Maintaining health: proactive client-oriented community day treatment centres for the chronic mentally ill.
Maintaining health: proactive client-oriented community day treatment centres for the chronic mentally ill.
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保持健康：积极主动、以客户为导向的慢性精神病患者社区日间治疗中心。
DOI：
10.1046/j.1365-2850.1999.00186.x
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发表时间：
1999
影响因子：
2.7
通讯作者：
L. Dean
中科院分区：
文献类型：
--
作者：
E. Yurkovich;T. Smyer;L. Dean
这项扎根理论研究比较了两个农村心理健康日间治疗中心，大天空中心和蒙大拿中心的客户对健康的定义。基于原始的扎根理论研究的七个慢性精神病/残疾客户在大天空中心（Yurkovich等人。1997年），核心变量，“防止失控”和相关属性，与蒙大拿州中心的9名居民进行了验证。虽然与以前的研究结果建立了“适合”，但这两个中心之间出现了差异。这些差异与工作人员在为慢性精神病患者提供治疗时的哲学方法有关。大天空中心的护理提供者使他们的客户能够从他们的同龄人那里学习新的行为，并承担新的角色，如新人，成员和领导者。他们还鼓励一种亲社会的态度，并通过有价值地参与治疗创造一种归属感。蒙大拿中心的客户没有能力在治疗环境中尝试新的行为，或在中心的同龄人中寻求社会支持网络，这将培养归属感。结果是，蒙大拿中心的客户比大天空中心的客户更依赖正规医疗保健系统。当今医疗保健中的竞争力量-家庭成员，心理健康提供者和保险或管理式护理提供者-很容易忽视或无法获得客户对其健康状况和维护的看法，特别是当它涉及日间治疗中心时。日间治疗中心作为一个治疗社区，需要教育过程中，创新的护理实践和以客户为中心的干预措施的重要性将进行讨论。
This grounded theory study compared the definition of health by clients of two rural mental health day treatment centres, Big Sky Centre and Montana Centre. Based on an original grounded theory study of seven chronic mentally ill/disabled clients in Big Sky Centre (Yurkovich et al. 1997), the core variable, 'preventing loss of control' and related properties, were validated with nine residents of Montana Centre. While establishing a 'fit' with previous research findings, differences emerged between these two centres. These differences related to the staffs' philosophical approaches in providing treatment to the chronic mentally ill. Big Sky Centre care providers empowered their clients to learn new behaviours from their peers and assume new roles such as newcomer, member and leader. They also encouraged a prosocial attitude, and created a sense of belonging through valued involvement in their treatment. Montana Centre clients were not empowered to try out new behaviours in the treatment environment, or seek social support networks among their peers at the centre, which would foster a sense of belonging. The result was that clients from Montana Centre relied on the formal healthcare system more often than clients from the Big Sky Centre. The competing forces in healthcare today--family members, mental health providers, and insurance or managed care providers--make it easy to lose sight of or fail to gain the client's perspective about their health status and maintenance, particularly as it concerns day treatment centres. The importance of the day treatment centre as a therapeutic community which requires educational processes, innovative nursing practice, and client-centred interventions will be discussed.