El model de recuperació i la seva aplicació als serveis de rehabilitació comunitària: una aproximació qualitativa des de la perspectiva dels usuaris i professionals

Palomer Roca, Eduard
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Introduction Recovery as a concept and as a goal towards which to orient health services is being implemented in the Anglo-Saxon world. In our context, this new paradigm still has little weight but it is beginning to penetrate both professional and users discourses, research and also in public health policies. However, we have little research on the applicability of this concept and how to organize services to promote it in our territory. Aim The present work aims to gain knowledge about how the people affected by a mental disorder treated in Rehabilitation Day Center (RDC) understand recovery, to know what are the factors of the services and their professionals that CDC users perceive that facilitate this process and those that hinder them. It also aims to explore what recovery means for RDC professionals, the factors and attitudes that facilitate and hinder it, and the conditions necessary for these processes to take place. Methodology Qualitative methodology based on Grounded Theory has been used. We have carried out 7 Focus Groups with users of different rehabilitation services in the province of Girona and 6 Focus Groups with professionals from the same rehabilitation services. Results An identity saturated by the disease, the presence of a very marked self-stigma, and acceptance of the disease are the most recurrent themes during the recovery process. Lack of expectations from professionals, coercive practices, and professional distance are seen as the most important barriers to recovery. Regarding how professionals live the transformation process, the following categories have been established: ambivalence during the change of model; changes in professional role; barriers and difficulties during the paradigm shift and therapeutic factors. Conclusions Encouraging the enrichment of personal identity, addressing self-stigma and changing professional practices and attitudes is necessary to promote personal recovery in people with serious mental disorders. Training, good practice guides based on evidence that allow transforming the paradigm into concrete actions, monitoring tools, organizational commitment and spaces for discussion and negotiation of meanings, are key elements for the implementation of the recovery paradigm ​
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