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Delaney KR, Loucks J, Ray R, Blair EW, Nadler-Moodie M, Batscha C, Sharp DM, Milliken D. Delineating Quality Indicators of Inpatient Psychiatric Hospitalization. J Am Psychiatr Nurses Assoc 2022; 28:391-401. [PMID: 33190586 DOI: 10.1177/1078390320971367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Assuring quality care is critical to the well-being and recovery of individuals receiving inpatient psychiatric treatment, yet a comprehensive map of quality inpatient care does not exist. AIMS To isolate and describe quality elements of inpatient psychiatric treatment. METHODS A survey queried psychiatric inpatient nursing leaders on what they considered to be critical elements of quality. The survey was emailed to 40 American Psychiatric Nurses Association members, and 39 individuals responded. In the survey, participants were asked to comment on the importance of six dimensions of quality as well as quality indicators used on their units. RESULTS Data from this survey indicate how thought leaders conceptualized quality of inpatient care. A unifying philosophy of care was endorsed as a quality element as was structure that affords staff available time on the unit-engaging with patients. While staffing levels were viewed as important, the respondents commented on the nuances between staffing and quality. Participants endorsed the importance of involving individuals in their treatment planning as well as tapping into patients' perspectives on the treatment experience. CONCLUSIONS The participants' responses compliment the quality literature and reinforce the need to develop a comprehensive map of quality elements. These elements interact in complex way, for instance, staffing, engagement, and teamwork is tied to the organizational structure and philosophy of care, which in turn facilitates consumer involvement in care. Thus, gauging the impact of quality on outcomes will demand consideration of the interaction of factors not just the linear relationship of one element to an outcome.
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Affiliation(s)
- Kathleen R Delaney
- Kathleen R. Delaney, PhD, PMH-NP, FAAN, Rush College of Nursing, Chicago, IL, USA
| | | | - Richard Ray
- Richard Ray, MS, RN, PMH-BC, Northwestern Memorial Hospital Stone Institute of Psychiatry, Chicago, IL, USA
| | - Ellen W Blair
- Ellen Blair, DNP, APRN, PMHCNS-BC, Hartford Hospital, Hartford, CT, USA
| | - Marlene Nadler-Moodie
- Marlene Nadler-Moodie, MSN, APRN, PMHCNS-BC, Scripps Mercy Hospital San Diego, CA, USA
| | - Catherine Batscha
- Catherine Batscha, DNP, RN, University of Louisville, Louisville, KY, USA
| | - David M Sharp
- David Sharp, PhD, RN, Mississippi College, Clinton, MS, USA
| | - Dani Milliken
- Dani Milliken, DHA, MS, BSN, RN, Children's Hospital of Orange County, Orange, CA, USA
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Silva B, Pauli G, Diringer O, Morandi S, Bonsack C, Golay P. Perceived fairness as main determinant of patients' satisfaction with care during psychiatric hospitalisation: An observational study. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2022; 82:101793. [PMID: 35472846 DOI: 10.1016/j.ijlp.2022.101793] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Patient satisfaction with care is widely recognized as one of the most important indicator of quality in mental health care. It can impact several treatment outcomes, such as treatment adherence and engagement with services. At the same time, as an outcome in itself, satisfaction with care is also affected by several factors, first and foremost by being coerced. The main aim of this study was to test if perceiving treatment pressures as fair and effective could positively impact patient satisfaction, even more than formal coercive measures. METHODS Globally, 133 voluntary and involuntary inpatients were interviewed. Socio-demographic and clinical characteristics, including history of previous experiences of formal coercion and legal status of the hospitalisation, were collected through a structured questionnaire and medical charts. The participants were also asked to complete the Index of Fairness and Index of Effectiveness tools as well as a structured questionnaire on satisfaction with care. Simple and multiple linear regressions were performed. RESULTS Although several factors were found to affect satisfaction with care when taken independently, perceived fairness was the stronger predictor of both satisfaction with treatment (β =.234; p = .022) and satisfaction with decision-making involvement (β =.360; p < .001) when controlling for confounders. CONCLUSIONS Our results point to the paramount importance of developing and implementing interventions that promote procedural fairness in psychiatric treatment and thereby improve patient satisfaction while reducing the risk of disengagement with care.
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Affiliation(s)
- Benedetta Silva
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland; Cantonal Medical Office, Health of Canton of Vaud, Department of Health and Social Action (DSAS), Avenue des Casernes 2, 1014 Lausanne, Switzerland.
