mental health workers

精神卫生工作者
  • 文章类型: Journal Article
    正在进行的以色列-哈马斯战争给本已紧张的工作场所的精神卫生工作者带来了额外的挑战。这项研究的重点是共同的创伤现实对精神卫生工作者的心理影响,源于以色列-哈马斯战争。在暴露于2023年10月7日的恐怖袭击和这一事件后的战争爆发一个月后,147名精神卫生工作者完成了关于人口统计学等各种变量的问卷,焦虑症状,急性应激症状,媒介诱发的继发性创伤,个人韧性,国家复原力(NR),创伤后成长(PTG)。研究发现,曾有过创伤的精神卫生工作者表现出更高的焦虑症状,急性应激症状,和媒体诱发的继发性创伤。此外,急性应激和焦虑与媒体诱发的继发性创伤呈正相关。宗教信仰,个人韧性,发现NR与较低的焦虑和急性应激症状有关。宗教信仰也与个人韧性呈正相关,NR,和PTG。与其他精神卫生工作者相比,与创伤幸存者和疏散人员一起工作的精神卫生工作者的PTG更高。在精神卫生工作者中,不良反应和适应性反应均很明显。虽然预计会有创伤性压力,个人,专业,NR因素可能会减轻其影响。提供培训,社会支持,受管制的媒体曝光,压力管理,以意义为中心的应对策略可以帮助保护工人的福祉。
    The ongoing Israel-Hamas war is posing additional challenges for mental health workers in an already stressful workplace. This study centres on the psychological effects of the shared traumatic reality on mental health workers, arising from the Israel-Hamas war. One month after exposure to the terrorist attack of 7 October 2023 and the outbreak of war following this event, 147 mental health workers completed questionnaires regarding a variety of variables such as demographics, anxiety symptoms, acute stress symptoms, media-induced secondary trauma, personal resilience, National resilience (NR), and post-traumatic growth (PTG). The study found that mental health workers with previous trauma displayed higher anxiety symptoms, acute stress symptoms, and media-induced secondary trauma. Additionally, acute stress and anxiety were positively correlated with media-induced secondary trauma. Religiosity, personal resilience, and NR were found associated with lower anxiety and acute stress symptoms. Religiosity was also positively correlated with personal resilience, NR, and PTG. The PTG of mental health workers working with trauma survivors and evacuees was higher compared to that of other mental health workers. Both adverse and adaptive reactions were evident among mental health workers. While traumatic stress is expected, individual, professional, and NR factors may mitigate its effects. Providing training, social support, regulated media exposure, stress management, and meaning-focused coping strategies can help safeguard workers\' well-being.
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  • 文章类型: Journal Article
    法医患者针对工作人员的越轨行为经常发生,导致有害的心理和身体伤害,强调预防措施的紧迫性。这些事件,在治疗关系中出现,涉及患者和员工行为之间的复杂互动。本研究旨在根据事件特征,如影响,严重程度,(推定)原因,类型的侵略,和后果,使用潜在类分析(LCA)。此外,基于员工的事件集群的变化,病人,并对背景特征进行了调查。共发生1184起侵犯事件,由工作人员报告,并在2018-2022年间由患者针对工作人员,是从Fivoor的数字事件报告系统中提取的,荷兰法医精神病保健组织.潜在类别分析揭示了六个事件类别:1)低冲击力的言语攻击;2)中等冲击力的言语攻击;3)中等冲击力的身体攻击;4)中等冲击力的言语威胁/攻击;5)具有高冲击力的身体攻击;6)具有高冲击力的言语和身体威胁/攻击。工作人员和患者的年龄和性别存在显着差异,工作人员职能,在这些类别中观察到患者诊断。影响较大的事件在高安全诊所更为普遍,而影响较低的事件在智障患者的诊所中更为常见。尽管有诸如信息缺失之类的限制,由于患者之间不同类型的侵犯事件,需要量身定制的预防方法,工作人员,和单位。
    Transgressive incidents directed at staff by forensic patients occur frequently, leading to detrimental psychological and physical harm, underscoring urgency of preventive measures. These incidents, emerging within therapeutic relationships, involve complex interactions between patient and staff behavior. This study aims to identify clusters of transgressive incidents based on incident characteristics such as impact, severity, (presumed) cause, type of aggression, and consequences, using latent class analysis (LCA). Additionally, variations in incident clusters based on staff, patient, and context characteristics were investigated. A total of 1,184 transgressive incidents, reported by staff and targeted at staff by patients between 2018-2022, were extracted from a digital incident reporting system at Fivoor, a Dutch forensic psychiatric healthcare organisation. Latent Class Analysis revealed six incident classes: 1) verbal aggression with low impact; 2) verbal aggression with medium impact; 3) physical aggression with medium impact; 4) verbal menacing/aggression with medium impact; 5) physical aggression with high impact; and 6) verbal and physical menacing/aggression with high impact. Significant differences in age and gender of both staff and patients, staff function, and patient diagnoses were observed among these classes. Incidents with higher impact were more prevalent in high security clinics, while lower-impact incidents were more common in clinics for patients with intellectual disabilities. Despite limitations like missing information, tailored prevention approaches are needed due to varying types of transgressive incidents across patients, staff, and units.
