Peoples' understandings of a primary care-based mental health self-help clinic
Peoples' understandings of a primary care-based mental health self-help clinic
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DOI：
10.1016/s0738-3991(03)00114-9
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发表时间：
2004-04-01
影响因子：
3.5
通讯作者：
Richards, D
中科院分区：
文献类型：
--
作者：
Rogers, A;Oliver, D;Richards, D
自助方案越来越多地被提倡作为管理心理健康问题的一种手段。这项定性研究探讨了病人的理解使用英国初级保健为基础的自助诊所（由护士促进）。作为对诊所进行更广泛评估的一部分，对诊所用户进行了有目的的子样本的深入访谈。数据表明，人们将他们的问题理解为失去了科普能力，诊所的基本精神与通过激励患者重新建立和保持对日常生活的控制来恢复应对感非常匹配。然而，一些病人经历了先前的期望和自助诊所的实际使用之间的不和谐感。如果事先不熟悉自助，让病人参与改变的机制可能是困难的。一些患者期望得到正式的咨询，并受到他们以前的服务经验和在转诊时与全科医生讨论的影响。在患者意识到自助材料是改变的关键机制之前，需要时间和积极参与。病人可以从信息和转诊过程中受益，这强调了自我效能的中心地位，病人在转诊前是“变革推动者”。(C)2003爱思唯尔科学爱尔兰有限公司保留所有权利。
Self-help programmes are increasingly advocated as a means of managing mental health problems. This qualitative study explored patients' understandings of the use of a UK primary care-based self-help clinic (facilitated by a nurse). As part of a wider evaluation of the clinic, in-depth interviews were conducted with a purposive sub-sample of clinic users. Data indicate that people understand their problem as one of having lost an ability to cope, and that the ethos underlying the clinic is well matched to restore a sense of coping, by motivating patients to re-establish and retain control over their everyday lives. However, some patients experienced a sense of dissonance between prior expectations and actual use of the self-help clinic. Without prior familiarity with self-help, engaging the patient as the mechanism of change may be difficult. Some patients expected formal counselling and were influenced in this by their previous experience of services and discussions with the GP at the point of referral. It takes time and active engagement with self-help materials before patients become aware that they are a crucial mechanism of change. Patients may benefit from information and a referral process, which emphasises the centrality of self-efficacy and the patient as 'change agent' prior to referral. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.