Faglige interesser
- Kvalitet, implementering, psykosebehandling, samhandling, brukererfaringer
- Multisenterstudie Utfall av behandling ved akutteam
- Multisenterstudie Implementering av psykosebehandling
- Cluster-randomisert studie av tverrfaglige helseteam ved legesentre
- Multisenterstudie Barn som pårørende
- Evaluering av ACT-team i Norge
Bakgrunn
- Spesialist i psykiatri, dr.med., psykoterapeut, psykoterapiveileder, gruppeanalytiker
- Avdelingsoverlege Nordfjord psykiatrisenter 1983-2000
- Forskningssjef Avdeling psykisk helse i SINTEF 2001-2006
- Overlege Ahus Divisjon psykisk helsevern/professor II Institutt for psykiatri UiO 2006-2007
- Avdelingssjef FOU-avdeling psykisk helsevern Ahus/professor II i psykiatri ved Avdeling for helsetjenester og psykiatri, Institutt for klinisk medisin, UiO fra 2008
Publikasjoner
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Nordin, Håkan; Mathisen, Gro Ellen; Rørtveit, Kristine; Johannessen, Jan Olav; Ruud, Torleif & Hartveit, Miriam
[Vis alle 7 forfattere av denne artikkelen]
(2024).
Implementing Clinical Guidelines for the Treatment of Psychosis: The Frontline Leaders’ Point of View. A Qualitative Study.
Journal of Healthcare Leadership.
ISSN 1179-3201.
16,
s. 93–104.
doi:
10.2147/JHL.S430285.
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Ruud, Torleif; Hasselberg, Nina Eide; Siqveland, Johan & Holgersen, Katrine Høyer
(2024).
Patient-reported outcome, clinician-reported outcome, and patient satisfaction with treatment by crisis resolution teams: a multicenter pre-post study of outcome and associated factors in Norway.
BMC Psychiatry.
ISSN 1471-244X.
24(1).
doi:
10.1186/s12888-024-05543-3.
Fulltekst i vitenarkiv
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Haugom, Espen Woldsengen; Saltyte Benth, Jurate; Stensrud, Bjørn; Ruud, Torleif; Clausen, Thomas & Landheim, Anne Signe
(2023).
Shared decision making and associated factors among patients with psychotic disorders: a cross-sectional study.
BMC Psychiatry.
ISSN 1471-244X.
23(1).
doi:
10.1186/s12888-023-05257-y.
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Background: Shared decision making is a process where patients and clinicians collaborate to make treatment choices based on the patients' preferences and best available evidence. The implementation of shared decision making remains limited for patients with psychotic disorders despite being recommended at policy level, being advocated as ethical right and wanted by the patient's. A barrier to implementation that is often mentioned is reduced decision-making capacity among patients. The challenges of implementing shared decision making highlights a need for more knowledge on shared decision making for these patients. Moreover, the association between patient-related characteristics and shared decision making is unclear, and further research have been suggested. More knowledge of factors associated with involvement in shared decision making can enhance understanding and help to empower patients in the decision-making process. The current study examined the extent of reported shared decision making among patients with a psychotic disorder in mental health care and factors associated with shared decision making.
Methods: This study included 305 participants with a psychotic disorder from 39 clinical inpatient and outpatient sites across Norway. Shared decision making was assessed using the CollaboRATE survey. A linear mixed model was estimated to assess characteristics associated with shared decision making scores.
Results: The CollaboRATE mean score was 6.3 (ranging from 0 to 9), the top score was 14.1% and increased global satisfaction with services was significantly associated with a higher level of shared decision making (regression coefficient 0.27, 95% confidence interval (0.23; 0.32), p < 0.001).
Conclusions: The low top score shows that few patients felt that they received the highest possible quality of shared decision making, indicating that many patients found room for improvement. This suggests that services for patients with psychotic disorders should be designed to give them a greater role in decision making. Shared decision making might play a key role in mental health care, ensuring that patients with psychotic disorders are satisfied with the services provided.
Trial registration: NCT03271242, date of registration: 5 Sept. 2017.
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Haune, Monica Christine; Nissen, Alexander; Christiansen, Øivin; Myrvold, Trine; Ruud, Torleif & Heiervang, Einar Røshol
(2023).
Comprehensive Health Assessment for Children in Out-of-Home Care: An Exploratory Study of Service Needs and Mental Health in a Norwegian Population.
Child Psychiatry and Human Development.
ISSN 0009-398X.
doi:
10.1007/s10578-023-01619-5.
