The web of silence: a qualitative case study of early intervention and support for healthcare workers with mental ill-health.
The web of silence: a qualitative case study of early intervention and support for healthcare workers with mental ill-health.
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DOI：
10.1186/1471-2458-14-138
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发表时间：
2014-02-08
影响因子：
4.5
通讯作者：
Moll SE
中科院分区：
文献类型：
--
作者：
Moll SE
在医护人员中，压力和精神疾病的比例很高，但许多人尽管出现了影响他们表现的症状，仍继续工作。有心理健康问题的工人通常会受到排斥，得不到他们需要的支持。然而，如果问题得不到解决，这些问题可能会变得更糟，不仅危及工人的健康和安全，而且危及他/她的同事和患者的健康和安全。早期识别和支持可以改善工作成果和促进恢复，但需要更多关于如何在医疗保健工作背景下促进这一进程的信息。这项研究的目的是探索形成对正在与心理健康问题作斗争的医护人员的早期干预和支持的关键个人和组织力量，并确定改变的障碍和机会。在一家大型城市医疗保健组织中进行了一项定性的案例研究，以探索整个组织中员工的认知和体验。对8名在工作中经历过心理健康问题的医护人员以及8名与苦苦挣扎的员工(经理、同事、工会领导人)进行互动的工作场所利益相关者进行了深入访谈。另有67名员工完成了一项在线调查。对访谈和调查的分析以解释性描述过程为指导，以确定早期干预和支持的关键障碍。有许多关于对员工心理健康问题的沉默和不作为的报道。确定心理健康问题的不确定性、对精神疾病的污名、专业能力的论述、社会紧张、工作量压力、保密期望以及无法及时获得心理健康支助，是阻碍员工获得其所需帮助的关键因素。尽管有少数例外，但总体研究结果指出，在支持有心理健康问题的员工方面存在许多障碍。为了解决复杂的知识、态度、人际关系和组织方面的行动障碍，需要一种多层次的知识转化战略，该战略不仅要考虑心理健康素养和反污名干预措施，而且要解决可能成为变革障碍的工作环境的独特背景。
There is a high rate of stress and mental illness among healthcare workers, yet many continue to work despite symptoms that affect their performance. Workers with mental health issues are typically ostracized and do not get the support that they need. If issues are not addressed, however, they could become worse and compromise the health and safety, not only of the worker, but his/her colleagues and patients. Early identification and support can improve work outcomes and facilitate recovery, but more information is needed about how to facilitate this process in the context of healthcare work. The purpose of this study was to explore the key individual and organizational forces that shape early intervention and support for healthcare workers who are struggling with mental health issues, and to identify barriers and opportunities for change. A qualitative, case study in a large, urban healthcare organization was conducted in order to explore the perceptions and experiences of employees across the organization. In-depth interviews were conducted with eight healthcare workers who had experienced mental health issues at work as well as eight workplace stakeholders who interacted with workers who were struggling (managers, coworkers, union leaders). An online survey was completed by an additional 67 employees. Analysis of the interviews and surveys was guided by a process of interpretive description to identify key barriers to early intervention and support. There were many reports of silence and inaction in response to employee mental health issues. Uncertainty in identifying mental health problems, stigma regarding mental ill health, a discourse of professional competence, social tensions, workload pressures, confidentiality expectations and lack of timely access to mental health supports were key forces in preventing employees from getting the help that they needed. Although there were a few exceptions, the overall study findings point to many barriers to supporting employees with mental health issues. In order to address the complex knowledge, attitudinal, interpersonal and organizational barriers to action, a multi-layered knowledge translation strategy is needed, that considers not only mental health literacy and anti-stigma interventions, but addresses the unique context of the work environment that can act as a barrier to change.
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影响因子：
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作者：
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通讯作者：
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