Identifying the determinants of perceived quality in outpatient child and adolescent mental health services from the perspectives of parents and patients

Kapp, Carole; Perlini, Thomas; Jeanneret, Tiffanie; Stéphan, Philippe; Rojas-Urrego, Alejandro; Macías, Manuel Jato; Halfon, Olivier; Holzer, Laurent; Urben, Sébastien

doi:10.1007/s00787-017-0985-z

Cited by 21 publications

(54 citation statements)

References 45 publications

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“…Polite and sympathetic provider behaviour makes the patient feel comfortable [4, 7]. Other studies conducted among OPD patients in Iran and Europe have found that a feeling of reassurance is related to a positive perception of care quality by both patients and parents [9] and patient satisfaction increases with perceived provider empathy and explanations [2, 8].…”

Section: Discussionmentioning

confidence: 99%

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Experience and perceived quality of care of patients and their attendants in a specialized mental hospital in Bangladesh

Nuri

Sarker

Ahmed

et al. 2019

Int J Ment Health Syst

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Background A person’s perception of health service quality depends on his or her expectations and priorities. If the perception of care is good, then it eventually enhances future health service utilization, adherence to treatment and desired outcomes. Understanding a patient’s perspective is key for delivering a better quality patient-centred health care service. This study explored experience and perception of patients and their attendants of mental health care services at the National Institute of Mental Health (NIMH) which is the only national level mental health institute in Bangladesh. NIMH is located in the capital city and provides specialized mental health care services for the whole population. Methods A facility-based cross-sectional study was conducted using a mixed-method design at the NIMH. A total of 40 respondents (patients, or their attendants if the patient was minor or unable to respond due to lack of mental stability) visiting the outpatient department (OPD) of NIMH were selected by purposive sampling. For each of the ten ICD 10 categories (10th revision of International Classification of Diseases by the World Health Organization [WHO]) for mental disorders, four patients were chosen. Finally, 13 patients and 27 attendants (on behalf of 17 minor patients and 10 adult patients unable to respond) participated in the interview. Results The respondents rated 34 short statements clustered around four dimensions of care (accessibility, interpersonal communications, condition of the waiting and consultation rooms, and general quality of OPD services) and we interpreted those scores as follows: 7.6–10 very satisfied/very good quality, 5.1–7.5 satisfied/good quality, 2.6–5.0 dissatisfied/poor quality and 1.0–2.5 completely dissatisfied/very poor quality. For accessibility and interpersonal communications, the patients perceived care as very good (average scores on a Likert scale of 1–10 were 8.3 and 7.6, respectively). The respondents considered the condition of the waiting and consultation rooms and general quality of OPD care as good (average scores 5.8 and 7.1, respectively). NIMH had serious lack of resources in terms of functional medical equipment and physicians appointed, which negatively impacted on the service quality. Conclusions Patients receiving services from the NIMH OPD had a positive perception of the quality of care in general. But, at an individual level, some respondents expressed dissatisfaction. Our findings are informative for quality improvement and client-oriented care service planning at NIMH, Bangladesh.

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Section: Discussionmentioning

confidence: 99%

“…Future utilization of psychiatric services depends on how satisfied patients are with the services received [4]. So, by understanding the patients’ perspective, a better quality, patient-centred health care can be delivered and premature termination of therapy can be avoided [9].…”

Section: Introductionmentioning

confidence: 99%

Experience and perceived quality of care of patients and their attendants in a specialized mental hospital in Bangladesh

Nuri

Sarker

Ahmed

et al. 2019

Int J Ment Health Syst

View full text Add to dashboard Cite

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“…There has been an ongoing shift in the direction of shared decision-making and person-centered treatment in adolescent mental healthcare (10,15,16). Shared decision-making is associated with patient engagement and perceived quality and satisfaction with the healthcare services (8,17,18). However, most research on shared decision-making have focused on implementation and experiences with decision aids, while little is known about mental health outcomes (18).…”

Section: Introductionmentioning

confidence: 99%

“…There is also a dearth of research in adolescent mental healthcare and adolescents' perspectives (19,20). Previous qualitative research with adolescents highlights the importance of providing mental health services that incorporate individual expectations, needs, and goals (8,21,22). Research should also explore how and if person-centered care contributes to recovery and a reduction in the use of restraints (23).…”

