Needs and Experiences in Psychiatric Treatment (NEPT)- Piloting a Collaboratively Generated, Initial Research Tool to Evaluate Cross-Sectoral Mental Health Services

Abstract

BackgroundResearch tools to evaluate institutions or interventions in the field of mental health have rarely been constructed by researchers with personal experience of using the mental health system (“experiential expertise”). This paper presents a preliminary tool that has been developed within a participatory-collaborative process evaluation as part of a controlled, multi-center, prospective cohort study (PsychCare) to evaluate psychiatric flexible and integrative treatment, FIT for short, models in Germany.MethodThe collaborative research team consisting of researchers with and without experiential expertise developed 12 experiential program components of FIT models by an iterative research process based on the Grounded Theory Methodology. These components were transformed into a preliminary research tool that was evaluated by a participatory expert panel, and during a pilot and validation study, the latter using a random sample of 327 users from 14 mental health departments. Internal consistency of the tool was tested using Cronbach's alpha. Construct validity was evaluated using a Principal Components Analysis (PCA) and a Jonckheere Terpstra test in relation to different implementation levels of the FIT model. Concurrent validity was tested against a German version of the Client Satisfaction Questionnaire (ZUF-8) using correlation analysis and a linear regression model.ResultsThe evaluation of the expert panel reduced 29 initial items to 16 that were further reduced to 11 items during the pilot study, resulting into a research tool (Needs and Experiences in Psychiatric Treatment—NEPT) that demonstrated good internal consistency (Cronbach's alpha of 0.89). PCA yielded a 1-component structure, which accounted for 49% of the total variance supporting the unidimensional structure of the tool. The total NEPT score increased alongside the increasing implementation of the FIT model (p < 0.05). There was evidence (p < 0.001) for convergent validity assessed against the ZUF-8 as criterion measure.ConclusionsThe NEPT tool seems to be promising for further development to assess the experiences with and fulfillment of needs of psychiatric care models from the perspective of users. This paper demonstrates that it is possible to use a participatory-collaborative approach within the methodologically rigorous confines of a prospective, controlled research design.

Developing a research tool to detect iatrogenic adverse events in psychiatric health care by involving service users and health professionals

“…As importantly it also reveals the different ways that service users and health professionals make sense of treatment. This is in line with previous research (Aboaja et al., 2021; Follevåg & Seim, 2021; von Peter et al., (2022) which shows that this interaction and the sharing of experience is useful for improving practice.…”

“…The benefits of service user involvement are typically framed as ensuring greater relevance of research questions, improving response rates and increasing the impact of dissemination (National Institute of Health Research, 2014). The inclusion of service users in the development of research tools can contribute to service development, which, in turn, can reduce adverse events (AEs) and promote quality-assured healthcare services (Berzins et al, 2020;von Peter et al, (2022). Roelandt et al (2020) argue that the International Classification of Disease (ICD) should be co-constructed by professionals, service users and carers.…”

Vorteile der Modellversorgung nach § 64b SGB V aus Sicht von Nutzern

“…Umfassendere Informationen zum Ablauf und den verwendeten Methoden der PsychCare-Prozessevaluation finden sich anderen-orts [2][3][4]. Diese Prozessevaluation ist als ein Folgeprojekt der Eva-Mod64b-Studie zu verstehen [5], die ebenfalls zum Ziel hatte, Modellvorhaben und ihre vielfältigen Auswirkungen zu untersuchen.…”

“…Wie dargestellt, sind die entwickelten Merkmale nicht isoliert voneinander zu betrachten: Die Implementierung der Modellversorgung wirkt sich auf die Ausprägung der hinter den Merkmalen stehenden Aspekte der Operationalisierung aus. Die Nutzer der Modellkliniken beschrieben über alle Kliniken hinweg eine bedürfnisorientiertere und flexiblere Behandlung als die der Regelversorgung, und waren, wie in einer weiteren Teilstudie der PsychCare-Prozessevaluation gezeigt [3], insgesamt zufriedener. Gleichzeitig stellten wir uns die Frage, welchen Einfluss das kollaborative Studiendesign auf diese Forschungsergebnisse hatte.…”

How to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis

“…A continuous relationship between user and practitioner is described as a key principle of psychiatric care ( 14 , 17 ). In a widespread definition, this element of continuity of care (CoC) is named relational continuity and described as “ the therapeutic relationship between a patient and one or more clinicians […] and provides coherence through clinicians’ growing comprehensive knowledge of the patient ” ( 18 ).…”