Integrating a Patient-Controlled Admission Program Into Mental Health Hospital Service: A Multicenter Grounded Theory Study

Ellegaard, Trine; Bliksted, Vibeke; Mehlsen, Mimi; Lomborg, Kirsten

doi:10.1177/1049732318756301

Cited by 3 publications

(19 citation statements)

References 32 publications

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“…With a retrospective explorative method such as interviews, participants may tend to be positive about their experiences. However, in a qualitative study of MHPs' perspectives, it was found that the staff also experienced that patients gained more responsibility (Ellegaard et al., 2018). A cross‐sectional study found that psychotic symptoms were determinants of quality of life for patients with schizophrenia and suggest providing interventions to train patients’ ability in self‐help and seeking help from others in order to promote skills of symptom management.…”

Section: Discussionmentioning

confidence: 99%

“…In Denmark, a national multicentre study was carried out over 3 years. The Danish study found that the mental health professionals (MHP) strived to integrate PCA into clinical practice and were motivated by the idea of establishing a partnership with patients (Ellegaard, Bliksted, Mehlsen, & Lomborg, 2018). A survey study evaluating this programme found that the patients signed a PCA contract to receive help early and that they initiated an admission to prevent symptoms increasing.…”

Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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Feeling safe with patient‐controlled admissions: A grounded theory study of the mental health patients' experiences

Ellegaard

Bliksted

Mehlsen³

et al. 2020

Journal of Clinical Nursing

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Aim To develop a grounded theory of the patients' experiences with patient‐controlled admission. Background Research indicates a potential for involving patients in mental health care, but there is a need to develop and investigate new approaches in health services. Patient‐controlled admission is an option for patients with severe mental disorders to refer themselves for a brief hospital admission when needed and thus avoid the usual admission procedure. Design Classic grounded theory with generation of a theory based on the constant comparative method for data collection and analysis. Methods Field observations and interviews with 26 mental health patients. The COREQ checklist was followed. Results We found that patient‐controlled admission induced safety by providing faster access to help and thus preventing further deterioration of symptoms. Being self‐determined, achieving calmness and receiving care with support and guidance from professionals during admission contributed to the sense of safety. The familiarity with the mental health professionals in their related units supported the patients in managing their situation. On the other hand, feelings of being overlooked by the professionals and experiencing uncertainty could undermine patients' feeling of safety. Conclusions We demonstrate that safety is a focal point for patients when receiving help and support in mental health care. Patient‐controlled admission can induce a feeling of safety both at the hospital and at home. Patients' self‐determination is strengthened, and brief admissions give them an opportunity to handle what they are currently struggling with. Professionals can support patients in this, but their actions can also reduce patients’ feeling of safety. Relevance to clinical practice Patient involvement can be introduced in psychiatry, and even severely ill patients seem to be able to assess their own condition. Feasibility may, however, be associated with the attitude and behaviour of the professionals in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Feeling safe with patient‐controlled admissions: A grounded theory study of the mental health patients' experiences

Ellegaard

Bliksted

Mehlsen³

et al. 2020

Journal of Clinical Nursing

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“…Integrating user participation into current care models can be done in diverse ways and encounters different challenges depending on the situation. Ellegaard et al [ 38 ] thoroughly discussed the implementation process for patient participation for a patient-controlled admission programme. Here, it was concluded that staff juggled an interaction between managing their work duties and managing the new user-led care situation.…”

Section: Resultsmentioning

confidence: 99%

“…To further create feelings of support for user participation, projects aiming to strengthen user partnerships should not merely superficially claim to be a project of user partnership, but show ownership of the partnership component [ 35 ]. This can for example be achieved through a bottom up approach showing the interest from the users or staff [ 30 , 32 , 38 ] and through equality of information [ 24 , 26 – 28 , 30 , 33 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

The processes involved in the establishment of user-provider partnerships in severe psychiatric illnesses: a scoping review

Boerkoel

Brommels

2022

BMC Psychiatry

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Purpose With the rising relevance of person-centred care, initiatives towards user-led decision making and designing of care services have become more frequent. This designing of care services can be done in partnership, but it is unclear how. The aim of this scoping review was to identify for mental health services, what user-provider partnerships are, how they arise in practice and what can facilitate or hinder them. Methods A scoping review was conducted to obtain a broad overview of user provider partnerships in severe mental illness. Data was inductively analysed using a conventional content analysis approach, in which meaning was found in the texts. Results In total, 1559 titles were screened for the eligibility criteria and the resulting 22 papers found relevant were analysed using conventional content analysis. The identified papers had broad and differing concepts for user-provider partnerships. Papers considered shared decision making and user-involvement as partnerships. Mechanisms such as open communication, organisational top-down support and active participation supported partnerships, but professional identity, power imbalances and stress hindered them. Users can be impeded by their illness, but how to deal with these situations should be formalised through contracts. Conclusion The field of research around user-provider partnerships is scattered and lacks consensus on terminology. A power imbalance between a user and a provider is characteristic of partnerships in mental healthcare, which hinders the necessary relationship building allowing partnerships to arise. This power imbalance seems to be closely linked to professional identity, which was found to be difficult to change.

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Framing the Multi‐Centre Qualitative Research Design as a Novel Methodology for Nursing and Healthcare Research: Reflections and A Methodological Discussion

Bayuo,

Wong,

et al. 2024

Journal of Advanced Nursing

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AimTo discuss the multi‐centre qualitative methodology as a unique design, articulate its guiding paradigm/theoretical perspectives, and highlight its methodological and methodical issues. A secondary objective is to generate further scholarly discourse regarding the multi‐centre approach within the broader qualitative research tradition.DesignMethodological discussion.FindingsRather than an emphasis on only experiences, the multi‐centre approach is presented as a unique design which also focuses on uncovering why a phenomenon or problem exists and perceptions regarding the phenomenon/problem. With its focus on capturing multiple subjective realities, the multi‐centre qualitative design is arguably underpinned by pragmatist constructivism which offers a robust framework for researching phenomenon in a way that is both theoretically informed and practically relevant. Methodologically, the multi‐centre qualitative research design emphasises a problem‐centred enquiry, collaborative approach and rigorous study protocols, systematic site selection, contextual immersion and sensitivity and methodical flexibility.ConclusionWith the rapidly evolving nursing and global health landscape, the multi‐centre design lends itself to exploring and capturing perceptions on a larger scale compared to single site studies. Careful planning, availability of adequate resources, rigorous protocols and quality assurance plans are critical to ensuring its success.Implications for Profession and Patient CareThe multi‐centre approach offers the possibility of undertaking the same study across multiple settings/locations which has the potential to improve representation and strengthen transferability.ImpactThis methodological discussion offers clarity regarding the use of the multi‐centre approach and offering strategies for its subsequent uptake in nursing and healthcare research.Reporting MethodNot applicable.Patient and Public ContributionNo patient or public contribution.

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Integrating a Patient-Controlled Admission Program Into Mental Health Hospital Service: A Multicenter Grounded Theory Study

Cited by 3 publications

References 32 publications

Feeling safe with patient‐controlled admissions: A grounded theory study of the mental health patients' experiences

Feeling safe with patient‐controlled admissions: A grounded theory study of the mental health patients' experiences

The processes involved in the establishment of user-provider partnerships in severe psychiatric illnesses: a scoping review

Framing the Multi‐Centre Qualitative Research Design as a Novel Methodology for Nursing and Healthcare Research: Reflections and A Methodological Discussion

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