Section: Introductionmentioning

confidence: 99%

I’m not a diagnosis: Adolescents’ perspectives on user participation and shared decision-making in mental healthcare

Bjønness

Grønnestad

Storm

2020

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

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Background: Adolescents have the right to be involved in decisions affecting their healthcare. More knowledge is needed to provide quality healthcare services that is both suitable for adolescents and in line with policy. Shared decision-making has the potential to combine user participation and evidence-based treatment. Research and governmental policies emphasize shared decision-making as key for high quality mental healthcare services. Objective: To explore adolescents' experiences with user participation and shared decision-making in mental healthcare inpatient units. Method: We carried out ten in-depth interviews with adolescents (16-18 years old) in this qualitative study. The participants were admitted to four mental healthcare inpatient clinics in Norway. Transcribed interviews were subjected to qualitative content analysis. Results: Five themes were identified, representing the adolescents' view of gaining trust, getting help, being understood, being diagnosed and labeled, being pushed, and making a customized treatment plan. Psychoeducational information, mutual trust, and a therapeutic relationship between patients and therapists were considered prerequisites for shared decision-making. For adolescents to be labeled with a diagnosis or forced into a treatment regimen that they did not initiate or control tended to elicit strong resistance. User involvement at admission, participation in the treatment plan, individualized treatment, and collaboration among healthcare professionals were emphasized. Conclusion: Routines for participation and involvement of adolescents prior to inpatient admission is recommended. Shared decision-making has the potential to increase adolescents' engagement and reduce the incidence of involuntary treatment and re-admission to inpatient clinics. In this study, shared decision-making is linked to empowerment and less to standardized decision tools. To be labeled and dominated by healthcare professionals can be a barrier to adolescents' participation in treatment. We suggest placing less emphasis on diagnoses and more on individualized treatment.

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“…There are not many studies conducted to parents' single visit experiences in child psychiatric clinic, as earlier studies focused mostly on the predictors of satisfaction, stages or results of care. Satisfaction can be predicted strongest from encountering parents' met expectations and strain, other notable predictors are parents' optimism and improvement with their child's condition (10)(11)(12)(13). Based on healthcare districts own reports and previous studies in Finland, the psychiatric services for children have been satisfied for both, parents 0 and children (14,15).…”

Section: Introductionmentioning

confidence: 99%

Parents’ satisfaction with child psychiatry

Räty

Haaranen

Rissanen

2019

Scandinavian Caring Sciences

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Aims Effective social and healthcare services are important for recipient point of view. Reforms in field of social and health care affect straight to the lives of children, adolescents and families. Voice of the parents’ of the child psychiatric patient must be heard during reforms. The purpose of this study was to explore the parents’ satisfaction with the child psychiatric clinic in southern Finland in the autumn 2017. Methods The questionnaire for parents’ included 12 questions related to a single visit experience in clinic. In total, 168 responses were collected at the end of the visits. Likert scale responses were analysed statistically with nonparametric methods for the relationship between variables such as the respondent relationship to the child and the type of visit. The open‐ended questions were analysed by qualitative content analysis. Results The relationship with the child was multifaceted: 54% were mothers and 18% fathers, 13% other adults and 3% child welfare workers. The respondents’ age distribution was 18–62 years, and the average age was 39 years. The respondents were satisfied with their visit at the clinic. The respondents’ relationship with the child was determined how successful the visit was in the point of view of respondent in some cases. There was no difference in the experience for the first‐time visitors and returning visitors or the parents′ who had visited the clinic at the same time. Conclusions Even there was significant difference experiencing the visit in some cases, the respondents were satisfied and visits deemed to have benefit. The speed and availability of care and the skills and competence of the staff were appreciated. Atmosphere in the clinic was warm and positive. Development point of view, lack of information about the duration of the visit was raised to parents at the beginning of the visit.

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Identifying the determinants of perceived quality in outpatient child and adolescent mental health services from the perspectives of parents and patients

Cited by 21 publications

References 45 publications

Experience and perceived quality of care of patients and their attendants in a specialized mental hospital in Bangladesh

Experience and perceived quality of care of patients and their attendants in a specialized mental hospital in Bangladesh

I’m not a diagnosis: Adolescents’ perspectives on user participation and shared decision-making in mental healthcare

Parents’ satisfaction with child psychiatry

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