| | - Guillaume Pauli
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Oana Diringer
- Psychiatric Center of Neuchâtel (CNP), 2074 Marin-Epagnier, Switzerland
| | - Stéphane Morandi
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland; Cantonal Medical Office, Health of Canton of Vaud, Department of Health and Social Action (DSAS), Avenue des Casernes 2, 1014 Lausanne, Switzerland
| | - Charles Bonsack
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Philippe Golay
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland; General Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland; Institute of Psychology, Faculty of Social and Political Science, University of Lausanne, Switzerland
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Cocho Santalla C, Vera López I, Bardón Rivera B, Gómez Olmeda MD, Duque Domínguez R, Fadón Martín P, Blanco Prieto M, García Jorge S, Martínez Hernanz Á, Molina Serrano A, Mollejo Aparicio E, Nava García P, Salvador Robert M, Sánchez Morla EM, Sanz-Aranguez Ávila B, Vives Luengo A, Martínez Arias MR, Sanz Fuentenebro FJ. Satisfacción percibida con los ingresos en unidades de hospitalización breve psiquiátricas: diseño y validación del cuestionario PSYQUEST. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021. [DOI: 10.1016/j.rpsm.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kidd S, McKenzie K, Wang W, Agrawal S, Voineskos A. Examining a Digital Health Approach for Advancing Schizophrenia Illness Self-Management and Provider Engagement: Protocol for a Feasibility Trial. JMIR Res Protoc 2021; 10:e24736. [PMID: 33492235 PMCID: PMC7870355 DOI: 10.2196/24736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 11/13/2022] Open
Abstract
Background In schizophrenia spectrum populations, adherence to treatment is poor, community-based supports are limited, and efforts to foster illness self-management have had limited success. These challenges contribute to frequent, lengthy, and costly hospital readmissions and poor functional outcomes. Digital health strategies, in turn, hold considerable promise in the effort to address these problems. Objective This feasibility trial will examine a digital health platform called App4Independence (A4i), which was designed to enhance illness self-management and treatment engagement for individuals with schizophrenia. Methods Feasibility metrics in this single-blind, randomized trial include study recruitment and retention, rate of technology use, safety, and utility in clinical interactions. Other outcome metrics include symptomatology, treatment adherence, patient-provider alliance, and quality of life. In this trial, 160 study participants with schizophrenia spectrum diagnoses will be randomized to either treatment or control conditions, with pretest-posttest outcomes measured over a 6-month period. Results This study was funded by the Canadian Institutes of Health Research in January 2020 and received Institutional Review Board approval on August 13, 2020. This study plans to begin recruiting in January 2021 and will be completed within 3 years. Data collection is projected to begin in January 2021. Conclusions This research will provide critical information for the development of this new technology in the larger effort to address a key problem in the schizophrenia field—how to leverage technology to enhance illness self-management and care engagement in resource-limited service contexts. International Registered Report Identifier (IRRID) PRR1-10.2196/24736
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Affiliation(s)
- Sean Kidd
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Kwame McKenzie
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Wei Wang
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sacha Agrawal
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Ercis M, Seçkin M, Ayık B, Üçok A. Correlates of Patient Satisfaction in Psychiatric Inpatient Care: A Survey Study from a Tertiary Hospital in Turkey. J Psychosoc Nurs Ment Health Serv 2020; 59:38-47. [PMID: 33301044 DOI: 10.3928/02793695-20201203-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In the current study, a questionnaire to evaluate satisfaction levels and related factors upon discharge was completed by 100 patients receiving care for mental illness in a tertiary care hospital in Turkey. The relationships among sociodemographic variables, nonpharmacological interventions, and participants' views about the treatment course and quality of care they received were investigated. Overall satisfaction levels of participants were good. Older participants reported more positive opinions. Involuntary hospitalization, use of restraints/seclusion, or electroconvulsive therapy did not change overall satisfaction. Participants who were hospitalized for the first time were more afraid of other patients, which may imply that this population needs special care from the treatment team. Spending an adequate amount of time and providing necessary information about their treatment plan impact patients' treatment experience positively. [Journal of Psychosocial Nursing and Mental Health Services, 59(4), 38-47.].
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McBain RK, Collins RL, Wong EC, Breslau J, Cefalu MS, Roth E, Burnam MA. Mental Health Services and Personal Recovery in California: A Population-Based Analysis. Psychiatr Serv 2020; 71:580-587. [PMID: 32114940 PMCID: PMC7265972 DOI: 10.1176/appi.ps.201900204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Personal recovery measures have been examined among treatment-seeking individuals enrolled in high-quality care. The authors examined whether utilization of mental health services as typically delivered is associated with personal recovery among adults with clinically significant psychological distress. METHODS The Kessler Psychological Distress Scale (K-6) measured respondents' (N=1,954) psychological distress level. The authors also assessed five dimensions of personal recovery-hope, life satisfaction, empowerment, connectedness, and internalized stigma. Multivariable linear regression analyses were used to examine relationships between personal recovery and treatment, self-reported treatment completion, provider type, and adequacy of care, adjusting for covariates including K-6 score. RESULTS Participants who received care >12 months prior to the survey reported lower levels of hope (95% confidence interval [CI]=-0.36, -0.06, p<0.01), empowerment (95% CI=-0.26, -0.02, p<0.05), and connectedness (95% CI=-0.37, -0.06, p<0.01) than those who had not received treatment. Those who received care in the past 12 months reported lower levels of hope (95% CI=-0.47, -0.14, p<0.001) and life satisfaction (95% CI=-0.42, -0.05, p<0.01). However, treatment completion was associated with higher levels of empowerment (95% CI=0.02, 0.56, p<0.05) and hope (95% CI=0.04, 0.62, p<0.05) and lower levels of stigma (95% CI=-1.21, -0.21, p<0.01) compared with noncompletion. Differences according to provider type and adequacy of care were nonsignificant. CONCLUSIONS Utilization of mental health services was associated with lower levels of personal recovery, which may indicate that care-as typically utilized and received-does not promote personal recovery. Longitudinal research is needed to determine causal relationships underlying these associations.
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Affiliation(s)
- Ryan K McBain
- RAND Health Care, RAND Corporation, Boston (McBain); Santa Monica, California (Collins, Wong, Cefalu, Roth, Burnam); and Pittsburgh (Breslau)
| | - Rebecca L Collins
- RAND Health Care, RAND Corporation, Boston (McBain); Santa Monica, California (Collins, Wong, Cefalu, Roth, Burnam); and Pittsburgh (Breslau)
| | - Eunice C Wong
- RAND Health Care, RAND Corporation, Boston (McBain); Santa Monica, California (Collins, Wong, Cefalu, Roth, Burnam); and Pittsburgh (Breslau)
| | - Joshua Breslau
- RAND Health Care, RAND Corporation, Boston (McBain); Santa Monica, California (Collins, Wong, Cefalu, Roth, Burnam); and Pittsburgh (Breslau)
| | - Mathew S Cefalu
- RAND Health Care, RAND Corporation, Boston (McBain); Santa Monica, California (Collins, Wong, Cefalu, Roth, Burnam); and Pittsburgh (Breslau)
| | - Elizabeth Roth
- RAND Health Care, RAND Corporation, Boston (McBain); Santa Monica, California (Collins, Wong, Cefalu, Roth, Burnam); and Pittsburgh (Breslau)
| | - M Audrey Burnam
- RAND Health Care, RAND Corporation, Boston (McBain); Santa Monica, California (Collins, Wong, Cefalu, Roth, Burnam); and Pittsburgh (Breslau)
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Godoy JA, Pavan G, Monteiro RT, Motta LS, Pacheco MA, Nogueira EL, Spanemberg L. Satisfaction with care in a Brazilian psychiatric inpatient unit: differences in perceptions among patients according to type of health insurance. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2019; 41:27-35. [PMID: 30994784 DOI: 10.1590/2237-6089-2017-0156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/14/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION User satisfaction assessment in mental health services is an important indicator of treatment quality. The objective of this study was to evaluate treatment satisfaction in a sample of inpatients with mental disorders and the associations between levels of satisfaction and clinical/sociodemographic variables. METHODS This exploratory study investigated 227 psychiatric inpatients who answered the Patient Satisfaction with Mental Health Services Scale (SATIS-BR) and the Perception of Change Scale (EMP). SATIS scores were analyzed according to associations with clinical and sociodemographic data. Pearson correlations were used to correlate SATIS scores with other variables. RESULTS We found a high degree of satisfaction with care at the psychiatric inpatient unit assessed. In general, patients rated maximum satisfaction for most items. The highest satisfaction scores were associated with patients receiving treatment through the Brazilian Unified Health System (SUS) and with less education. SATIS showed a moderate positive correlation with EMP. The worst evaluated dimension was physical facilities and comfort of the ward. CONCLUSION Patients treated via SUS may be more satisfied than patients with private health insurance when treated in the same facility. The evaluation of treatment satisfaction can be used to reorganize services at psychiatric inpatient units.
