Comparing patients’ perspectives of “good care” in Dutch outpatient psychiatric services with academic perspectives of patient-centred care

Abstract

Background: Over the past six decades, the concept of patient-centred care (PCC) has been discussed in health research, policy and practice. However, research on PCC from a patients' perspective is sparse and particularly absent in outpatient psychiatric services. Aim: to gain insight into what patients with bipolar disorder and ADHD consider ''good care'' and what this implies for the conceptualisation of PCC. Method: A literature review on the different conceptualisations of PCC was complemented with qualitative explorative research on the experiences and needs of adults with ADHD and with bipolar disorder with mental healthcare in the Netherlands using focus group discussions and interviews.

Identifying and Addressing Barriers to Treatment Decision‐making in Bipolar II Disorder: Clinicians’ Perspective

“…This supports other findings that successful adaptation of SDM to chronic care (Montori, Gafni, & Charles, 2006) and mental health (Hamann & Heres, 2014;Maassen, Schrevel, Dedding, Broerse, & Regeer, 2016) settings requires greater emphasis on partnership-building and the therapeutic relationship. This supports other findings that successful adaptation of SDM to chronic care (Montori, Gafni, & Charles, 2006) and mental health (Hamann & Heres, 2014;Maassen, Schrevel, Dedding, Broerse, & Regeer, 2016) settings requires greater emphasis on partnership-building and the therapeutic relationship.…”

“…Consistent with clinicians placing a high value of patientcentredness and involvement, many endorsed the therapeutic relationship as integral to effective treatment decision-making. This supports other findings that successful adaptation of SDM to chronic care (Montori, Gafni, & Charles, 2006) and mental health (Hamann & Heres, 2014;Maassen, Schrevel, Dedding, Broerse, & Regeer, 2016) settings requires greater emphasis on partnership-building and the therapeutic relationship. Critically, a therapeutic relationship founded on mutual trust reportedly alleviated patient-clinician disagreement over treatment and made patients with acute symptoms more comfortable deferring decision-making responsibility to clinicians.…”

“…Despite the importance of collaborative approaches to decision-making, many patients with bipolar disorder continue to experience low levels of involvement in shared treatment decision-making despite expressing a preference for it (Fisher, Manicavasagar, Kiln, & Juraskova, 2016;Liebherz, Tlach, Härter, & Dirmaier, 2015). This mismatch between preferred and experienced levels of patient involvement in bipolar disorder may not only compromise patient outcomes (De las Cuevas, Peñate, & de Rivera, 2014a;Park et al, 2014), but also points to barriers to achieving SDM in this population.…”

Child- and Family-Centered Practices in a Post-Bureaucratic Era: Inherent Conflicts Encountered by the New Child Welfare Professional

“…A further limitation might be that it is difficult to generalize from a single case study; this path is not straightforward. However, when we broaden our view to developments in the fields of health and mental health more specifically, we see similar movements towards patient-centered care and "recovery" (Maassen, Schrevel, Dedding, Broerse, & Regeer, 2016). We therefore anticipate that the results of our study might also provide valuable insights for the field of (mental) health.…”

Patient-centred care and patient engagement to inform the use of psychosocial interventions with opioid substitution treatment: another path for Day & Mitcheson to follow

“…There have been calls for PCC with patients requiring chronic opiate management for pain , but patients who use illicit drugs are less likely to be asked about their treatment preferences and are assumed to lack the capacity to make informed decisions. Such views run contrary to calls for the use of PCC, with patients experiencing severe mental illness who, despite potentially experiencing cognitive deficits, are understood to have care preferences . Patients with substance use disorders have care preferences which may improve their ability to engage in treatment.…”