Repper J, Ford R, Cooke A
Department of Nursing and Midwifery, University of Nottingham, England.
J Adv Nurs. 1994 Jun;19(6):1096-104. doi: 10.1111/j.1365-2648.1994.tb01193.x.
Despite the shift in recent policy toward people with severe and long-term mental health problems, there is considerable evidence that mental health nurses tend to prioritize clients with acute, neurotic or short-term problems and become demoralized when working with people with persistent needs and disabilities. Mental health nurses need to find ways of developing effective relationships with these people in order to offer a service which the client is not only willing to engage in, but takes an active part in, and which allows care providers to derive satisfaction from their work. Through 46 in-depth interviews with case managers (working specifically with people with long-term mental health problems) and their clients, this qualitative study provides some guidelines for mental health nurses working in this field. Analysis of the interviews revealed that both clients and case managers focused on the problems and strategies associated with developing and maintaining relationships with one another. Furthermore, the interviews suggested that case managers adopted a philosophy for working that enabled both clients and case managers to feel positive about the work. The principles of this value base, and the way it was used in the process of case management, are explored in this account.
尽管最近政策转向关注患有严重和长期心理健康问题的人群，但有大量证据表明，心理健康护士往往将急性、神经症性或短期问题的患者作为优先考虑对象，而在为有持续需求和残疾的人提供服务时会感到士气低落。心理健康护士需要找到与这些人建立有效关系的方法，以便提供一种不仅患者愿意参与，而且会积极参与的服务，同时让护理人员从工作中获得满足感。通过对个案经理（专门为患有长期心理健康问题的人提供服务）及其客户进行46次深入访谈，这项定性研究为该领域的心理健康护士提供了一些指导方针。对访谈的分析表明，客户和个案经理都关注与彼此建立和维持关系相关的问题和策略。此外，访谈还表明，个案经理采用了一种工作理念，使客户和个案经理都能对工作感到积极。本报告探讨了这一价值观基础的原则及其在个案管理过程中的应用方式。
