Professionals’ Perspective on Needs of Persons Who Frequently Use Psychiatric Emergency Services

Schmidt, Manuela; Garmy, Pernilla; Stjernswärd, Sigrid; Janlöv, Ann-Christin

doi:10.1080/01612840.2019.1663565

Cited by 9 publications

(6 citation statements)

References 42 publications

(73 reference statements)

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“…Waldemar et al, 2019). Finally, negative experiences and unmet needs of acute care may contribute to the increasing probability of concurrent visits and recidivism, leading to strain on a system that is characterized by limited resources (Schmidt, Garmy, Stjernswärd, & Janlöv, 2020).…”

Section: Introductionmentioning

confidence: 99%

Experiences of acute care by persons with mental health problems: An integrative literature review

Schmidt

Umans

2020

Psychiatric Ment Health Nurs

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Accessible summary What is known on the subject? Understanding experiences of acute care by persons with mental health problems is vital for improving these experiences through the development of different parts of the care delivery and its facilities. Literature has extensively addressed experiences of persons with mental health problems in acute care settings. Yet, there is a paucity of studies that aggregate and organize these findings in presenting development‐oriented solutions for the improvements of these experiences. What the paper adds to existing knowledge? Acute care can be understood through patients’ experiences of structure (such as setting, staff and resources); process (such as communication and interpersonal relations); and outcome (such as satisfaction and post‐discharge well‐being and health) and suggests improvements in these domains. The paper illuminates that previous literature has mainly captured negative experiences of acute care by persons with mental health problems, and suggests diverting the focus to the best practices and to seek inspiration from other fields of research. What are the implications for practice? Attending to the improvement and development of different parts of the acute care might be an important step in improving experiences of persons with mental health problems. For example, improving resource allocation systems and facilities, emphasizing professionalism in encounters with these patients and systematically assessing patient satisfaction during and after visits are important areas that require attention. Abstract AimThe provision of acute care to persons with mental health problems is challenging due to difficulties in encountering this group and the vulnerability of these persons. Understanding this group's experiences with acute care is thus an important endeavour. The purpose of this review was to critically and systematically identify and assess previous research on experiences of acute care by persons with mental health problems, guided by Donabedian's structure–process–outcome framework (Prospero ID: CRD42019116652). Method and resultsAn integrative literature review was performed, resulting in the identification of 43 studies. The search was conducted using five electronic databases: Web of Science Core, PubMed, MEDLINE, CINAHL and PsycINFO. DiscussionThe review revealed that patients experienced structure components such as setting, staff and resources in a predominantly negative way. A predominately negative picture also emerged of the process components, where, for example, communication and interpersonal relations were represented by negative experiences, with limited positive experiences reported. The outcome components, related to patients’ satisfaction and their well‐being after discharge, were also predominantly experienced negatively. Implications for practiceUsing Donabedian's framework of structure, process and outcome allowed us to systematize the literature reviewed, to identify the research gaps and to suggest ways forward for the ...

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Section: Introductionmentioning

confidence: 99%

Experiences of acute care by persons with mental health problems: An integrative literature review

Schmidt

Umans

2020

Psychiatric Ment Health Nurs

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“…Another qualitative study conducted with the same sample explored ED staff understanding of frequent users and their needs. 18 Nurses and physicians perceived that psychiatric FUED frequent users needed to be relieved from loneliness, hopelessness, and psychiatric symptoms with cohesive care and support.…”

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confidence: 99%

Healthcare Providers’ Perceptions of Challenges with Frequent Users of Emergency Department Care in Switzerland: A Qualitative Study

Bodenmann

Kasztura

Graells

et al. 2021

INQUIRY

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Frequent users of emergency departments (FUED; ≥ 5 ED visits/year) commonly cumulate medical, social, and substance use problems requiring complex and sustained care coordination often unavailable in ED. This study aimed to explore ED healthcare providers’ challenges related to FUED care to gain insight into the support and resources required to address FUED complex needs. An online survey was sent to all general adult emergency services within Switzerland (N = 106). Participants were asked to indicate the extent to which they perceived that FUED represented a problem and to describe the main challenges encountered. In total, 208 physicians and nurses from 75 EDs (70.7%) completed the survey. Among the 208 participants, 134 (64%) reported that FUED represented a challenge and 133 described 1 to 5 challenges encountered. A conventional content analysis yielded 4 main categories of perceived challenges. Negative consequences in the ED secondary to FUED’s presence (eg, ED overcrowding, staff helplessness, and fatigue) was the most frequently reported challenge, followed by challenges related to FUEDs’ characteristics (eg, mental health and social problems) leading to healthcare complexity. The third most frequently encountered challenge was related to the ED inappropriateness and inefficiency to address FUEDs’ needs. Finally, challenges related to the lack of FUED healthcare network were the least often mentioned. ED healthcare providers experience a wide range of challenges related to FUED care. These findings suggest that currently EDs nor their staff are equipped to address FUEDs’ complex needs.

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“…Encountering caring healthcare professionals in acute healthcare contexts has been found to be a predictor of patient satisfaction [36]. Studies from Swedish PES found that from a professional's perspective caring encounters were an empathetic and humane way to interact with the patient [27], while from a frequent visitor's perspective they involved being cared for, being understood, feeling welcomed, and being treated with kindness, humanity and fairness [26]. This study is in strong agreement with those findings emphasizing the humane element of the encounter.…”

Section: Discussionmentioning

confidence: 99%

“…Caring encounters have been identified by both professionals and patients in Sweden as central need among persons who frequently use PES [26,27]. Not only are those encounters important for identifying patients' healthcare needs [3], but they also become a goal or intervention in themselves meeting patients' human needs such as being confirmed as a person.…”

Section: Introductionmentioning

confidence: 99%

Encounters with Persons Who Frequently Use Psychiatric Emergency Services: Healthcare Professionals’ Views

Schmidt

Stjernswärd

Garmy

et al. 2020

IJERPH

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Encounters and interactions between healthcare professionals and patients are central in healthcare services and delivery. Encountering persons who frequently use psychiatric emergency services (PES), a complex patient group in a complex context, may be particularly challenging for healthcare professionals. The aim of the study was to explore healthcare professionals’ experiences of such encounters. Data were collected via individual interviews (N = 19) and a focus group interview with healthcare professionals consisting of psychiatric nurses, assistant nurses, and physicians. The data were analyzed with qualitative content analysis. This study focused on the latent content of the interview data to gain a rich understanding of the professionals’ experiences of the encounters. Two themes were identified: “Nurturing the encounter with oneself and colleagues for continuous, professional improvement” and “Striving for a meaningful connection with the patient”. The professionals experienced their encounters with persons who frequently use PES as caring, professional, and humane processes. Prerequisites to those encounters were knowing and understanding oneself, having self-acceptance and self-compassion, and working within person-centered cultures and care environments.

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Professionals’ Perspective on Needs of Persons Who Frequently Use Psychiatric Emergency Services

Cited by 9 publications

References 42 publications

Experiences of acute care by persons with mental health problems: An integrative literature review

Experiences of acute care by persons with mental health problems: An integrative literature review

Healthcare Providers’ Perceptions of Challenges with Frequent Users of Emergency Department Care in Switzerland: A Qualitative Study

Encounters with Persons Who Frequently Use Psychiatric Emergency Services: Healthcare Professionals’ Views

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