Abstract：
WHAT IS KNOWN ON THE SUBJECT?: It is generally accepted that all interventions carried out by mental health nurses involve engagement with the patient; this engagement is a process that is gradually constructed and is not immediate. In Spain during last decade, nurses working in assertive outreach teams have gradually replaced the traditional institutional setting in favour of environments that are more familiar to the patient. In contrast, when patients and nurses interact outside institutional settings, a new approach and skillset is required in order to adapt to the new environment. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We have systematically identified and assessed the available evidence on how nurses work in assertive outreach team programmes. The therapeutic link is not just assistance; it is actually a construct, which is established between nurse and patient, with the aim of favouring, fostering and strengthening the therapeutic relationship. Only a few studies have discussed the nurse-patient therapeutic link in assertive outreach services. However, it seems important that nurses use a standardized language, that is, a language promoted as a model of correct use and used for functions of greater prestige, especially in public administration and teaching, to integrate it into the theoretical framework. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: With the synthesis that we present, we hope that it promote a more consistent use of the engagement concept in research on this topic. In turn, this will enhance staff support and training and will foster evidence-based practice. The conceptualization of nursing language and its use by professionals helps to improve practice and the lack of a theoretical framework with a nurse perspective. It is necessary to establish a consensus between mental health nurses around the engagement\' meaning in the programmes of assertive outreach teams. ABSTRACT: Introduction During last decade in Spain, nurses working in assertive outreach programmes have replaced the traditional institutional setting in favour of the patient\'s own environment. Engagement with patients requires a different skillset when the axis of the nurse-patient interaction is the patient\'s own environment. The engagement alone could be associated with the innate concept of patient\'s care and the helping relationship. However, in the individualized care models, the engagement seems to be an instrument with its own characteristics for the purpose of providing mental health care. Aim/Question To systematically identify and assess the empirical evidence on the relationships and engagement between patients with mental illness (schizophrenia, psychotic disorders, schizoaffective disorders, mood disorders and disorders of adult personality) and nursing mental health nurses. Method Systematic literature review based on PRISMA guidance. Results We identified and reviewed seven primary research studies. Following the analytic processes, three themes emerged: existence of different engagement levels, training needs and skills in the creation and consolidation of the engagement, and engagement as process. Discussion The engagement of nurse and patient is understood as a process that incorporates different stages. Whilst it is established, the engagement is subject to positive and negative influences. For the creation of the engagement and its maintenance specialized skills, knowledge and personal attributes (resilience, psychosocial skills, compressive knowledge of mental health illnesses, capacity to build effective relationships, adaptability and problem-solving) are necessary, but the main focus is on context where it develops, selected by the patient himself, for example, his home. Implications for Practice Administrators may have questions about appropriate hiring practices for assertive outreach teams since certain skills are necessary to obtain un engagement process, and staff training should be considered a key issue to provide specific skills for enhancing engagement and the therapeutic relationship. Conclusion The engagement must be understood as a long-term process. For the creation of the engagement and its maintenance, specialized skills, knowledge and personal attributes are necessary.
摘要：
什么是已知的主题？：一般接受的是，所有的干预措施进行的心理健康护士涉及与患者的参与;这种参与是一个过程，是逐步构建的，不是立即。在过去的十年里，在西班牙，在自信的外展团队中工作的护士已逐渐取代传统的机构设置，转而使用患者更熟悉的环境。相比之下,当病人和护士在机构之外互动时，为了适应新的环境，需要一种新的方法和技能。论文对现有知识有何帮助？：我们已经系统地确定并评估了有关护士如何在自信的外展团队计划中工作的现有证据。治疗环节不仅仅是援助；它实际上是一种结构，这是在护士和病人之间建立的，为了有利于，培养和加强治疗关系。只有少数研究讨论了自信的外展服务中的护士与患者的治疗联系。然而,护士使用标准化的语言似乎很重要，也就是说,一种被推广为正确使用模式的语言，用于具有更大声望的功能，特别是在公共管理和教学方面，将其融入理论框架。实践的含义是什么？：通过我们介绍的综合，我们希望它促进在有关该主题的研究中更一致地使用参与概念。反过来,这将加强员工支持和培训，并促进循证实践。护理语言的概念化及其专业人员的使用有助于改善实践和缺乏具有护士视角的理论框架。有必要在心理健康护士之间就自信外展团队计划中的参与意义达成共识。摘要：简介在过去的十年中，在西班牙，在自信外展计划中工作的护士已经取代了传统的机构设置，有利于患者自身的环境。当护患互动的轴心是患者自身的环境时，与患者的互动需要不同的技能。单独的参与可能与患者护理和帮助关系的固有概念有关。然而,在个性化护理模式中，参与似乎是一种具有自身特征的工具，目的是提供精神保健。目的/问题系统地识别和评估有关精神疾病患者之间关系和参与的经验证据（精神分裂症，精神病,分裂情感障碍,情绪障碍和成人人格障碍）和护理心理健康护士。方法基于PRISMA指导的系统文献综述。结果我们确定并回顾了7项主要研究。在分析过程之后，出现了三个主题:存在不同的参与水平，在创建和巩固参与方面的培训需求和技能，和参与作为过程。讨论护士和患者的参与被理解为包含不同阶段的过程。虽然它是建立的，参与受到积极和消极影响。为了创建项目及其维护专业技能，知识和个人属性(韧性，心理社会技能,关于精神健康疾病的知识，建立有效关系的能力，适应性和解决问题)是必要的，但主要关注的是它发展的背景，由病人自己选择，例如,他的家。对实践管理员的影响可能会对自信外展团队的适当雇用实践产生疑问，因为某些技能是获得非参与过程所必需的，和员工培训应被视为一个关键问题，以提供增强参与和治疗关系的特定技能。结论参与必须被理解为一个长期的过程。为了创建接合及其维护，专业技能,知识和个人属性是必要的。
