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严重精神疾病患者及其子女的家庭聚焦式护理的当前实践与障碍:一项针对捷克心理学家和精神科医生的调查

Current Practices and Barriers of Family-focused Care of Patients with Severe Mental Illness and Their Children: A Survey Among Czech Psychologists and Psychiatrists.

作者信息

Havelková Anna, Havelka David

机构信息

Faculty of Arts, Masaryk University, Brno, Czech Republic.

Children's psychiatry hospital, Opařany, Czech Republic.

出版信息

Scand J Child Adolesc Psychiatr Psychol. 2025 Aug 23;13(1):103-116. doi: 10.2478/sjcapp-2025-0010. eCollection 2025 Jan.

Abstract

BACKGROUND

Children of parents with mental illness are known to be at risk of developing mental illnesses due to hereditary and socio-economic factors. The family-focused practice in the treatment of adult patients with severe mental illness benefits patients and their children, and can help prevent mental health problems in children of parents with mental illness. Therefore, professionals caring for adult patients must contribute to the early identification of families at risk and initiate the necessary care.

OBJECTIVE

This study aimed to determine the current practices of psychologists and psychiatrists in the Czech Republic-the extent to which they include parental issues and their patients' children in their treatment, how informed they are about the available support, their attitudes toward a family-focused practice, potential barriers to family-focused practice, and recommendations for improvements in care for children of parents with mental illness.

METHODS

A structured online questionnaire completed by 193 professionals (51.8% psychiatrists, 48.2% psychologists) working with adults with severe mental illness in various healthcare settings.

RESULTS

A large majority (95.9%) of respondents regularly asked about the parenting status of their patients and 75.1% had a positive attitude toward involving children more in treatment. Although most respondents were comfortable discussing parenting (91.2%), they only discussed parenting topics if the patients themselves brought them up. Minors were rarely invited to treatment (26.4%), usually on a one-off basis. Major barriers cited include a lack of set procedures for working with families, lack of coherence of services, lack of time, shortage of professionals to refer to, and perceived lack of training and experience.

CONCLUSION

Although most professionals know that their patients have children and believe that children of parents with mental illness are at risk of developing problems, they are hindered by a variety of organizational and systemic barriers in implementing the family-focused approach more frequently in practice. Subject to wider expert discourse, the findings may contribute to informed policy formulation.

摘要

背景

众所周知,由于遗传和社会经济因素,患有精神疾病的父母的子女有患精神疾病的风险。针对成年重症精神疾病患者的以家庭为中心的治疗方法对患者及其子女有益,并且可以帮助预防患有精神疾病的父母的子女出现心理健康问题。因此,照顾成年患者的专业人员必须致力于早期识别有风险的家庭并启动必要的护理。

目的

本研究旨在确定捷克共和国心理学家和精神科医生的当前做法——他们在治疗中纳入父母问题及其患者子女的程度、他们对现有支持的了解程度、他们对以家庭为中心的治疗方法的态度、以家庭为中心的治疗方法的潜在障碍,以及改善对患有精神疾病的父母的子女护理的建议。

方法

193名在各种医疗环境中为成年重症精神疾病患者提供服务的专业人员(51.8%为精神科医生,48.2%为心理学家)完成了一份结构化在线问卷。

结果

绝大多数(95.9%)受访者经常询问患者的育儿状况,75.1%的受访者对让孩子更多地参与治疗持积极态度。尽管大多数受访者乐于讨论育儿问题(91.2%),但他们只有在患者自己提出时才会讨论育儿话题。未成年人很少被邀请参与治疗(26.4%),通常是一次性的。提到的主要障碍包括缺乏与家庭合作的既定程序、服务缺乏连贯性、时间不足、可供咨询的专业人员短缺,以及感觉缺乏培训和经验。

结论

尽管大多数专业人员知道他们的患者有孩子,并且认为患有精神疾病的父母的子女有出现问题的风险,但他们在实践中更频繁地实施以家庭为中心的方法时受到各种组织和系统障碍的阻碍。在更广泛的专家讨论的前提下,这些发现可能有助于制定明智的政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d1c/12378433/46ca6a50ede3/j_sjcapp-2025-0010_fig_001.jpg

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