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青年视角下的“高度个性化和基于测量的医疗照护”:教育材料的定性协同设计。

Youth Perspectives on 'Highly Personalised and Measurement-Based Care': Qualitative Co-Design of Education Materials.

机构信息

The Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia.

出版信息

Health Expect. 2024 Aug;27(4):e14137. doi: 10.1111/hex.14137.

Abstract

OBJECTIVES

Despite high levels of mental ill-health amongst young people (aged 15-30), this group demonstrates low help-seeking and high drop-out from mental health services (MHS). Whilst shared decision-making can assist people in receiving appropriate and effective health care, young people frequently report that they do not feel involved in treatment decisions. The current study focused on co-design of a clinical education and participant information programme for the Brain and Mind Centre Youth Model of Care. This model, which articulates a youth-focused form of highly personalised and measurement-based care, is designed to promote shared decision-making between young people and clinical service providers.

METHODS

We conducted workshops with 24 young people (16-31; M = 21.5) who had accessed mental health services. Participants were asked what advice they would give to young people entering services, before giving advice on existing materials. Workshops were conducted and transcripts were coded using thematic analysis by two lived experience researchers and a clinical researcher.

RESULTS

Young people found it empowering to be educated on transdiagnostic models of mental illness, namely clinical staging, which gives them a better understanding of why certain treatments may be inappropriate and ineffective, and thus reduce self-blame. Similarly, young people had limited knowledge of links between mental health and other life domains and found it helpful to be educated on multidisciplinary treatment options. Measurement-based care was seen as an important method of improving shared decision-making between young people and health professionals; however, to facilitate shared decision-making, young people also wanted better information on their rights in care and more support to share their expertise in their own needs, values and treatment preferences.

CONCLUSIONS

These findings will inform the delivery of the further development and implementation of a youth-specific clinical education and participant information programme for the BMC Youth Model.

PATIENT OR PUBLIC CONTRIBUTION

Workshops were facilitated by researchers with lived expertise in mental ill-health (A.H. and/or C.G.) and a clinical researcher (who has expertise as an academic and a clinical psychologist). A.H. and C.G. were also involved in conceptualisation, analysis, interpretation, review and editing of this paper.

摘要

目的

尽管年轻人(15-30 岁)的心理健康问题严重,但这一群体寻求心理健康服务的帮助较少,且中途退出服务的情况较多。虽然共同决策可以帮助人们获得适当和有效的医疗保健,但年轻人经常报告说,他们觉得自己没有参与治疗决策。本研究专注于为脑与心智中心青年照护模式共同设计临床教育和参与者信息方案。该模式阐述了一种以年轻人为中心的高度个性化和基于测量的护理形式,旨在促进年轻人与临床服务提供者之间的共同决策。

方法

我们与 24 名(16-31 岁;M=21.5)曾接受过心理健康服务的年轻人进行了研讨会。参与者在提供现有材料建议之前,被要求提供他们对进入服务的年轻人的建议。由两名具有实际经验的研究人员和一名临床研究人员对研讨会进行记录和编码分析。

结果

年轻人发现接受关于精神疾病的跨诊断模型(即临床分期)的教育是赋权的,这使他们更好地理解为什么某些治疗可能不适当和无效,从而减少自责。同样,年轻人对心理健康与其他生活领域之间的联系知之甚少,他们发现接受关于多学科治疗方案的教育很有帮助。基于测量的护理被视为改善年轻人和卫生专业人员之间共同决策的重要方法;然而,为了促进共同决策,年轻人还希望更好地了解他们在护理中的权利,并获得更多的支持,以分享他们在自己的需求、价值观和治疗偏好方面的专业知识。

结论

这些发现将为进一步开发和实施脑与心智中心青年照护模式的特定于青年的临床教育和参与者信息方案提供信息。

患者或公众贡献

研讨会由具有心理健康实际经验的研究人员(A.H. 和/或 C.G.)和临床研究人员(具有学术和临床心理学家的专业知识)共同主持。A.H. 和 C.G. 还参与了本文的概念化、分析、解释、审查和编辑。

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Being in a space of sharing decision-making for dignified mental care.处于共享决策的空间,以实现有尊严的精神关怀。
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