Person-centred psychosis care in the inpatient setting:Staff experiences of an educational intervention.

• Introduction: The key component in this research project is to test and implement a person-centred psychosis care approach that leads to an active partnership between health professionals and patients. Only by transforming the relationship between the patient and the care provider from the present state of dependency into an equal partnership can we achieve a more effective care model with enhanced financial efficacy and patient self-efficacy. Person-centred psychosis care means to shift away from a model in which the patient is the passive target of a medical intervention to a model where a contractual arrangement is made involving the patient as an active part in the care and the decision-making process. The patient illness narrative is the starting point for building a collaborative, equalitarian health professional-patient partnership that confirms capacities in patients. The patient narrative is the patient´s account of his/her illness, symptoms, and the impact on life. Finally the narrative and agreed partnership needs to be documented in order to secure further care. Methods: The person centered care intervention will be implemented at all four in-patient wards at the Psychosis clinic. An implementation group has been formed and representatives from the four wards are included in this group (section leaders, heads of the wards, and senior ward psychiatrists). The implementation group makes decisions regarding the organization and content of the staff education sessions. The research process has a participatory design which is structured by the foundation pillars in the gPCC model and composes of four workshops together with 33% of the staff in the psychosis care wards, at the department of psychosis, Sahlgrenska University Hospital. All workshops focus on person-centred care and how to implement this care approach at all four in-patient wards at the Psychosis clinic. Now that the educational intervention has been completed it is in our belief that the care offered on the ward is more person-centred. This project will explore this with a simple “before” and “after” design. The primary outcome will be patient empowerment as measured by the “Making Decisions Empowerment Scale”. This scale been validated and used internationally in studies involving persons with severe mental ill-health. Results: All the participants in this project have completed the second phase of the gPCC implementation model and they have agreed on person-centred tasks to implement in their units. Our hypothesis is that persons who receive inpatient treatment after the implementation of the intervention will score higher on ratings of empowerment and consumer satisfaction than those on the “pre-intervention” wards. Further, we hypothesize that shorter hospital stays and less use of involuntary treatments will be observed on the post-intervention wards. Discussion: A person-centered care approach can increase partnership between mental health service users and providers. A basic tenant of person-centered care is that the patient is seen as a capable person who has self-respect and self-esteem. A key element in person-centred care is the dialogue between the professional and the patient, a dialogue with the person, rather than talking to (or informing) a person. The staff education package in itself provides us with an excellent opportunity for transfer of research findings into the care setting. The members of the teaching staff are used as active researchers who will incorporate results from ongoing of the teacher’s results from our ongoing clinical projects on cognition, adherence, and stigma.

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MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences (hsv//eng)

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