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A comprehensive model for routine multi-disciplinary health assessment for children in out-of-home care was piloted in a Norwegian region. This paper reports on identified service needs and mental disorders among 196 children (0–17 years) receiving the assessment. Cross-sectional data was extracted from assessment reports. Results show needs across a range of services, with a mean of 2.8 recommended services for children aged 0–6 and 3.3 for children aged 7–17. Mental disorders were identified in 50% of younger children, and 70% of older children. For all children, overall service need was associated with mental disorders, in addition to male gender among younger children. Need for specialized mental health services was associated with mental disorders among younger children and increasing age among older children. The high frequency of service needs and mental disorders illustrate the importance of offering comprehensive health assessments routinely to this high-risk child population and necessitates coordinated service delivery.
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Stavnes, Kristin Anne; Ruud, Torleif; Saltyte Benth, Jurate; Hanssen-Bauer, Ketil; Solantaus, Tytti & Hilsen, Marit
[Vis alle 10 forfattere av denne artikkelen]
(2023).
Norwegian health personnel’s contacts and referrals for children of ill parents: an exploratory cross-sectional multi-centre study.
BMC Health Services Research.
ISSN 1472-6963.
23(1).
doi:
10.1186/s12913-023-09607-0.
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Background In 2010, changes were made to the Norwegian Health Personnel Act. This led to all health personnel being obliged to support the patients’ children and families. The aims of this study were to investigate whether health
personnel contacted or referred the patients’ children to family/friends or public services. We also investigated if there were factors in the family or the services that increased or decreased the degree of contacts and referrals. In addition
the patients were asked whether the law had been a help or even a burden. This study was part of a larger multi-site study of children of ill parents conducted in fve health trusts in Norway.
Method We used cross-sectional data from 518 patients and 278 health personnel. The informants completed a questionnaire addressing the law. Data were analyzed by factor analysis and logistic regression.
Results The health personnel contacted/referred children to diferent services, but not to the degree desired by their parents. Only a few contacted family/friends, or the school and/or the public health nurse, those representing the helpers who live closest to the child, and thus well situated to participate in help and preventive eforts. The service most often referred to was the child welfare service.
Conclusion The results indicate a change in contacts/referrals for children from their parents’ health personnel but also reveal remaining needs for support/help for these children. Health personnel should strive to write more refer‑
rals and take more contacts than the current study suggests, to secure adequate support for children of ill parents in Norway, as intended in The Health Personnel Act.
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Israel, K Pravin; Ruud, Torleif & Weimand, Bente Margrethe
(2023).
Carer involvement in the assessment of personal recovery: A naturalistic study of assertive community treatment in Norway.
Frontiers in Psychiatry.
ISSN 1664-0640.
14,
s. 1–8.
doi:
10.3389/fpsyt.2023.1135135.
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Background: The user and carer movements have come a long way in becoming embedded in mainstream mental health services for individuals with serious mental illness. However, implementing recovery-oriented practice continues to be plagued by an individualistic clinical focus. The carers do not feel integrated despite policies and best intentions. The implementation of Assertive Community Treatment (ACT) provided an opportunity to involve the carers and compare their assessment of personal recovery with the users.
Aims: The aims of this study were to examine (i) how family carers and users differed in their assessment of personal recovery, (ii) whether familial and personal relationships influenced how carers assess personal recovery of users, and (iii) if the experience of family carers with the ACT team was associated with personal recovery.
Methods: The naturalistic, explorative study recruited 69 users and 36 family carers from 12 Norwegian ACT teams. The users and carers assessed the user’s personal recovery. Family carers also reported their experience and satisfaction with the ACT teams. Analyses included independent and paired sample T-tests and correlation analysis.
Results: Family carers were significantly more conservative than the users’ assessment of the intrapsychic and interpersonal subscales of personal recovery. The pattern held true whether the family carers were matched to the users or part of the total sample. Lastly, there was a significant negative correlation between the family carer’s experience of cooperation with the ACT team and their assessment of the user’s intrapersonal process of recovery.
Conclusions: The results of our study were consistent with previous research on carer involvement in MHS. However, it is the first study that engaged carers and assessed personal recovery of the users of ACT services. Discrepancy between carers and users is the rule. Clinicians are encouraged to embrace the discrepancy and diversity carers bring and learn the methodology of multi- informant assessments. There also is a need to address, update, and integrate the personal, familial, and relational aspects of recovery. Modification of recovery measures such as QPR and their creative use with carers has the potential to generate valuable third-party information and to involve them meaningfully in mental health services.
