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Symons M, Finlay-Jones A, Meehan J, Raymond N, Watkins R. Nurturing families: One year pilot outcomes for a modified Parent Child Assistance Program in Australia. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000580. [PMID: 36962438 PMCID: PMC10022323 DOI: 10.1371/journal.pgph.0000580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 07/11/2022] [Indexed: 11/18/2022]
Abstract
Alcohol and Other Drug (AOD) exposure during pregnancy is linked to serious adverse child outcomes, including Fetal Alcohol Spectrum Disorder (FASD). The Parent-Child Assistance Program (PCAP) supports women with problematic AOD use, who are pregnant or have young children, and are not effectively engaging with services. PCAP has been shown to reduce alcohol exposed pregnancies, promote AOD abstinence, increase employment and family planning and improve child outcomes. This manuscript reports the first pilot evaluation of the PCAP program delivered in Australia. A pre-post-intervention repeated measures design was used. Eleven women receiving PCAP from a not-for-profit organisation were invited to take part in the study, with eight providing complete pre-post data. Home visitation case management was provided by trained and experienced case-managers. Clients were assisted to engage with existing services effectively to meet their own goals via a combination of relational theory, motivational interviewing and harm reduction concepts. The PCAP Modified Addiction Severity Index 5th Edition was adapted for use in Australia and was used to measure domains of addiction severity related problems as the primary outcome. Secondary outcomes included client satisfaction and program fidelity. There were significant changes in composite addiction severity scores from baseline to one year. 80% of participants had periods of abstinence of longer than four months. All clients had better connection to services, no subsequent AOD exposed pregnancies, and were highly satisfied with the program. Four had children returned to their care. Implementation was similar to the original PCAP program with major differences including case-managers relying on training manuals only without undertaking in-person training; being more experienced; providing more direct AOD counselling; and having less supervision. The findings will inform future program delivery and methodology for a larger longitudinal study assessing outcomes at program exit.
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Affiliation(s)
- Martyn Symons
- National Health and Medical Research Council FASD Research Australia Centre of Research Excellence, West Perth, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Amy Finlay-Jones
- National Health and Medical Research Council FASD Research Australia Centre of Research Excellence, West Perth, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | | | | | - Rochelle Watkins
- National Health and Medical Research Council FASD Research Australia Centre of Research Excellence, West Perth, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
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Gentil L, Grenier G, Bamvita JM, Fleury MJ. Satisfaction with health and community services among homeless and formerly homeless individuals in Quebec, Canada. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:22-33. [PMID: 31452296 DOI: 10.1111/hsc.12834] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 07/02/2019] [Accepted: 08/02/2019] [Indexed: 06/10/2023]
Abstract
User satisfaction is a crucial quality indicator in health service provision. Few studies have measured user satisfaction among homeless and formerly homeless individuals, despite the high prevalence of mental health disorders (MHD) in this population. The purpose of this study was to assess overall satisfaction among 455 homeless and formerly homeless individuals who were receiving health and community services, and to identify factors associated with user satisfaction. Data collection occurred between January and September 2017. Study participants were 18 years old or over, with experience of homelessness in the current or recent past. They completed a questionnaire eliciting socio-demographic information, and data on residential history, service use and satisfaction and health profiles. Multivariate linear analysis was performed on overall satisfaction with health and community services in the previous 12 months. Independent variables were organised as predisposing, enabling and needs factors based on the Gelberg-Andersen Behavioral Model. The mean satisfaction score was 4.11 (minimum: 1; maximum: 5). Variables associated with greater user satisfaction included: older age, residence in permanent housing, common MHD (e.g., depression, anxiety), having a family physician, having a case manager, strong social network, good quality of life and, marginally, male sex and having substance use disorders (SUD). By contrast, frequent users of public ambulatory health services were the most dissatisfied. User satisfaction was more strongly associated with enabling factors. Strategies for improving satisfaction include: promoting more tailored primary care programmes (including family physician) adapted to the needs of this population, better integrating primary care with specialised services including SUD integrated treatment and enhancing continuity of care through the reinforcement of case management services. Further efforts aimed at increasing access to permanent housing with supports, and eliciting more active involvement by relatives and friends may also improve user satisfaction with services, and reduce unnecessary service use.
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Affiliation(s)
- Lia Gentil
- Douglas Mental Health University Institute, Montréal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Institut Uiniversitaire sur le Dépendances, Montreal, QC, Canada
- Recherche et intervention sur les substances psychoactives Québec, Trois Rivières, QC, Canada
| | - Guy Grenier
- Douglas Mental Health University Institute, Montréal, QC, Canada
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King BM, Linette D, Donohue-Smith M, Wolf ZR. Relationship Between Perceived Nurse Caring and Patient Satisfaction in Patients in a Psychiatric Acute Care Setting. J Psychosoc Nurs Ment Health Serv 2019; 57:29-38. [DOI: 10.3928/02793695-20190225-01] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/02/2019] [Indexed: 11/20/2022]
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Stallvik M, Flemmen G, Salthammer JA, Nordfjærn T. Assessing health service satisfaction among users with substance use disorders within the municipalities in Norway. Subst Abuse Treat Prev Policy 2019; 14:18. [PMID: 31060571 PMCID: PMC6501295 DOI: 10.1186/s13011-019-0207-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 04/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess what is associated with health service satisfaction among adults with a substance use disorder receiving services provided within different municipalities in Norway. An additional aim was to examine demographic and municipality characteristics, mental health, and types of substance use associated with health service satisfaction. METHOD A cross-sectional partial explorative study was executed in 2017 among 491 service users with substance use disorders from 20 randomly selected municipalities. The sample consisted of 70% males. The sample majority were single and unemployed, and their main sources of healthcare were the general practitioner (78%), The Norwegian Labor and Welfare Administration (72%), and addiction counsellors (62%). RESULTS Overall satisfaction was negatively associated with age, size of municipality, Global Severity Index (GSI) and illicit substance use during the last 12 months. Satisfaction with practical help, such as housing, economy, work and education, was negatively associated with GSI and positively associated with onset of first alcohol intoxication. Satisfaction with personnel was positively associated with onset of first alcohol intoxication and negatively associated with municipality size, GSI and illicit use the last 12 months. The results showed that more than half of the respondents (54%) to a large or great extent were satisfied with the overall services provided. The services they were less satisfied with were related to housing, economy, getting started with exercise and establishing a social network. CONCLUSION The results show areas associated with satisfaction and domains where the municipalities can improve their services to meet the users' needs and increase service satisfaction.
