Psychiatric Emergency Room Care: Staff Perspectives

描述(由申请人提供)：这项建议是一系列研究的第一步，旨在更好地了解繁忙的城市精神科急诊室(PER)中发生的事情。几乎没有注意到参与PER护理的工作人员、消费者和其他利益攸关方的观点、态度和信念，以及这些观点对提供护理的影响。这项提案的重点是每名工作人员。我们将通过询问PER工作人员在PER中做什么来描述PER工作人员的工作以及他们与患者的互动。我们将描述员工对影响他们与病人互动的影响的理解，特别是与他们工作的社会背景和偶然性相关的影响--每个员工对他们所做的事情有什么想法和感受？我们将评估工作人员对使用PER的患者的态度和信念，以及工作人员识别或标记使用PER的患者的过程。最后，我们将初步探索工作人员贴上标签(无论是正面还是负面)的患者与其他患者之间是否存在差异，并探索消费者/患者根据工作人员标识或标签接受的PER在护理内容和性质上是否存在差异。我们将借鉴定性和定量的研究方法。这项建议的指导理论涉及工作场所特征和对工作人员的需求之间的关系，以及工作人员对他们的工作和与他们合作的病人的看法。标签理论将有助于指导我们对与PER中员工标签对护理过程的潜在影响相关的结果的分析和解释。数据收集方法将包括结构化观察、深度访谈、焦点小组和带有量化分析的结构化病历审查。这些数据侧重于PER的工作人员，将对PER内适当的干预和服务的设计产生巨大影响，并最终与对消费者和其他利益相关者的研究相结合，以改善使用PER的人的临床结果。如果我们要以适合消费者/患者和每个工作人员的方式提供精神科急救服务，我们必须增加我们对PER工作人员的工作的了解，工作人员对他们工作的理解，他们对与他们合作的病人的态度，以及使用PER的群体患者的方式，以及工作人员标签对PER护理过程的潜在影响。

DESCRIPTION (provided by applicant): This proposal is a first step in a line of research designed to better understand what occurs in busy, urban psychiatric emergency rooms (PERs). Little attention has been paid to the perspectives, attitudes and beliefs of the staff, consumers and other stakeholders involved in PER care, and the influence of these perspectives on the provision of care. This proposal focuses on PER staff. We will describe the work of PER staff and their interactions with patients by asking what PER staff do in the PER. We will describe staff understandings of the influences, particularly those related to the social context and contingencies of their work, on their interactions with patients - How do PER staff think and feel about what they do? We will assess staff attitudes and beliefs about patients who use the PER and the processes by which staff identify or label patients who use the PER. And finally we will explore in a preliminary fashion whether there are differences between patients labeled (either positively or negatively) by staff and other patients and to explore if there are differences in the content and nature of care in the PER received by consumers/patients based on staff identification or labeling. We will draw upon both qualitative and quantitative research methodologies. The proposal is informed by guiding theories which relate to the relationship between workplace characteristics and demands on staff, and staff perspectives on their work and the patients they work with. Labeling theory will help guide our analyses and interpretation of the results related to the potential impact of staff labeling on the process of care in the PER. Data collection methods will include structured observations, in-depth interviews, focus groups and a structured medical chart review with quantitative analyses. These data, which focus on the staff of the PER, will have tremendous implications for the designing of appropriate interventions and services within the PER and ultimately when integrated with research on consumers and other stake holders, to improve the clinical outcomes of people who use the PER. We must increase our understanding of the work of the PER staff, the staffs understanding's of their work, their attitudes about the patients they work with and the way the group patients who use the PER, and the potential impact of the labeling of staff on the process of PER care, if we are to provide psychiatric emergency care in ways that are appropriate for consumers/patients and PER staff.