精神卫生服务中提前指令:有关利益相关者的观点的定性研究
Ína Rós Jóhannesdóttir1,2, Helga Sif Fridjónsdóttir1,2, Marianne Elisabeth Klinke1,2
1Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
Journal of psychiatric and mental health nursing
|February 18, 2025
概括
精神卫生保健的预先指令赋予患者权力,但面临实施障碍. 用户和提供者都看到了好处,但对控制和自主性的不同看法需要通过教育和参与来协调.
科学领域:
- 心理健康服务研究 心理健康服务研究
- 患者自主研究 患者自主研究
- 医疗保健政策分析 政策分析
背景情况:
- 预先指令的目的是减少胁迫,增强患者在精神卫生保健中的发言权.
- 这些指令的有限使用源于利益相关者的不同观点和熟悉程度低.
- 了解这些观点对于有效实施至关重要.
研究的目的:
- 探索利益相关者对冰岛精神卫生服务中预先指示的观点.
- 为了确定潜在的好处和实施挑战.
- 为更好地整合预先指示的战略提供信息.
主要方法:
- 聚焦小组与冰岛的心理健康服务用户和提供者进行了讨论.
- 有目的的抽样确保了多样化的参与者代表.
- 多个类别的设计促进了不断的比较和解释性分析.
主要成果:
- 在四个重点小组中,有19名参与者 (4名用户,15名提供者) 报告说,他们对预先指示的熟悉程度有限,并且以前使用过预先指示.
- 两组人都看好预先指令,但重点不同.
- 用户优先考虑自我表达和自治;提供者虽然支持赋权,但表示担心放弃控制,维持权力不平衡.
结论:
- 实施预先指令需要对话,以调整利益相关者的期望.
- 战略方法应包括教育和利益相关者参与.
- 需要共同创建的干预措施来协调不同的观点,并促进采用.
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