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  • 文章类型: Journal Article
    目的:这项研究旨在检查(a)在COVID-19大流行的三个时间点护士的应对策略和替代创伤后成长(VPTG)的变化;(b)具有独特应对特征的离散护士群体,以及(c)这些应对特征与VPTG在各个时间点之间的关联。
    背景:虽然关于医疗专业人员大流行对心理健康的负面影响的文献很多,对护士的积极后果知之甚少,他们使用的应对策略,以及这些如何随着时间的推移而变化。
    方法:这是一项基于网络的横断面调查,在大流行期间的三个时间点。
    方法:429名护士在网上完成了创伤后成长量表(PTGI)和简要应对问题量表(COPE),以测量替代创伤后成长(VPTG)和应对策略,分别。使用STROBE检查表报告本研究。
    结果:在第三个时间点观察到明显更高的VPTG评分。在三个时间点采用不同的应对策略。护士对这一流行病的反应要么是积极的,回避者或被动应对者。与被动概况相比,主动概况的护士报告的VPTG水平明显更高,而积极型和回避型之间的差异并不显著。
    结论:尽管护士在实现高VPTG方面具有积极应对的优势,回避型copers比被动型copers有更多的收益(VPTG),建议做一些事情来应对压力源-让它试图避免它-比什么都不做要好。
    结论:确定护士之间不同的应对情况及其与VPTG的关联对于政策制定者和从业人员在制定量身定制的预防和干预措施以帮助护士有效地管理大流行的需求特别有用。
    没有患者或公众贡献,因为该研究是由作者独家进行的。
    OBJECTIVE: This study aimed to examine (a) changes in coping strategies and vicarious post-traumatic growth (VPTG) across three timepoints of the COVID-19 pandemic among nurses; (b) discrete groups of nurses with unique coping profiles and (c) the association of these coping profiles with VPTG across the timepoints.
    BACKGROUND: Although literature abounds with the negative mental health consequences of the pandemic among healthcare professionals, much less is known about the positive consequences on nurses, the coping strategies that they use, and how these change over time.
    METHODS: This was a cross-sectional web-based survey at three timepoints during the pandemic.
    METHODS: A sample of 429 nurses completed online the Post-Traumatic Growth Inventory (PTGI) and the Brief Coping Orientation to Problems Experienced Inventory (COPE) to measure vicarious post-traumatic growth (VPTG) and coping strategies, respectively. The STROBE checklist was used to report the present study.
    RESULTS: Significantly higher VPTG scores were observed during the third timepoint. Different coping strategies were employed across the three timepoints. Nurses responded to the pandemic either with an active, an avoidant or a passive coping profile. Significantly higher VPTG levels were reported by the nurses of the active profile compared to those of the passive profile, whereas the difference between active and avoidant profiles was not significant.
    CONCLUSIONS: Notwithstanding the preponderance of the nurses with the active coping profile in achieving high VPTG, the avoidant copers had more gains (VPTG) than the passive copers, suggesting that doing something to cope with the stressor-let it be trying to avoid it-was better than doing nothing.
    CONCLUSIONS: The identification of distinct coping profiles among nurses and their association with VPTG is of particular use to policymakers and practitioners in developing tailored prevention and intervention efforts to help the nurses effectively manage the demands of the pandemic.