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Hestmark, Lars; Romøren, Maria; Heiervang, Kristin Sverdvik; Hansson, Kristiane Myckland; Ruud, Torleif & Saltyte Benth, Jurate
[Vis alle 9 forfattere av denne artikkelen]
(2023).
Implementation of Guidelines on Family Involvement for Persons with Psychotic Disorders (IFIP): A Cluster Randomised Controlled Trial.
Administration and Policy in Mental Health and Mental Health Services Research.
ISSN 0894-587X.
50,
s. 520–533.
doi:
10.1007/s10488-023-01255-0.
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Family involvement is part of the evidence-based treatment for persons with psychotic disorders, yet is under-implemented
despite guideline recommendations. This study assessed whether an implementation support programme increased the
adherence to guidelines on family involvement, compared to guideline/manual only. In a cluster randomised design,
community mental health centre units in South-East Norway went through stratified allocation to the experimental (n = 7)
or control (n = 7) arm. Experimental clusters received an implementation support programme including clinical training
and supervision, appointing a family coordinator and an implementation team, a toolkit, and fidelity measurements at
baseline, 12, 18, and 24 months with on-site feedback and supervision. Control clusters received no such support and
had fidelity measurements at baseline and 24 months without feedback. During fidelity measurements, adherence to the
guidelines was measured with the basic family involvement and support scale, the general organizational index, and the
family psychoeducation fidelity scale, the latter being the primary outcome. The scales consist of 12–14 items rated from 1
to 5. Data was analysed with an independent samples t-test, linear mixed models, and a tobit regression model. At 24 months,
the mean scores were 4.00 or higher on all scales in the experimental arm, and the increase in adherence to the guidelines
was significantly greater than in the control arm with p-values < 0.001. Large-scale implementation of guidelines on family
involvement for persons with psychotic disorders in community mental health centres may be accomplished, with substantial
implementation support.
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Hustoft, Kjetil; Larsen, Tor Ketil; Brønnick, Kolbjørn Kallesten; Joa, Inge; Johannessen, Jan Olav & Ruud, Torleif
(2022).
Psychiatric patients’ attitudes towards being hospitalized: a national multicentre study in Norway.
BMC Psychiatry.
ISSN 1471-244X.
22,
s. 1–8.
doi:
10.1186/s12888-022-04362-8.
Fulltekst i vitenarkiv
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Stavnes, Kristin Anne; Ruud, Torleif; Saltyte Benth, Jurate; Hanssen-Bauer, Ketil; Weimand, Bente Margrethe & Solantaus, Tytti
[Vis alle 13 forfattere av denne artikkelen]
(2022).
Norwegian health personnel’s compliance with new legislation on children of ill parents: an exploratory cross-sectional multicentre study.
BMC Health Services Research.
ISSN 1472-6963.
22,
s. 1–18.
doi:
10.1186/s12913-022-08268-9.
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Background: In 2010 the Norwegian Parliament introduced amendments to the Health Personnel Act requiring all
health personnel to inform and offer help to their patients’ children and families. We evaluated whether health per‑
sonnel adhered to their obligations outlined in the Act and investigated whether family and health services charac‑
teristics were associated with the degree of compliance with the legislation. Our study was part of a larger Norwegian
multi‑site study conducted in five health trusts across Norway, assessing the situation for families living with parental
illness.
Method: A cross‑sectional study using quantitative data obtained from 518 patients 246 children and 278 health
personnel was performed. All informants completed a questionnaire, including an instrument corresponding to the
obligations in the legislation. Descriptive analyses, factor analysis and logistic regression analysis were used.
Results: The legislation was only partially implemented in the clinics of the health trusts. Compared to estimates
prior to the introduction of the new legislation, the situation had improved somewhat, but much work remains to
be done to fulfil the obligations decreed by law. The more time‑consuming the obligations were, the less often they
were met. The substance abuse and mental health services followed up on their obligations to a greater extent than
did the physical health services. Conversely, children of physically ill parents were better informed by their families
than were children of parents with mental health and substance abuse disorders. When asked the same questions,
reports from health personnel were more positive compared to those of children and patients regarding the legisla‑
tion’s fulfillment.
Conclusion: Data suggest that there has been a change in the support offered to children of ill parents. Additional
work is required, however, for the Health Personnel Act to function as fully intended
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Hartveit, Miriam; Hovlid, Einar; Øvretveit, John; Assmus, Jörg; Bond, Gary & Joa, Inge
[Vis alle 11 forfattere av denne artikkelen]
(2022).
Can systematic implementation support improve programme fidelity by improving care providers’ perceptions of implementation factors? A cluster randomized trial.
BMC Health Services Research.
ISSN 1472-6963.
