Decision-making participation of people with mental health difficulties at a community rehabilitation center in Taiwan.

IF 2.1 4区医学 Q2 NURSING

International Journal of Qualitative Studies on Health and Well-Being Pub Date : 2025-12-01 Epub Date: 2025-03-19 DOI:10.1080/17482631.2025.2475566

Meng-Hsuan Hsieh, Heng-Hao Chang

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引用次数: 0

Abstract

Purpose: This study employed institutional ethnography to analyse the experiences of individuals with mental health difficulties in a Taiwanese community rehabilitation centre.

Methods: This study applies the institutional ethnography method. Data were gathered through participatory observation; in-depth interviews with individuals with mental health difficulties and professionals; and textual analysis of policies, regulations, and practices within the centre.

Results: First, entrenched power dynamics persist, stifling discourse on the agency of individuals with mental health difficulties. The prevalent medical model continues to govern service provision, reinforcing professional hierarchies that impede collaboration. Second, community rehabilitation centres exacerbate disadvantages for case managers (who are muted in the presence of professionals) and service users (who lose autonomy in professional discussions). Third, compliance assessments overshadow individualized care. Fourth, the community rehabilitation model may inadvertently confine service users, prolonging institutionalization and conforming to societal norms.

Conclusions: This study underscores the need for significant improvements in Taiwan's mental healthcare system to emphasize individuals' rights.

查看原文本刊更多论文

台湾某社区康复中心心理健康障碍者的决策参与。

摘要目的：本研究采用制度人种学分析台湾某社区康复中心心理健康困难个体的体验。方法：本研究采用制度民族志方法。通过参与式观察收集数据；与精神健康有困难的个人和专业人员进行深入访谈；以及对该中心的政策、法规和实践的文本分析。结果：首先，根深蒂固的权力动力学持续存在，抑制了对心理健康困难个体代理的讨论。流行的医疗模式继续支配着服务的提供，强化了阻碍合作的专业等级制度。其次，社区康复中心加剧了个案管理者（在专业人士面前保持沉默）和服务使用者（在专业讨论中失去自主权）的劣势。第三，依从性评估掩盖了个性化护理。第四，社区康复模式可能在不经意间限制了服务使用者，延长了制度化和符合社会规范。结论：本研究强调台湾的精神卫生保健系统需要显著改善，以强调个人权利。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Qualitative Studies on Health and Well-Being Multiple-

CiteScore

3.20

自引率

5.60%

发文量

审稿时长

14 weeks

期刊介绍： International Journal of Qualitative Studies on Health and Well-being acknowledges the international and interdisciplinary nature of health-related issues. It intends to provide a meeting-point for studies using rigorous qualitative methodology of significance for issues related to human health and well-being. The aim of the International Journal of Qualitative Studies on Health and Well-being is to support and to shape the emerging field of qualitative studies and to encourage a better understanding of all aspects of human health and well-being.