Senger Brannon, MacDonald Quinn, Pencer Alissa, Crocker Candice E, Hughes Jean, Tibbo Philip G
Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.
Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
Early Interv Psychiatry. 2025 Jan;19(1):e13553. doi: 10.1111/eip.13553. Epub 2024 May 26.
AIM: Most young adults experiencing psychosis enter early intervention services (EIS) via inpatient and emergency departments. These experiences are suggested to negatively impact their views of treatment and engagement in EIS. However, limited research has examined the impact of young adults' prior help-seeking experiences on these outcomes. The present study aimed to explore how young adults engaged in EIS have experienced initial help-seeking and make sense of these experiences in the context of their current treatment. METHODS: Using an interpretative phenomenological analysis approach, semi-structured interviews were conducted with 12 young adults (mean age = 24.83) within their first 3-12 months of treatment in EIS. Interviews aimed to examine their experiences of help-seeking and referral to EIS as well as the impact of these experiences on their subsequent perception of, and engagement with EIS. RESULTS: 3 superordinate themes emerged: (1) Navigating the Maze of Healthcare (2) Dignity and (3) Impact of Help-Seeking and Referral Experiences. Participants with referral pathways involving urgent care services described more adversity during their referral pathway and tended to describe help-seeking experiences as contributing to negative views towards EIS and diminished engagement in treatment. CONCLUSIONS: The impact of early negative experiences with healthcare on views towards EIS and engagement is evident in participants' accounts. Sense making was further contextualized by participants' illness insight, degree of recovery, and social support throughout experiences. Emergent themes highlight the need for psychiatric services to emphasize service users' dignity and for EIS to provide opportunities for patients to process past negative mental healthcare experiences to strengthen engagement.
目的:大多数患有精神病的年轻人通过住院部和急诊科进入早期干预服务(EIS)。这些经历被认为会对他们对治疗的看法以及参与EIS产生负面影响。然而,仅有有限的研究考察了年轻人先前的求助经历对这些结果的影响。本研究旨在探讨参与EIS的年轻人如何经历最初的求助过程,并在他们当前治疗的背景下理解这些经历。 方法:采用解释现象学分析方法,对12名在EIS接受治疗的前3至12个月内的年轻人(平均年龄 = 24.83岁)进行了半结构化访谈。访谈旨在考察他们寻求帮助并被转介至EIS的经历,以及这些经历对他们随后对EIS的认知和参与度的影响。 结果:出现了3个上位主题:(1)在医疗保健迷宫中摸索;(2)尊严;(3)求助和转介经历的影响。涉及紧急护理服务的转介途径的参与者在转介过程中描述了更多的困境,并且倾向于将求助经历描述为导致对EIS的负面看法以及治疗参与度降低的原因。 结论:参与者的叙述中明显体现了早期医疗保健负面经历对EIS看法和参与度的影响。在整个经历中,参与者的疾病洞察力、康复程度和社会支持进一步将意义建构置于具体情境中。新出现的主题强调精神科服务需要强调服务使用者的尊严,EIS需要为患者提供机会来处理过去负面的精神卫生保健经历,以加强参与度。
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