Patient empowerment in risk management: a mixed-method study to explore mental health professionals’ perspective

Abstract

Background In the last years, patients’ empowerment has been increasingly recognized as a crucial dimension of patient-centered healthcare and patient safety. Nevertheless, little work has been done so far in the field of patient safety to investigate strategies for empowering psychiatric patients. Therefore, the aim of this study was to identify, by using focus groups, whether and how psychiatric patients’ empowerment can improve risk management according to the perspective of healthcare providers (HPs). Methods A mixed-method approach composed of a qualitative data collection method (i.e., focus groups) and a quantitative analysis technique (i.e., inductive content analysis) was applied. HPs working in mental health settings shared their perspectives on psychiatric patients’ empowerment in risk management. After the transcription of the audio-taped discussions and the subsequent development of a hierarchical four-level coding system (strategy versus critical issue, thematic area, category, subcategory), two independent raters codified the transcripts and synthesized the content. Absolute frequencies are reported for quantitative data. Results Twelve focus groups consisting of six to ten participants, each with an overall sample size of 95 participants (65 women; average age ± SD 47 ± 9 yrs), were enrolled. A total of 1252 participants’ verbal contributions (i.e., units of analysis) were assessed. Strategies and critical issues (Level 1) were mentioned almost equally (52 and 48%, respectively) by the HPs. Most of the contributions at Level 2 referred to the thematic areas Treatment and Cure (69%) and Emergency Management (21%). In the area Treatment and Cure , the category Therapeutic Compliance (Level 3) was discussed in one third of all contributions. Conclusions Our results suggest that HPs consider patients as crucial partners in risk management and expect them to play a key role in actively enhancing safety. Policy makers should be aware that risk management in mental health settings particularly relies on the therapeutic relationship between HPs and patients. Therefore, allocating sufficient human and financial resources to mental health care aiming to further support the relationship between patients and HPs is of utmost importance. Electronic supplementary material The online version of this article (10.1186/s12913-019-4215-x) contains supplementary material, which is available to authorized users.

Mental health professionals’ perceived barriers and enablers to shared decision-making in risk assessment and risk management: a qualitative systematic review

“…The papers were published between 1999 and 2019 and were predominantly qualitative in design ( n = 18). Semi-structured interviews were the most common data collection method ( n = 15); four studies utilised focus groups [ 61 , 63 – 65 ]; and one used in-depth interviews [ 60 ]. Three studies used unstructured observation in addition to semi-structured interviews [ 66 – 68 ].…”

‘If we would change things outside we wouldn’t even need to go in…’ supporting recovery via community‐based actions: A focus group study on psychiatric rehospitalization

“…The importance of the everyday environment upon mental well‐being has been reported elsewhere, 69 as has the influence of eudaimonic well‐being reflecting judgements of meaning and purpose in life 70 . Meaning can also be supported by incorporating the environmental landscape into day‐to‐day life including agriculture, farms, animals, plants, gardening and the forest that have been found useful for promoting mental and physical health, 71 something which is also worth attending to in a hospital environment 72 . However, the authors are not aware of any previous studies relating these aspects to psychiatric rehospitalization per se 73,74 …”

“…70 Meaning can also be supported by incorporating the environmental landscape into day-to-day life including agriculture, farms, animals, plants, gardening and the forest that have been found useful for promoting mental and physical health, 71 something which is also worth attending to in a hospital environment. 72 However, the authors are not aware of any previous studies relating these aspects to psychiatric rehospitalization per se. 73,74 Promoting recovery from mental health difficulty can be done in different ways, and aspects from community life can be seen to play an important part in this.…”

A Review of Various Methods of Management of Risk in the Field of Emergency Medicine

“…The availability of further investigations around the perspective of risk management of patients in emergency department settings could be very essential for achieving more accurate knowledge on the newest procedures of minimising the potential of happening various kinds of risks and damages to the patients and emergency staff. Through the possibility of the creation of more novel events due to changes to new job positions from one side and also the creation of new medical treatment and equipment in the medical centres from the other side, the possibility of occurrence of more dangerous and risky events would be increased significantly [64], [65].…”