    UNASSIGNED: No patient or public contribution since the study was exclusively conducted by the authors.
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  • 文章类型: Journal Article
    背景:精神卫生工作者(MHW)在执行与提供精神卫生服务有关的任务时,每天都会面临能力冲突。这可能与缺乏对他们作为护理人员和提供者的任务的理解有关。此外,在大多数低收入环境中,目前尚不清楚如何组织和协调现有服务以提供精神卫生保健.为了理解上述内容,本研究旨在确定刚果民主共和国(DRC)城市地区目前的精神卫生保健服务组合.
    方法:于2021年2月至4月在卢本巴希进行了一项定性的描述性研究。我们与74名关键线人(家庭成员,初级保健医生,等。)和13次与关键线人(传统治疗师,精神病医生,等。).我们进行了定性的内容分析,在分析框架的指导下,这导致了从家庭层面到专门设施的全面MHW清单的发展,探索他们在护理交付中的任务,识别现有服务,并定义他们当前的组织。
    结果:对FGD和IDI转录本的分析表明,传统的治疗师和家庭护理人员是卢本巴希的主要提供者。对MHW执行的任务的探索揭示了生活方式,传统疗法,心理治疗,和药物是向患者提供/建议的主要护理类型。活跃的非正式护理人员目前不提供与其能力相对应的护理。现有的罕见精神卫生专家目前不承认初级保健提供者和非正式护理人员在护理提供中的任务,他们的贡献被认为是微不足道的。我们确定了五种类型的服务:非正式服务,传统治疗服务,社会服务,初级保健服务,和精神病服务。分析指出了这些服务的理想组合的倒置。
    结论:我们的研究结果表明,心理健康服务的组合并不理想,并指出MHW之间明显缺乏合作。迫切需要明确定义MHW的任务,建立非专业人士的能力,将心理健康相关的任务转移给他们,并提高对协作护理方法的认识。
    BACKGROUND: Mental health workers (MHWs) are exposed to conflicts of competence daily when performing tasks related to the provision of mental health services. This may be linked to a lack of understanding of their tasks as caregivers and providers. Furthermore, in most low-income settings, it is unclear how the available services are organized and coordinated to provide mental health care. To understand the above, this study aimed to identify the current mix of services for mental health care in the urban Democratic Republic of the Congo (DRC).
    METHODS: A qualitative descriptive study was carried out in Lubumbashi from February to April 2021. We conducted 7 focus group discussions (FGDs) with 74 key informants (family members, primary care physicians, etc.) and 13 in-depth interviews (IDIs) with key informants (traditional healers, psychiatrists, etc.). We performed a qualitative content analysis, guided by an analytical framework, that led to the development of a comprehensive inventory of MHWs from the household level to specialized facilities, exploring their tasks in care delivery, identifying existing services, and defining their current organization.
    RESULTS: Analysis of transcripts from the FGDs and IDIs showed that traditional healers and family caregivers are the leading providers in Lubumbashi. The exploration of the tasks performed by MHWs revealed that lifestyle, traditional therapies, psychotherapy, and medication are the main types of care offered/advised to patients. Active informal caregivers do not currently provide care corresponding to their competencies. The rare mental health specialists available do not presently recognize the tasks of primary care providers and informal caregivers in care delivery, and their contribution is considered marginal. We identified five types of services: informal services, traditional therapy services, social services, primary care services, and psychiatric services. Analyses pointed out an inversion of the ideal mix of these services.
    CONCLUSIONS: Our findings show a suboptimal mix of services for mental health and point to a clear lack of collaboration between MHWs. There is an urgent need to clearly define the tasks of MHWs, build the capacity of nonspecialists, shift mental health-related tasks to them, and raise awareness about collaborative care approaches.
