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- Hansson, Lars, et al.
(författare)
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What works for whom in a computer-mediated communication intervention in community psychiatry? Moderators of outcome in a cluster randomized trial.
- 2008
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Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; Aug 27, s. 404-409
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Tidskriftsartikel (refereegranskat)abstract
- Objective: An intervention to structure patient-key worker communication has been tested in a randomized controlled trial. The aim of this paper was to investigate effectiveness of the intervention in terms of moderators of effectiveness. Method: A total of 507 patients with schizophrenia were included. Moderators of effectiveness were investigated using two-way anovas. Results: Patients with a better relationship with their key worker and a shorter duration of illness at baseline benefited more from the intervention in terms of quality of life. Patients who received the intervention who were in competitive employment or had a shorter duration of illness showed greater reduction of unmet needs. Older patients receiving the intervention had better treatment satisfaction. Conclusion: Outcome of the intervention was moderated by patient characteristics. Moreover, the moderating characteristics varied depending on the specific outcome. Evidence on moderators is very limited, even though, they are significant for understanding, targeting and implementing complex interventions.
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- Priebe, Stefan, et al.
(författare)
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Structured patient-clinician communication and 1-year outcome in community mental healthcare - Cluster randomised controlled trial
- 2007
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Ingår i: British Journal of Psychiatry. - : Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 191:5, s. 420-426
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Tidskriftsartikel (refereegranskat)abstract
- Background Patient-clinician communication is central to mental healthcare but neglected in research. Aims To testa new computer-mediated intervention structuring patient-clinician dialogue (DIALOG) focusing on patients' quality of life and needs for care. Method In a cluster randomised controlled trial, 134 key workers in six countries were allocated to DIALOG or treatment as usual; 507 people with schizophrenia or related disorders were included. Every 2 months for I year, clinicians asked patients to rate satisfaction with quality of life and treatment, and request additional or different support. Responses were fed back immediately in screen displays, compared with previous ratings and discussed. Primary outcome was subjective quality of life, and secondary outcomes were unmet needs and treatment satisfaction. Results Of 507 patients, 56 were lost to follow-up and 451 were included in intention-to-treat analyses. Patients receiving the DIALOG intervention had better subjective quality of life, fewer unmet needs and higher treatment satisfaction after 12 months. Conclusions Structuring patient clinician dialogue to focus on patients' views positively influenced quality of life, needs for care and treatment satisfaction.
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- Vrij, Aldert, et al.
(författare)
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Outsmarting the liars The benefit of asking unanticipated questions
- 2009
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Ingår i: Law and Human Behavior. - 0147-7307 .- 1573-661X. ; 33:2, s. 159-166
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Tidskriftsartikel (refereegranskat)abstract
- We hypothesised that the responses of pairs of liars would correspond less with each other than would responses of pairs of truth tellers, but only when the responses are given to unanticipated questions. Liars and truth tellers were interviewed individually about having had lunch together in a restaurant. The interviewer asked typical opening questions which we expected the liars to anticipate, followed by questions about spatial and/or temporal information which we expected suspects not to anticipate, and also a request to draw the layout of the restaurant. The results supported the hypothesis, and based on correspondence in responses to the unanticipated questions, up to 80% of liars and truth tellers could be correctly classified, particularly when assessing drawings.
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- Wiersma, Durk, et al.
(författare)
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Individual unmet needs for care: are they sensitive as outcome criterion for the effectiveness of mental health services interventions?
- 2009
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 44:4, s. 317-324
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Tidskriftsartikel (refereegranskat)abstract
- Background Mental health interventions should demonstrate an effect on patients' functioning as well as his/her needs, in particular on unmet needs whose assessment depends on the perspective of either the patient or the clinician. However, individual met and unmet needs appear to change over time, qualitatively and quantitatively, raising questions about their sensitivity to change and about the association between level of needs and treatment. Methods Data on baseline and follow-up need assessment in community mental health services in four European countries in the context of a cluster randomised trial on a novel mental health service intervention were used, which involved 102 clinicians with key worker roles and 320 patients with schizophrenia or related psychotic disorders. Need assessment was performed with the Camberwell assessment of needs short appraisal schedule (CANSAS) among patients as well as clinicians. Focus is the sensitivity to change in unmet needs over time as well as the concordance between patient and clinician ratings and their relationship with treatment condition. Results At follow-up 294 patients (92%) had a full need assessment, while clinician rated needs were available for 302 patients (94%). Generally, the total number of met needs remained quite stable, but unmet needs decreased significantly over time, according to patients as well as to clinicians. Sensitivity to change of unmet needs is quite high: about two third of all unmet needs made a transition to no or met need, and more than half of all unmet needs at follow-up were new. Agreement between patient and clinician on unmet needs at baseline as well as follow-up was rather low, without any indication of a specific treatment effect. Conclusions Individual unmet needs appear to be quite sensitive to change over time but as yet less suitable as outcome criterion of treatment or specific interventions.
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