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Taksal A, Mohan G, Malla A, Rabouin D, Levasseur M, Rangaswamy T, Padmavati R, Joober R, Margolese HC, Schmitz N, Iyer SN. Patient- and family-reported experiences of their treating teams in early psychosis services in Chennai, India and Montreal, Canada. Asian J Psychiatr 2024; 98:104118. [PMID: 38908214 DOI: 10.1016/j.ajp.2024.104118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Cross-cultural psychosis research has mostly focused on outcomes, rather than patient and family experiences. Therefore, our aim was to examine differences in patients' and families' experiences of their treating teams in early intervention services for psychosis in Chennai, India [low- and middle-income country] and Montreal, Canada [high-income country]. METHODS Patients (165 in Chennai, 128 in Montreal) and their families (135 in Chennai, 110 in Montreal) completed Show me you care, a patient- and family-reported experience measure, after Months 3, 12, and 24 in treatment. The measure assesses the extent to which patients and families view treating teams as being supportive. A linear mixed model with longitudinal data from patient and family dyads was used to test the effect of site (Chennai, Montreal), stakeholder (patient, family), and time on Show me you care scores. This was followed by separate linear mixed effect models for patients and families with age and gender, as well as symptom severity and functioning as time-varying covariates. RESULTS As hypothesized, Chennai patients and families reported more supportive behaviours from their treating teams (β=4.04; β= 9, respectively) than did Montreal patients (Intercept =49.6) and families (Intercept=42.45). Higher symptom severity over follow-up was associated with patients reporting lower supportive behaviours from treating teams. Higher levels of positive symptoms (but lower levels of negative symptoms) over follow-up were associated with families reporting lower supportive behaviours from treating teams. There was no effect of time, age, gender and functioning. CONCLUSIONS The levels to which treating teams are perceived as supportive may reflect culturally shaped attitudes (e.g., warmer attitudes towards healthcare providers in India vis-à-vis Canada) and actual differences in how supportive treating teams are, which too may be culturally shaped. Being expected to be more involved in treatment, Chennai families may receive more attention and support, which may further reinforce their involvement. Across contexts, those who improve over follow-up may see their treating teams more positively.
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Affiliation(s)
- Aarati Taksal
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, 6875, Lasalle Boulevard, Montreal, QC H4H 1R3, Canada
| | - Greeshma Mohan
- Schizophrenia Research Foundation (SCARF), R/7A North Main Road, Anna Nagar (West Extn.), Chennai, TN 600101, India
| | - Ashok Malla
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, 6875, Lasalle Boulevard, Montreal, QC H4H 1R3, Canada; Department of Psychiatry, McGill University, Ludmer Research & Training Building, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada
| | - Daniel Rabouin
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, 6875, Lasalle Boulevard, Montreal, QC H4H 1R3, Canada
| | | | - Thara Rangaswamy
- Schizophrenia Research Foundation (SCARF), R/7A North Main Road, Anna Nagar (West Extn.), Chennai, TN 600101, India
| | - Ramachandran Padmavati
- Schizophrenia Research Foundation (SCARF), R/7A North Main Road, Anna Nagar (West Extn.), Chennai, TN 600101, India
| | - Ridha Joober
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, 6875, Lasalle Boulevard, Montreal, QC H4H 1R3, Canada; Department of Psychiatry, McGill University, Ludmer Research & Training Building, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada
| | - Howard C Margolese
- Department of Psychiatry, McGill University, Ludmer Research & Training Building, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; Prevention and Early Intervention Program for Psychosis, McGill University Health Centre (PEPP-MUHC), Institute Allan Memorial, 1025, avenue Pine Ouest, Montréal, QC H3A 1A, Canada
| | - Norbert Schmitz
- Department of Psychiatry, McGill University, Ludmer Research & Training Building, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada
| | - Srividya N Iyer
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, 6875, Lasalle Boulevard, Montreal, QC H4H 1R3, Canada; Department of Psychiatry, McGill University, Ludmer Research & Training Building, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada.
