Mekuriaw Birhanie, Cutler Natalie Ann, River Jo
Faculty of Health, University of Technology Sydney, Sydney, Australia.
Department of Psychiatry, College of Health and Medical Science, Dilla University, Dilla, Ethiopia.
Int J Ment Health Nurs. 2025 Apr;34(2):e70035. doi: 10.1111/inm.70035.
Recovery-oriented practice is a contemporary and internationally accepted approach to mental health care. Moving away from privileging 'clinical recovery', it recognises and supports 'personal recovery', defined as living a meaningful life. Family and carers' (carers) understanding, and support of recovery-oriented practice is crucial to the provision of comprehensive and continuous mental health care. Few studies exist on carers' knowledge and experiences of recovery-oriented practice. We conducted a systematic review to explore carers' understanding of recovery-oriented practice in mental health settings. A narrative synthesis was undertaken using both deductive and inductive approaches, guided by the established framework for recovery-oriented practice by Le Boutillier and colleagues. Findings indicated that carers have a grasp of the principles and aims of recovery-oriented care, which aligned with the selected framework. However, carers' comprehension also identified shortcomings in how recovery-oriented practices were currently implemented in mental health services. Extending the work of Le Boutillier and colleagues, this review found that carers experienced a 'disillusionment with mental health services'. While carers were keen to be involved and support recovery, they often felt excluded by mental health workers and the broader mental health system. This sense of exclusion led to carers feeling unsupported and disinclined to engage with the service, and this adversely affected their well-being. Findings suggest that operationalising recovery-oriented practice requires more genuine involvement of carers in decision-making forums such as care planning meetings, and formal feedback mechanisms be made available to integrate their perspectives into service development.
以康复为导向的实践是一种当代的、国际公认的精神卫生保健方法。它摒弃了对“临床康复”的特权化,转而认可并支持“个人康复”,即过上有意义的生活。家庭和照顾者(照顾者)对以康复为导向的实践的理解和支持,对于提供全面和持续的精神卫生保健至关重要。关于照顾者对以康复为导向的实践的知识和经验的研究很少。我们进行了一项系统综述,以探讨照顾者对精神卫生环境中以康复为导向的实践的理解。采用了演绎和归纳方法进行叙述性综合,以Le Boutillier及其同事建立的以康复为导向的实践框架为指导。研究结果表明,照顾者掌握了以康复为导向的护理的原则和目标,这与所选框架一致。然而,照顾者的理解也指出了精神卫生服务目前实施以康复为导向的实践方式中的不足之处。扩展Le Boutillier及其同事的工作,本综述发现照顾者经历了“对精神卫生服务的幻灭”。虽然照顾者渴望参与并支持康复,但他们常常感到被精神卫生工作者和更广泛的精神卫生系统排斥。这种被排斥感导致照顾者感到缺乏支持,不愿意参与服务,这对他们的幸福感产生了不利影响。研究结果表明,实施以康复为导向的实践需要照顾者更切实地参与决策论坛,如护理计划会议,并提供正式的反馈机制,以便将他们的观点纳入服务发展中。