PDF(Pubmed)
Abstract：
BACKGROUND: In recognition of the burden of Perinatal Mental Health problems, NHS England invested £365 million to transform women\'s access to mental health care, including investment in Community Perinatal Mental Health Services. This study examined how elements of provider care affected women\'s engagement with these services.
METHODS: Semi-structured interviews were conducted with 139 women and explored their experiences of care from 10 different Community Perinatal Mental Health Teams; including which service components participants believed made a difference to their initial and continued engagement. Realist analysis was used to create context-mechanism-outcome configurations (CMOCs) across interviews, since not all parts of the configurations were always articulated within singular interviews.
RESULTS: Four key pillars for engagement were identified: perinatal competence, relationship building, accurate reassurance, and reliability. The way perinatal competencies were relayed to women mattered; compassion, understanding and consistency were critical interactional styles. The extent to which these factors affected women\'s engagement varied by their context and personal characteristics.
CONCLUSIONS: As mental health problems increase, disproportionately affecting vulnerable populations, it is critical to continue to ensure support is not only available, but appropriately meets the needs of those individuals. Our findings suggest that key staff behaviours applied at the right time can support women\'s engagement and potentially contribute to better treatment outcomes.
METHODS: Semi-structured interviews were conducted with 139 women and explored their experiences of care from 10 different Community Perinatal Mental Health Teams; including which service components participants believed made a difference to their initial and continued engagement. Realist analysis was used to create context-mechanism-outcome configurations (CMOCs) across interviews, since not all parts of the configurations were always articulated within singular interviews.
RESULTS: Four key pillars for engagement were identified: perinatal competence, relationship building, accurate reassurance, and reliability. The way perinatal competencies were relayed to women mattered; compassion, understanding and consistency were critical interactional styles. The extent to which these factors affected women\'s engagement varied by their context and personal characteristics.
CONCLUSIONS: As mental health problems increase, disproportionately affecting vulnerable populations, it is critical to continue to ensure support is not only available, but appropriately meets the needs of those individuals. Our findings suggest that key staff behaviours applied at the right time can support women\'s engagement and potentially contribute to better treatment outcomes.
摘要：
背景：认识到围产期心理健康问题的负担，NHS英格兰投资3.65亿英镑改变妇女获得精神保健的机会，包括对社区围产期心理健康服务的投资。这项研究调查了提供者护理的要素如何影响女性对这些服务的参与。
方法：对139名妇女进行了半结构化访谈，并从10个不同的社区围产期心理健康小组中探讨了她们的护理经验；包括参与者认为哪些服务成分对她们的初始和持续参与产生了影响。现实主义分析用于在访谈中创建上下文-机制-结果配置(CMOC)，因为并不是所有的部分配置总是在单一的采访中表达。
结果：确定了参与的四个关键支柱：围产期能力，关系建设,准确的保证，和可靠性。围产期能力传递给女性的方式很重要；同情心，理解和一致性是关键的互动风格。这些因素影响女性参与的程度因其背景和个人特征而异。
结论：随着心理健康问题的增加，不成比例地影响弱势群体，至关重要的是，继续确保支持不仅可用，但适当地满足了这些人的需求。我们的研究结果表明，在正确的时间应用关键员工的行为可以支持女性的参与，并可能有助于更好的治疗结果。
方法：对139名妇女进行了半结构化访谈，并从10个不同的社区围产期心理健康小组中探讨了她们的护理经验；包括参与者认为哪些服务成分对她们的初始和持续参与产生了影响。现实主义分析用于在访谈中创建上下文-机制-结果配置(CMOC)，因为并不是所有的部分配置总是在单一的采访中表达。
结果：确定了参与的四个关键支柱：围产期能力，关系建设,准确的保证，和可靠性。围产期能力传递给女性的方式很重要；同情心，理解和一致性是关键的互动风格。这些因素影响女性参与的程度因其背景和个人特征而异。
结论：随着心理健康问题的增加，不成比例地影响弱势群体，至关重要的是，继续确保支持不仅可用，但适当地满足了这些人的需求。我们的研究结果表明，在正确的时间应用关键员工的行为可以支持女性的参与，并可能有助于更好的治疗结果。