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Villani M, Kovess-Masféty V. Comparing stigma between French people experiencing schizophrenia versus bipolar disorders. Int J Soc Psychiatry 2024; 70:679-688. [PMID: 38279558 DOI: 10.1177/00207640231223428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
BACKGROUND Among the multiple challenges that people experiencing mental illness in general, and schizophrenia or bipolar disorders in particular, have to face, stigma appears to be one of the most difficult to tackle. In France, the body of research about stigma regarding people experiencing schizophrenia or bipolar disorders is growing, but not as much as in other western countries. AIMS In this context, our study aims to explore and compare stigma in French people experiencing schizophrenia or bipolar disorders, along with their respective mental healthcare system experience, in order to better address them within public health policies. METHODS 20 French mental health service users experiencing schizophrenia and 20 experiencing bipolar disorders answered the Stigma Scale, which assesses three dimensions of stigma (discrimination, difficulties of divulgation and lack of positive aspects). A semi-structured interview was used to collect information about the experience of the mental healthcare system (level of information, access to diagnosis, treatment, access to psychoeducation, etc.). RESULTS People experiencing schizophrenia and people experiencing bipolar disorders are different populations in terms of social impairment. However, they share a comparable negative experience of the mental healthcare system and a comparable level of information about their illness, to the exception of diagnosis divulgation, as people experiencing bipolar disorders have a better access to their diagnosis. People experiencing schizophrenia perceive a higher actual discrimination than people experiencing bipolar disorders. CONCLUSIONS Public health policies should take into account the strong perception of actual discrimination of people experiencing schizophrenia, with capitalizing on what seems beneficial for people experiencing bipolar disorders.
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Affiliation(s)
- M Villani
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne, France
| | - V Kovess-Masféty
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne, France
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Tian J, Chen S, Zhou Y, Guo W, Huang X, Fan G. Propensity Score Matching Analysis of the Influence of Waiting Time Satisfaction on Community Resident's Satisfaction With Medical Institutions: An Extensive Survey of Outpatient Population in Shantou City of Southern China. J Prim Care Community Health 2024; 15:21501319241255914. [PMID: 38853426 PMCID: PMC11163933 DOI: 10.1177/21501319241255914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 06/11/2024] Open
Abstract
OBJECTIVE This study was designed to perform a nuanced analysis of the multifaceted association between community residents' satisfaction and their perceived satisfaction concerning the visit duration at medical facilities, that could be harnessed to enhance and streamline the process of hierarchical diagnosis and treatment, thereby augmenting healthcare outcomes and patient experiences. METHODS Respondents who had utilized services from medical institutions were invited to fill out questionnaires by scanning QR codes. Additionally, surveys also distributed questionnaires through WeChat groups of community residents in densely populated areas of the community, as well as WeChat groups for patients who had previously visited local hospitals. To balance differences between groups, propensity score matching was applied to analyze the contrast between residents satisfied and dissatisfied with their medical visits. After eliminating the interference of confounding factors, a comparative analysis was conducted on the relationship between resident satisfaction and medical institution experience.After eliminating the interference of confounding factors, a comparative analysis was conducted to delve deeply into the relationship between residents' satisfaction and their experiences at medical facilities. RESULTS The study incorporated a large dataset encompassing 2356 community residents. Upon successful propensity score matching, logistic regression analysis elucidated several determinants of overall resident satisfaction. Notably, the grade of the medical institution (χ2 = 8.226, P < .05), satisfaction with the time invested in the registration process (χ2 = 11.04, P < .05), satisfaction with the waiting duration for consultation (χ2 = 15.759, P < .05), and satisfaction with the travel time to the hospital (χ2 = 45.157, P < .05) each exerted significant influence on the holistic satisfaction of residents with their medical experience. CONCLUSION Factors such as the grade of the medical institution, satisfaction related to registration and waiting durations, and travel time to the hospital emerged as crucial determinants shaping community residents' holistic satisfaction with their medical encounters. These findings underscore the exigency for strategic allocation and optimization of medical resources, refinement of the classification system, and enhancement of public health education on the graded diagnosis and treatment schema. The study also demonstrates the value of employing advanced propensity score matching and predictive modelling techniques in health services research.
