Family care for persons with severe mental illness: experiences and perspectives of caregivers in Uganda.
Family care for persons with severe mental illness: experiences and perspectives of caregivers in Uganda.
复制标题
DOI：
10.1186/s13033-021-00470-2
复制
发表时间：
2021-05-20
影响因子：
3.6
通讯作者：
Cappo D
中科院分区：
文献类型：
--
作者：
Verity F;Turiho A;Mutamba BB;Cappo D
在社会保护支持有限的低收入环境中，家庭必然是提供照顾和支持的关键资源。矛盾的是，对严重精神疾病患者的家庭护理质量一直与支持康复、住院逾期和可预防的再入院联系在一起。本研究探讨了低收入国家乌干达坎帕拉国立精神病院PLSMI患者家属的护理经验。开展这项研究的目的是为YouBelongHome （YBH）的发展提供信息，这是一项由乌干达注册非政府组织YouBelong Uganda （YBU）实施的社区心理健康干预措施。对坎帕拉布塔比卡国家转诊精神病院（BNRMH）康复病房准备出院病人的护理人员组成的10个焦点小组的定性数据进行了分析。这是2017年为YouBelong乌干达开展的一项混合方法基线研究的数据子集，该研究旨在探索乌干达瓦基索和坎帕拉地区PLSMI的再入院率和社区支持。在定性分析中出现了三个相互关联的主题：由PLSMI的护理人员提供的一系列直接的，实际的护理，情感家庭动态，以及护理的社会和文化背景。家庭照顾的角色是多方面的、具有挑战性的和不断变化的。它包括在污名化和歧视以及难以获得和使用循证药物可能导致的挑战性行为的背景下，保护PLSMI不受伤害和滥用。人们依赖传统治疗师和信仰治疗师，他们反映了不同的信仰体系和寻求健康的行为，而不是医疗保健。前往卫生设施的交通阻碍了获得家庭护理系统以外的帮助。支撑这些经验的是低经济资源的影响。在乌干达，家庭支持可以成为PLSMI心理健康康复的关键资源和积极因素。实施切实可行的面向家庭的心理健康干预措施需要有文化意识。这应基于对动态家庭关系的理解、对将其置于精神环境中的严重精神疾病的文化理解、不同的家庭形式、照料做法和挑战以及社区态度。在乌干达的情况下，有限的（精神）卫生系统基础设施以及获得药物和服务的障碍，如经济和运输障碍，加剧了这些复杂性。
In low-income settings with limited social protection supports, by necessity, families are a key resource for care and support. Paradoxically, the quality of family care for people living with Severe Mental Illness (PLSMI) has been linked to support for recovery, hospital overstay and preventable hospital readmissions. This study explored the care experiences of family members of PLSMI with patients at the national mental hospital in Kampala, Uganda, a low income country. This study was undertaken to inform the development of YouBelongHome (YBH), a community mental health intervention implemented by YouBelong Uganda (YBU), a registered NGO in Uganda. Qualitative data was analysed from 10 focus groups with carers of ready to discharge patients on convalescent wards in Butabika National Referral Mental Hospital (BNRMH), Kampala. This is a subset of data from a mixed methods baseline study for YouBelong Uganda, undertaken in 2017 to explore hospital readmissions and community supports for PLSMI from the Wakiso and Kampala districts, Uganda. Three interrelated themes emerge in the qualitative analysis: a range of direct, practical care provided by the caregiver of the PLSMI, emotional family dynamics, and the social and cultural context of care. The family care giving role is multidimensional, challenging, and changing. It includes protection of the PLSMI from harm and abuse, in the context of stigma and discrimination, and challenging behaviours that may result from poor access to and use of evidence-based medicines. There is reliance on traditional healers and faith healers reflecting alternative belief systems and health seeking behaviour rather than medicalised care. Transport to attend health facilities impedes access to help outside the family care system. Underpinning these experiences is the impact of low economic resources. Family support can be a key resource and an active agent in mental health recovery for PLSMI in Uganda. Implementing practical family-oriented mental health interventions necessitates a culturally aware practice. This should be based in understandings of dynamic family relationships, cultural understanding of severe mental illness that places it in a spiritual context, different family forms, caregiving practices and challenges as well as community attitudes. In the Ugandan context, limited (mental) health system infrastructure and access to medications and service access impediments, such as economic and transport barriers, accentuate these complexities.
登录
查看更多内容
影响因子：
4.4
作者：
Kalseth J;Lassemo E;Wahlbeck K;Haaramo P;Magnussen J
通讯作者：
Magnussen J
影响因子：
2.3
作者：
Chronister, Julie;Chou, Chih-Chin;Liao, Hsin-Ya
通讯作者：
Liao, Hsin-Ya
影响因子：
3.6
作者：
Abbo, Catherine;Ekblad, Solvig;Musisi, Seggane
通讯作者：
Musisi, Seggane
影响因子：
4.6
作者：
Rosenfarb, IS;Bellack, AS;Aziz, N
通讯作者：
Aziz, N
影响因子：
5.8
作者：
Davidson, L;Chinman, M;Tebes, JK
通讯作者：
Tebes, JK