Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-18T16:02:09.707Z Has data issue: false hasContentIssue false

Relationships Between Quality of Care, Empowerment, and Outcomes in Psychiatric Inpatients

Published online by Cambridge University Press:  15 February 2018

Lillian L.Y. Seow*
Affiliation:
The University of Western Australia, Perth, Western Australia
Andrew C. Page
Affiliation:
The University of Western Australia, Perth, Western Australia
Geoffrey R. Hooke
Affiliation:
The University of Western Australia, Perth, Western Australia
Jason Y.S. Leong
Affiliation:
The University of Western Australia, Perth, Western Australia
*
Address for correspondence: Lillian Seow, School of Psychological Science, 35 Stirling Highway, Crawley 6009 WA, Australia. Email: [email protected]
Get access

Abstract

Background: Consumer perceptions of care are a key measure of service quality. The Consumer Perceptions of Care (CPoC) survey is often used to assess patients’ evaluations of the quality of services received. Aims: The study explored the factor structure of the CPoC, the relationships between perceived quality of care, empowerment, perceived treatment outcomes, and symptom change, as well as the effect of allowing patients to self-identify during the CPoC survey on their ratings of perceptions of care. Methods: In the first phase of the current study, 2,125 psychiatric inpatients were surveyed about their perceptions of care, and their symptoms were also measured at both admission and discharge. The second phase examined 720 inpatients who had given consent so that perceptions of care could be compared with outcome data. Results: Increased levels of empowerment were associated with favourable ratings of perceived treatment outcomes. Although perceived treatment outcomes and empowerment were correlated with actual symptom change, these correlations were small. Furthermore, the influence of self-identification on ratings of perceptions of care was found to be small. Conclusions: Examining patients’ perceived and actual treatment outcomes may provide mental health service providers with a more nuanced perspective of the hospital experiences of their patients.