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Affiliation(s)
- Jiahong Tian
- Cancer hospital of Shantou University Medical College, Shantou, China
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Shoupei Chen
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Yuqiu Zhou
- Nursing College of Harbin Medical University, Daqing, China
| | - Weiying Guo
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Xueqin Huang
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Guanhua Fan
- Cancer hospital of Shantou University Medical College, Shantou, China
- Shantou University Medical College, Shantou, China
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Fischer R, Scheunemann J, Bohlender A, Duletzki P, Nagel M, Moritz S. 'You are trying to teach us to think more slowly!': Adapting Metacognitive Training for the acute care setting-A case report. Clin Psychol Psychother 2022; 29:1877-1885. [PMID: 35586971 DOI: 10.1002/cpp.2755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 11/11/2022]
Abstract
Psychological group interventions for the acute inpatient care setting are scarce. Whereas Metacognitive Training for patients with Psychosis (MCT) provides a widely accessible, easy-to-implement intervention for patients with mild to moderate symptoms, it is less adequate for the acute care setting with respect to length and density of information. We present the adaptation process and the resulting adaptation of MCT, MCT-Acute, for the acute inpatient care setting. We report the case of a first patient, NK, who participated in MCT-Acute during her mandated stay on the locked acute ward due to an exacerbation of schizophrenia. NK participated in MCT-Acute 12 times, evaluated the training overall as positive and reported that she used exercises she had learned during training to improve her mood. She also described changing her behaviour in everyday life to think more slowly and make less hasty decisions, which is a central topic discussed in MCT and MCT-Acute. Conducting an adapted version of MCT in the acute care setting is feasible, and the present case report suggests that MCT-Acute may be a useful complement to a multidisciplinary treatment plan to stabilize patients with severe mental illness in acute inpatient care.
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Affiliation(s)
- Rabea Fischer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry and Psychotherapy, Asklepios Clinic North-Wandsbek, Hamburg, Germany
| | - Jakob Scheunemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alison Bohlender
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Patric Duletzki
- Department of Psychiatry and Psychotherapy, Asklepios Clinic North-Wandsbek, Hamburg, Germany
| | - Matthias Nagel
- Department of Psychiatry and Psychotherapy, Asklepios Clinic North-Wandsbek, Hamburg, Germany.,Clinic for Psychiatry and Psychotherapy, University Clinic Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Serhal S, Saini B, Bosnic-Anticevich S, Emmerton L, Bereznicki B, Bereznicki L, Mitchell B, Wright B, Wilson K, Krass I, Bec, Mecon SJ, Billot L, Armour C. Pharmacist-delivered asthma management services - what do patients think? J Am Pharm Assoc (2003) 2022; 62:1260-1269.e2. [DOI: 10.1016/j.japh.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 10/19/2022]
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Siebert S, Leopold K, Baumgardt J, von Hardenberg LS, Burkhardt E, Bechdolf A. Specialized inpatient treatment for young people with early psychosis: acute-treatment and 12-month results. Eur Arch Psychiatry Clin Neurosci 2022; 272:1-14. [PMID: 35141809 PMCID: PMC9508217 DOI: 10.1007/s00406-022-01379-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 01/09/2022] [Indexed: 01/02/2023]
Abstract
The objective of the study was to investigate the development of clinical outcomes of young people with early psychosis in a specialized inpatient treatment and assess the feasibility of such an intervention in an inpatient setting. The study was a prospective cohort study of patients with early psychosis treated at the specialized inpatient treatment "Fühinterventions-und Therapiezentrum, FRITZ" (early intervention and therapy center) in Berlin, Germany. The primary outcomes were attitudes towards psychiatric medication and patient satisfaction with treatment after 6 weeks. Secondary outcomes were clinical symptoms, functioning, remission, recovery, all-cause treatment discontinuation, and rehospitalisation at 6 and 12 months after inpatient treatment. We recruited 95 inpatients with early psychosis. Attitudes towards psychiatric medication (Δ6weeks = 3.00, d6weeks = 0.55; Δ6mo = 2.15, d6mo = 0.35; Δ12mo = 3.03, d12mo = 0.52) and patient satisfaction (Δ6weeks = 0.21, d6weeks = 0.40; Δ6mo = 0.32, d6mo = 0.43; Δ12mo = 0.13, d12mo = 0.17) changed with medium effect sizes at six weeks up to a 6- and 12-month follow-up. Clinical outcomes changed significantly with medium-to-large-effect sizes over 12 months CGIΔ12mo = 1.64, d12mo = -1.12; PANSS totalΔ12mo = 20.10, d12mo = -0.76; GAFΔ12mo = 19.58, d12mo = 1.25). The all-cause treatment discontinuation rate was 13.69% (n = 13) at a 6-month and 35.79% (n = 34) at a 12-month follow-up. The rehospitalization rate was 30.53% (n = 29) at a 6-month and 43.16% (n = 41) at a 12-month follow-up. Patients with specialized inpatient treatment for early psychosis showed improvements in attitude towards psychiatric medication, patient satisfaction, symptoms, and functioning for up to 12 months.Trial registration: DRKS00024351, 2021/02/11 retrospectively registered.
