1
|
Krause KR, Calderón A, Pino VG, Edbrooke-Childs J, Moltrecht B, Wolpert M. What treatment outcomes matter in adolescent depression? A Q-study of priority profiles among mental health practitioners in the UK and Chile. Eur Child Adolesc Psychiatry 2024; 33:151-166. [PMID: 36719524 PMCID: PMC10806045 DOI: 10.1007/s00787-023-02140-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 01/05/2023] [Indexed: 02/01/2023]
Abstract
Evidence-based and person-centred care requires the measurement of treatment outcomes that matter to youth and mental health practitioners. Priorities, however, may vary not just between but also within stakeholder groups. This study used Q-methodology to explore differences in outcome priorities among mental health practitioners from two countries in relation to youth depression. Practitioners from the United Kingdom (UK) (n = 27) and Chile (n = 15) sorted 35 outcome descriptions by importance and completed brief semi-structured interviews about their sorting rationale. By-person principal component analysis (PCA) served to identify distinct priority profiles within each country sample; second-order PCA examined whether these profiles could be further reduced into cross-cultural "super profiles". We identified three UK outcome priority profiles (Reduced symptoms and enhanced well-being; improved individual coping and self-management; improved family coping and support), and two Chilean profiles (Strengthened identity and enhanced insight; symptom reduction and self-management). These could be further reduced into two cross-cultural super profiles: one prioritized outcomes related to reduced depressive symptoms and enhanced well-being; the other prioritized outcomes related to improved resilience resources within youth and families. A practitioner focus on symptom reduction aligns with a long-standing focus on symptomatic change in youth depression treatment studies, and with recent measurement recommendations. Less data and guidance are available to those practitioners who prioritize resilience outcomes. To raise the chances that such practitioners will engage in evidence-based practice and measurement-based care, measurement guidance for a broader set of outcomes may be needed.
Collapse
Affiliation(s)
- Karolin Rose Krause
- Research Department for Clinical, Educational and Health Psychology, University College London, Gower Street, Bloomsbury, London, WC1E 6BT, UK.
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.
| | - Ana Calderón
- Facultad de Psicología y Humanidades, Universidad San Sebastián, Sede Santiago, Chile
| | - Victor Gomez Pino
- Facultad de Medicina, Departamento de Psiquiatría Norte, Hospital Clínico, Clínica Psiquiátrica Universitaria, Universidad de Chile, Avenida La Paz 1003, Recoleta, Chile
| | - Julian Edbrooke-Childs
- Research Department for Clinical, Educational and Health Psychology, University College London, Gower Street, Bloomsbury, London, WC1E 6BT, UK
- Evidence-Based Practice Unit, Anna Freud National Centre for Children and Families, 4-8 Rodney Street, London, N1 9JH, UK
| | - Bettina Moltrecht
- Evidence-Based Practice Unit, Anna Freud National Centre for Children and Families, 4-8 Rodney Street, London, N1 9JH, UK
- Centre for Longitudinal Studies, University College London, 55-59 Gordon Square, London, WC1H 0NU, UK
| | - Miranda Wolpert
- Research Department for Clinical, Educational and Health Psychology, University College London, Gower Street, Bloomsbury, London, WC1E 6BT, UK
- Wellcome Trust, 215 Euston Rd, Bloomsbury, London, NW1 2BE, UK
| |
Collapse
|
2
|
Arnold MSc A, Wärdig PhD R, Hultsjö PhD S. Brief Admission for Patients with Self-Harm from the Perspective of Outpatient Healthcare Professionals. Issues Ment Health Nurs 2022; 43:356-364. [PMID: 34428124 DOI: 10.1080/01612840.2021.1956657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The aim of the study was to describe the role of brief-admission (BA) in treating high-risk patients with self-harm from the perspective of outpatient healthcare staff in Sweden. Ten outpatient healthcare professionals from three psychiatric clinics were interviewed. Data were analyzed using a conventional content analysis. The findings of this study help support the role of BA as an acute crisis management intervention, and describe how BA serves as a useful adjunct to outpatient treatment, especially for patients with complementarily psychotherapeutic interventions. The findings also suggest that implementing BA may increase treatment opportunities for outpatient staff and strengthen the concept of person-centered care.
Collapse
Affiliation(s)
- Amanda Arnold MSc
- The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Rikard Wärdig PhD
- Department of Health, Medicine and Caring Sciences, Division of Nursing and Reproductive Health, Linköping University, Linköping, Sweden
| | - Sally Hultsjö PhD
- Department of Health, Medicine and Caring Sciences, Division of Nursing and Reproductive Health, Linköping University, Linköping, Sweden.,Department of Psychiatry, Futurum akademin for halsa och vard, Jönköping, Sweden
| |
Collapse
|
3
|
McKenzie K, Gregory J, Hogg L. Mental Health Workers' Attitudes Towards Individuals With a Diagnosis of Borderline Personality Disorder: A Systematic Literature Review. J Pers Disord 2022; 36:70-98. [PMID: 34124949 DOI: 10.1521/pedi_2021_35_528] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The attitudes of mental health workers toward individuals with mental health conditions can impact the quality of care they provide. Negative attitudes among mental health workers seem particularly common in response to people diagnosed with borderline personality disorder (BPD). The current review aimed to identify and review the literature regarding mental health workers' attitudes toward individuals diagnosed with BPD, specifically focusing on studies comparing workers' attitudes toward BPD with attitudes toward other mental health diagnoses. The findings suggest that mental health workers have more negative attitudes toward individuals labeled as having BPD than toward individuals with other diagnoses, such as depression. This is likely due to factors associated with the label itself, in addition to workers' perceptions of BPD symptoms and previous experiences of delivering treatment. The implications of these findings are considered, with a particular focus on how mental health services can effectively address negative attitudes toward BPD.