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Affiliation(s)
- Marianne Stallvik
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Grete Flemmen
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Jo Arild Salthammer
- Center of Drug and Alcohol expertise, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Trond Nordfjærn
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Fortin M, Cao Z, Fleury MJ. A typology of satisfaction with mental health services based on Andersen's behavioral model. Soc Psychiatry Psychiatr Epidemiol 2018; 53:587-595. [PMID: 29450599 DOI: 10.1007/s00127-018-1498-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 02/02/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Patients with mental disorders (MDs) form a highly heterogeneous group, whose satisfaction with mental health services (MHS) may vary according to different variables. Identifying patient subgroups with similar levels of satisfaction may help identify variables that contribute to satisfaction or dissatisfaction with services. This study established a typology of patient satisfaction with MHS that revealed variables specific to each group. METHODS The study included 325 patients with MDs across four health service networks offering integrated and diversified services. Data were collected using five standardized instruments, and participant medical records. A conceptual framework was developed, based on Andersen's Behavioral Model, which integrates socio-demographic, clinical, needs-related and service use variables. Using cluster analysis, a typology of patient satisfaction was created. RESULTS Analyses yielded four patient clusters: two where levels of satisfaction were relatively high and two with lower levels of satisfaction (range 3.74-4.37). Greater care continuity and higher income related to greater patient satisfaction; whereas co-occurring MDs and substance use disorders (SUD), as well as more numerous and severe needs, characterized dissatisfied patients who were frequent users of MHS. CONCLUSIONS Results highlight the need for continuity of care and adequate socio-economic conditions for increasing patient satisfaction with MHS. Lower levels of satisfaction among patients with common MDs and SUDs suggest the importance of addressing their specific needs to enhance satisfaction and MH recovery.
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Affiliation(s)
- Marilyn Fortin
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Hospital Research Centre, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada
| | - Zhirong Cao
- Douglas Hospital Research Centre, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada
| | - Marie-Josée Fleury
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
- Douglas Hospital Research Centre, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada.
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Fortin M, Zhirong C, Fleury MJ. Satisfaction with primary and specialized mental health care among patients with mental disorders. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2018. [DOI: 10.1080/00207411.2018.1448661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Marilyn Fortin
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Douglas Hospital Research Centre, Montreal, Quebec, Canada
| | - Cao Zhirong
- Douglas Hospital Research Centre, Montreal, Quebec, Canada
| | - Marie-Josée Fleury
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Douglas Hospital Research Centre, Montreal, Quebec, Canada
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Fortin M, Bamvita JM, Fleury MJ. Patient satisfaction with mental health services based on Andersen's Behavioral Model. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:103-114. [PMID: 29056085 PMCID: PMC5788132 DOI: 10.1177/0706743717737030] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The purpose of this article was to assess the satisfaction of adult patients who received mental health services (MHS) in healthcare networks staffed by multidisciplinary professionals and offering a range of MHS, and to identify variables associated with patient satisfaction. METHODS This cross-sectional study included 325 patients with mental disorders (MDs) among 4 Quebec health service networks. Data were collected using 9 standardized instruments and participant medical records. A 3-factor conceptual framework (predisposing, enabling, and needs-related factors) based on Andersen's Behavioral Model was used, integrating sociodemographic, clinical, needs-related, service utilization, social support, and quality-of-life (QOL) variables. An adjusted multiple linear regression model was performed. RESULTS The global mean score for patient satisfaction was 4.11 (minimum: 2.0; maximum: 5.0). Among the enabling factors, continuity of care, having a case manager, and help received from services were positively associated with patient satisfaction, whereas being hospitalized was negatively associated. Among the needs-related factors, the number of needs was negatively associated with satisfaction. CONCLUSIONS Findings demonstrated higher levels of satisfaction among patients who received good continuity of care and well-managed, frequent services in relation to their needs. Dissatisfaction was higher for patients with serious unmet needs or those hospitalized, which underlines the importance of taking these particular variables into account in the interest of improving MHS delivery and patient recovery.
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Affiliation(s)
- Marilyn Fortin
- 1 Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,2 Douglas Hospital Research Centre, Montreal, Quebec, Canada
| | | | - Marie-Josée Fleury
- 1 Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,2 Douglas Hospital Research Centre, Montreal, Quebec, Canada
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