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Affiliation(s)
- Stefan Siebert
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating FRITZ and soulspace, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin, Dieffenbachstraße 1, 10967, Berlin, Germany
| | - Karolina Leopold
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating FRITZ and soulspace, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin, Dieffenbachstraße 1, 10967, Berlin, Germany
| | - Johanna Baumgardt
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating FRITZ and soulspace, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin, Dieffenbachstraße 1, 10967, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Laura-Sophie von Hardenberg
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating FRITZ and soulspace, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin, Dieffenbachstraße 1, 10967, Berlin, Germany
| | - Eva Burkhardt
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating FRITZ and soulspace, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin, Dieffenbachstraße 1, 10967, Berlin, Germany
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating FRITZ and soulspace, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin, Dieffenbachstraße 1, 10967, Berlin, Germany.
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany.
- Orygen, Parkville, VIC, Australia.
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Stokes DC, Kishton R, McCalpin HJ, Pelullo AP, Meisel ZF, Beidas RS, Merchant RM. Online Reviews of Mental Health Treatment Facilities: Narrative Themes Associated With Positive and Negative Ratings. Psychiatr Serv 2021; 72:776-783. [PMID: 34015944 PMCID: PMC9116241 DOI: 10.1176/appi.ps.202000267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Previous studies indicate that patients' satisfaction with mental health care is correlated with both treatment outcomes and quality of life. The aims of this study were to describe online reviews of mental health treatment facilities, including key themes in review content, and to evaluate the correlation between narrative review themes, facility characteristics, and review ratings. METHODS United States National Mental Health Services Survey (N-MHSS) facilities were linked to corresponding Yelp pages, created between March 2007 and September 2019. Correlations between review ratings and both machine learning-generated latent Dirichlet allocation topics and N-MHSS-reported facility characteristics were measured by using Spearman's rank-order correlation coefficient. Significance was defined by a Bonferroni-adjusted p<0.001. RESULTS Of 10,191 unique mental health treatment facilities, 1,383 (13.6%) had relevant Yelp pages with 8,133 corresponding reviews. The number of newly reviewed facilities and the number of new reviews increased throughout the study period. Narrative topics positively correlated with review ratings included caring staff (Spearman's ρ=0.39) and nonpharmacologic treatment (ρ=0.16). Topics negatively correlated with review ratings included rude staff (ρ=-0.14) and safety and abuse (ρ=-0.14). Of 126 N-MHSS survey items, 11 were positively correlated with review rating, including "outpatient mental health facility" (ρ=0.13), and 33 were negatively correlated with review rating, including accepting Medicare (ρ=-0.21). CONCLUSIONS Narrative topics provide information beyond what is currently collected through the N-MHSS. Topics associated with positive and negative reviews, such as staff attitude toward patients, can guide improvement in patients' satisfaction and engagement with mental health care.
