Всемирная психиатрия. №1 2014

Восстановление пациентов: от заблуждений к пониманию. Внедрение реабилитационно- ориентированных подходов в систему оказания психиатрической помощи

MIKE SLADE1, MICHAELA AMERING2, MARIANNE FARKAS3, BRIDGET HAMILTON4, MARY O’HAGAN5, GRAHAM PANTHER6, RACHEL PERKINS7, GEOFF SHEPHERD7, SAMSON TSE8, ROB WHITLEY9

1King’s College London, Health Service and Population Research Department, Institute of Psychiatry, Denmark Hill, London SE5 8AF, UK (Великобритания); 2Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Австрия); 3Center for Psychiatric Rehabilitation, Boston University, West Boston, MA 02215, USA (США); 4University of Melbourne, School of Health Sciences, Parkville, Melbourne 3010, Australia (Австралия); 5Education House, Wellington, New Zealand (Новая Зеландия); 6Redpanther Research, Auckland, New Zealand (Новая Зеландия); 7Centre for Mental Health, Maya House, London, UK (Великобритания); 8Department of Social Work and Social Administration, University of Hong Kong, Hong Kong (Гонконг); 9Douglas Hospital Research Centre, McGill University, Montreal, Canada (Канада)

Стр. 11-19

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Опубликовано: 11 февраля 2014

Аннотация / Abstract

a:2:{s:4:"TEXT";s:65534:"a:2:{s:4:"TYPE";s:4:"HTML";s:4:"TEXT";s:69248:"Понимание процесса восстановления как личного и субъективного опыта пациента в настоящее время распространено во многих странах. Развитие стратегии восстановления требует серьезных изменений в системах оказания психиатрической помощи. Изменить укоренившиеся порядки всегда непросто. В этой статье мы выделяем следующие семь ошибочных позиций («заблуждений»), сформировавшихся у психиатров в отношении процесса реабилитации: восстановление — новая концепция; восстановление для «моих» пациентов вряд ли возможно; добиться восстановления пациента возможно исключительно эффективной психофармакотерапией; принудительное стационарное лечение и назначение фармакотерапии способствуют восстановлению; ориентация на восстановление пациентов приведет к закрытию многих лечебных учреждений; восстановление с это возвращение пациентов к доболезненному уровню здоровья и независимости; человек может быть полезен для общества только в случае полного выздоровления. Далее мы рассматриваем десять эмпирически обоснованных подходов, способствующих процессу восстановления пациентов, выделяя ключевые составляющие этого процесса: поддержку родственников, надежду и оптимизм, индивидуальность, наличие намерений и целеустремленности, а также создание условий для полноправного участия в жизни общества (схема CHIME – от connectedness, hope, identity, meaning, empowerment). Обозначенные десять подходов включают в себя: систему взаимопомощи («равный равному»); предварительные указания на случай утраты дееспособности; планирование действий по восстановлению здоровья; организацию процесса выздоровления; переориентацию (The REFOCUS); обретение сил; реабилитационные группы или реабилитационные образовательные программы; трудоустройство; жилищное обеспечение и социальную поддержку; мероприятия по рассмотрению актуальных проблем в сфере психического здоровья. Наконец, мы очерчиваем три значимые научные проблемы: необходимость расши...

Понимание процесса восстановления как личного и субъективного опыта пациента в настоящее время распространено во многих странах. Развитие стратегии восстановления требует серьезных изменений в системах оказания психиатрической помощи. Изменить укоренившиеся порядки всегда непросто. В этой статье мы выделяем следующие семь ошибочных позиций («заблуждений»), сформировавшихся у психиатров в отношении процесса реабилитации: восстановление — новая концепция; восстановление для «моих» пациентов вряд ли возможно; добиться восстановления пациента возможно исключительно эффективной психофармакотерапией; принудительное стационарное лечение и назначение фармакотерапии способствуют восстановлению; ориентация на восстановление пациентов приведет к закрытию многих лечебных учреждений; восстановление с ...

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Вход / Регистрация

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Восстановление пациентов: от заблуждений к пониманию. Внедрение реабилитационно- ориентированных подходов в систему оказания психиатрической помощи

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ИНТЕРАКТИВ

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ИЗДАНИЯ-ПАРТНЕРЫ

Восстановление пациентов: от заблуждений к пониманию. Внедрение реабилитационно- ориентированных подходов в систему оказания психиатрической помощи

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