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Affiliation(s)
| | | | - Ricardo Tavares Monteiro
- Núcleo de Formação Específica em Neurociências, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Luis Souza Motta
- Hospital São Lucas, PUCRS, Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Marco Antonio Pacheco
- Hospital São Lucas, PUCRS, Porto Alegre, RS, Brazil.,Núcleo de Formação Específica em Neurociências, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Eduardo Lopes Nogueira
- Hospital São Lucas, PUCRS, Porto Alegre, RS, Brazil.,Instituto de Geriatria e Gerontologia, PUCRS, Porto Alegre, RS, Brazil
| | - Lucas Spanemberg
- Hospital São Lucas, PUCRS, Porto Alegre, RS, Brazil.,Núcleo de Formação Específica em Neurociências, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
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Isobel S. 'In some ways it all helps but in some ways it doesn't': The complexities of service users' experiences of inpatient mental health care in Australia. Int J Ment Health Nurs 2019; 28:105-116. [PMID: 29897669 DOI: 10.1111/inm.12497] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2018] [Indexed: 11/30/2022]
Abstract
Recovery-oriented mental health care requires active involvement of service users in the evaluation of care. While experience of care surveys is routinely given out upon discharge, capturing the depth and detail of service users' experiences in such a way to meaningfully improve services may require more in-depth and targeted approaches. This study aimed to gather voluntary and involuntary service users' experiences of care during hospitalization in two acute adult mental health inpatient units, through the collaborative completion of a purpose designed tool. The purpose of the study was to examine broad experiences of care and to identify the utility of proactive approaches to ongoing service evaluation. Overall, 67 participants were interviewed. Findings highlight the complexity of experiences of care including how an admission can seemingly facilitate clinical recovery while not being recovery-oriented. The findings also detail areas for improvement in the way that care is delivered and evaluated. The implications are particularly pertinent for mental health nurses to consider how, within the existing constraints of their roles, they can provide therapeutic care to all service users.
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Affiliation(s)
- Sophie Isobel
- Mental Health Research, Sydney Local Health District, Concord Centre for Mental Health, Concord, New South Wales, Australia
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Mourelatou I, Gaete J, Fewings S, Hickie O, Kyriakopoulos M. What Was Helpful Questionnaire (WHQ): Psychometric Properties of a Novel Tool Designed to Capture Parental Perceived Helpfulness of Interventions in Children Requiring Mental Health Inpatient Care. Front Psychiatry 2019; 10:80. [PMID: 30863325 PMCID: PMC6399118 DOI: 10.3389/fpsyt.2019.00080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 02/05/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Children in mental health inpatient care require multiple treatments. There is not a comprehensive instrument to assess perceived helpfulness of this combination of interventions. Aims: To develop and evaluate the psychometric properties of the What was Helpful Questionnaire (WHQ), a tool designed to capture parental perceived helpfulness of the multidimensional management approach used in inpatient children's units. Methods: A total of 73 inpatients and their families were included in this study. The WHQ consists of six items exploring the perceived helpfulness of different aspects of care. Demographic and clinical variables were collected on admission and discharge. An exploratory factor analysis using polychoric correlations was performed to assess the item structure of the scale and the Cronbach's alpha coefficient was used for internal reliability. Associations were assessed using regressions models. Results: WHQ is a unidimensional scale with an internal reliability of 0.77. No associations were identified between WHQ total score and age, gender, and Children's Global Assessment Scale scores change. A strong relationship between the WHQ total score and parental Acorn Satisfaction Questionnaire total score was found. Conclusions: Results add evidence for the validity and the reliability of the WHQ to measure parental perceived helpfulness of interventions offered in inpatient children's units.
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Affiliation(s)
- Ifigeneia Mourelatou
- National and Specialist Acorn Lodge Inpatient Children's Unit, South London and Mausdley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
| | - Jorge Gaete
- National and Specialist Acorn Lodge Inpatient Children's Unit, South London and Mausdley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom.,Department of Public Health and Epidemiology, Faculty of Medicine, Universidad de los Andes, Santiago, Chile
| | - Sandra Fewings
- National and Specialist Acorn Lodge Inpatient Children's Unit, South London and Mausdley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
| | - Oona Hickie
- National and Specialist Acorn Lodge Inpatient Children's Unit, South London and Mausdley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
| | - Marinos Kyriakopoulos
- National and Specialist Acorn Lodge Inpatient Children's Unit, South London and Mausdley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Ratner Y, Zendjidjian XY, Mendyk N, Timinsky I, Ritsner MS. Patients' satisfaction with hospital health care: Identifying indicators for people with severe mental disorder. Psychiatry Res 2018; 270:503-509. [PMID: 30347377 DOI: 10.1016/j.psychres.2018.10.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 09/14/2018] [Accepted: 10/08/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Patients' perception of psychiatric healthcare is a critical indicator in measuring service quality. The aim of the study was to determine patient's level of satisfaction with the quality of health care delivered at the inpatient departments, and to identify the service quality factors that were important to patients. METHOD The Satisfaction with Psychiatry Care Questionnaire-22 was administered to 125 consecutive inpatients with schizophrenia or schizoaffective disorder in a stable condition. Sociodemographic and background variables, illness and symptom severity, insight, social anhedonia, self-esteem, perceived social support, and satisfaction with quality of life were collected. RESULTS Although the participants generally expressed satisfaction with the inpatient services, they indicated that the weakest aspects of the service were in the domains of 'personal experience', 'information' and 'activity'. Women were significantly more dissatisfied than men with 'staff', 'care', and by general satisfaction. Multiple regression analysis revealed that satisfaction with hospital health care was associated with five indicators: insight, satisfaction with physical health, self-efficacy, family support, and social anhedonia. CONCLUSION Personality related factors rather than psychopathological symptoms were associated with a satisfaction with care of admitted patients with severe mental illness. These factors could be targets for interventions aimed to improve treatment and hospital services.