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Affiliation(s)
- Daniel C Stokes
- Penn Medicine Center for Digital Health (Stokes, McCalpin, Pelullo, Merchant), Center for Emergency Care Policy and Research, Department of Emergency Medicine (Stokes, Meisel, Merchant), Department of Psychiatry (Beidas), and Penn Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, University of Pennsylvania, Philadelphia; National Clinician Scholars Program (Kishton), Leonard Davis Institute of Health Economics (Meisel, Merchant), and Penn Implementation Science Center at the Leonard Davis Institute (Beidas), University of Pennsylvania, Philadelphia
| | - Rachel Kishton
- Penn Medicine Center for Digital Health (Stokes, McCalpin, Pelullo, Merchant), Center for Emergency Care Policy and Research, Department of Emergency Medicine (Stokes, Meisel, Merchant), Department of Psychiatry (Beidas), and Penn Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, University of Pennsylvania, Philadelphia; National Clinician Scholars Program (Kishton), Leonard Davis Institute of Health Economics (Meisel, Merchant), and Penn Implementation Science Center at the Leonard Davis Institute (Beidas), University of Pennsylvania, Philadelphia
| | - Haley J McCalpin
- Penn Medicine Center for Digital Health (Stokes, McCalpin, Pelullo, Merchant), Center for Emergency Care Policy and Research, Department of Emergency Medicine (Stokes, Meisel, Merchant), Department of Psychiatry (Beidas), and Penn Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, University of Pennsylvania, Philadelphia; National Clinician Scholars Program (Kishton), Leonard Davis Institute of Health Economics (Meisel, Merchant), and Penn Implementation Science Center at the Leonard Davis Institute (Beidas), University of Pennsylvania, Philadelphia
| | - Arthur P Pelullo
- Penn Medicine Center for Digital Health (Stokes, McCalpin, Pelullo, Merchant), Center for Emergency Care Policy and Research, Department of Emergency Medicine (Stokes, Meisel, Merchant), Department of Psychiatry (Beidas), and Penn Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, University of Pennsylvania, Philadelphia; National Clinician Scholars Program (Kishton), Leonard Davis Institute of Health Economics (Meisel, Merchant), and Penn Implementation Science Center at the Leonard Davis Institute (Beidas), University of Pennsylvania, Philadelphia
| | - Zachary F Meisel
- Penn Medicine Center for Digital Health (Stokes, McCalpin, Pelullo, Merchant), Center for Emergency Care Policy and Research, Department of Emergency Medicine (Stokes, Meisel, Merchant), Department of Psychiatry (Beidas), and Penn Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, University of Pennsylvania, Philadelphia; National Clinician Scholars Program (Kishton), Leonard Davis Institute of Health Economics (Meisel, Merchant), and Penn Implementation Science Center at the Leonard Davis Institute (Beidas), University of Pennsylvania, Philadelphia
| | - Rinad S Beidas
- Penn Medicine Center for Digital Health (Stokes, McCalpin, Pelullo, Merchant), Center for Emergency Care Policy and Research, Department of Emergency Medicine (Stokes, Meisel, Merchant), Department of Psychiatry (Beidas), and Penn Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, University of Pennsylvania, Philadelphia; National Clinician Scholars Program (Kishton), Leonard Davis Institute of Health Economics (Meisel, Merchant), and Penn Implementation Science Center at the Leonard Davis Institute (Beidas), University of Pennsylvania, Philadelphia
| | - Raina M Merchant
- Penn Medicine Center for Digital Health (Stokes, McCalpin, Pelullo, Merchant), Center for Emergency Care Policy and Research, Department of Emergency Medicine (Stokes, Meisel, Merchant), Department of Psychiatry (Beidas), and Penn Medical Ethics and Health Policy (Beidas), Perelman School of Medicine, University of Pennsylvania, Philadelphia; National Clinician Scholars Program (Kishton), Leonard Davis Institute of Health Economics (Meisel, Merchant), and Penn Implementation Science Center at the Leonard Davis Institute (Beidas), University of Pennsylvania, Philadelphia
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Relationship between satisfaction with mental health services, personal recovery and quality of life among service users with psychosis: a cross-sectional study. BMC Health Serv Res 2021; 21:439. [PMID: 33964917 PMCID: PMC8105980 DOI: 10.1186/s12913-021-06409-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background Mental health policy internationally emphasizes patient centredness and personal recovery. This study investigated the relationship between satisfaction with mental health services among service users with psychosis in Norway, and personal recovery, perceived support for personal recovery, and quality of life. Methods Cross-sectional data were collected from 292 service users diagnosed with psychosis from 39 clinical sites across Norway. Satisfaction with services was assessed using the Client Satisfaction Questionnaire-8. A linear mixed model was estimated to explore the relationship between satisfaction with services and preselected covariates, and to control for confounding factors. Results A large majority of participants (89%) reported moderate-to-high levels of satisfaction. Satisfaction with services was positively associated with perceived support for personal recovery, but not with personal recovery or quality of life. In addition, service users under a Community Treatment Order (CTO) were significantly less satisfied than those who were not. Conclusions Satisfaction levels among service users were higher compared with similar, international studies. Those who feel supported in their personal recovery were more satisfied with the care they receive, which support the need for implementation of recovery-oriented practices for service users with psychosis. However, satisfaction with services was not related to service user-rated quality of life or level of personal recovery; thus, more follow-up studies are needed. The lower satisfaction of service users placed under CTOs shows the importance of targeted interventions to improve satisfaction with services among this group. Trial registration NCT03271242, date of registration: 5 sept. 2017.
