Implementation of guidelines on family involvement for persons with psychotic disorders in community mental health centres (IFIP): protocol for a cluster randomised controlled trial

BMC Health Services Research

Lars Hestmark¹  Maria Romøren¹  Reidar Pedersen¹  Kristiane Myckland Hansson¹  Elisabeth Geke Marjan Landeweer²  Kristin Sverdvik Heiervang³  Torleif Ruud⁴  Eline Aas⁵  Bente Weimand⁶  Irene Norheim⁷  Reidun Norvoll⁸ 

[1] Centre for Medical Ethics, University of Oslo, Kirkeveien 166 Fredrik Holsts hus, 0450, Oslo, Norway;Centre for Medical Ethics, University of Oslo, Kirkeveien 166 Fredrik Holsts hus, 0450, Oslo, Norway;Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands;Centre for Medical Ethics, University of Oslo, Kirkeveien 166 Fredrik Holsts hus, 0450, Oslo, Norway;Division of Mental Health Services, Akershus University Hospital, Sykehusveien 25, 1474, Nordbyhagen, Norway;Centre for Medical Ethics, University of Oslo, Kirkeveien 166 Fredrik Holsts hus, 0450, Oslo, Norway;Division of Mental Health Services, Akershus University Hospital, Sykehusveien 25, 1474, Nordbyhagen, Norway;Institute of Clinical Medicine, University of Oslo, Oslo, Norway;Department of Health Management and Health Economics, University of Oslo, Oslo, Norway;Division of Mental Health Services, Akershus University Hospital, Sykehusveien 25, 1474, Nordbyhagen, Norway;Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway;School of Nursing and Midwifery, Queens University, Belfast, Northern Ireland;Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Lier, Norway;Work Research Institute, Oslo Metropolitan University, Oslo, Norway;

关键词: Family intervention;    Psychotic disorders;    Schizophrenia;    Family psychoeducation;    Family involvement;    Mental health service research;    Clinical ethics;    Implementation;   

DOI  :  10.1186/s12913-020-05792-4

来源: Springer

【 摘 要 】

BackgroundFamily involvement for persons with psychotic disorders is under-implemented in mental health care, despite its firm scientific, economic, legal and moral basis. This appears to be the case in Norway, despite the presence of national guidelines providing both general recommendations on family involvement and support in the health- and care services, and specific guidance on family interventions for patients with psychotic disorders. The aim of this project is to improve mental health services and the psychosocial health of persons with psychotic disorders and their relatives, by implementing selected recommendations from the national guidelines in community mental health centres, and to evaluate this process.MethodsThe trial is cluster randomised, where 14 outpatient clusters from community mental health centres undergo stratified randomisation with an allocation ratio of 1:1. The seven intervention clusters will receive implementation support for 18 months, whereas the control clusters will receive the same support after this implementation period. The intervention consists of: 1. A basic level of family involvement and support. 2. Family psychoeducation in single-family groups. 3. Training and guidance of health care personnel. 4. A family coordinator and 5. Other implementation measures. Fidelity to the intervention will be measured four times in the intervention arm and two times in the control arm, and the differences in fidelity changes between the arms constitute the primary outcomes. In each arm, we aim to include 161 patients with psychotic disorders and their closest relative to fill in questionnaires at inclusion, 6 months and 12 months, measuring psychosocial health and satisfaction with services. Clinicians will contribute clinical data about patients at inclusion and 12 months. Use of health and welfare services and work participation, for both patients and relatives, will be retrieved from national registries. We will also perform qualitative interviews with patients, relatives, health care personnel and leaders. Finally, we will conduct a cost-effectiveness analysis and a political economy analysis.DiscussionThis project, with its multilevel and mixed methods approach, may contribute valuable knowledge to the fields of family involvement, mental health service research and implementation science.Trial registrationClinicalTrials.gov Identifier NCT03869177. Registered 11.03.19.

【 授权许可】

CC BY