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  • 文章类型: Journal Article
    背景:由于报告的压力和倦怠率不断上升,精神卫生专业人员的幸福感越来越受到关注。先前的研究表明,由于临床负荷,精神卫生工作者(MHW)的生活质量风险增加,薪资问题,缺乏工作以外的自我保健活动的时间。缺乏关于MHW健康的研究(即,心理学研究生,学术教师,精神病医生,和心理健康顾问)及其与工作场所环境的关系。这项研究调查了影响参与者社交的工作相关因素,情感,和职业幸福。
    方法:参与者通过专业组织的列表员招募,并回答有关其心理健康的问题(广泛性焦虑症-7和患者健康问卷-9),支持系统(感知社会支持的多维尺度),和三个定性问题,关于他们喜欢什么或发现什么挑战他们的工作和任何障碍,从事自我保健活动。
    结果:对定性问题和描述性统计进行了归纳定性分析,为其定性回答提供了背景。
    结论:机构可以通过创建网点来教授员工自我保健策略并在工作中实践这些策略来更好地支持员工。
    The well-being of mental health professionals has been of growing concern due to the increasing rates of reported stress and burnout. Previous research suggests that the quality of life for mental health workers (MHWs) is at an increased risk due to clinical load, salary concerns, and lack of time for self-care activities outside of work. There is a lack of research regarding the wellness of MHWs (i.e., psychology graduate students, academic faculty, psychiatrists, and mental health counselors) and its relation to the workplace environment. This study examined job-related factors that impacted participants\' social, emotional, and professional well-being.
    Participants were recruited via professional organization listservs and answered questions about their psychological health (Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9), support systems (Multidimensional Scale of Perceived Social Support), and three qualitative questions about what they enjoy or find challenging about their work and any barriers to engaging in self-care activities.
    An inductive qualitative analysis of the qualitative questions and descriptive statistics are presented to provide context for their qualitative responses.
    Institutions can better support their workers by creating outlets to teach their staff self-care strategies and practice these strategies at work.
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  • 文章类型: News
    除了COVID-19大流行期间爆发的健康危机之外,俄罗斯和乌克兰之间的战争正在以负面的方式影响罗马尼亚人口的心理健康和福祉。
    这项研究旨在调查与俄罗斯和乌克兰之间的武装冲突有关的社交媒体消费和大量信息对罗马尼亚人传播假新闻的影响。此外,它探索了几种心理特征,包括韧性,一般健康,感知压力,应对策略,和对战争的恐惧,作为暴露于创伤事件或与战争受害者互动的函数。
    参与者(N=633)完成了一般健康问卷(GHQ),CERQ量表及其九个分量表,感知压力量表(PSS),和BRS量表(简短弹性量表),最后一个衡量韧性的指标。信息过载,通过调整与这些变量相关的项目,评估了信息紧张和相关人员传播假新闻的可能性。
    我们的结果表明,信息应变部分缓和了信息过载与传播虚假信息的趋势之间的关系。此外,它们表明,信息紧张部分缓和了网上花费的时间和传播虚假信息的趋势之间的关系。此外,我们的发现表明,在对战争的恐惧和应对策略方面,与难民一起工作的人与没有工作的人之间存在高度和中度的差异。我们发现两组在一般健康方面没有实际差异,韧性和感知压力的水平。
    讨论了发现人们分享虚假信息的原因的重要性,需要采取策略来打击这种行为,包括信息图表和旨在教人们如何检测假新闻的游戏。同时,需要进一步支持援助人员,以维持高水平的心理健康。
    UNASSIGNED: In addition to the health crisis that erupted during the COVID-19 pandemic, the war between Russia and Ukraine is impacting the mental health and wellbeing of the Romanian population in a negative way.
    UNASSIGNED: This study sets out to investigate the impact that social media consumption and an overload of information related to the armed conflict between Russia and Ukraine is having on the distribution of fake news among Romanians. In addition, it explores the way in which several psychological features, including resilience, general health, perceived stress, coping strategies, and fear of war, change as a function of exposure to traumatic events or interaction with victims of war.
    UNASSIGNED: Participants (N = 633) completed the General Health Questionnaire (GHQ), the CERQ scale with its nine subscales, the Perceived Stress Scale (PSS), and the BRS scale (Brief Resilience Scale), the last of which measures resilience. Information overload, information strain and the likelihood of the person concerned spreading fake news were assessed by adapting items related to these variables.