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Berzina N, Petrošina E, Taube M. The assessment of factors associated with patient satisfaction in evaluation of mental health care center. Nord J Psychiatry 2021; 75:79-86. [PMID: 32707004 DOI: 10.1080/08039488.2020.1795715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIMS The study was conducted to explore patient satisfaction and to identify factors associated with patient satisfaction with the care in psychiatric wards using Psychiatric Inpatient Patient Experience Questionnaire On-Site (PIPEQ-OS) self-assessment tool. Such studies to detect factors associated with patient satisfaction in mental health care have not yet been conducted in Latvia. METHODS Cross-sectional study was conducted over 6-month period in 2018. Total amount of 773 mental health care patients were offered to fill in the questionnaire in subacute and acute wards. From them, 419 (54.2%) filled and returned the questionnaire and 354 (45.8%) refused to fill it. Descriptive statistical analysis and factor correlation was done. RESULTS Response rate was found to be 54.2%. Patients generally showed high satisfaction with received care. However, lower satisfaction rates were found in items related to engagement of relatives and patients in the treatment process, as well as patients were less satisfied with information provided. Statistically significant higher satisfaction was associated with organic mental disorders compared to schizophrenia spectrum disorders, as well as with female gender, older age, being employed or pensioner, being married or divorced. Patient education level did not show significant association with self-assessment scores. CONCLUSION The study revealed possible directions for improvement in the future in terms of providing information to patients, involvement of relatives and patients in the process of treatment. Further studies with more patients and involvement of other hospitals are required to assess factors associated with the satisfaction to organize care and to plan treatment according to the needs of the patients.
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Affiliation(s)
- Natalija Berzina
- Department of Psychiatry and Narcology, Riga Stradiņš University, Riga, Latvia
| | - Eva Petrošina
- Statistics Unit, Riga Stradiņš University, Riga, Latvia
| | - Maris Taube
- Department of Psychiatry and Narcology, Riga Stradiņš University, Riga, Latvia
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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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Allerby K, Goulding A, Ali L, Waern M. Striving for a more person-centered psychosis care: results of a hospital-based multi-professional educational intervention. BMC Psychiatry 2020; 20:523. [PMID: 33148190 PMCID: PMC7640678 DOI: 10.1186/s12888-020-02871-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/15/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Reluctance on the part of mental health professionals constitutes an important barrier to patient participation in care. In order to stimulate person-centeredness in the inpatient care of persons with psychotic illness, we developed and tested an educational intervention for hospital staff (including psychiatrists) at all four wards at the Psychosis Clinic, Sahlgrenska University Hospital in Gothenburg, Sweden. The intervention was co-created by professionals, patients, and researchers using a participatory approach. In addition to lectures and workshops, staff created and implemented small projects to increase person-centeredness on their own wards. A primary focus was to establish a partnership between patient and staff by capturing and utilizing the patient's narrative to support active engagement in the care process. This included the development of a person-centered care plan. We hypothesized that the intervention would be associated with increased patient empowerment (primary outcome) and satisfaction with care (secondary outcome). METHODS A before and after design was used to test group differences in patient empowerment (Empowerment Scale) and consumer satisfaction (UKU-ConSat Rating Scale). All patients receiving inpatient psychosis care during measuring periods were eligible if meeting inclusion criteria of schizophrenia spectrum disorder, age > 18, and ability to comprehend study information. Severe cognitive deficit and inadequate