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Affiliation(s)
- Yael Ratner
- Shaar Menashe Mental Health Center, Hadera, Israel
| | - Xavier Y Zendjidjian
- Aix-Marseille Univ, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Marseille, France.
| | - Nina Mendyk
- Shaar Menashe Mental Health Center, Hadera, Israel.
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Silva SN, Lima MG, Ruas CM. Brazilian Mental Health Services Assessment: user satisfaction and associated factors. CIENCIA & SAUDE COLETIVA 2018; 23:3799-3810. [PMID: 30427450 DOI: 10.1590/1413-812320182311.25722016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 11/11/2016] [Indexed: 11/21/2022] Open
Abstract
Patient satisfaction is an important criterion for assessing the quality of Brazilian mental health services at Psychosocial Care Centers (CAPS - from the Portuguese 'Centro de Atenção Psicossocial'). The aim of this study was to evaluate the satisfaction of users at the main CAPS in a region of Minas Gerais state, Brazil, as well as associated factors. This was a cross-sectional study with 11 CAPS. Patients were interviewed using the Patient Satisfaction with Mental Health Services Scale (SATIS-BR) and a semi-structured questionnaire containing sociodemographic and clinical variables. The users were satisfied with the CAPS, particularly in terms of staff competence and the welcome received and care provided. The physical facilities and comfort at the centers obtained the lowest satisfaction scores on the scale. Almost half of the users were unfamiliar with basic aspects of their drug therapy, such as the name of medicines, and one-third reported inappropriate use of medications. Users of midsize CAPS and those providing treatment for alcohol and drug addiction were more satisfied than patients at mental health or 24-hour CAPS. Although this study identified a need for improvement in physical facilities, mechanisms of participation and patient empowerment, the users were satisfied with the CAPS care model.
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Affiliation(s)
- Sarah Nascimento Silva
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Departamento de Farmácia Social, Faculdade de Farmácia, Universidade Federal de Minas Gerais (UFMG). Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
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Hornik-Lurie T, Shalev A, Haknazar L, Garber Epstein P, Ziedenberg-Rehav L, Moran GS. Implementing recovery-oriented interventions with staff in a psychiatric hospital: A mixed-methods study. J Psychiatr Ment Health Nurs 2018; 25:569-581. [PMID: 30411432 DOI: 10.1111/jpm.12502] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/28/2018] [Accepted: 11/02/2018] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Recovery-oriented care is a means of providing mental health treatment, focused on the patient's individual needs and active involvement in one's own care. However, this approach presents with challenges, particularly in psychiatric hospitals, which tend to be focused on symptom reduction. WHAT DOES THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study examines the influence of three different recovery-oriented training programmes/interventions (namely, illness management and recovery, peer support, and psychiatric advance directives) on the attitudes and practice of mental health staff (including nurses) in an inpatient setting, using a mixed-methods methodology. We quantitatively assess the knowledge, attitudes and practices developed following recovery-oriented training, compared to staff not trained in these interventions. We interviewed staff exposed to the different interventions to learn about their personal views and characterized the benefits and challenges they experienced. Mainly, the illness management and recovery training created a positive change in the work attitude and some work-related practices of mental health staff and the increased presence of a person-centred approach supporting patient autonomy. However, and contrary to expectations, there was no increase in practices that support personal goals or provide individually tailored services. Peer support had an experiential impact among mental health staff, initiating a more humane, positive approach to patients. Psychiatric advance directives were reported as more challenging to implement and with limited impact. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Recovery-oriented trainings can be internalized and implemented by staff in medical model psychiatric settings. Despite recovery-oriented training, challenges do occur-notably, they are hardest to implement in acute wards/patient states and by psychiatric nurses. Using multiple recovery-oriented programmes/interventions can accelerate the momentum for change in traditional settings and promote positive practice. Ongoing comprehensive mental health staff training on recovery-oriented care programmes is essential in order to sustain change over time. Training is not enough in itself-hospital administrations need to be actively involved in promoting recovery-oriented policies. ABSTRACT: Introduction Developing person-centred recovery-oriented care is a challenge in mental health systems, particularly psychiatric hospitals. Aim To assess the knowledge, attitudes and practices developed following recovery-oriented training of nurses and other staff; to identify the benefits and challenges involved in the implementation of recovery-oriented intervention in psychiatric wards. Method A mixed-methods study compared recovery knowledge, attitudes and practices of 37 mental health ward staff trained in recovery-oriented intervention, against 35 staff not trained. Fifteen staff were interviewed about their experiences, and protocols were qualitatively analysed. Results The quantitative outcomes partially confirmed positive changes in attitudes and some practices. Qualitative interviews complemented these findings, revealing greater use of a person-centred approach and support for patient autonomy. However, we did not find differences between groups in quantitative outcomes pertaining to personal goals or providing individually tailored services. Discussion This study validates the implementation of recovery training and practices in psychiatric settings, and identifies the challenges involved. We discuss psychiatric nurse conflicts in implementation in acute wards. Implications for practice Our findings support the need for broader staff training in recovery-oriented interventions. Recruiting the support of the hospital administration for recovery-oriented intervention programmes is key, both ethically and structurally.
