Abstract Aim: This paper explores wound care for people living with mental health difficulties from a nursing perspective and considers what can be done to improve it. Objective: To analyze policy and practice relating to wound care for people experiencing mental ill health using the ideas of ‘wicked problems’ and ‘problems of many hands’ Methods: Policy and practice analysis informed by theory. Results: Recent UK policy is to ensure parity of esteem so that people with mental ill-health receive the same quality of care as those with physical ill-health. However, the provision of physical care to people experiencing mental ill health, including the provision of wound care, constitutes a ‘problem of many hands’ arising in the context of the mental health system being a complex one replete with wicked problems. Wicked problems are resistant to solutions and problems of many hands are complex and multifaceted, and involve the interplay of different actors. Addressing problems of many hands in this context requires systems thinking and solutions enabling different people to work collaboratively. Conclusions: The wound care of people experiencing mental ill health has been largely overlooked, as it transcends the domains of mental health and tissue viability policy and practice. A strong system level approach is needed to improve care, characterized by closer interprofessional teamworking. Highlights The wound care of people experiencing mental ill-health is largely overlooked. People with mental illness receive their wound care from tissue viability nurses. Wound care can be conceptualized as a ‘problem of many hands’. System level policies are needed to improve this aspect of health care.

中文翻译：

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精神卫生保健中的伤口：需要解决的“多手邪恶问题”的原型？

摘要目的：本文从护理角度探讨了对精神健康困难患者的伤口护理，并考虑了可以采取的改善方法。目的：使用“邪恶问题”和“多手问题”的思想分析与精神疾病患者的伤口护理有关的政策和实践。方法：以理论为依据的政策和实践分析。结果：英国最近的政策是确保尊重，以使患有精神疾病的人获得与患有身体疾病的人相同的护理质量。但是，由于精神卫生系统是一个充满邪恶问题的复杂问题，因此为患有精神疾病的人们提供身体护理，包括提供伤口护理，构成了“多手问题”。邪恶的问题无法解决，许多双手的问题复杂多方面，涉及不同参与者的相互作用。解决这种情况下的多手问题需要系统思考和解决方案，以使不同的人能够协同工作。结论：患有精神疾病的人们的伤口护理已被广泛忽视，因为它超越了精神健康和组织生存力政策和实践的领域。需要一种强有力的系统级方法来改善护理，其特点是跨专业团队之间的紧密合作。要点很大程度上忽视了患有精神疾病的人们的伤口护理。患有精神疾病的人从组织生存力护士那里获得伤口护理。可以将伤口护理概念化为“多手问题”。