Доказательная модель симптом-редуцирования на групповом уровне как организующий принцип охраны психического здоровья: время перемен?
Всемирная психиатрия. №1 2019
Доказательная модель симптом-редуцирования на групповом уровне как организующий принцип охраны психического здоровья: время перемен?
Jim van Os1-3, Sinan Guloksuz2,4, Thomas Willem Vijn5, Anton Hafkenscheid6, Philippe Delespaul2,7
1Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands; 2Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands; 3Department of Psychosis Studies, King’s College London, King’s Health Partners, Institute of Psychiatry, London, UK; 4Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; 5Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, The Netherlands; 6Arkin/Sinai Centrum, Amsterdam, The Netherlands; 7Mondriaan, Heerlen/Maastricht, The Netherlands
Стр. 88-96
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Опубликовано: 22 января 2019
Аннотация / Abstract
a:2:{s:4:"TEXT";s:65534:"a:2:{s:4:"TYPE";s:4:"HTML";s:4:"TEXT";s:81406:"Перевод: Шкурина Ж.В. (Москва)
Редактура: к.м.н. Бойко А.С. (Томск)
На содержание и организацию охраны психического здоровья серьезно повлиял подход, согласно которому проблемы психического здоровья понимаются как поддающиеся диагностике расстройства с возможностью их лечения практикующими специалистами, применяющими рекомендации по доказательным практикам (evidence-based practice – EBP) симптом-редуцирования на групповом уровне. Однако модель доказательных практик симптом-редуцирования подвергается давлению, поскольку она может представляться изолированной от нужд пациентов, игнорирует доказательства транссиндромальной природы психических расстройств, преувеличивает роль технических аспектов лечения по сравнению с межличностной и ритуальной составляющими ухода и недооценивает отсутствие возможности распространения результатов от доказательных практик с группового уровня на индивидуальный. Все больше данных указывают на то, что психические расстройства редко «излечиваются» и их корректнее рассматривать в качестве уязвимостей. Уровень жизни может значимо возрасти в том случае, если люди научатся жить с психической уязвимостью в результате длительного процесса повышения своей жизнестойкости в социальных и экзистенциальных аспектах. В данной работе мы анализируем, как бы выглядели службы охраны психического здоровья, если бы вышеупомянутые факторы принимались во внимание. Служба охраны психического здоровья в XXI веке наилучшим образом может быть представлена как небольшое оздоровительное сообщество, способствующее налаживанию связей и повышению устойчивости при обучении жизни с психической уязвимостью, дополненное ограниченным числом религиозных учреждений. Коллегиальная поддержка, организуемая на уровне восстановительных колледжей, могла бы составить основу сообщества. Лечение должно быть направлено на транссиндромальную редукцию симптомов с ориентацией на более высокоуровневый процесс ...
Перевод: Шкурина Ж.В. (Москва)
Редактура: к.м.н. Бойко А.С. (Томск)
На содержание и организацию охраны психического здоровья серьезно повлиял подход, согласно которому проблемы психического здоровья понимаются как поддающиеся диагностике расстройства с возможностью их лечения практикующими специалистами, применяющими рекомендации по доказательным практикам (evidence-based practice – EBP) симптом-редуцирования на групповом уровне. Однако модель доказательных практик симптом-редуцирования подвергается давлению, поскольку она может представляться изолированной от нужд пациентов, игнорирует доказательства транссиндромальной природы психических расстройств, преувеличивает роль технических аспектов лечения по сравнению с межличностной и ритуальной составляющими ухода и недооценивает отсутствие возможности ра...
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