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Opsøgende Psykoseteam (ACT-model) - en tværfaglig teambaseret intervention: Om modeltrofasthed og oplevelsen af reduktion af kompleksitet
Nordic Council of Ministers, Nordic School of Public Health NHV.
2014 (Danish)Independent thesis Advanced level (degree of Master (Two Years))Student thesisAlternative title
Outreach PsychosisTeam(ACT) model: a multi-disciplinary team-based intervention about fidelity and the experience of reducing complexity. (English)
Abstract [da]

Formålet: Psykiatriens udvikling er konstant præget af ønsket om effektive behandlings-metoder. Etablering af ACT (Assertive Community Treatment) -er skabt i erkendelse af, at psykiatrien i hospitalerne ikke i tilstrækkelig grad har evnet at helbrede. Med afsæt i de kronisk psykisk syge, vil dette MPH arbejde fokusere på denne gruppes sundhedstilstand, ved at studere arbejdsmetoden ACT. En arbejdsmetode som sundheds-og socialvæsenet i stigende grad accepterer som organisation og funktion til forebyggelse og sundhedsfremme. Der er i de sindslidendes liv brug for en arbejdsmodel, hvor en kompetent hjælper kan støtte den sindslidende i at begribe hverdagen, så der dannes et meningsfuldt grundlag for at håndtere livet. Formålet med studiet er, at få mere viden om, hvordan de danske ACT teams fungerer i en hektisk hverdag. Modellen har i udlandet vist, at have god effekt på reduktion af kompleksitet og sikre en bedre sammenhæng i det psykiatriske arbejde. Studiet er ligeledes en efterprøvning af, om der arbejdes modeltrofast overfor ACT i Danmark.

Metode: Studiet belyser ACT interventionen ved hjælp af en struktureret elektronisk spørgeundersøgelse og efterfølgende kvalitativ indholdsanalyse. Efterfølgende fravalg af størstedelen af den indsamlede kvantitative data, grundet lav svarprocent.

Resultat: I undersøgelsen deltog 72 respondenter fordelt på 31 respondenter fra Region Hovedstaden (43 %),12 respondenter fra Region Sjælland (17%), 11 respondenter fra Region Syddanmark (15 %), 2 respondenter fra Region Midtjylland (3%) og endelig 16 respondenter fra Region Nordjylland (22%). Antal ACT teams i Danmark er fordelt med 33 teams i Region Hovedstaden, et team i Region Sjælland, otte teams i Region Syddanmark, 11 teams i Region Midtjylland og endelig fire teams i Region Nordjylland. Danske ACT teams arbejder anderledes og med en anden sammensætning / funktion end den oprindelige model fra USA. ACT har vist sin funktionsdygtighed gennem mere end de sidste 10 år i Danmark. ACT teams indtænker salutogenitet i sin arbejdsform og fokuserer på ressourcer og på at forbedre sundhedstilstanden. ACT er opsøgende og assertivt i sin kontakt til klienterne.

Konklusion: ACT har med sit indtog i Danmark vist,at tilgodese et behov hos både klienter, den arbejdende psykiatri og samfundet. Psykiatrien skal behandle klienterne, der hvor de er – i deres eget liv. Med tilbud som er tilgængelige, sammenhængende og meningsfulde for den enkeltes vej mod et godt liv uden eller på trods af sygdom. Arbejdsmetoden er effektiv i reduktion af sundhedsfaglig og socialfaglig kompleksitet og teammedlemmerne udtrykker stor arbejdstilfredshed ved metoden. Teammedlemmerne i danske ACT-teams evner at arbejde i teams. Det tværfaglige samarbejde opleves meningsfuldt og håndterbart. ACT arbejdet er attraktivt og kan rekruttere kompetente medlemmer. Kvaliteten af de ydelser som ACT teams leverer, inkluderer forebyggelse, pleje, behandling, rehabilitering samt en øget oplevelse af tilgængelighed, koordination, kontinuitet og reduktion af kompleksitet. De danske ACT teams er ikke modeltro mod ACT –men tilpasset danske forhold og begrænsninger. ACT team har ikke fuldstændig myndighedsfunktion. ACT som model er under udvikling og tillempes mere og mere i en dansk kontekst

Abstract [en]

Background: Inpsychiatry, development is characterized by a desire for efficient treatment. Establishment of Assertive Community Treatment (ACT) was created in recognition that psychiatric hospitals have not adequately been able to restore health. Based on the chronic mentally ill, this study focused on the Outreach Psychosis Team by studying the working method ACT. Health and social services are increasingly willing to accept ACT as an organized and functional method for prevention and health promotion. Mentally ill people need a working model in which a competent assistant can support the patient in comprehending everyday life and form a meaningful basis for dealing with life.

Aim: This study aimed to gain more knowledge about how ACT teams in Denmark operate in a hectic schedule, and determine whether teams adhere to the ACT model.

Method: The study highlighted ACT intervention using a structured electronic survey and subsequent qualitative content analysis. However, most of the collected quantitative data was rejected due to a low response rate .

Results:The study included 72 respondents, 31 working in Region Hovedstaden, 12 in Region Sjælland 11 in Region Syddanmark, 2 in Region Midtjylland, and 16 in Region Nordjylland. ACT teams in Denmark include 33 teams in Region Hovedstaden, 1 in Region Sjælland, 8 in Region Syddanmark, 11 in Region Midtjylland, and 4 in Region Nordjylland. The teams work differently and with a different composition and function than the original US model, but they have proven their functionality for more than 10 years. ACT includes salutogenesis in its working methods, and focuses on resources and on improving health. Moreover, ACT is proactive and assertive in dealing with clients.

Conclusion: Psychiatry must treat clients wherever they are intheir own lives with offers that are available, consistent, and meaningful to each person on his way to a good life without or in spite of illness. ACT in Denmark has shown that it considers the needs of both clients (i.e., working psychiatry and society), and the working method efficiently reduces the complexity of health care and social work. Team members appreciate the working method. Members of Danish ACT teams are capable of working in teams, and they experience interdisciplinary collaboration as meaningful and manageable. Because working in an ACT team is attractive, it is possible to recruit competent members. Services provided by ACT teams include prevention, care, treatment, rehabilitation, an increased sense of accessibility, coordination and continuity, and decreased complexity. The Danish ACT teams do not strictly adhere to the original ACT model, but rather have adapted to Danish conditions and limitations. Abroad, ACT reduces complexity and ensures greater consistency in mental health work. They do not have complete authority. Currently, ACT is being developed and adjusted to a Danish context

Place, publisher, year, edition, pages
2014. , 61 p.
Series
Master of Public Health, MPH, ISSN 1104-5701 ; MPH 2014:38
Keyword [en]
Assertive Community Treatment ( ACT = Outreach psychosis team ), model fidelity, reduction of complexity, team - based intervention, interdisciplinary cooperation
Keyword [da]
Assertive Community Treatment (ACT = Opsøgende psykoseteam), modeltrofasthed, reduktion af kompleksitet, teambaseret intervention, tværfaglig samarbejde
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3636OAI: oai:DiVA.org:norden-3636DiVA: diva2:783550
Presentation
2014-11-12, Nordic School of Public Health NHV, Göteborg, Sweden, 15:28 (Danish)
Supervisors
Note

ISBN 978-91-982280-3-6

Available from: 2015-01-26 Created: 2015-01-26 Last updated: 2015-01-26Bibliographically approved

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