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Affiliation(s)
- Tzipi Hornik-Lurie
- The Falk Institute for Mental Health Studies, Kfar Shaul Hospital, Jerusalem, Israel
| | - Anat Shalev
- Spitzer Department of Social Work, Ben Gurion University of the Negev, Beer-Sheva, Israel.,Beer-Sheva Mental Health Center, Beer Sheva, Israel
| | - Lior Haknazar
- Spitzer Department of Social Work, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | | | | | - Galia S Moran
- Spitzer Department of Social Work, Ben Gurion University of the Negev, Beer-Sheva, Israel
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White DA, McGuire AB, Luther L, Anderson AI, Phalen P, McGrew JH. Consumer factors predicting level of treatment response to illness management and recovery. Psychiatr Rehabil J 2017; 40:344-353. [PMID: 28910123 PMCID: PMC5739957 DOI: 10.1037/prj0000284] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aims to identify consumer-level predictors of level of treatment response to illness management and recovery (IMR) to target the appropriate consumers and aid psychiatric rehabilitation settings in developing intervention adaptations. METHOD Secondary analyses from a multisite study of IMR were conducted. Self-report data from consumer participants of the parent study (n = 236) were analyzed for the current study. Consumers completed prepost surveys assessing illness management, coping, goal-related hope, social support, medication adherence, and working alliance. Correlations and multiple regression analyses were run to identify self-report variables that predicted level of treatment response to IMR. RESULTS Analyses revealed that goal-related hope significantly predicted level of improved illness self-management, F(1, 164) = 10.93, p < .001, R2 = .248, R2 change = .05. Additionally, we found that higher levels of maladaptive coping at baseline were predictive of higher levels of adaptive coping at follow-up, F(2, 180) = 5.29, p < .02, R2 = .38, R2 change = .02. Evidence did not support additional predictors. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Previously, consumer-level predictors of level of treatment response have not been explored for IMR. Although 2 significant predictors were identified, study findings suggest more work is needed. Future research is needed to identify additional consumer-level factors predictive of IMR treatment response in order to identify who would benefit most from this treatment program. (PsycINFO Database Record
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Affiliation(s)
- Dominique A White
- Department of Psychology, Indiana University-Purdue University Indianapolis
| | - Alan B McGuire
- Health Services Research and Development, Richard L. Roudebush, Veterans Affairs Medical Center
| | - Lauren Luther
- Department of Psychology, Indiana University-Purdue University Indianapolis
| | | | - Peter Phalen
- School of Psychological Sciences, University of Indianapolis
| | - John H McGrew
- Department of Psychology, Indiana University-Purdue University Indianapolis
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Lim E, Wynaden D, Heslop K. Recovery-focussed care: How it can be utilized to reduce aggression in the acute mental health setting. Int J Ment Health Nurs 2017; 26:445-460. [PMID: 28960737 DOI: 10.1111/inm.12378] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2017] [Indexed: 12/19/2022]
Abstract
Consumer aggression is common in the acute mental health inpatient setting. Mental health nurses can utilize a range of interventions to prevent aggression or reduce its impact on the person and others who have witnessed the event. Incorporating recovery-focussed care into clinical practice is one intervention, as it fosters collaborative partnerships with consumers. It promotes their engagement in decisions about their care and encourages self-management of their presenting behaviours. It also allows the consumer to engage in their personal recovery as their mental health improve. Yet there is a paucity of literature on how nurses can utilize recovery-focussed care with consumers who are hospitalized and in the acute phase of their illness. In the present study, we report the findings of a scoping review of the literature to identify how recovery-focussed care can be utilized by nurses to reduce the risk of consumer aggression. Thirty-five papers met the inclusion criteria for review. Four components were identified as central to the use of recovery-focussed care with consumers at risk of becoming aggressive: (i) seeing the person and not just their presenting behaviour; (ii) interact, don't react; (iii) coproduction to achieve identified goals; and (iv) equipping the consumer as an active manager of their recovery. The components equip nurses with strategies to decrease the risk of aggression, while encouraging consumers to self-manage their challenging behaviours and embark on their personal recovery journey. Further research is required to evaluate the translation of these components clinically in the acute care setting.
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Affiliation(s)
- Eric Lim
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - Dianne Wynaden
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - Karen Heslop
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
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Krupchanka D, Khalifeh H, Abdulmalik J, Ardila-Gómez S, Armiya'u AY, Banjac V, Baranov A, Bezborodovs N, Brecic P, Čavajda Z, de Girolamo G, Denisenko M, Dickens HA, Dujmovic J, Ergovic Novotny D, Fedotov I, Fernández MA, Frankova I, Gasparovic M, Giurgi-Oncu C, Grahovac T, James BO, Jomli R, Kekin I, Knez R, Lanfredi M, Lassman F, Mehta N, Nacef F, Nawka A, Nemirovsky M, Ola BA, Oshodi YO, Ouali U, Peharda T, Razic Pavicic A, Rojnic Kuzman M, Roventa C, Shamenov R, Smirnova D, Smoljanic D, Spikina A, Thornicroft A, Tomicevic M, Vidovic D, Williams P, Yakovleva Y, Zhabenko O, Zhilyaeva T, Zivkovic M, Thornicroft G, Sartorius N. Satisfaction with psychiatric in-patient care as rated by patients at discharge from hospitals in 11 countries. Soc Psychiatry Psychiatr Epidemiol 2017; 52:989-1003. [PMID: 28285452 DOI: 10.1007/s00127-017-1366-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 02/16/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE There is disregard in the scientific literature for the evaluation of psychiatric in-patient care as rated directly by patients. In this context, we aimed to explore satisfaction of people treated in mental health in-patient facilities. The project was a part of the Young Psychiatrist Program by the Association for the Improvement of Mental Health Programmes. METHODS This is an international multicentre cross-sectional study conducted in 25 hospitals across 11 countries. The research team at each study site approached a consecutive target sample of 30 discharged patients to measure their satisfaction using the five-item study-specific questionnaire. Individual and institution level correlates of 'low satisfaction' were examined by comparisons of binary and multivariate associations in multilevel regression models. RESULTS A final study sample consisted of 673 participants. Total satisfaction scores were highly skewed towards the upper end of the scale, with a median total score of 44 (interquartile range 38-48) out of 50. After taking clustering into account, the only independent correlates of low satisfaction were schizophrenia diagnosis and low psychiatrist to patient ratio. CONCLUSION Further studies on patients' satisfaction should additionally pay attention to treatment expectations formed by the previous experience of treatment, service-related knowledge, stigma and patients' disempowerment, and power imbalance.
