Kristian J. Paaske

Hvordan kan patienter involveres i psykiatrisk pleje? Generering af ny viden om patientinvolvering i behandlingspsykiatrien gennem aktionsforskning

Head supervisor: Frederik Alkier Gildberg Professor (Associate) & Head of Research Lecturer in Forensic Mental Health, PhD, MScN, RN. CPS, Institute of Regional Health Research, Faculty of Health Science, University of Southern Denmark. Lecturer & Head of Research, Dept. of Psychiatry Middelfart, Region of Southern Denmark.

Co-Supervisor: John Andersen Professor. PhD in Sociology and Planning, Planning Studies (Plan, By og Proces) Department of People and Technology (IMT) Roskilde Universitet

Co-Supervisor: Ellen Boldrup Tingleff PhD, MScN, RN, Senior lecturer. Nursing Education, Vejle, UCL University

Danish Abstract

Baggrund for studiet er, at sundhedsvæsenet har fået til opdrag at indføre patientinvolvering herunder også i psykiatrien. Det forventes, at patientinvolvering vil kunne bidrage til højere patienttilfredshed, bedre patientsikkerhed, bedre behandlingsresultater, en mere effektiv brug af ressourcer, at patienter klarer sig bedre og at patienterne oplever højere livskvalitet. Det har imidlertid vist sig vanskeligt at indføre patientinvolvering i psykiatrien. Det skyldes bl.a. at patientinvolveringen er et uklart begreb, og det stiller krav til patienterne om at være selvkontrollerende. Endelig er patientinvolvering i opposition til tre rationaler i psykiatrien, nemlig neoliberalisme, et smalt vidensbegreb og medicinsk paternalisme. På trods af barriererne oplever sygeplejersker i psykiatrien sig engageret i forhold til at arbejde med patientinvolvering.Formålet med studiet er derfor at udvikle viden om, hvordan patientinvolvering italesættes og praktiseres i psykiatrisk sygepleje i en voksen psykiatrisk afdeling, undersøge hvilke holdninger og erfaringer plejepersonale har til patientinvolvering, og i samarbejde med patienterne, personalet og ledelsen at udvikle, implementere og evaluere metoder til patientinvolvering i en voksen psykiatrisk afdeling. Metoden i studiet er aktionsforskning og positioneres videnskabsteoretisk indenfor kritisk teori. Metodisk forventes det, at der skal laves deltagerobservationer, semistrukturerede interviews og fremtidsværksteder. Studiet afvikles i samarbejde med Psykiatrisk Afdeling Middelfart over 3 år. 

English Abstract

Background. The Danish healthcare system has been entrusted with implementing patient participation, among others in the psychiatric care units. Patient participation is expected to contribute to a higher degree of patient satisfaction, patient security, better treatment results, a more efficient use of resources, a higher degree of patient empowerment and experience higher quality of life. However, it has proven difficult to implement patient participation in the psychiatric units. This is due to a number of factors. First and foremost, the concept of patient participation is based on the assumption that patients are capable of exercising self-control. This is a difficult assumption to make a priori in psychiatric care units. Second, the concept of patient participation is in opposition to three rationales in psychiatric research, namely neoliberal thinking, a narrow understanding of what constitutes knowledge, and medical paternalism. Nevertheless, nurses in psychiatric care units are motivated to work with patient participation. The aim of the study. The study aims at developing new knowledge of how care staff in a forensic psychiatric care unit speak of and practice patient participation. It also aims at exploring their perceptions of and experiences with patient participation. And finally, in cooperation with care staff, patients and the management level, the study aims at developing, implementing and evaluating methods to increase patient participation in an adult psychiatric care unit. The method. The study is an action research study positioned within critical theory. Expected methods to be used in the study include participant observation, semi-structured interviews and future workshops. The study is conducted in cooperation with Middelfart Psychiatric Unit and lasts three years.