    UNASSIGNED: Our results suggest that information strain partially moderates the relationship between information overload and the tendency to spread false information. Also, they indicate that information strain partially moderates the relationship between time spent online and the tendency to spread false information. Furthermore, our findings imply that there are differences of high and moderate significance between those who worked with refugees and those who did not as regards fear of war and coping strategies. We found no practical differences between the two groups as regards general health, level of resilience and perceived stress.
    UNASSIGNED: The importance of discovering the reasons why people share false information is discussed, as is the need to adopt strategies to combat this behavior, including infographics and games designed to teach people how to detect fake news. At the same time, aid workers need to be further supported to maintain a high level of psychological wellbeing.
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  • 文章类型: Journal Article
    背景边缘性人格障碍(BPD)是一种以情绪不稳定为特征的精神疾病。在一般人群中,其患病率可高达1.8%。精神卫生工作者(MHW)对该疾病的知识不足和负面看法会影响患者的护理及其寻求帮助的行为。本研究旨在探讨MHW对BPD的知识和态度。方法对沙特阿拉伯(SA)五个地区的MHW进行了横断面研究,使用评估知识的问卷,态度,和关于BPD的培训。结果从1028家MHW收集的数据显示出良好的知识水平。在女性中观察到了优越的知识,中部地区的居民,医师,那些接受过特定BPD培训的人,以及与BPD患者有更多经验和频繁互动的MHW。参与者对识别有中等到较高的感知知识和信心,评估,和BPD患者的管理。本科培训计划是有关该疾病的最新信息来源。虽然66%的参与者承认他们发现与BPD患者打交道更加困难,并且认为患者管理不足,71%的人愿意参加进一步的BPD培训。结论SA中MHW对BPD有中等认识,但对BPD有负面认识;需要进行专门的培训以改善对BPD患者的护理。
    Background Borderline personality disorder (BPD) is a mental illness characterized by emotional instability. Its prevalence can be as high as 1.8% among the general population. Poor knowledge and negative perceptions of the disorder by mental health workers (MHWs) can affect patients\' care and their help-seeking behavior. This study aims to explore MHW\'s knowledge and attitudes toward BPD. Method A cross-sectional study was conducted on MHWs across the five regions of Saudi Arabia (SA) using a questionnaire that assessed knowledge, attitude, and training regarding BPD. Results  Data collected from 1028 MHWs showed a good knowledge level. Superior knowledge was observed among females, residents in the central region, physicians, those who received specific BPD training, and MHWs who had more experience and frequent interactions with BPD patients. Participants had moderate to high levels of perceived knowledge and confidence regarding the identification, assessment, and management of BPD patients. Undergraduate training programs were the most reported source of information on the disorder. While 66% of participants admitted that they find dealing with BPD patients more difficult and thought patient management was inadequate, 71% were willing to attend further BPD training. Conclusion MHWs in SA have moderate knowledge of but negative perceptions of BPD; specific training is needed to improve the care provided for BPD patients.
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  • 文章类型: Journal Article
    COVID-19的限制促使苏格兰精神卫生部门迅速适应服务提供和新的工作方式。这项研究探讨了精神卫生工作者(MHW)远程提供服务的经验。二十名与会者,在COVID-19大流行期间,他曾在苏格兰国家卫生服务机构(NHS)的精神卫生专业工作,参加了在线半结构化面试。转录数据,然后使用归纳主题分析进行分析。报告了两个主要主题:(1)“提高MHW和服务用户的灵活性”和(2)“远程治疗挑战治疗边界”。关于(1)虚拟平台被认为在整个COVID-19大流行期间对维持患者护理至关重要,并且是服务用户(SU)的宝贵资源,这些服务用户以前在访问面对面服务时曾因流动性或社交焦虑而苦苦挣扎。一些MHW还指出了其生产力和舒适度的好处。关于(2)MHW强调,在家中进行远程治疗的同时,工作与生活的界限变得模糊,在某些情况下,通常,舒适的空间与SU讨论的创伤性内容有关。这些压力源似乎因MHW的隔离而加剧,因为他们不太能够利用同事的支持。Further,保密性不能保证,因为MHW和SU都必须容纳他们的家庭成员。这些发现突出了MHW在适应心理健康工作实践的快速变化方面的重要见解,特别是关于交付质量的挑战,安全和公平的服务以及越来越多地使用远程治疗。这些见解对于在一系列医疗保健环境和寻求采用精神卫生服务提供混合模式的国家中告知服务发展和支持未来大流行准备至关重要。
