Factors associated with physician self-efficacy in mental illness management and team-based care

Loeb, Danielle F.; Leister, Erin; Ludman, Evette; Binswanger, Ingrid A.; Crane, Lori A.; Dickinson, Miriam; Kline, Danielle; deGruy, Frank V.; Nease, Donald E.; Bayliss, Elizabeth A.

doi:10.1016/j.genhosppsych.2017.11.003

Cited by 8 publications

(9 citation statements)

References 73 publications

(53 reference statements)

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“…Greater MIM was significantly associated with higher score on mental illness management knowledge assessment, greater communication self-efficacy and access to psychology referral. Feeling “not at all” or “slightly” prepared to manage bipolar disorder at residency completion was associated with lower MIM self-efficacy [74]. Finally, the multivariable analysis supported a focus on PCP mental illness management knowledge, communication skills, attitudes toward team-based care, and experience of treating serious mental illness such as bipolar disorder.…”

Section: Resultsmentioning

confidence: 92%

“…Then, using multivariable linear regression, the TBC (7 items) and MIM (10 items) scores were assessed as predictors of communication self-efficacy, attitudes toward team care, team climate, implementation of team care, knowledge and experience treating mental illness, and practice characteristics. (See Additional file 2: Phase 1 Survey Instrument) The participants, data collection, and data analysis of this study have been previously described [73, 74].…”

Section: Methodsmentioning

confidence: 99%

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Designing the relational team development intervention to improve management of mental health in primary care using iterative stakeholder engagement

et al. 2019

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Background Team-based models of care are efficacious in improving outcomes for patients with mental and physical illnesses. However, primary care clinics have been slow to adopt these models. We used iterative stakeholder engagement to develop an intervention to improve the implementation of team-based care for this complex population. Methods We developed the initial framework for Relational Team Development (RELATED) from a qualitative study of Primary Care Providers’ (PCPs’) experiences treating mental illness and a literature review of practice facilitation and psychology clinical supervision. Subsequently, we surveyed 900 Colorado PCPs to identify factors associated with PCP self-efficacy in management of mental illness and team-based care. We then conducted two focus groups for feedback on RELATED. Lastly, we convened an expert panel to refine the intervention. Results We developed RELATED, a two-part intervention delivered by a practice facilitator with a background in clinical psychology. The facilitator observes PCPs during patient visits and provides individualized coaching. Next, the facilitator guides the primary care team through a practice change activity with a focus on relational team dynamics. Conclusion The iterative development of RELATED using stakeholder engagement offers a model for the development of interventions tailored to the needs of these stakeholders. Trial registration Not applicable. Electronic supplementary material The online version of this article (10.1186/s12875-019-1010-z) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Designing the relational team development intervention to improve management of mental health in primary care using iterative stakeholder engagement

et al. 2019

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“…The PCP pre- and post-intervention survey consisted of several validated measures. We previously developed and validated measures of PCP self-efficacy in mental illness management and team-based care [75, 76]. The mental illness management (10 items) and team-based (7 items) scales are scored on a 0 to 10 Likert scale where 0 is “not at all confident” and 10 is “extremely confident”.…”

Section: Discussionmentioning

confidence: 99%

Mixed method evaluation of Relational Team Development (RELATED) to improve team-based care for complex patients with mental illness in primary care

et al. 2019

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Background Patients with mental illness are frequently treated in primary care, where Primary Care Providers (PCPs) report feeling ill-equipped to manage their care. Team-based models of care improve outcomes for patients with mental illness, but multiple barriers limit adoption. Barriers include practical issues and psychosocial factors associated with the reorganization of care. Practice facilitation can improve implementation, but does not directly address the psychosocial factors or gaps in PCP skills in managing mental illness. To address these gaps, we developed Relational Team Development (RELATED). Methods RELATED is an implementation strategy combining practice facilitation and psychology clinical supervision methodologies to improve implementation of team-based care. It includes PCP-level clinical coaching and a team-level practice change activity. We performed a preliminary assessment of RELATED with a convergent parallel mixed method study in 2 primary care clinics in an urban Federally Qualified Health Center in Southwest, USA, 2017-2018. Study participants included PCPs, clinic staff, and patient representatives. Clinic staff and patients were recruited for the practice change activity only. Primary outcomes were feasibility and acceptability. Feasibility was assessed as ease of recruitment and implementation. Acceptability was measured in surveys of PCPs and staff and focus groups. We conducted semi-structured focus groups with 3 participant groups in each clinic: PCPs; staff and patients; and leadership. Secondary outcomes were change in pre- post- intervention PCP self-efficacy in mental illness management and team-based care. We conducted qualitative observations to better understand clinic climate. Results We recruited 18 PCPs, 17 staff members, and 3 patient representatives. We ended recruitment early due to over recruitment. Both clinics developed and implemented practice change activities. The mean acceptability score was 3.7 (SD=0.3) on a 4-point Likert scale. PCPs had a statistically significant increase in their mental illness management self-efficacy [change = 0.9, p-value= <.01]. Focus group comments were largely positive, with PCPs requesting additional coaching. Conclusions RELATED was feasible and highly acceptable. It led to positive changes in PCP self-efficacy in Mental Illness Management. If confirmed as an effective implementation strategy, RELATED has the potential to significantly impact implementation of evidence-based interventions for patients with mental illness in primary care.

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“…An increasing concern is reported among the innovative care models for managing chronic diseases in patients, with a growing need for health care services (Loeb et al, 2018). McNab et al (2018) write that effective care requires multidisciplinary care, interventional resources, and community-based social networks.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Clinical Team Competence: Case of Saudi Arabia

Moussa¹,

Sofyani²,

Alblowi³

et al. 2020

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PURPOSE OF REVIEW: High-level nurse-doctor collaboration and competence reduce average hospital duration of the patient and mortality rates. Critical care unit plays an integral role as it integrates techniques and principles for ensuring high-quality care in a dynamic work environment. This study determines the status of critical care unit professionals, particularly nurses concerning their teamwork self-assessment. The descriptive correlational study design following a quantitative research design was used. Purposive sampling was employed for selecting 143 critical care unit nurses from Al-Ansar General Hospital, Saudi Arabia. A survey using a teamwork effectiveness self-assessment questionnaire was held for collecting data, which was then statistically analyzed. RECENT FINDINGS: Findings showed a significant and positive correlation between nurses’ interests and priorities with their job functions and problem-solving abilities. It showed that the manager’s support and guidance along with the nurse’s participation in decision-making helped the nurses to resolve critical problems and make rapid decisions in critical hours. SUMMARY: Nurses’ conflict management and effective time utilization were significantly and positively correlated. This provided physical and structural opportunities, adequate education and training, and a supportive environment to overcome problems impeding teamwork effectiveness.

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Factors associated with physician self-efficacy in mental illness management and team-based care

Cited by 8 publications

References 73 publications

Designing the relational team development intervention to improve management of mental health in primary care using iterative stakeholder engagement

Designing the relational team development intervention to improve management of mental health in primary care using iterative stakeholder engagement

Mixed method evaluation of Relational Team Development (RELATED) to improve team-based care for complex patients with mental illness in primary care

Evaluation of Clinical Team Competence: Case of Saudi Arabia

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