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Affiliation(s)
- Dzmitry Krupchanka
- Department of Social Psychiatry, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic. .,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Hind Khalifeh
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Sara Ardila-Gómez
- Research Institute, School of Psychology, University of Buenos Aires, Buenos Aires, Argentina
| | | | - Visnja Banjac
- Clinic of Psychiatry, University Clinical Center of the Republic of Srpska, Banjaluka, Bosnia and Herzegovina
| | | | | | | | - Zoran Čavajda
- Department of Acute and Biological Psychiatry, Clinical Hospital Centre Osijek, Osijek, Croatia
| | - Giovanni de Girolamo
- Unit of Psychiatric Epidemiology and Evaluation, Saint John of God Clinical Research Centre, Brescia, Italy
| | - Maria Denisenko
- Mental Health Clinic No1, Nizhny Novgorod, Russian Federation
| | | | | | | | - Ilya Fedotov
- Ryazan State Medical University, Ryazan, Russian Federation
| | - Marina A Fernández
- Research Institute, School of Psychology, University of Buenos Aires, Buenos Aires, Argentina
| | | | | | - Catalina Giurgi-Oncu
- ″Victor Babes" University of Medicine and Pharmacy of Timisoara, Timisoara, Romania
| | | | - Bawo O James
- Federal Neuro-Psychiatric Hospital, Benin City, Nigeria
| | - Rabaa Jomli
- Department of Psychiatry "A" at Razi Hospital, Manouba, Tunisia.,Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Ivana Kekin
- University Hospital Centre Zagreb, Zagreb, Croatia
| | - Rajna Knez
- University Hospital Center Rijeka, Rijeka, Croatia
| | - Mariangela Lanfredi
- Unit of Psychiatry, Saint John of God Clinical Research Centre, Brescia, Italy
| | | | | | - Fethi Nacef
- Department of Psychiatry "A" at Razi Hospital, Manouba, Tunisia.,Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Alexander Nawka
- Institute of Neuropsychiatric Care (INEP), Prague, Czech Republic
| | | | | | - Yewande O Oshodi
- Department of Psychiatry, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Uta Ouali
- Department of Psychiatry "A" at Razi Hospital, Manouba, Tunisia.,Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | | | | | - Martina Rojnic Kuzman
- University Hospital Centre Zagreb, Zagreb, Croatia.,Zagreb School of Medicine, Zagreb, Croatia
| | | | | | - Daria Smirnova
- Department of Psychiatry, Samara State Medical University, Samara, Russian Federation
| | | | - Anna Spikina
- Medical University Named After I.I. Mechnikov, Saint Petersburg, Russian Federation
| | - Amalia Thornicroft
- Occupational Therapy Department, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Marko Tomicevic
- Neuropsychiatric Hospital "Dr. Ivan Barbot", Popovaca, Croatia
| | | | - Paul Williams
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Yulia Yakovleva
- Saint Petersburg Bekhterev Psychoneurological Research Institute, Saint Petersburg, Russian Federation
| | - Olena Zhabenko
- Railway Clinical Hospital #1 Station Kyiv, Kyiv, Ukraine
| | - Tatiana Zhilyaeva
- Department of Psychiatry and Medical Psychology, Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russian Federation
| | - Maja Zivkovic
- University Psychiatric Hospital Vrapce, Zagreb, Croatia
| | - Graham Thornicroft
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneve, Switzerland
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Polacek MJ, Allen DE, Damin-Moss RS, Schwartz AJA, Sharp D, Shattell M, Souther J, Delaney KR. Engagement as an Element of Safe Inpatient Psychiatric Environments. J Am Psychiatr Nurses Assoc 2015; 21:181-90. [PMID: 26156057 DOI: 10.1177/1078390315593107] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND The American Psychiatric Nurses Association (APNA) Institute for Safe Environments (ISE) has focused on key elements that affect safety in psychiatric treatment environments; one of these key elements is patient engagement. An ISE workgroup discussed and reviewed the literature on engagement and safety in inpatient psychiatric settings. This article presents what we have learned about the role that engagement plays in inpatient treatment of severely mentally ill individuals and evidence that links nurse-patient engagement to safety. OBJECTIVES To describe, using supporting literature, the role that nurse-patient engagement plays in creating safe, therapeutic environments for individuals with severe mental illness. DESIGN (1) Define engagement and describe why it is an important element of safe treatment environments; (2) identify what helps and what hinders patients in their engagement with nurses, and nurses in their engagement with patients; (3) describe how engagement may improve unit safety; and (4) propose recommendations and set future directions for practice, research, and education. CONCLUSION Engagement may provide the foundation for safe, therapeutic, and recovery-oriented treatment. In the future, APNA's ISE plans to build upon this foundation by developing a clinical model of nurse-patient engagement and safety by drawing together emerging research and practice models.
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Affiliation(s)
| | - Diane E Allen
- Diane E. Allen, MN, RN-BC, NEA-BC, New Hampshire Hospital, Concord, NH, USA
| | - Rebecca S Damin-Moss
- Rebecca S. Damin-Moss, MSn, CARN-BC, CPHQ, Durham VA Medical Center, Durham, NC, USA
| | | | - David Sharp
- David Sharp, PhD, RN, Louisiana College, Pineville, LA, USA
| | - Mona Shattell
- Mona Shattell, PhD, RN, FAAN, DePaul University, Chicago, IL, USA
| | - Justin Souther
- Justin Souther, RN-BC, New Hampshire Hospital, Concord, NH, USA
| | - Kathleen R Delaney
- Kathleen R. Delaney, PhD, PMH-NP, Rush College of Nursing, Chicago, IL, USA
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Delaney KR, Johnson ME, Fogg L. Development and testing of the combined assessment of psychiatric environments: a patient-centered quality measure for inpatient psychiatric treatment. J Am Psychiatr Nurses Assoc 2015; 21:134-47. [PMID: 25979881 DOI: 10.1177/1078390315581338] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Inpatient psychiatric treatment satisfaction measures are not constructed from patients' perspective of hospitalization experiences that they deem meaningful and important. OBJECTIVE To develop and conduct psychometric testing of a measure that evaluates person-centered care on inpatient psychiatric units, the Combined Assessment of Psychiatric Environments (CAPE). The measure is built on a theoretical framework holding that if optimal care is to be achieved, all major stakeholders (patients and staff) need to experience a positive environment. DESIGN An instrument development design was used to create the patient/staff nurse versions of the CAPE and to test their dimensions. The pilot versions of the CAPE were tested on six inpatient psychiatric units to determine the psychometrics of the staff/patient versions. RESULTS The overall reliability of both versions of the CAPE (staff/patient) was .91. The test-retest reliability for both versions was significant at the .01 level. Construct validity was established via factor analysis. Criterion-related validity was demonstrated by correlations of the two versions of the CAPE to instruments that were conceptually related. CONCLUSION The CAPE is a valid and reliable instrument that can be used to examine practice and the patient experience on inpatient psychiatric units. The CAPE highlights that patient-centered environments of care are intertwined with staff experiences of support for their role.
