A qualitative study to investigate Swiss hospital personnel's perceived importance of and experiences with patient's mental-somatic multimorbidities.
A qualitative study to investigate Swiss hospital personnel's perceived importance of and experiences with patient's mental-somatic multimorbidities.
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DOI：
10.1186/s12888-021-03353-5
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发表时间：
2021-07-12
期刊：
影响因子：
4.4
通讯作者：
SomPsyNet Consortium
中科院分区：
文献类型：
--
作者：
Aebi NJ;Caviezel S;Schaefert R;Meinlschmidt G;Schwenkglenks M;Fink G;Riedo L;Leyhe T;Wyss K;SomPsyNet Consortium
综合医院环境中的心身多病与长期住院、频繁再住院和病程恶化有关，因此强调需要更全面地治疗医院患者。然而，要解决这些环境中的心理健康问题，还需要克服一些挑战。本研究调查了瑞士巴塞尔医院环境中医院工作人员对患者心身多重疾病的认知重要性和经验，特别考虑了医生和护士之间的差异。对瑞士巴塞尔不同医院的护士 (n = 10) 和医生 (n = 8) 进行了 18 次半结构化访谈。框架分析的归纳方法用于开发主题。数据分析得出四个主题：1）综合医院内心身多病的相关性；2）卫生专业人员管理心理健康情绪；3）治疗心身多病患者的知识和能力；4）在医院环境中处理心身多病的跨专业合作。发现综合医院患者的心身多病与所有医院专业人员相关，尽管护士的心理健康优先级更高比对医生来说。这可能是由于工作环境不同或综合医院有效的跨专业合作造成的。医生和护士都强调了处理耻辱感的困难、缺乏对精神疾病的了解、对治疗躯体疾病的重视、优先事项和工作可用性的竞争，这些都阻碍了综合医院对心身多病的充分处理。为了支持卫生专业人员将心理健康纳入工作中，综合医院内需要适当的环境，例如与患者交流的私人房间。此外，需要改变课程和继续培训，以提高对身心多重疾病的理解并减少负面刻板印象。同样，需要加强卫生专业人员之间的跨专业合作，以充分识别和治疗患有精神多病的患者。应更加注重医生提高他们在日常躯体治疗护理中考虑患者心理健康的能力。在线版本包含可在 10.1186/s12888-021-03353-5 获取的补充材料。
Mental–somatic multimorbidity in general hospital settings is associated with long hospital stays, frequent rehospitalization, and a deterioration of disease course, thus, highlighting the need for treating hospital patients more holistically. However, there are several challenges to overcome to address mental health conditions in these settings. This study investigated hospital personnel’s perceived importance of and experiences with mental–somatic multimorbidities of patients in hospital settings in Basel, Switzerland, with special consideration of the differences between physicians and nurses. Eighteen semi-structured interviews were conducted with nurses (n = 10) and physicians (n = 8) in different hospitals located in Basel, Switzerland. An inductive approach of the framework analysis was used to develop the themes. Four themes emerged from the data analysis: 1) the relevance of mental–somatic multimorbidity within general hospitals, 2) health professionals managing their emotions towards mental health, 3) knowledge and competencies in treating patients with mental–somatic multimorbidity, and 4) interprofessional collaboration for handling mental–somatic multimorbidity in hospital settings.The mental–somatic multimorbidities in general hospital patients was found to be relevant among all hospital professionals, although the priority of mental health was higher for nurses than for physicians. This might have resulted from different working environments or in efficient interprofessional collaboration in general hospitals. Physicians and nurses both highlighted the difficulties of dealing with stigma, a lack of knowledge of mental disorders, the emphasis place on treating somatic disorders, and competing priorities and work availability, which all hindered the adequate handling of mental–somatic multimorbidity in general hospitals. To support health professionals to integrate mental health into their work, proper environments within general hospitals are needed, such as private rooms in which to communicate with patients. In addition, changes in curriculums and continuing training are needed to improve the understanding of mental–somatic multimorbidities and reduce negative stereotypes. Similarly, interprofessional collaboration between health professionals needs to be strengthened to adequately identify and treat mentally multimorbid patients. A stronger focus should be placed on physicians to improve their competencies in considering patient mental health in their daily somatic treatment care. The online version contains supplementary material available at 10.1186/s12888-021-03353-5.
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