    COVID-19 restrictions drove rapid adaptations to service delivery and new ways of working within Scotland\'s mental health sector. This study explores mental health workers\' (MHWs\') experiences of delivering their services remotely. Twenty participants, who had worked in mental health professions in the National Health Service (NHS) in Scotland throughout the COVID-19 pandemic, took part in online semi-structured interviews. Data was transcribed then analysed using an inductive thematic analysis. Two major themes are reported: (1) \'Improved Flexibility for both MHWs and Service Users\' and (2) \'Teletherapies Challenge Therapeutic Boundaries\'. In relation to (1) virtual platforms were seen as vital in maintaining patient care throughout the COVID-19 pandemic and a valuable resource for service users (SUs) who had previously struggled with mobility or social anxieties when accessing face-to-face services. Some MHWs\' also noted benefits for their productivity and comfort. Regarding (2) MHWs highlighted that whilst conducting teletherapies from home, work-life boundaries became blurred and, in some instances, typically comforting spaces became associated with the traumatic content discussed by SUs. These stressors seemed to be compounded by MHWs\' isolation, as they were less able to draw upon their colleagues for support. Further, confidentiality could not be assured, as MHWs and SUs alike had to accommodate their family members. These findings highlight important insights from MHWs in adapting to rapid changes in mental health working practices, particularly in relation to the challenges of delivering quality, safe and equitable services and the increased use of teletherapies. Such insights are vital in informing service developments and supporting future pandemic preparedness across a range of healthcare contexts and countries seeking to adopt hybrid models of mental health service delivery.
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  • 文章类型: Journal Article
    由于受影响的心理健康,患有精神疾病的人经历了巨大的性健康和生殖健康挑战。全球范围内,精神疾病的患病率呈上升趋势,随之而来的是有性和生殖挑战的人数增加,需要紧急公共卫生干预.然而,关于精神卫生工作者的看法和经验的信息,该人群的主要卫生保健提供者普遍缺乏,但对于制定适当的政策和公共卫生干预措施至关重要。
    探讨乌干达精神卫生保健工作者对乌干达精神疾病患者的性健康和生殖健康的看法和经验,以便向卫生部提出如何改善这种状况的建议。
    采用定性研究设计,利用电话半结构化的深入访谈,从乌干达国家精神转诊医院的14名精神卫生工作者那里收集数据,Butabika.进行了针对性的抽样和便利招募,并使用主题内容分析对收集的数据进行了分析。
    产生了四个主题,其中包括具有正常性需求的精神疾病患者,精神疾病对性行为和人际关系的影响,保护精神病患者性行为的做法,以及在精神病院提供性健康和生殖健康服务时遇到的障碍。
    患有精神疾病的人经历了大量的性健康和生殖健康挑战,需要公共卫生干预。然而,将性健康和生殖健康服务整合到精神病院尚未成功,使精神病患者仍然面临未解决的健康挑战。因此,应制定和执行政策,以确保在所有精神卫生服务提供点成功地融合性健康和生殖健康。
    People with Mental Illness experience vast sexual and reproductive health challenges due to the affected mental health. Globally, prevalence of mental illness is on the rise with subsequent increase in the number of people with sexual and reproductive challenges warranting urgent public health intervention. However, information on the perceptions and experiences of mental health workers, the key health care providers for this population is generally lacking yet it\'s essential for formulation of appropriate policies and public health interventions.
    To explore Ugandan mental health care worker\'s perspectives and experiences on the sexual and reproductive health of people living with mental illness in Uganda in order to generate recommendations to the ministry of health on how it can be improved.
    Qualitative study design was employed with utilization of phone call semi-structured in-depth interviews to collect data from 14 mental health workers from Uganda\'s National mental referral hospital, Butabika. Purposive sampling and convenience recruitment was done and the collected data was analyzed using Thematic content analysis.
    Four themes were generated which included people with Mental illness having normal sexual needs, mental illness effect on sexuality and relationships, practices for safeguarding sexuality of people with mental illness and the barriers encountered in the provision of sexual and reproductive health services at a mental hospital.