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Affiliation(s)
- Kathleen R Delaney
- Kathleen R. Delaney, PhD, PMH-NP, FAAN, Rush University College of Nursing, Chicago, IL, USA
| | - Mary E Johnson
- Mary E. Johnson, PhD, RN, PMHCNS-BC, FAAN, Rush University College of Nursing, Chicago, IL, USA
| | - Louis Fogg
- Louis Fogg, PhD, Rush University College of Nursing, Chicago, IL, USA
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18
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Kidd SA, McKenzie KJ, Virdee G. Mental health reform at a systems level: widening the lens on recovery-oriented care. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2014; 59:243-9. [PMID: 25007277 PMCID: PMC4079144 DOI: 10.1177/070674371405900503] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 02/01/2014] [Indexed: 11/15/2022]
Abstract
This paper is an initial attempt to collate the literature on psychiatric inpatient recovery-based care and, more broadly, to situate the inpatient care sector within a mental health reform dialogue that, to date, has focused almost exclusively on outpatient and community practices. We make the argument that until an evidence base is developed for recovery-oriented practices on hospital wards, the effort to advance recovery-oriented systems will stagnate. Our scoping review was conducted in line with the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (commonly referred to as PRISMA) guidelines. Among the 27 papers selected for review, most were descriptive or uncontrolled outcome studies. Studies addressing strategies for improving care quality provide some modest evidence for reflective dialogue with former inpatient clients, role play and mentorship, and pairing general training in recovery oriented care with training in specific interventions, such as Illness Management and Recovery. Relative to some other fields of medicine, evidence surrounding the question of recovery-oriented care on psychiatric wards and how it may be implemented is underdeveloped. Attention to mental health reform in hospitals is critical to the emergence of recovery-oriented systems of care and the realization of the mandate set forward in the Mental Health Strategy for Canada.
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Affiliation(s)
- Sean A Kidd
- Assistant Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario; Head, Psychology Service, Complex Mental Illness Program, Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario
| | - Kwame J McKenzie
- Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario; Medical Director, Underserved Populations Program, Centre for Addiction and Mental Health, Toronto, Ontario
| | - Gursharan Virdee
- Student, City University, Department of Psychology, London, England; Research Analyst, Complex Mental Illness Program, Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Ontario
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19
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Tang L. Helping the decision maker effectively promote various experts' views into various optimal solutions to China's institutional problem of health care provider selection through the organization of a pilot health care provider research system. Health Res Policy Syst 2013; 11:11. [PMID: 23557082 PMCID: PMC3623858 DOI: 10.1186/1478-4505-11-11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 03/19/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The main aim of China's Health Care System Reform was to help the decision maker find the optimal solution to China's institutional problem of health care provider selection. A pilot health care provider research system was recently organized in China's health care system, and it could efficiently collect the data for determining the optimal solution to China's institutional problem of health care provider selection from various experts, then the purpose of this study was to apply the optimal implementation methodology to help the decision maker effectively promote various experts' views into various optimal solutions to this problem under the support of this pilot system. METHODS After the general framework of China's institutional problem of health care provider selection was established, this study collaborated with the National Bureau of Statistics of China to commission a large-scale 2009 to 2010 national expert survey (n = 3,914) through the organization of a pilot health care provider research system for the first time in China, and the analytic network process (ANP) implementation methodology was adopted to analyze the dataset from this survey. RESULTS The market-oriented health care provider approach was the optimal solution to China's institutional problem of health care provider selection from the doctors' point of view; the traditional government's regulation-oriented health care provider approach was the optimal solution to China's institutional problem of health care provider selection from the pharmacists' point of view, the hospital administrators' point of view, and the point of view of health officials in health administration departments; the public private partnership (PPP) approach was the optimal solution to China's institutional problem of health care provider selection from the nurses' point of view, the point of view of officials in medical insurance agencies, and the health care researchers' point of view. CONCLUSIONS The data collected through a pilot health care provider research system in the 2009 to 2010 national expert survey could help the decision maker effectively promote various experts' views into various optimal solutions to China's institutional problem of health care provider selection.
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Affiliation(s)
- Liyang Tang
- Department of Economics, School of Economics and Management, Tsinghua University, Beijing 100084, China.
