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患者在住院环境中接受基于认知行为疗法的精神病危机干预的体验:定性探索。

Patient's Experiences of a Cognitive Behaviour Therapy Informed Crisis Intervention for Psychosis Delivered in Inpatient Settings: A Qualitative Exploration.

机构信息

Research and Development, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford, UK.

Division of Psychiatry, University College London, London, UK.

出版信息

Clin Psychol Psychother. 2024 Jul-Aug;31(4):e3033. doi: 10.1002/cpp.3033.

Abstract

Cognitive behaviour therapy for psychosis (CBTp) should be offered to patients receiving psychiatric inpatient care, yet very little is known about patients' perspectives on this. The aim of this study was to examine patients' experiences of a CBTp-informed intervention delivered in inpatient settings. We recruited 10 participants from the intervention arm of a randomised controlled trial examining the feasibility and acceptability of a CBTp-informed intervention for psychiatric inpatient settings. We undertook semistructured interviews examining their experiences of the intervention and analysed them using thematic analysis. The study was conducted in partnership with a coproduction group of key stakeholders (people with lived experience, family and carers, and clinicians). The intervention was found helpful by almost all participants, and all participants would recommend it to others in similar situations to themselves. The results demonstrated that participants valued the therapist's professionalism and emphasised the importance of the therapeutic relationship. Participants highlighted the importance of the therapy focusing on navigating admission and developing skills to manage the crisis experience so they could return to their normal lives. Participants described challenges to having psychological therapy in the acute crisis context including therapy interruptions and ongoing distressing experiences of psychosis. The study demonstrated the importance of prioritising the therapeutic relationship, that therapy was a valued process to navigate admission and discharge, but that some environmental and patient-level challenges were present. Further research is needed to explore inpatients' experiences of psychological interventions in this setting. TRIAL REGISTRATION: ISRCTN trial registry: ISRCTN59055607.

摘要

精神病认知行为疗法(CBTp)应提供给接受精神科住院治疗的患者,但人们对患者对此的看法知之甚少。本研究旨在探讨患者对在住院环境中提供的 CBTp 知情干预的体验。我们从一项随机对照试验的干预组中招募了 10 名参与者,该试验旨在检验一种 CBTp 知情干预在精神科住院环境中的可行性和可接受性。我们进行了半结构化访谈,探讨他们对干预的体验,并使用主题分析对其进行分析。该研究是与一个由主要利益相关者(有生活经验的人、家人和照顾者以及临床医生)组成的合作小组合作进行的。几乎所有参与者都认为该干预措施很有帮助,所有参与者都会向与自己情况相似的人推荐它。研究结果表明,参与者重视治疗师的专业性,并强调治疗关系的重要性。参与者强调了治疗的重要性,即重点是帮助患者应对入院并培养应对危机体验的技能,以便他们能够恢复正常生活。参与者描述了在急性危机情况下接受心理治疗所面临的挑战,包括治疗中断和持续的精神病痛苦体验。该研究表明,优先考虑治疗关系非常重要,治疗是一种有价值的入院和出院过渡过程,但存在一些环境和患者层面的挑战。需要进一步研究以探讨在这种环境下住院患者对心理干预的体验。试验注册:ISRCTN 临床试验注册:ISRCTN59055607。

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