Patient, family and clinician preferences for the intensity and implementation of patient and family participation in healthcare design and delivery in psychiatry

Abstract

Background and objectivesPatient and family participation is when the views and experiences of patients and family are sought and taken into account in healthcare. This research identifies patient, family and clinician preferences for the intensity and implementation of patient and family participation in healthcare design and delivery in an adult outpatient psychiatry service. MethodsA three round Delphi Technique Experiment (DTE) with 31 participants from an outpatient psychiatry service. Patients, family members and clinicians were included. ResultsThere was a strong level of agreement reached between patients, family members and clinicians with consensus achieved in 60/65 questions. Patient participation to the point of being involved in the decision making process (87%; n = 27/31) at all times (73%; n = 22/30) was supported. Family participation to the point of being involved in discussions (66%; n = 23/35) as problems arise (67%; n = 21/31) was supported. Participants agreed on the use of patient and family representatives with factors such as ability to dedicate time considered during selection. Personal experience, discussions with wider populations and pre-identified priorities should contribute to representative input. Training was identified as necessary for all stakeholders, including clinicians. ConclusionsThis is the first time that patients, family members and clinicians have all been included in a DTE on this topic. The inclusion of these groups is essential for the development of long-lasting sustainable participation. The focus on preferences for family participation is also novel. Given the role of family members in care and management of chronic illnesses, identification of their role is key.