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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >Supported decision-making from the perspectives of mental health service users, family members supporting them and mental health practitioners
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Supported decision-making from the perspectives of mental health service users, family members supporting them and mental health practitioners

机译：支持精神卫生服务用户的观点，支持他们和心理健康从业者的家庭成员的支持决策

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Background: Supporting the decision-making of mental health service users fulfils professional, ethical and moral obligations of mental health practitioners. It may also aid personal recovery. Previous research on the effectiveness of supported decision-making interventions is limited. Aims: The study aims to explore from several perspectives the barriers and facilitators to supported decision-making in an Australian context. Supported decision-making was considered in terms of interpersonal experiences and legal supported decision-making mechanisms. Methods: In all, 90 narrative interviews about experiences of supported decision-making were conducted and analysed. Participants were mental health service users who reported diagnoses of schizophrenia, psychosis, bipolar disorder and severe depression; family members supporting them and mental health practitioners, including psychiatrists. The data were analysed thematically across all participants. Results: Negative interpersonal experiences in the mental health care system undermined involvement in decision-making for people with psychiatric diagnoses and family carers. Mental health practitioners noted their own disempowerment in service systems as barriers to good supported decision-making practices. All groups noted the influence of prevailing attitudes towards mental health service users and the associated stigma and discrimination that exist in services and the broader community. They believed that legal supported decision-making mechanisms facilitate the participation of mental health service user and their family supporters in supported decision-making. Conclusions: Enabling supported decision-making in clinical practice and policy can be facilitated by (1) support for good communication skills and related attitudes and practices among mental health practitioners and removing barriers to their good practice in health and social services and (2) introducing legal supported decision-making mechanisms.
机译：背景：支持心理健康服务使用者的决策履行了心理健康从业者的专业、伦理和道德义务。它也可能有助于个人康复。以往关于支持性决策干预有效性的研究有限。目的：本研究旨在从多个角度探讨澳大利亚背景下支持决策的障碍和促进因素。支持性决策是根据人际经验和法律支持的决策机制来考虑的。方法：总共进行了90次关于支持性决策经验的叙述性访谈，并进行了分析。参与者是精神卫生服务使用者，他们报告了精神分裂症、精神病、双相情感障碍和严重抑郁症的诊断；支持他们的家庭成员和心理健康从业者，包括精神科医生。对所有参与者的数据进行了主题分析。结果：精神卫生保健系统中的负面人际关系经历削弱了精神病患者和家庭护理者参与决策的能力。心理健康从业者指出，他们自己在服务系统中的权力被剥夺，是良好决策实践的障碍。所有群体都注意到对心理健康服务使用者的普遍态度的影响，以及服务和更广泛社区中存在的相关污名和歧视。他们认为，法律支持的决策机制有助于心理健康服务使用者及其家庭支持者参与支持的决策。结论：通过（1）支持心理健康从业者的良好沟通技能、相关态度和实践，消除他们在健康和社会服务方面良好实践的障碍，以及（2）引入法律支持的决策机制，可以促进在临床实践和政策中支持决策。

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