Creation of consensus recommendations for collaborative practice in the Malaysian psychiatric system: a modified Delphi study

Abstract

Background: There is strong evidence that collaborative practice in mental healthcare improves outcomes for patients. The concept of collaborative practice can include collaboration between healthcare workers of different professional backgrounds and collaboration with patients, families and communities. Most models of collaborative practice were developed in Western and high-income countries and are not easily translatable to settings which are culturally diverse and lower in resources. This project aimed to develop a set of recommendations to improve collaborative practice in Malaysia. Methods: In the first phase, qualitative research was conducted to better understand collaboration in a psychiatric hospital (previously published). In the second phase a local hospital level committee from the same hospital was created to act on the qualitative research and create a set of recommendations to improve collaborative practice at the hospital for the hospital. Some of these recommendations were implemented, where feasible and the outcomes discussed. These recommendations were then sent to a nationwide Delphi panel. These committees consisted of healthcare staff of various professions, patients and carers. Results: The Delphi panel reached consensus after three rounds. The recommendations include ways to improve collaborative problem solving and decision making in the hospital, ways to improve the autonomy and relatedness of patients, carers and staff and ways to improve the levels of resources (e.g. skills training in staff, allowing people with lived experience of mental disorder to contribute). Conclusions: This study showed that the Delphi method is a feasible method of developing recommendations and guidelines in Malaysia and allowed a wider range of stakeholders to contribute than traditional methods of developing guidelines and recommendations.

International modified Delphi study on malaria preventive behaviour: new themes, contexts and framework for future research onPlasmodium knowlesimalaria

“…The collective responses for each round included simple statistical summaries and open-ended responses that illustrated the participants’ collective opinions. The analysis favoured the percentages of agreement and median measures of central tendency,38 39 and the results of all three rounds were presented to the study participants in a text format via emails so they could easily discern the group and individual responses to each question and their individual contributions to the consensus.…”

“…After exporting the online applications’ anonymous ratings to a Microsoft Excel spreadsheet and conducting our analysis, we calculated each statement’s percentage of agreement and median 32 38. We deemed the median suitable for ordinal scales, including a Likert scale 48.…”

“…One critical characteristic of the Delphi study is the ability to obtain expert input from individuals who were widely dispersed geographically and at any time they felt like responding within the given duration of time 37. The findings of Delphi study can generate recommendations for future studies or strategies 36 38. Thus, gathering the expert’s collective opinion is critical, suggesting innovative strategies to intervene in future disease burdens 33 39…”

Validation of the Malay-Version of Recovery Knowledge Inventory among mental health providers in Malaysia

“…Even in primary care, there is a treatment gap of over 90%. Cultural factors influence how people work together, and caregiving models are typically developed in Western settings, so they may not be the best caregiving models for Asian environments, rendering poor representations ( 50 ).…”