22(1).
doi:
10.1186/s12913-022-08168-y.
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Background: Investigations of implementation factors (e.g., collegial support and sense of coherence) are recommended to better understand and address inadequate implementation outcomes. Little is known about the relationship between implementation factors and outcomes, especially in later phases of an implementation effort. The aims of this study were to assess the association between implementation success (measured by programme fidelity) and care providers' perceptions of implementation factors during an implementation process and to investigate whether these perceptions are affected by systematic implementation support.
Methods: Using a cluster-randomized design, mental health clinics were drawn to receive implementation support for one (intervention) and not for another (control) of four evidence-based practices. Programme fidelity and care providers' perceptions (Implementation Process Assessment Tool questionnaire) were scored for both intervention and control groups at baseline, 6-, 12- and 18-months. Associations and group differences were tested by means of descriptive statistics (mean, standard deviation and confidence interval) and linear mixed effect analysis.
Results: Including 33 mental health centres or wards, we found care providers' perceptions of a set of implementation factors to be associated with fidelity but not at baseline. After 18 months of implementation effort, fidelity and care providers' perceptions were strongly correlated (B (95% CI) = .7 (.2, 1.1), p = .004). Care providers perceived implementation factors more positively when implementation support was provided than when it was not (t (140) = 2.22, p = .028).
Conclusions: Implementation support can facilitate positive perceptions among care providers, which is associated with higher programme fidelity. To improve implementation success, we should pay more attention to how care providers constantly perceive implementation factors during all phases of the implementation effort. Further research is needed to investigate the validity of our findings in other settings and to improve our understanding of ongoing decision-making among care providers, i.e., the mechanisms of sustaining the high fidelity of recommended practices.
Trial registration: ClinicalTrials.gov Identifier: NCT03271242 (registration date: 05.09.2017).
Keywords: Implementation; Implementation outcomes; Implementation process; Mental health; Readiness.
© 2022. The Author(s).
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Hansson, Kristiane Myckland; Romøren, Maria; Pedersen, Reidar; Weimand, Bente Margrethe; Hestmark, Lars & Norheim, Irene
[Vis alle 9 forfattere av denne artikkelen]
(2022).
Barriers and facilitators when implementing family involvement for persons with psychotic disorders in community mental health centres - a nested qualitative study.
BMC Health Services Research.
ISSN 1472-6963.
22(1).
doi:
10.1186/s12913-022-08489-y.
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Background
The uptake of family involvement in health care services for patients with psychotic disorders is poor, despite a clear evidence base, socio-economic and moral justifications, policy, and guideline recommendations. To respond to this knowledge-practice gap, we established the cluster randomised controlled trial: Implementation of guidelines on Family Involvement for persons with Psychotic disorders in community mental health centres (IFIP). Nested in the IFIP trial, this sub-study aims to explore what organisational and clinical barriers and facilitators local implementation teams and clinicians experience when implementing family involvement in mental health care for persons with psychotic disorders.
Methods
We performed 21 semi-structured focus groups, including 75 participants in total. Implementation team members were interviewed at the initial and middle phases of the intervention period, while clinicians who were not in the implementation team were interviewed in the late phase. A purposive sampling approach was used to recruit participants with various engagement in the implementation process. Data were analysed using manifest content analysis.
Results
Organisational barriers to involvement included: 1) Lack of shared knowledge, perceptions, and practice 2) Lack of routines 3) Lack of resources and logistics. Clinical barriers included: 4) Patient-related factors 5) Relative-related factors 6) Provider-related factors. Organisational facilitators for involvement included: 1) Whole-ward approach 2) Appointed and dedicated roles 3) Standardisation and routines. Clinical facilitators included: 4) External implementation support 5) Understanding, skills, and self-efficacy among mental health professionals 6) Awareness and attitudes among mental health professionals.
Conclusions
Implementing family involvement in health care services for persons with psychotic disorders is possible through a whole-ward and multi-level approach, ensured by organisational- and leadership commitment. Providing training in family psychoeducation to all staff, establishing routines to offer a basic level of family involvement to all patients, and ensuring that clinicians get experience with family involvement, reduce or dissolve core barriers. Having access to external implementation support appears decisive to initiate, promote and evaluate implementation. Our findings also point to future policy, practice and implementation developments to offer adequate treatment and support to all patients with severe mental illness and their families.
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Linde, Janniche; Schmid, Marit Therese; Ruud, Torleif; Fröding, Regina & Biringer, Eva Aaker
(2022).
Social Factors and Recovery: A Longitudinal Study of Patients with Psychosis in Mental Health Services.
