CPB Serveis de Salut Mental, Barcelona, Spain.
GRIVIS Research Group, Nursing Department, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.
J Psychiatr Ment Health Nurs. 2020 Jun;27(3):246-257. doi: 10.1111/jpm.12573. Epub 2019 Nov 18.
WHAT IS KNOWN ON THE SUBJECT?: Most studies have focused on whether hospital admissions have been reduced by the introduction of crisis services, rather than focusing on how these services are employed. Research has also shown that home assistance decreases costs and increases the level of patient satisfaction, thereby being more efficient in terms of the cost/effectiveness ratio than is traditional hospital care. Patient satisfaction with nursing care has long been identified as a key element of quality of care; however, satisfaction with nursing care among patients and families receiving crisis resolution at home has not been studied yet. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: There is limited research on patient satisfaction with CRHTTs. This study provides new insights and data including that on relationships between patient satisfaction and the teams' attention to person-centred mental health care. The difference between this study and other studies on patient satisfaction with crisis resolution home treatment teams is that this study focused on patients' and families' satisfaction with the nursing care provided by crisis resolution home treatment teams rather than with the general service provided. This study is the first of its kind with such a focus. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This research has both academic and clinical implications. Patients' and their families' satisfaction with nursing care is an integral aspect for evaluating mental health services, and this is especially important regarding services provided by crisis resolution home treatment teams because such teams are currently being introduced in countries such as Spain. Closely examining patients and families' satisfaction with nursing care can also foster improvements in current practices. Nurses in crisis teams might need to focus on equalizing power relations, which the data gathered in this study suggests is most important to patient satisfaction. ABSTRACT: Introduction Crisis resolution home treatment teams (CRHTT) provide short-term, intensive home treatment to people experiencing mental health crises. Patient satisfaction has long been identified as a key element of quality of care; however, satisfaction with nursing care as part of this service has not been studied yet. Aim To assess patients' and their families' satisfaction with the nursing care provided through a home care program offered by a hospital in Catalonia which administers person-centred care. Method A mixed methods research design was conducted. A cross-sectional study including quantitative survey data and qualitative interview data with a phenomenological focus was conducted. Results Twenty interviews were conducted. Patients and relatives reported high satisfaction that seems to be related to the person-centred nature of the care. Discussion The findings provide new insights, including how home treatment tends to equalize power relations between nurses and patients/the patient's family members, and how nurses increase sensitivity when focusing on service users' needs and priorities, leading to high patient and family satisfaction. Implications for practice This research has both academic and clinical implications. It highlights what mental health patients and their families value most about home care and interactions with nurses, and also drives improvements in current practices.
已知信息:大多数研究都集中在引入危机服务后是否减少了住院人数,而不是关注这些服务的使用方式。研究还表明,家庭援助可以降低成本并提高患者满意度,因此在成本效益比方面比传统的医院护理更有效。患者对护理的满意度一直被认为是护理质量的关键因素;然而,尚未研究在家中接受危机解决服务的患者和家属对护理的满意度。本文的其他新发现:对危机解决家庭治疗团队(CRHTT)的患者满意度的研究有限。本研究提供了新的见解和数据,包括患者满意度与团队对以患者为中心的心理健康护理的关注之间的关系。这项研究与其他关于危机解决家庭治疗团队患者满意度的研究的不同之处在于,这项研究侧重于患者和家属对危机解决家庭治疗团队提供的护理的满意度,而不是对一般服务的满意度。这是此类研究中的首例。对实践的意义:这项研究具有学术和临床意义。患者及其家属对护理的满意度是评估心理健康服务的一个组成部分,对于危机解决家庭治疗团队提供的服务尤其重要,因为此类团队目前正在西班牙等国家推出。仔细检查患者和家属对护理的满意度也可以促进当前实践的改进。危机团队中的护士可能需要关注平等权力关系,这是本研究数据表明对患者满意度最重要的因素。摘要:介绍危机解决家庭治疗团队(CRHTT)为经历心理健康危机的人提供短期、强化的家庭治疗。患者满意度一直被认为是护理质量的关键因素;然而,作为该服务的一部分的护理满意度尚未得到研究。目的评估患者及其家属对加泰罗尼亚一家医院提供的家庭护理计划中护理的满意度,该计划提供以患者为中心的护理。方法采用混合方法研究设计。进行了一项横断面研究,包括定量调查数据和以现象学为重点的定性访谈数据。结果进行了 20 次访谈。患者和亲属报告的满意度很高,这似乎与护理的以患者为中心性质有关。讨论研究结果提供了新的见解,包括家庭治疗如何倾向于平衡护士与患者/患者家属之间的权力关系,以及护士如何在关注服务使用者的需求和优先事项时提高敏感性,从而导致患者和家属的高度满意。对实践的意义本研究具有学术和临床意义。它强调了精神健康患者及其家属最看重家庭护理和与护士的互动,也推动了当前实践的改进。
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