Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland.
Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland.
Arch Psychiatr Nurs. 2024 Aug;51:120-126. doi: 10.1016/j.apnu.2024.06.002. Epub 2024 Jun 10.
Concerns about the applicability of recovery orientation to forensic care have surfaced due to the traditionally restrictive practices associated with forensic institutions. We interviewed 19 experts-by-experience and 18 professionals working with them across five Finnish forensic hospitals and one out-patient clinic to describe how they define recovery in forensic.
We utilized semi-structured, one-on-one interviews and then analyzed the collected data using structural narrative analysis. Our points of interest were the plots of the recovery stories and the ways in which various factors affected recovery. We also investigated whether staff and experts-by-experience had different perceptions of recovery in forensic psychiatry, and whether recovery-oriented practices were present in these accounts.
A wider mutual narrative with a chronological plot was identified, and recovery-oriented practices and goals were found with a special emphasis on offending. Insight into mental illness, motivation for self-care, trust in therapeutic relationships, and gaining possibilities to proceed in care were found to promote recovery, whereas insufficient understanding of the illness, a closed environment, lack of trust, and substance abuse hindered the recovery process. Both the professionals and experts felt that the most prominent goal of recovery is integration into society.
The views of the interviewed experts-by-experience and professionals regarding recovery were rather univocal. Forensic psychiatric services in Finland were found to demonstrate recovery-oriented features, which can be promoted further by involving experts-by-experience in different assignments. The results also highlight that the families of patients should become more active partners in care.
Recovery in forensic psychiatric hospitals can be perceived as a process towards a new role in society. To reach this goal the forensic patients need support from staff, peers, and family. We found numerous factors which enable and hinder the recovery process, and which should be considered during forensic care.
由于与法医机构相关的传统限制做法，人们对恢复取向在法医护理中的适用性产生了担忧。我们采访了 19 名有经验的专家和 18 名与他们一起在芬兰的五所法医医院和一家门诊诊所工作的专业人员，以描述他们如何定义法医中的恢复。
我们使用半结构化的一对一访谈，然后使用结构叙事分析对收集的数据进行分析。我们感兴趣的是恢复故事的情节以及各种因素对恢复的影响方式。我们还调查了工作人员和有经验的专家是否对法医精神病学中的恢复有不同的看法，以及这些叙述中是否存在以恢复为导向的做法。
确定了一个具有时间顺序情节的更广泛的共同叙述，并发现了以康复为导向的实践和目标，特别强调犯罪。对精神疾病的洞察力、自我保健的动机、对治疗关系的信任以及获得继续治疗的可能性被发现可以促进康复，而对疾病的理解不足、封闭的环境、缺乏信任和药物滥用则阻碍了康复过程。专业人员和专家都认为，康复的最突出目标是融入社会。
接受采访的有经验的专家和专业人员对康复的看法相当一致。芬兰的法医精神病服务被发现具有以康复为导向的特征，可以通过让有经验的专家参与不同的任务来进一步促进。结果还强调，患者的家属应该成为护理的更积极的合作伙伴。
法医医院的康复可以被视为在社会中扮演新角色的过程。为了实现这一目标，法医患者需要得到工作人员、同伴和家人的支持。我们发现了许多促进和阻碍康复过程的因素，在法医护理中应该考虑这些因素。
