Study to assess the effect of a structured communication approach on quality of life in secure mental health settings (Comquol): study protocol for a pilot cluster randomized trial

Trials

Stefan Priebe⁴  Joanna Krotofil⁵  Ian Marsh³  Sandra Eldridge⁴  Tom Craig²  Janet Parrott¹  Dominic Beer¹  Catherine Kinane⁵  Douglas MacInnes³ 

[1] Oxleas NHS Foundation Trust, Dartford, UK;Institute of Psychiatry, King’s College London, London, UK;Canterbury Christ Church University, Canterbury, UK;Queen Mary University of London, London, UK;Kent and Medway NHS and Social Care Partnership Trust, Maidstone, UK

关键词: Solution-focused brief therapy;    Quality of life;    Mental health;    Forensic;    DIALOG;    Comquol;   

Others  :  1093228
DOI  :  10.1186/1745-6215-14-257

 received in 2013-04-04, accepted in 2013-08-02,  发布年份 2013

【 摘 要 】

Background

Forensic mental health services have largely ignored examining patients’ views on the nature of the services offered to them. A structured communication approach (DIALOG) has been developed with the aim of placing the patient’s perspective on their care at the heart of the discussions between patients and clinicians. The effectiveness of the structured communication approach in community mental health services has been demonstrated, but no trial has taken place in a secure psychiatric setting. This pilot study is evaluating a 6-month intervention combining DIALOG with principles of solution-focused therapy on quality of life in medium-secure settings.

Methods and design

A cluster randomized controlled trial design is being employed to conduct a 36-month pilot study. Participants are recruited from six medium-secure inpatient services, with 48 patients in the intervention group and 48 in the control group. The intervention uses a structured communication approach. It comprises six meetings between patient and nurse held monthly over a 6-month period. During each meeting, patients rate their satisfaction with a range of life and treatment domains with responses displayed on a tablet. The rating is followed by a discussion of how to improve the current situation in those domains identified by the patient. Assessments take place prior to the intervention (baseline), at 6 months (postintervention) and at 12 months (follow-up). The primary outcome is the patient’s self-reported quality of life.

Discussion

This study aims to (1) establish the feasibility of the trial design as the basis for determining the viability of a large full-scale trial, (2) determine the variability of the outcomes of interest (quality of life, levels of satisfaction, disturbance, ward climate and engagement with services), (3) estimate the costs of the intervention and (4) refine the intervention following the outcome of the study based upon the experiences of the nurses and patients. The intervention allows patients to have a greater say in how they are treated and targets care in areas that patients identify as important to them. It is intended to establish systems that support meaningful patient and caregiver involvement and participation.

Trial registration

Current Controlled Trials,ISRCTN34145189

【 授权许可】

   
2013 MacInnes et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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