Year: 2011
Type: dissertation
Abstract: The main objective with this thesis is to improve the understanding of\nuser involvement in inpatient mental health services. This thesis\nconceptualizes and operationalizes service user involvement into\nvariables that can be empirically measured. This thesis also assesses the\nimplications of conducting the intervention program “Service user\ninvolvement in practice.” The program was implemented in order to\nincrease attention to user involvement and to develop current user\ninvolvement practices in inpatient departments in two community\nmental health centers (CMHCs).\nIn paper 1, multiple items to measure user involvement were\ndeveloped, validated, and empirically tested with service providers in\none CMHC. In paper 2, we used cross-sectional data from service\nproviders in inpatient departments in five CMHCs. The study\ninvestigates if providers’ reports of user involvement vary between\norganizational contexts and ascertains if a provider’s characteristics\naffect the reports. In the intervention stage, both qualitative and\nquantitative data were collected. The qualitative data were used in\npaper 3 and provided insight into both inpatients’ and providers’\nexperiences with user involvement. In paper 4, we used quantitative\nsurvey data from providers and inpatients to study the possible effect of\nthe intervention program “Service user involvement in practice” on\nreports of user involvement. The study design was quasi-experimental,\ninvolving inpatient departments in five CMHCs. Two CMHC took part\nin the intervention program while three CMHCs participated as\ncomparisons.\nIn paper 1, the Service User Involvement in Mental Health (SUIM)\nScale was developed with 30 items and four subscales: “Democratic\npatient involvement,” “Assisted patient involvement,” “Carer\ninvolvement,” and “Management support.” The cross-sectional data in\npaper 2 showed that user involvement at the departmental and\nindividual level could be measured with three subscales or variables:\n“assisted patient involvement,” “patient collaboration,” and\n“organizational user involvement.” The first two variables were derived\nfrom the Service User Involvement in Mental Health (SUIMH) Scale,\nwhile “organizational user involvement” is a selection of items from\nthe Consumer Participation Questionnaire (CPQ) (Kent & Read, 1998).\nThe data also revealed that reports of user involvement at the\ndepartmental level were low, but there were differences among\nCMHCs. Providers reported more often user involvement at the\nindividual level, and providers’ work shifts arrangements impacted on\nthese reports. The qualitative data in paper 3 revealed that user\ninvolvement is a complex matter in inpatient mental health care.\nProviders and patients hold different perspectives on several issues\nrelated to user involvement and involvement in treatment and care. In\npaper 4, the quantitative survey data from providers showed that there\nwere significant changes in three of the user involvement variables:\n“organizational user involvement,” “patient collaboration,” and “carer\ninvolvement.” There were no significant differences between patients\nin the intervention and comparison groups with regard to their\nexperiences with treatment and care.\nThe results in this thesis shows that service user involvement from\nproviders’ perspective can be measured with the following variables:\n“patient collaboration,” “assisted patient involvement,” “carer\ninvolvement,” “management support,” and “organizational user\ninvolvement.” Attention should be paid to the relatively few reports of\n“organizational user involvement” and that there are variations among\ninstitutions with regard to implementation user involvement. The study\nresults suggest that an intervention program can turn attention to and\nincrease competence about user involvement among providers and\ninpatients but that more work is needed to increase patients’ selfadvocacy.
Author: Marianne Storm
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2471170199