Development of a Recovery-Oriented Nursing Program for People with Mental Illness

康复是一种令人满意的、充满希望的、有贡献的生活方式，即使是在疾病造成的限制下。以康复为导向的方法，强调消费者和临床医生之间伙伴关系的重要性，已被认为是一种有前途的替代服务，可以促进严重精神疾病患者的康复和福祉。我们项目的目的是从消费者的角度阐明康复的概念，并制定和评估以康复为导向的护理计划。2004年进行了一项定性研究，以澄清严重精神疾病患者所定义的康复概念。47名社区精神病患者（35名男性和12名女性）提供了书面同意接受访谈。访谈的定性分析揭示了康复的两种类型：“以新人的身份重生，同时保持伤口”和“超越社会规范，重新找回自己的生活价值”。与康复更相关的五个因素还包括：“学会多少是太多，挑战不可能”、“学会疾病自我管理”、“结合社会资源满足基本需求”、“获得社会的支持和信任”、“因希望过平凡的生活而痛苦”。前两个类别表明个人层面的恢复，后三个类别表明社会制度的性质削弱了社会边缘人群的信心和能力。研究结果表明，需要转变对精神疾病的社会价值观。2005年，制定了以康复为导向的护理计划，并对其在临床实践中的相关性进行了研究。活动共分为四个环节，分别是“寻找康复的希望”、“倡导自我”、“尊重自私”和“重建新的自我”。该项目采用小组讨论的方式。社区中有8名患有精神疾病的人（6男2女）提供了参加该计划的书面同意。节目中的讨论被录下来，观察结果被记录在现场笔记中。小组讨论帮助参与者相互学习新的应对策略，发现彼此的力量，并将他们的疾病经历重新融入他们的生活。参与者提出的一个核心问题不是如何管理疾病和残疾，而是如何过他/她的生活，这表明康复是一个完整的过程，超越了精神卫生系统。研究结果表明，需要一种整体的方法，在这种方法中，人的生活被用作一个有组织的康复结构，而不是一种由病理学和缺陷来定义人的方法。少

Recovery is a way of living a satisfying, hopeful, and contributing life even with the limitations caused by illness. A recovery-oriented approach, which emphasizes the importance of a partnership between consumer and clinician, has been recognized as a promising alternative service that can facilitate healing and well-being of people with serious mental illness. The aims of our project were to clarify the concept of recovery from the perspective of consumers as well as to develop and evaluate a recovery-oriented nursing program.In 2004, a qualitative study was conducted to clarify the concept of recovery as defined by people with serious mental illness. Forty seven persons (35 men and 12 women) with mental illness in the community provided written consent to be interviewed. Qualitative analysis of interviews revealed two categories of recovery : "rebirth as a new person while holding the wound within" and "transcendence of social norms and reclaim of own life values". Five factors rel … More ated to recovery were also identified : "learning how much is too much and challenging the impossible", "learning illness self-management", "combining social resources to meet the basic needs", "having support and trust from society", and "suffering from wishing for an ordinary life". The first two categories suggest recovery at a personal level, while the latter three categories suggest the nature of social systems that undermine confidence and competence of socially marginalized people. The findings indicated the need for a transformation of societal values toward mental illness.In 2005, a recovery-oriented nursing program was developed and its relevance in clinical practice was examined. The program consisted of total of four sessions to promote "finding hope for recovery", "advocating for oneself", "honoring selfishness" and "reconstructing a new sense of self". The program utilized small group discussions. Eight persons (six men and two women) with mental illness in the community provided written consent to participate in the program. Discussions in the program were tape-recorded and observations were recorded in field notes. Discussions in a small group helped participants learn new coping strategies from each other, discover strength in each other, and reintegrate their illness experiences into their lives. A central issue raised by the participants was not how to manage the illness and disabilities but how to live his/her life, suggesting recovery is a total process and spans beyond the mental health system. The findings indicated the need for a holistic approach in which person's life is utilized as an organizing construct of recovery rather than an approach in which persons are defined by pathology and deficits. Less