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首页> 外文期刊>Social science and medicine >Illness careers and continuity of care in mental health services: a qualitative study of service users and carers.
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Illness careers and continuity of care in mental health services: a qualitative study of service users and carers.

机译：精神卫生服务中的疾病职业和护理连续性：对服务使用者和护理人员的定性研究。

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Continuity of care is considered by patients and clinicians as an essential feature of good quality care in long-term disorders, yet there is general agreement that it is a complex concept and the lack of clarity in its conceptualisation and operationalisation has been linked to a deficit of user involvement. In this paper we utilise the concept of the 'patient career' to frame patient accounts of their experiences of the mental health care system. We aimed to capture the experiences and views of users and carers focusing on the meanings associated with particular (dis)continuities and transitional episodes that occurred over their illness career. As part of a large longitudinal study of continuity of care in mental health a sub-sample of 31 users was selected together with 14 of their carers. Qualitative interviews framed around the service user's illness career explored general experiences of relationship with services, care, continuity and transition from both user and carer perspectives. Five key themes emerged: relational (dis)continuity; depersonalised transitions; invisibility and crisis; communicative gaps and social vulnerability. One of the important findings was the fragility of continuity and its relationship to levels of satisfaction. Supportive, long-term relationships could be quickly undermined by a range of factors and satisfaction levels were often closely related to moments of transition where these relationships were vulnerable. Examples of continuity and well managed transitions highlighted the importance of professionals personalising transitions and situating them in the context of the daily life of service users. Further research is required to identify how best to negotiate these key points of transition in the future.
机译：患者和临床医生认为，连续性护理是长期疾病中高质量护理的基本特征，但人们普遍认为这是一个复杂的概念，其概念和操作上缺乏明确性已导致缺陷用户参与度。在本文中，我们利用“患者职业”的概念来构架患者对他们在精神保健系统中的经历的描述。我们旨在捕获用户和护理人员的经验和观点，重点关注与疾病生涯中发生的特定（不连续）连续性和过渡性发作相关的含义。作为一项关于精神卫生保健连续性的大型纵向研究的一部分，选择了31位使用者的子样本以及14位护理者。针对服务使用者疾病生涯的定性访谈从使用者和护理者的角度探讨了与服务，护理，连续性和过渡的关系的一般经验。出现了五个关键主题：关系（不连续）连续性;非个性化的过渡;隐形和危机;沟通差距和社会脆弱性。重要发现之一是连续性的脆弱性及其与满意度之间的关系。长期的支持性关系可能会受到一系列因素的破坏，满意度水平通常与这些关系脆弱的过渡时刻密切相关。连续性和管理良好的过渡的例子凸显了专业人员个性化过渡并将其置于服务用户日常生活中的重要性。需要做进一步的研究，以确定将来如何最好地协商这些关键的转变点。

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