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作者信息

Jiguet Sarah, Michel Thibault, Capdevielle Delphine

机构信息

Centre Hospitalier Leon Jean Gregory, Thuir, France.

Service Universitaire de Psychiatrie Adulte, CHU de Montpellier, Montpellier, France.

出版信息

Can J Psychiatry. 2024 Aug;69(8):598-606. doi: 10.1177/07067437241246589. Epub 2024 Apr 24.

Abstract

OBJECTIVE

Ambulatory care without consent is widely used, but it is controversial, and its effectiveness has not yet been proven. The patient experience remains largely unstudied in France, particularly that of young patients, yet their adherence to care in the early stages of the disease is complex and has an impact on their prognoses. The aim of this study is to investigate the experience of young patients undergoing a program of care (POC) in order to suggest ways of optimizing their care and to enrich the debate on the use of POCs.

METHOD

Semi-structured interviews were conducted with 11 patients between ages 20 and 32, who were either undergoing a POC or had done so in the previous 5 years, followed by a semi-pragmatic phenomenological analysis of the resulting transcripts.

RESULTS

(1) The outpatient experience with restraints is contradictory, ranging from deprivation and intrusion to support and protection. (2) The POC is portrayed as a framework for developing awareness of disorders and acceptance of care. (3) Patients report a lack of information about care with restraints, even to the point of being unaware of its existence. Patient-psychiatrist interactions within the POC are complicated by the restraints, but remain perceived as a care relationship. (4) They report constraints in their daily lives in connection to the POC, which can complicate professional involvement.

CONCLUSION

The results support the importance of nurturing the therapeutic relationship within the POC and involving patients more in their care, starting with better information. They support the use of POCs as a temporary tool to be combined with work on adherence to treatment and support for social and professional reintegration.

SPECIALTY

Psychiatry.

摘要

目的

未经同意的非住院治疗被广泛使用,但存在争议,其有效性尚未得到证实。在法国,患者体验在很大程度上仍未得到研究,尤其是年轻患者的体验,然而他们在疾病早期对治疗的依从性很复杂,且会影响其预后。本研究的目的是调查接受护理计划(POC)的年轻患者的体验,以便提出优化其护理的方法,并丰富关于使用POC的讨论。

方法

对11名年龄在20至32岁之间、正在接受POC或在过去5年内接受过POC的患者进行了半结构化访谈,随后对访谈记录进行了半实用现象学分析。

结果

(1)有约束措施的门诊体验是矛盾的,从被剥夺和被侵扰到获得支持和保护。(2)POC被描绘为一个培养对疾病的认识和接受治疗的框架。(3)患者报告称缺乏关于有约束措施的护理的信息,甚至不知道其存在。POC中的患者与精神科医生的互动因约束措施而变得复杂,但仍被视为一种护理关系。(4)他们报告了与POC相关的日常生活中的限制,这可能会使职业参与变得复杂。

结论

研究结果支持在POC中培养治疗关系以及让患者更多地参与其护理的重要性,首先要提供更好的信息。研究结果支持将POC用作一种临时工具,与致力于治疗依从性以及支持社会和职业重新融入的工作相结合。

专业

精神病学。

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