Samarbeid mellom ansatte og pårørende til personer med en nyoppdaget alvorlig psykisk lidelse

Abstract

Norsk: Denne studien er fase 2 i prosjektet: «Samarbeid mellom ansatte og pårørende til personer med en nyoppdaget alvorlig psykisk lidelse». Studien er et samarbeid mellom Divisjon psykiske helsevern, Avdeling for psykosebehandling og rehabilitering og Høgskolen i Hedmark, Avdeling for helse- og idrettsfag. Gjennomføringen skjer innen Seksjon for utredning, diagnostisering og behandling, som gir et tilbud til unge mennesker med psykoselidelse. Hovdemål: Bygge opp et tilbud, basert på vitenskapelig kunnskap og praksisbasert evidens, som pårørende til de unge med en nyoppdaget psykoselidelse opplever møter deres behov og ønsker.

English: This study is part of the research project: «Collaboration between staff and relatives to persons with recently discovered serious mental illness». The study is a collaboration between Innlandet Hospital Trust, Division of Mental Health Care, Department of Psychosis Treatment and Rehabilitation and Hedmark University College, Faculty of Health and Sports. The study is carried out in: Section of assessment, diagnosing and treatment. Main objective of the study: To develop a service, based on scientific knowledge and practice based evidence, which meets the needs of relatives to young people with recently discovered serious mental illness. The overall design is co-operative inquiry. The present study is considered as phase 2 (2005–2007) of a larger study. It is based on data from phase 1 (2003–2005): Qualitative research interviews with 24 relatives (19 parents and 5 adult siblings) (Nordby & Kjønsberg, 2005). Methods used in phase 2: eight focus group interviews (one with a group of parents and one interview with professionals in each of the four participating units and three with mixed groups of relatives and staff), dialogue based teaching lessons, deliberation meetings, document analysis and a postenquete among relatives). Data were analysed by means of qualitative content analysis and descriptive analyses. Results indicate some changes in practice and procedures which regulate the cooperation between relatives and professionals. The changes vary in the four units depending on the focus of development. The changes are manifested by the relatives entering earlier into collaboration with the staff, and that support is secured to relatives when the patient is transferred to another unit. There is more focus on and support to siblings. Still the units need to focus on siblings to get them included. One of the units has changed the distribution of responsibility among the staff to secure continuity early in the collaboration process with the relatives. One unit has introduced an agenda to the relatives before formal meetings to clarify the aim of the meeting and to reduce insecurity among the relatives. During eight focus group interviews, dialogue based teaching sessions, deliberation meetings and a postenquete some essential conceptions have emerged as important to good quality cooperation between relatives and staff: Encounter, hope, giving and receiving information, roles and support and guidance. The siblings have brought into focus the importance of viewing the patient as a whole person. In the focus group interview both relatives and staff underline the importance of imparting hope. 63 % of relatives experienced this in «large degree» or «very large degree». Only 7 % (two relatives) answered in «little degree». An evaluation of methods used in this research project judge the design of co-operative inquiry as a relevant strategy in future development in health care practice, though continuity of the project and information to staff should be more focused and taken care of.