Striving for a more person-centered psychosis care: results of a hospital-based multi-professional educational intervention

BMC Psychiatry

Lilas Ali¹  Anneli Goulding²  Katarina Allerby³  Margda Waern³ 

[1] Institute of Health Care Sciences, Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Box 100, 40530, Gothenburg, Sweden;Psychiatry Department, Region Västra Götaland, Sahlgrenska University Hospital, 41345, Gothenburg, Sweden;Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 41345, Gothenburg, Sweden;Department of Psychology, University of Gothenburg, Haraldsgatan 1, 41314, Gothenburg, Sweden;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;

关键词: Schizophrenia;    Psychosis;    Person-centered psychosis care;    Person-centered care;    Patient outcomes;    Empowerment;    Consumer satisfaction;   

DOI  :  10.1186/s12888-020-02871-y

来源: Springer

【 摘 要 】

BackgroundReluctance 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).MethodsA 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.ResultsANCOVAs 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).ConclusionThe 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 registrationThe trial was retrospectively registered at ClinicalTrials.gov June 9, 2017, identifier: NCT03182283

【 授权许可】

CC BY