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“并非全靠药物治疗”:改善急性精神科病房中感官疗法的应用——一项定性分析

'It's Not All About Medication': Improving the Use of Sensory Approaches in an Acute Mental Health Unit-A Qualitative Analysis.

作者信息

Wright Lisa, Meredith Pamela, Bennett Sally

机构信息

School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.

Metro North Mental Health, the Prince Charles Hospital, Metro North Hospital and Health Service, Brisbane, Australia.

出版信息

Int J Ment Health Nurs. 2025 Jul;34(4):e70118. doi: 10.1111/inm.70118.

Abstract

Improving the use of recovery-orientated and trauma-informed practices, such as sensory approaches, in acute mental health units (AMHUs) has proven challenging, and the biomedical model predominates. Limited research has explored how addressing local barriers to the use of sensory approaches can change clinical practice in these units. This study aimed to understand the factors that led to changes in practice following the implementation of a tailored strategy designed to improve the use of sensory approaches. Implementation strategies were co-designed with key stakeholders, guided by the Behaviour Change Wheel and Integrated Knowledge Translation. Strategies included: provision of sensory materials/resources; education and training; prompts and reminders; modelling; audit and feedback; workplace coalition; and facilitation. A qualitative descriptive design was used to conduct semi-structured interviews (n = 7) with mental health clinicians and peer support workers. Data were analysed inductively using reflective thematic analysis. Seven key themes emerged from the data: That's just how we do things now, More options available, Wide range of benefits, Everyone needs to be trained, People drove change, You haven't got time and Risk considerations. Participants reported how sensory approaches had become part of routine practice over the course of the project; however, the key ongoing barrier to their use was lack of time. Findings from this study highlight how addressing local contextual barriers to the use of sensory approaches can result in change in ward culture and improved use. Overall, the tailored strategy resulted in a move towards more consumer-centred, trauma-informed and recovery-orientated care in an AMHU.

摘要

事实证明,在急性精神科病房(AMHU)中推广以康复为导向和创伤知情的做法(如感官疗法)具有挑战性,生物医学模式占据主导地位。有限的研究探讨了如何克服感官疗法应用中的局部障碍,从而改变这些病房的临床实践。本研究旨在了解实施一项旨在改善感官疗法应用的定制策略后,导致实践发生变化的因素。实施策略是与关键利益相关者共同设计的,以行为改变轮和综合知识转化为指导。策略包括:提供感官材料/资源;教育与培训;提示与提醒;示范;审核与反馈;工作场所联盟;以及促进。采用定性描述性设计,对心理健康临床医生和同伴支持工作者进行了半结构化访谈(n = 7)。使用反思性主题分析对数据进行归纳分析。数据中出现了七个关键主题:这就是我们现在做事的方式、有更多选择、广泛的益处、每个人都需要接受培训、人们推动变革、你没有时间以及风险考量。参与者报告了在项目过程中感官疗法如何成为常规实践的一部分;然而,使用感官疗法的关键持续障碍是缺乏时间。本研究结果凸显了克服感官疗法应用中的局部背景障碍如何能够导致病房文化的改变和应用的改善。总体而言,该定制策略促使一个急性精神科病房朝着更加以患者为中心、创伤知情和以康复为导向的护理方向发展。

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