Abstract
BackgroundWhile patient involvement in mental health care is repeatedly stressed in policy documents, there are actually few studies that evaluate person-centred care interventions within psychiatric services. We present here the design and planned evaluation of an educational intervention for inpatient staff involved in the care of persons with schizophrenia and similar psychoses.Methods/designThe care intervention will be assessed using a non-randomised trial with a before and after approach. The intervention involves an educational and experimental learning phase for hospital staff, followed by an implementation phase. The intervention is multi-professional; psychiatrists, psychiatric nurses, psychiatric carers, social workers, occupational therapists, and a medical secretary will be engaged in a participatory approach where they practice how to create a partnership and explore recovery-related goals together with patients. Patient-related outcomes include empowerment and satisfaction with care. Ward-level outcomes include daily ward burden, length of inpatient stay, and number of days with involuntary care. In addition, qualitative methods will be applied to capture patient, next-of-kin, and staff perspectives.DiscussionThe care intervention is expected to contribute to the improvement of inpatient care for persons with severe and complex mental health issues.Trial registrationThe trial was retrospectively registered at ClinicalTrials.gov June 9, 2017, identifier: NCT03182283.
Highlights
While patient involvement in mental health care is repeatedly stressed in policy documents, there are few studies that evaluate person-centred care interventions within psychiatric services
The care intervention is expected to contribute to the improvement of inpatient care for persons with severe and complex mental health issues
An Open Space dialouge followed around the questions: How are we going to perform person-centred care with our patients? What is a person-centred care plan? How do we want the co-operation between the inpatient care and outpatient units to work? How should we relate to our patients’ will and view of the world? How can we perform person-centred care with patients who undergo involuntary treatment? How do we need to develop our existing structures and roles in order to be able to work in a person-centred way? Which challenges have we discovered when we work in a person-centred way? Which risks might there be with person-centred care? These discussions were summarized and discussed further
Summary
The current study employs a simple before and after design. While this is recognized as an important limitation, randomised control trials are not always optimal for assessing complex interventions in everyday clinical practice [23]. Care will be taken to ensure that participants are able to understand the meaning of the study and its procedures If this person-centred care intervention proves beneficial, the project may provide new directions for the planning of mental health services for persons with severe mental illness. The qualitative data will help to identify specific intervention components that are experienced as helpful or as barriers, from the perspectives of the individual patient, their relatives, and psychiatric staff. This is important as the planned intervention is complex in nature
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