提供服务时的心理健康素养和能力。此外，应努力对护理人员和社区进行教育并提高认识，以减少精神障碍患者所面临的耻辱感。
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