Type
Standard Papers
Copyright
Copyright © The Author(s) 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, R.M., Funnell, M.M., Butler, P.M., Arnold, M.S., Fitzgerald, J.T., & Feste, C.C. (1995). Patient empowerment: Results of a randomized controlled trial. Diabetes Care, 18, 943949.CrossRefGoogle ScholarPubMed
Antony, M.M., Bieling, P.J., Cox, B.J., Enns, M.W., & Swinson, R.P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10, 176181.CrossRefGoogle Scholar
Arnetz, J.E., Almin, I., Bergström, K., Franzen, Y., & Nilsson, H. (2004). Active patient involvement in the establishment of physical therapy goals: Effects on treatment outcome and quality of care. Advances in Physiotherapy, 6, 5069.CrossRefGoogle Scholar
Berry, K., Allott, R., Emsley, R., Ennion, S., & Barrowclough, C. (2014). Perceived empowerment in people with a dual diagnosis of schizophrenia spectrum disorder and substance misuse. Social Psychiatry and Psychiatric Epidemiology, 49, 377384. doi: https://doi.org/10.1007/s00127-013-0776-x CrossRefGoogle ScholarPubMed
Brazier, J.E., Harper, R., Jones, N., O'cathain, A., Thomas, K., Usherwood, T., & Westlake, L. (1992). Validating the SF-36 health survey questionnaire: New outcome measure for primary care. BMJ, 305, 160164. doi: https://doi.org/10.1136/bmj.305.6846.160 CrossRefGoogle ScholarPubMed
Eisen, S.V., Shaul, J.A., Leff, H.S., Stringfellow, V., Clarridge, B., & Cleary, P.D. (2001). Toward a national consumer survey: Evaluation of the CABHS and MHSIP instruments. The Journal of Behavioral Health Services & Research, 28, 347369.CrossRefGoogle Scholar
Grealish, A., Tai, S., Hunter, A., & Morrison, A.P. (2013). Qualitative exploration of empowerment from the perspective of young people with psychosis. Clinical Psychology & Psychotherapy, 20, 136148.CrossRefGoogle ScholarPubMed
Hu, L., & Bentler, P.M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 155. doi: 10.1080/10705519909540118 CrossRefGoogle Scholar
Jerrell, J.M. (2006). Psychometrics of the MHSIP Adult Consumer Survey. The Journal of Behavioral Health Services & Research, 33, 483488.CrossRefGoogle ScholarPubMed
LeVois, M., Nguyen, T.D., & Attkisson, C.C. (1981). Artifact in client satisfaction assessment: Experience in community mental health settings. Evaluation and Program Planning, 4, 139150. doi: 10.1016/0149-7189(81)90004-5 CrossRefGoogle ScholarPubMed
Lovibond, P.F., & Lovibond, S.H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour research and therapy, 33, 335343.CrossRefGoogle ScholarPubMed
Lovibond, S.H. (1983). The nature and measurement of anxiety, stress and depression. Paper presented at the 18th Annual Conference of the Australian Psychological Society.Google Scholar
Marsh, H.W., & Hocevar, D. (1985). Application of confirmatory factor analysis to the study of self-concept: First- and higher order factor models and their invariance across groups. Psychological Bulletin, 97, 562582.CrossRefGoogle Scholar
Morris-Yates, A. (2009). A pilot study of the routine collection and reporting of consumer perceptions of care in private hospital-based psychiatric services. Canberra, Australia: Australian Medical Association (on behalf of the Private Mental Health Alliance).Google Scholar
Newbold, A., Hardy, G., & Byng, R. (2013). Staff and patient experience of improving access to psychological therapy group interventions for anxiety and depression. Journal of Mental Health, 22, 456464. doi: https://doi.org/10.3109/09638237.2013.815333 CrossRefGoogle ScholarPubMed
Newnham, E.A., Harwood, K.E., & Page, A.C. (2009). The subscale structure and clinical utility of the Health of the Nation Outcome Scale. Journal of Mental Health, 18, 326334. doi: 10.1080/09638230802522486 CrossRefGoogle Scholar
O'Connor, B.P. (2000). SPSS and SAS programs for determining the number of components using parallel analysis and Velicer's MAP test. Behavior Research Methods, Instruments, & Computers, 32, 396402.CrossRefGoogle ScholarPubMed
Page, A.C., Hooke, G.R., & Morrison, D.L. (2007). Psychometric properties of the Depression Anxiety Stress Scales (DASS) in depressed clinical samples. British Journal of Clinical Psychology, 46, 283297. doi: 10.1348/014466506x158996 CrossRefGoogle ScholarPubMed
Queensland Health. (2009). Pilot study of the routine collection and reporting of information on Consumer Perceptions of Care in Queensland: Final Report for Queensland Health. Brisbane, Australia: Author.Google Scholar
Ronk, F.R., Korman, J.R., Hooke, G.R., & Page, A.C. (2013). Assessing clinical significance of treatment outcomes using the DASS-21. Psychological Assessment, 25, 11031110. doi: https://doi.org/10.1037/a0033100 CrossRefGoogle ScholarPubMed
Segal, S.P., Silverman, C.J., & Temkin, T.L. (2013). Self-Stigma and empowerment in combined-CMHA and consumer-run services: two controlled trials. Psychiatric Services, 64, 990996. doi: https://doi.org/10.1176/appi.ps.201200490 CrossRefGoogle ScholarPubMed
Smith, D., Roche, E., O'Loughlin, K., Brennan, D., Madigan, K., Lyne, J., . . . O'Donoghue, B. (2014). Satisfaction with services following voluntary and involuntary admission. Journal of Mental Health, 23, 3845. doi: https://doi.org/10.3109/09638237.2013.841864 CrossRefGoogle ScholarPubMed
Stack, A.G., & Martin, D.R. (2005). Association of patient autonomy with increased transplantation and survival among new dialysis patients in the United States. American Journal of Kidney Diseases, 45, 730742.CrossRefGoogle ScholarPubMed
Stickley, T., & Bonney, S. (2008). Recovery and mental health: A review of the British literature. Journal of Psychiatric and Mental Health Nursing, 15, 1214. https://doi.org/10.1111/j.1365-2850.2007.01185.x Google Scholar
Yanos, P.T., Primavera, L.H., & Knight, E.L. (2014). Consumer-run service participation, recovery of social functioning, and the mediating role of psychological factors. Psychiatric Services, 52, 493500. doi: https://doi.org/10.1176/appi.ps.52.4.493 CrossRefGoogle Scholar