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20
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Holikatti PC, Kar N, Mishra A, Shukla R, Swain SP, Kar S. A study on patient satisfaction with psychiatric services. Indian J Psychiatry 2012; 54:327-32. [PMID: 23372234 PMCID: PMC3554963 DOI: 10.4103/0019-5545.104817] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
CONTEXT Patient satisfaction with psychiatric services is an important construct, which influences multiple areas including treatment adherance and outcome. There is paucity of studies from India in this area. AIMS To measure satisfaction of psychiatric outpatients of Mental Health Institute, Cuttack, and to assess the relationship between demographic and clinical variables with different domains of patient satisfaction. SETTINGS AND DESIGN In a cross-sectional study, patients of age 18-60 years receiving treatment for at least six months from outpatient department of Mental Health Institute, SCB Medical College, Cuttack, were assessed. MATERIALS AND METHODS Participants (n=60) were selected randomly. Satisfaction was assessed by Patient Satisfaction Questionnaire-18 (PSQ-18) and the diagnoses were based on the Diagnostic and Statistical Manual-IV-TR. Severity of psychiatric disorder was measured using Clinical Global Impression-severity scale. The functioning level was assessed by Global Assessment of Functioning. STATISTICAL ANALYSIS Continuous variables compared using independent t-test or analysis of variance. RESULTS Diagnostic break-up of the patients included anxiety disorder (36.6%), major depressive disorder (30.0%), bipolar disorder (16.6%), and schizophrenia (16.6%). Greatest level of satisfaction was noted in interpersonal aspects (71.4%) and time spent with doctors (62.4%). General satisfaction level was a little over 50% (57%). Differences between composite scores of PSQ-18 in the diagnostic categories were statistically significant; patients with depression had the highest score followed by those with anxiety disorder, bipolar, and the least was with schizophrenia patients. There was variability among the demographic and clinical groups regarding the various subscale score of PSQ-18. CONCLUSIONS Satisfaction of psychiatric outpatients was observed to be different in various clinical and demographic groups and across many domains of satisfaction.
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Affiliation(s)
- Prabhakar C Holikatti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, (PGIMER), Chandigarh, India
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21
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Translating and Adapting Mental Health Service Outcome Measurements for Use in Taiwan. J Nurs Res 2011; 19:190-8. [DOI: 10.1097/jnr.0b013e318228cf9f] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Berghofer G, Castille DM, Link B. Evaluation of Client Services (ECS): a measure of treatment satisfaction for people with chronic mental illnesses. Community Ment Health J 2011; 47:399-407. [PMID: 20582570 DOI: 10.1007/s10597-010-9331-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2009] [Accepted: 06/08/2010] [Indexed: 01/18/2023]
Abstract
This article describes the development and psychometric assessment of the Evaluation of Client Services (ECS) measure of treatment satisfaction for people with chronic mental illnesses in community treatment settings. The ECS, a 20-item instrument, was validated in a sample of 184 individuals receiving outpatient mental health treatment in New York City. The four dimensions of the ECS, (1) treatment management and treatment outcome, (2) treatment relationship, (3) communication and information exchange, and (4) reachability of treatment facilities are internally consistent and stable over time. Analyses also show that the ECS is a valid indicator of satisfaction with mental health services which meaningfully correlates with quality of life and another measure of treatment satisfaction. The ECS is a brief and easy to understand treatment satisfaction tool with good psychometric properties.
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Affiliation(s)
- Gerlinde Berghofer
- Department of Quality Assurance, Psychosocial Services Vienna, Gonzagagasse 15, 1013 Vienna, Austria.
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23
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Zahid MA, Ohaeri JU, Al-Zayed AA. Factors associated with hospital service satisfaction in a sample of Arab subjects with schizophrenia. BMC Health Serv Res 2010; 10:294. [PMID: 20979599 PMCID: PMC2984495 DOI: 10.1186/1472-6963-10-294] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2009] [Accepted: 10/27/2010] [Indexed: 11/10/2022] Open
Abstract
Background Assessment of patients' satisfaction with health care services could help to identify the strengths and weaknesses of the system and provide guidance for further development. The study's objectives were to: (i) assess the pattern of satisfaction with hospital care for a sample of people with schizophrenia in Kuwait, using the Verona Service Satisfaction Scale (VSSS-EU); ii) compare the pattern of satisfaction with those of similar studies; and iii) assess the association of VSSS seven domains with a number of variables representing met and unmet needs for care, family caregiver burden, severity of psychopathology, level of psychosocial functioning, socio-demographic characteristics, psychological well-being and objective quality of life. Methods Consecutive outpatients in stable condition and their family caregivers were interviewed with the VSSS-EU and measures of needs for care, caregiver burden, quality of life and psychopathology. Results There were 130 patients (66.1%m, mean age 36.8). While over two-thirds expressed satisfaction with the domains of "overall satisfaction", "professionals' skills", "access", "efficacy", and "relatives' involvement", only about one-third were satisfied with the domains of "information" and "types of intervention". The later two domains were the areas in which European patients had better satisfaction than our patients, while our patients expressed better satisfaction than the Europeans in the domain of "relatives' involvement". In multiple regression analyses, self-esteem, positive and negative affect were the most important correlates of the domains of service satisfaction, while clinical severity, caregiver burden and health unmet needs for care played relatively minor roles. Conclusion The noted differences and similarities with the international data, as well as the predictive power of self-esteem and affective state, support the impression that patients' attitudes towards psychiatric care involve a complex relationship between clinical, personal and socio-cultural characteristics; and that many of the factors that impact on satisfaction with service relate to individual psychological characteristics. The weaknesses in the system, highlighted by the pattern of responses of the participants, indicate possible gaps in the provision of comprehensive psychiatric care in the country and obviate the need for public mental health education and development of services to enhance the quality of care.
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Affiliation(s)
- Muhammad A Zahid
- Department of Psychiatry, Faculty of Medicine, Kuwait University, PO Box 24923, Safat, 13110, Kuwait.
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24
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Tempier R, Hepp SL, Duncan CR, Rohr B, Hachey K, Mosier K. Patient-centered care in affective, non-affective, and schizoaffective groups: patients' opinions and attitudes. Community Ment Health J 2010; 46:452-60. [PMID: 20480394 DOI: 10.1007/s10597-010-9316-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Accepted: 04/28/2010] [Indexed: 01/17/2023]
Abstract
An outcome evaluation was conducted to obtain psychiatric inpatients' perspectives on acute care mental health treatment and services. The applicability of diagnostic categories based on affective, non-affective, and schizoaffective disorder were considered in the predictability of responses to treatment regimens and the related services provided in an inpatient psychiatric unit. A multidimensional approach was used to survey patients, which included the DAI-30, the BMQ, the SERVQUAL, and the CSQ-8. Overall, findings indicate that inpatient satisfaction could be improved with tailoring treatment to suit their respective symptoms. Furthermore, this exploratory study demonstrates some preliminary support for the inclusion of patients with a diagnosis of schizoaffective disorder as a separate group toward improving acute mental health care while hospitalized.
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Affiliation(s)
- Raymond Tempier
- Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada.
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