    People with mental illness experience a multitude of sexual and reproductive health challenges that need public health interventions. However, the integration of sexual and reproductive health services in a mental hospital are not yet successful making people with mental illness to remain with unaddressed health challenges. Policies should therefore be developed and implemented to ensure successful integration of sexual and reproductive health at all mental health service care provision points.
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  • 文章类型: Journal Article
    同行支持越来越被认为是世界各地精神卫生服务不可或缺的一部分。然而,大多数关于同行支持的研究来自高收入国家,很少关注不同设置之间的异同,以及它们如何影响实施。精神卫生工作者在将正式的同伴支持纳入法定服务方面可以发挥重要作用,他们对同伴支持的态度可能代表成功实施的障碍或促进者。因此,这项研究调查了精神卫生工作者对一系列高(德国,以色列),中间-(印度),和低收入国家(坦桑尼亚,乌干达)设置。
    在乌尔姆和汉堡(德国)进行了六个焦点小组,Butabika(乌干达),达累斯萨拉姆(坦桑尼亚),是舍瓦(以色列),还有Ahmedabad,古吉拉特邦(印度),共有35人参加。使用主题内容分析对成绩单进行分析。
    研究中心的参与者对精神卫生保健中的同伴支持表现出总体积极态度,尽管有人对同伴支持的潜在有害影响提出了一些担忧,例如负面的角色建模和向服务用户提供的建议不足。值得注意的是,来自低收入和中等收入国家的精神卫生工作者将同伴支持工作者描述为桥梁建设者,并强调同伴支持的共同利益。精神卫生工作者对同伴支持工作者的角色和角色边界的看法在各个站点之间有所不同。在某些设置中,精神卫生工作者强烈同意角色明确的必要性,而在其他人中,精神卫生工作者表达了不同的观点,有些人更喜欢模糊的角色界限。关于合作,精神卫生工作者将同伴支持工作者描述为支持者和利用者,平等的伙伴或强调需要信任和承诺。
    精神卫生工作者对同伴支持工作者的态度总体上是积极的,但它们也因当地情况而异,与同行支持的资源和以前的经验。这影响了他们对同伴支持工作者角色的概念,角色清晰,和合作。这项研究表明,调和对本地适应的需求和维护同伴支持的核心价值是必要的,也是可能的。特别是在全球范围内加速实施以恢复为导向的干预措施,如同伴支持。
    Peer support is increasingly acknowledged as an integral part of mental health services around the world. However, most research on peer support comes from high-income countries, with little attention to similarities and differences between different settings and how these affect implementation. Mental health workers have an important role to play in integrating formal peer support into statutory services, and their attitudes toward peer support can represent either a barrier to or facilitator of successful implementation. Thus, this study investigates mental health workers\' attitudes toward peer support across a range of high- (Germany, Israel), middle- (India), and low-income country (Tanzania, Uganda) settings.
    Six focus groups were conducted in Ulm and Hamburg (Germany), Butabika (Uganda), Dar es Salaam (Tanzania), Be\'er Sheva (Israel), and Ahmedabad, Gujarat (India) with a total of 35 participants. Transcripts were analyzed using thematic content analysis.
    Participants across the study sites demonstrated overall positive attitudes towards peer support in mental health care, although some concerns were raised on potentially harmful effects of peer support such as negative role modelling and giving inadequate advice to service users. Notably, mental health workers from low- and middle-income countries described peer support workers as bridge-builders and emphasized the mutual benefits of peer support. Mental health workers\' views on peer support workers\' roles and role boundaries differed between sites. In some settings, mental health workers strongly agreed on the need for role clarity, whereas in others, mental health workers expressed mixed views, with some preferring blurred role boundaries. Regarding collaboration, mental health workers described peer support workers as supporters and utilizers, equal partners or emphasized a need for trust and commitment.
    Mental health workers\' attitudes toward peer support workers were positive overall, but they also varied depending on local context, resources and previous experiences with peer support. This affected their conceptions of peer support workers\' roles, role clarity, and collaboration. This study demonstrated that reconciling the need for local adaptations and safeguarding the core values of peer support is necessary and possible, especially when the implementation of recovery-oriented interventions such as peer support is accelerating worldwide.
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