满足身体康复中青少年心理健康需求的服务：临床医生、青少年及其家庭成员的观点
Services Addressing Mental Health Needs of Youth in Physical Rehabilitation: Perspectives of Clinicians, Youth and Family Members.
作者信息
Tremblay Stephanie M, Lal Shalini, Ferro Mark A, Anaby Dana
机构信息
School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada.
出版信息
Child Care Health Dev. 2025 Jan;51(1):e70019. doi: 10.1111/cch.70019.
BACKGROUND
Knowledge about services addressing mental health provided in a rehabilitation setting to youth with physical disabilities is limited. This study aimed to better understand the needs, supports, challenges and potential solutions to optimize rehabilitation services for co-occurring physical and mental health needs, from the perspectives of youth, family members and clinicians.
METHODS
A qualitative descriptive approach using 22 individual interviews with youth, parents and clinicians from five rehabilitation centres in a large Canadian city was employed. Inductive thematic analysis was conducted.
RESULTS
Three themes were identified across the three stakeholder groups: (1) available clinical resources for mental health (access to mental health professionals, impact of organizational structures and mandates and continuity of services during transition to adult care); (2) clinician workforce capacity (mental health knowledge, skills and professional development, and therapeutic rapport between clinician and youth); and (3) links and partnerships with key players (improved pathways to access mental health services across programmes and organizations, and family involvement and advocacy).
CONCLUSION
This study provides insights to barriers for mental health care (such as limited mental health knowledge, tools and professional development and access to specialists within the team, restrictive organizational mandates and disruption of services during the transition to adult care), illustrating important aspects to address. Clinicians can be better equipped to address mental health in rehabilitation settings via training opportunities and peer and organizational support in addition to establishing links with external partners. Organizations can also ensure adequate staffing and create pathways within and beyond their institutions to deliver well-coordinated mental health services in a more accessible way.
背景
关于为身体残疾青年在康复环境中提供的心理健康服务的了解有限。本研究旨在从青年、家庭成员和临床医生的角度，更好地理解满足身体和心理健康并发需求的康复服务的需求、支持、挑战及潜在解决方案。
方法
采用定性描述方法，对加拿大一个大城市的五个康复中心的青年、家长和临床医生进行了22次个人访谈。进行了归纳主题分析。
结果
在三个利益相关者群体中确定了三个主题：（1）心理健康的可用临床资源（获得心理健康专业人员的机会、组织结构和任务的影响以及向成人护理过渡期间服务的连续性）；（2）临床医生劳动力能力（心理健康知识、技能和专业发展，以及临床医生与青年之间的治疗关系）；（3）与关键参与者的联系和伙伴关系（改善跨项目和组织获得心理健康服务的途径，以及家庭参与和倡导）。
结论
本研究揭示了心理健康护理的障碍（如心理健康知识、工具和专业发展有限，团队内专家获取受限，组织任务限制以及向成人护理过渡期间服务中断），阐明了需要解决的重要方面。临床医生除了与外部伙伴建立联系外，还可以通过培训机会、同行和组织支持，更好地在康复环境中应对心理健康问题。各组织还可以确保人员配备充足，并在其机构内外建立途径，以更便捷的方式提供协调良好的心理健康服务。
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