Collapse
Affiliation(s)
| | | | - Lorna Hogg
- Oxford Institute of Clinical Psychology Training and Research, University of Oxford, Oxford, U.K
| |
Collapse
|
4
|
Churruca K, Ludlow K, Wu W, Gibbons K, Nguyen HM, Ellis LA, Braithwaite J. A scoping review of Q-methodology in healthcare research. BMC Med Res Methodol 2021; 21:125. [PMID: 34154566 PMCID: PMC8215808 DOI: 10.1186/s12874-021-01309-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/30/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Q-methodology is an approach to studying complex issues of human 'subjectivity'. Although this approach was developed in the early twentieth century, the value of Q-methodology in healthcare was not recognised until relatively recently. The aim of this review was to scope the empirical healthcare literature to examine the extent to which Q-methodology has been utilised in healthcare over time, including how it has been used and for what purposes. METHODS A search of three electronic databases (Scopus, EBSCO-CINAHL Complete, Medline) was conducted. No date restriction was applied. A title and abstract review, followed by a full-text review, was conducted by a team of five reviewers. Included articles were English-language, peer-reviewed journal articles that used Q-methodology (both Q-sorting and inverted factor analysis) in healthcare settings. The following data items were extracted into a purpose-designed Excel spreadsheet: study details (e.g., setting, country, year), reasons for using Q-methodology, healthcare topic area, participants (type and number), materials (e.g., ranking anchors and Q-set), methods (e.g., development of the Q-set, analysis), study results, and study implications. Data synthesis was descriptive in nature and involved frequency counting, open coding and the organisation by data items. RESULTS Of the 2,302 articles identified by the search, 289 studies were included in this review. We found evidence of increased use of Q-methodology in healthcare, particularly over the last 5 years. However, this research remains diffuse, spread across a large number of journals and topic areas. In a number of studies, we identified limitations in the reporting of methods, such as insufficient information on how authors derived their Q-set, what types of analyses they performed, and the amount of variance explained. CONCLUSIONS Although Q-methodology is increasingly being adopted in healthcare research, it still appears to be relatively novel. This review highlight commonalities in how the method has been used, areas of application, and the potential value of the approach. To facilitate reporting of Q-methodological studies, we present a checklist of details that should be included for publication.
Collapse
Affiliation(s)
- Kate Churruca
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia.
| | - Kristiana Ludlow
- School of Psychology, University of Queensland, Brisbane, QLD, 4072, Australia
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Wendy Wu
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
| | - Kate Gibbons
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
| | - Hoa Mi Nguyen
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
| | - Louise A Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, NSW, 2109, Australia
| |
Collapse
|
5
|
Lester R, Prescott L, McCormack M, Sampson M. Service users' experiences of receiving a diagnosis of borderline personality disorder: A systematic review. Personal Ment Health 2020; 14:263-283. [PMID: 32073223 DOI: 10.1002/pmh.1478] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 01/22/2020] [Accepted: 01/30/2020] [Indexed: 11/11/2022]
Abstract
There is ongoing controversy regarding the borderline personality disorder (BPD) diagnosis. Whilst the experiences of people living with BPD have been widely acknowledged, the process of receiving the diagnosis is poorly described. This systematic review aimed to synthesize the existing research exploring people's experiences of receiving a diagnosis of BPD, as well as examining what is considered best practice in the diagnostic delivery process. The findings from 12 qualitative studies were synthesized using thematic analysis, generating two overarching themes: negative and positive experiences of receiving a diagnosis of BPD. These themes were described using the following sub-themes: the communication of diagnosis and meaning made of it, validity around diagnosis and attitudes of others. Results indicate that there is a substantial difference between a well-delivered and poorly delivered diagnosis. The diagnostic delivery process is fundamental to how people understand and interpret the BPD diagnosis. The way in which the BPD diagnosis is shared with people can ultimately shape their views about hope for recovery and their subsequent engagement with services. © 2020 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- R Lester
- St Helens Recovery Team, Harry Blackman House, Peasley Cross Hospital, St Helens, UK
| | - L Prescott
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - M McCormack
- St Helens Recovery Team, Harry Blackman House, Peasley Cross Hospital, St Helens, UK
| | - M Sampson
- St Helens Recovery Team, Harry Blackman House, Peasley Cross Hospital, St Helens, UK
| | | |
Collapse
|