Swedish language skills were exclusion criteria. Data on possible confounding variables including overall health (EQ-5D), symptom burden (PANSS), and functional ability (GAF) were collected alongside outcome measures. RESULTS ANCOVAs with overall health as a confounding variable showed no group differences regarding empowerment before (n = 50) versus after (n = 49) intervention, sample mean = 2.87/2.99, p = .142, eta2 = .02, CI = -.27-.04. Consumer satisfaction (n = 50/50) was higher in the post-implementation group (4.46 versus 11.71, p = .041 eta2 = .04, CI = -14.17- -.31). CONCLUSION The hypothesis regarding the primary outcome, empowerment, was not supported. An increase in the secondary outcome, satisfaction, was observed, although the effect size was small, and results should be interpreted with caution. Findings from this staff educational intervention can inform the development of future studies aimed at improvement of inpatient care for persons with severe mental illness. TRIAL REGISTRATION The trial was retrospectively registered at ClinicalTrials.gov June 9, 2017, identifier: NCT03182283.
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Affiliation(s)
- Katarina Allerby
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 41345, Gothenburg, Sweden. .,Psychosis Department, Region Västra Göraland; Sahlgrenska University Hospital, 41345, Gothenburg, Sweden.
| | - Anneli Goulding
- grid.8761.80000 0000 9919 9582Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 41345 Gothenburg, Sweden ,grid.8761.80000 0000 9919 9582Department of Psychology, University of Gothenburg, Haraldsgatan 1, 41314 Gothenburg, Sweden
| | - Lilas Ali
- grid.8761.80000 0000 9919 9582Institute of Health Care Sciences, Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Box 100, 40530 Gothenburg, Sweden ,grid.1649.a000000009445082XPsychiatry Department, Region Västra Götaland, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
| | - Margda Waern
- grid.8761.80000 0000 9919 9582Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 41345 Gothenburg, Sweden ,grid.1649.a000000009445082XPsychosis Department, Region Västra Göraland; Sahlgrenska University Hospital, 41345 Gothenburg, Sweden
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Bird V, Miglietta E, Giacco D, Bauer M, Greenberg L, Lorant V, Moskalewicz J, Nicaise P, Pfennig A, Ruggeri M, Welbel M, Priebe S. Factors associated with satisfaction of inpatient psychiatric care: a cross country comparison. Psychol Med 2020; 50:284-292. [PMID: 30696510 DOI: 10.1017/s0033291719000011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Patient satisfaction is a key indicator of inpatient care quality and is associated with clinical outcomes following admission. Different patient characteristics have been inconsistently linked with satisfaction. This study aims to overcome previous limitations by assessing which patient characteristics are associated with satisfaction within a large study of psychiatric inpatients conducted across five European countries. METHODS All patients with a diagnosis of psychotic (F2), affective (F3) or anxiety/somataform (F4) disorder admitted to 57 psychiatric inpatient units in Belgium, Germany, Italy, Poland and the UK were included. Data were collected from medical records and face-to-face interviews, with patients approached within 2 days of admission. Satisfaction with inpatient care was measured on the Client Assessment of Treatment Scale. RESULTS Higher satisfaction scores were associated with being older, employed, living with others, having a close friend, less severe illness and a first admission. In contrast, higher education levels, comorbid personality disorder and involuntary admission were associated with lower levels of satisfaction. Although the same patient characteristics predicted satisfaction within the five countries, there were significant differences in overall satisfaction scores across countries. Compared to other countries, patients in the UK were significantly less satisfied with their inpatient care. CONCLUSIONS Having a better understanding of patient satisfaction may enable services to improve the quality of care provided as well as clinical outcomes for all patients. Across countries, the same patient characteristics predict satisfaction, suggesting that similar analytical frameworks can and should be used when assessing satisfaction both nationally and internationally.
