Southwest Youth and the Experience of Psychiatric Treatment

西南青少年及精神科治疗经验

基本信息

批准号：
7280745
负责人：
Thomas Csordas
金额：
$ 54.5万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-07-20 至 2009-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7280745
关键词：
Accounting Admission activity Adolescent Adolescent Development African American Age American Anguish Arizona Back Caring Clinic Clinical Communities Competence Complement Consent Development Diagnosis Disease Distress Elements Ethnography Family Future Goals Government Growth and Development function Head Healthcare Hispanics Hospitals Indigenous Individual Inpatients Intervention Interview Knowledge Measures Mediation Mental Health Mental disorders Modeling Nature Navajo New Mexico Parents Pathway interactions Patients Pattern Perception Play Process Psyche structure Psychiatric therapeutic procedure Psychiatry Pueblo Race Range Rate Recording of previous events Religion and Spirituality Reporting Research Reservations Resources Schools Social Interaction Societies Stigmata Students System Therapeutic Time Training Youth aged care systems comparison group concept design expectation experience peer social stigma therapy development treatment program

项目摘要

The proposed study is an examination of cultural meaning, social interaction, and individual experience among adolescent patients in treatment for psychiatric disorder in the American Southwest (Arizona and New Mexico). Our long-term goal is to produce knowledge of broad use to those concerned with the treatment of adolescents suffering from mental illness in the context of significant cultural differences. The design is to compare the experience of consenting Navajo (n=16), Pueblo (n=16), Hispanic (n=16, Euro-American (n=16), and African-American (n=6) patients and a parent/guardian of each from admission through one year subsequent to discharge, using a combination of naturalistic observation, open-ended ethnography of a new inpatient unit that for the first time in history will provide on reservation residential psychiatric care for the most distressed among Navajo youth ages 12 to 18. The unique nature of the unit suggests that its treatment program will be treated as a model for other such facilities in the future, and therefore through going ethnographic description of the cultural processes relevant to its functioning is necessary and even urgent. We will interview a comparison group of 50 students drawn from public schools to establish a baseline for analysis. Analysis will emphasize descriptive ethnography, ranging from cultural conceptualization of community mental healthcare, to narrative case accounts of individual patients as they move from clinic to family, school, and religious settings. Ethnography will be complemented by quantitative analyses to determine how youth from different ethnic backgrounds differ on a variety of measures. Specific aims are organized under three interrelated headings: 1) Clinical Culture and Development of Treatment - To trace the development of a clinical culture and culturally sensitive treatment program within the new inpatient psychiatric unit and to compare patient, family and staff initial expectations about the new unit and the way those expectations are played out behaviorally in practice. 2) Definitions of Distress and Adolescent Development - To compare concepts of problem, illness, or disorder defined in psychiatric terms with patient and family understandings of young people's distress and the potential stigma associated with that distress, and to compare concepts of development, growth, and maturity across cultural groups with respect to contemporary cultural issues and obstacles faced by youth, 3) Therapeutic Process and Perception of Treatment - To describe patient experience of therapeutic process as they move from the community into treatment and back into the community, and to determine whether treatment in the new facility makes a difference for patients by comparing them to peers who have no disorder or history of interaction with the mental health care system.

拟议的研究是对青春期患者在美国西南部（亚利桑那州和新墨西哥州）的精神疾病治疗中的文化意义，社会互动和个人经验的检查。我们的长期目标是在具有重大文化差异的背景下对患有精神疾病的青少年治疗的人提供广泛使用的知识。该设计是为了比较同意纳瓦霍（n = 16），普韦布洛（n = 16），西班牙裔（n = 16，n = 16，欧洲裔美国人（n = 16）和非裔美国人（n = 6）患者（n = 6）患者和每个人的父母/守护者，随后出院到出院，使用自然主义的单位，以启用自然主义的组合，以启用自然主义的组合。在12至18岁的纳瓦霍（Navajo）青年中，对居民的精神病医疗保留，该单位的独特性质将被视为将来的其他此类设施的模型，因此，通过对文化过程的民族志描述，与其功能相关的文化过程是必不可少的。从社区心理保健的文化概念化到各个患者从诊所转向家庭，学校和宗教环境的叙事案例。人种志将通过定量分析来补充，以确定来自不同种族背景的青年在各种措施上如何有所不同。具体目标是在三个相互关联的标题下组织的： 1）临床文化和治疗的发展 - 追踪新的住院精神病学单位中临床文化和文化敏感治疗计划的发展，并比较患者，家庭和员工对新单元的最初期望以及这些期望在实践中的行为上的表现。 2）对困扰和青少年发展的定义 - 比较以精神科术语定义的问题，疾病或混乱的概念与患者和家庭对年轻人的痛苦的理解以及与这种困扰相关的潜在污名，以及比较在文化群体中与年轻人所面临的跨文化群体的发展，成长和成熟的概念 3）治疗过程和对治疗的看法 - 描述患者从社区转化为治疗并重返社区的治疗过程的经验，并确定新设施中的治疗是否会通过将患者与与精神卫生保健系统没有障碍或相互作用的同龄人进行比较来对患者产生影响。