美国乔治亚代写作业:有效性和可靠性差

Keywords:美国乔治亚代写作业

总之，研究表明，增加用户参与心理健康服务的交付和管理会出现有益的影响，其他工作人员，也患者。大多数用户参与的研究都集中在用户，或前用户的参与，在案件管理。有缺乏用户参与医疗保健服务的规划，或规划或执行研究研究评估用户参与的比较研究。此外，很少有英国为基础的研究，总体而言，用户参与研究是不好的方法学质量。因此，在NHS框架内的服务交付用户参与的有效性是不确定的。有一些困难的研究已经进行到日期。样本量通常是小的，修改后的评定量表的使用“可能导致偏见”，因为这些将不会被标准化，并有可能在联合国测试的尺度（辛普森和众议院，2002）的有效性和可靠性差。有一定程度的讽刺，用户参与并没有延伸到研究过程中，很少有用户被邀请评论研究设计或评级尺度。此外，在大多数研究设计的用户参与研究的混杂因素的范围。辛普森的房子（2002），例如，作者解释说，他们的发现，例如，当用户不太可能使住院治疗的客户，可能就是因为自己以前的不好的经历，或者是因为他们有更多的宽容所引起的症状表现，用以前的经验来帮助客户远离医院或更容易从事“客户需要住院治疗（P 258）。英国的医疗保健政策，大力支持在NHS的用户参与的发展，无论是在服务交付和评估服务。这不，但是，澄清什么是平均不到“用户参与”在实践中，“在英国，那里的卫生服务管理是由中央政府要求促进患者和公众参与，用户主导的改革已经阻碍了：不确定性如何介入，冲突管理优先；有限公司的员工和用户的承诺；与程度的“参与”表示不满”（Rutter et al，2004，p 1974）。研究表明，虽然一些工作人员发现用户参与的举措有益和有益的，其他人发现病人和医生之间的关系方面的困难。由用户参与产生的最常见的变化是改进的信息服务和更方便的服务提供，如简化任命程序。然而，用户参与的实际水平似乎仅限于管理约束。而研究表明，用户能够积极参与，还有专业的用户缺乏专业技能，有助于管理事务，对平等的感知（Poulton，1999）。此外，“专业人士似乎不愿意与他们所服务的人分享他们的知识和力量”（Poulton，1999，P 1295）。
美国乔治亚代写作业:有效性和可靠性差
此外，真正有效的用户参与受到限制的资源和时间承诺的工作人员在前线。护士认为自己缺乏时间来建立良好的质量与他们的服务用户的工作关系，并有一些混淆病人的专业界限。“如果一个护士在一个时刻，促进客户的选择和参与护理，并在接下来的要求执行强制精神卫生法部分，这可能会混淆和劝阻双方从事积极的工作联盟”（安东尼和克劳福德，2000，P 432）。然而，可能有更高的优先级，NHS的心理健康服务的实际用户代表的一部分，谁需要NHS心理健康服务。正如莱亚德（2005）在他最近的报告中所显示的，只有两个抑郁症患者接受任何形式的治疗，只有8%的人看到精神科医生和3%看到心理学家。由于缺乏资金和人员短缺的精神卫生部门之间的困难，获得服务，可以认为，寻址访问是更重要的是，用户参与在目前的时间。此外，很少有研究证据，以支持用户参与的政策，在实践中，有必要进行研究，告知NHS管理人员和临床医生在如何整合用户参与到他们的服务，以最好的效果。德福和福克纳（2004）表明，在服务规划也许建立用户参与的概念，很少有证据表明这延伸到心理健康研究中的用户参与。有一个明显的缺席导致用户研究和很少了解的用户壁垒LED研究项目.
美国乔治亚代写作业:有效性和可靠性差
In conclusion, research has shown that increased user participation in mental health services delivery and management would appear to have beneficial effects for other staff members, and also the patients. Most user participation studies have focused on involvement of users, or former users, in case management. There are a lack of comparative studies on user participation in the planning of health care services, or the planning or execution of research studies evaluating user participation. Furthermore, there are few UK based studies and, overall, user participation studies are not of good methodological quality. Therefore, the effectiveness of user participation in service delivery within the NHS framework is uncertain. There are a number of difficulties with the research that has been conducted to date. Sample sizes are usually small and the use of modified rating scales “could have led to bias” since these will not be standardised, and there maybe poor validity and reliability in the un-tested scales (Simpson and House, 2002). With some degree of irony, user participation did not extend to the research process and few users were invited to comment on research designs or the rating scales. Furthermore, there is scope for confounding factors in most of the research designs of user participation studies. Simpson and House (2002), for example, “Authors interpreted their findings, saying, for example, that when users were less likely to hospitalise clients, it might be because of their own previous bad experiences or because they had more tolerance for behaviour arising from symptoms, used previous experience to help clients stay out of hospital or more readily engaged clients needing hospitalisation” (p 258). British health care policy strongly supports the development of user participation within the NHS, both in service delivery and evaluation of services. It does not, however, clarify what is mean’t by ‘user involvement’ in practice and “In the UK, where health service managers are required by central government to promote patient and public involvement, user-led reform has been hampered by: uncertainty about how to involve, conflicting management priorities; limited staff commitment; and users’ dissatisfaction with the extent of ‘involvement’ offered” (Rutter et al, 2004, p 1974). Research studies showed that while some staff found user participation initiatives useful and rewarding, others found it difficult in terms of the relationship between patient and practitioner. The most common changes to arise from user participation are improved information services and more accessible service provision such as simplifying the appointments procedure. However, the actual level of user participation would appear to be limited to managerial constraints. While research studies have shown that users are capable of active participation, there remains a professional perception that users are lacking professional skills to contribute to management matters on a equal footing (Poulton, 1999). Furthermore, “professionals seem unable to contemplate sharing their power and knowledge with the people they serve” (Poulton, 1999, p 1295). Furthermore, truly effective user participation is restricted by lack of resources and time commitment by staff at the frontline. Nurses perceive themselves to be lacking the time to build good quality working relationships with their service users, and there is some confusion over the patient-professional boundaries. “If a nurse is at one moment facilitating client choices and involvement in care and in the next required to enforce compulsory mental Health Act sections, this is likely to confuse and discourage both parties from engaging in active working alliances” (Anthony and Crawford, 2000, p 432). However, there maybe higher priorities given that the actual users of NHS mental health services represent a fraction of those who need NHS mental health services. As Layard (2005) has shown in his recent report, only one in two people with depression receive any form of treatment and only 8% see a psychiatrist and 3% see a psychologist. Since lack of funding and staff shortages within the mental health sector are amongst the difficulties with access to services, it can be argued that addressing access is of more importance that user participation at the present time. Furthermore, there is little research evidence to support user participation policy in practice, and there is a need for research studies to inform NHS managers and clinicians in how to integrate user participation into their services to best effect. Telford and Faulkner (2004) have shown that while the notion of user involvement in service planning maybe established, there is little evidence that this extends to user involvement in mental health research. There is an marked absence of user-led research studies and little is understood of the barriers to user-led research programmes (Telford and Faulker, 2004). At present, user participation would appear to be mere ‘tokenism’ in a health care system that is unable to meet service demands. However, research studies from other countries have demonstrated that user participation is beneficial to staff and patients when applied properly and sensitively.