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Affiliation(s)
- Victoria Bird
- Unit for Social and Community Psychiatry (World Health Organisation Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK
| | - Elisabetta Miglietta
- Section of Psychiatry, Department of Public Health and Community Medicine, University of Verona, Verona, Italy
| | - Domenico Giacco
- Unit for Social and Community Psychiatry (World Health Organisation Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Lauren Greenberg
- Pragmatic Clinical Trials Unit, Queen Mary University of London, London, UK
| | - Vincent Lorant
- Institute of Health and Society IRSS, Université Catholique de Louvain, Bruxelles, Belgium
| | | | - Pablo Nicaise
- Institute of Health and Society IRSS, Université Catholique de Louvain, Bruxelles, Belgium
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Mirella Ruggeri
- Section of Psychiatry, Department of Public Health and Community Medicine, University of Verona, Verona, Italy
| | - Marta Welbel
- Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Stefan Priebe
- Unit for Social and Community Psychiatry (World Health Organisation Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK
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13
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Stabell LA, Gjestad R, Kroken RA, Løberg EM, Jørgensen HA, Johnsen E. Predictors of treatment satisfaction in antipsychotic-naïve and previously medicated patients with acute-phase psychosis. Nord J Psychiatry 2019; 73:349-356. [PMID: 31271338 DOI: 10.1080/08039488.2019.1636134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Treatment satisfaction predicts treatment adherence and long-term outcome for patients with psychosis. It is therefore important to understand the underpinnings of patient satisfaction in psychosis treatment for optimal treatment delivery. Aims: To examine the associations between satisfaction and level and change in positive symptoms, insight, depression and side effects of antipsychotics in previously medicated and antipsychotic-naïve patients. Method: Data derive from a randomised trial, with 226 respondents at baseline and 104 at follow-up. The measures were the positive subscale and insight item from the Positive and Negative Syndrome Scale, Calgary Depression Scale, the UKU Consumer Satisfaction Rating Scale, and the UKU side effects scale. Structural equation modelling was used to test the model. The full information maximum likelihood estimator used all available data. Results: In the sample of 226 patients, 67.3% were male and 44.2% were antipsychotic-naïve. The mean age was 34.1 years. For previously medicated patients, satisfaction was predicted by level of insight (b = -2.21, β = -0.42) and reduction in positive symptoms (b = -0.56, β = -0.39). For antipsychotic-naïve patients, satisfaction was predicted by level and change of insight (b = -2.21, β = -0.46), change in depression (b = -0.37, β = -0.26) and side effects (b = -0.15, β = -0.30). All predictors were significant at the 0.05 level. Conclusion: Reducing positive symptoms and side effects are important to enhance patient satisfaction. However, improving insight and reducing depression are more important in antipsychotic-naïve patients.
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Affiliation(s)
- Lena Antonsen Stabell
- a Division of Psychiatry and Centre of Excellence NORMENT, Haukeland University Hospital , Bergen , Norway
| | - Rolf Gjestad
- a Division of Psychiatry and Centre of Excellence NORMENT, Haukeland University Hospital , Bergen , Norway.,b Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital , Bergen , Norway
| | - Rune A Kroken
- a Division of Psychiatry and Centre of Excellence NORMENT, Haukeland University Hospital , Bergen , Norway.,c Department of Clinical Medicine, University of Bergen , Bergen , Norway
| | - Else-Marie Løberg
- a Division of Psychiatry and Centre of Excellence NORMENT, Haukeland University Hospital , Bergen , Norway.,d Department of Addiction Medicine, Haukeland University Hospital , Bergen , Norway.,e Department of Clinical Psychology, University of Bergen , Bergen , Norway
| | - Hugo A Jørgensen
- c Department of Clinical Medicine, University of Bergen , Bergen , Norway
| | - Erik Johnsen
- a Division of Psychiatry and Centre of Excellence NORMENT, Haukeland University Hospital , Bergen , Norway.,c Department of Clinical Medicine, University of Bergen , Bergen , Norway
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