Community mental health journal.
ISSN 0010-3853.
doi:
10.1007/s10597-022-01007-8.
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To study the prospective associations between social factors and recovery in patients with psychotic disorders in mental health specialist services. In this prospective observational cohort study, analyzes were based on baseline- and follow-up data after 18 months from 108 patients with psychosis. Personal recovery was assessed by the Questionnaire about the Process of Recovery (QPR). Linear regression models were used to test the prospective associations between social predictor variables and QPR. An association was found between experienced quality of interpersonal relationships at baseline and change in QPR score over the next 18 months. Stratified analyzes showed that the effect of experienced quality of interpersonal relationships on recovery was due to an association among persons living with others. Patients’ experience of quality of interpersonal relationships are prospectively associated with recovery. In conclusion, findings indicate that interpersonal relationships and social interaction are central drivers of recovery in patients with psychotic disorders.
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Fröding, Regina; Clausen, Hanne Kristin; Saltyte Benth, Jurate; Ruud, Torleif; Slade, Mike & Heiervang, Kristin Sverdvik
(2022).
Associations between personal recovery and service user-rated versus clinician-rated clinical recovery, a cross-sectional study.
BMC Psychiatry.
ISSN 1471-244X.
22.
doi:
10.1186/s12888-022-03691-y.
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Background
This study examined the relationship between service user-rated personal recovery and clinician-rated and service user-rated clinical recovery. The relationships between different subdomains of clinical recovery and personal recovery were also assessed.
Methods
In total, 318 mental health service users with a psychosis diagnosis and their clinicians from 39 sites across Norway completed standardized questionnaires regarding personal recovery, clinical symptoms and psychosocial functioning. Regression models were used to investigate the relationship between personal and clinical recovery.
Results
Overall, clinical recovery was positively associated with personal recovery, when rated both by service users and by clinicians. Personal recovery was associated with lower levels of depression, self-harm and problems with relationships when rated by the service users. Among the subdomains rated by the clinicians, personal recovery was associated with fewer problems with relationships and higher aggressiveness.
Conclusions
These findings suggest that affective symptoms are associated with personal recovery, indicating the need for greater focus on depression treatment among people with psychosis. Improving social connections is of importance for personal recovery, and might be an area where clinicians and service users can meet and find agreement on important treatment goals.
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Haugom, Espen Woldsengen; Stensrud, Bjørn; Beston, Gro; Ruud, Torleif & Landheim, Anne Signe
(2022).
Experiences of shared decision making among patients with psychotic disorders in Norway: a qualitative study.
BMC Psychiatry.
ISSN 1471-244X.
22(1).
doi:
10.1186/s12888-022-03849-8.
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Background: Shared decision making (SDM) is a process where the patient and the health professional collaborate
to make decisions based on both the patient’s preferences and the best available evidence. Patients with psychotic
disorders are less involved in making decisions than they would like. More knowledge of these patients’ experiences of SDM may improve implementation. The study aim was to describe and explore experiences of SDM among
patients with psychotic disorders in mental health care.
Methods: Individual interviews were conducted with ten persons with a psychotic disorder. They were service users
of two community mental health centres. The transcribed material was analysed using qualitative content analysis.
Results: Four-ffths of the participants in this study found that they received insufcient information about their
health situation and treatment options. All participants experienced that only one kind of treatment was often
presented, which was usually medication. Although the study found that diferent degrees of involvement were
practised, two thirds of the participants had little impact on choices to be made. This was despite the fact that they
wanted to participate and felt capable of participating, even during periods of more severe illness. The participants
described how important it was that SDM in psychosis was based on a trusting relationship, but stated that it took
time to establish such a relationship.
Conclusions: This study with ten participants indicates that patients with psychotic disorders experienced that they
were not allowed to participate as much as they wanted to and believed they were capable of. Some patients were
involved, but to a lesser degree than in SDM. More and better tailored information communicated within a trusting
relationship is needed to provide psychotic patients with a better basis for active involvement in decisions about their
health care.
Keywords: Shared decision making, psychotic disorders, mental health services, qualitative research
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Hasselberg, Nina; Klevan, Trude Gøril; Weimand, Bente; Uverud, Gunn-Marit; Holgersen, Katrine Høyer & Siqveland, Johan
[Vis alle 7 forfattere av denne artikkelen]
(2022).
Similarities and differences between service users’ and carers’ experiences of crisis resolution teams in Norway: a survey.
BMC Psychiatry.
ISSN 1471-244X.
22(1),
s. 1–11.
doi:
10.1186/s12888-022-03928-w.
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Background
Crisis resolution team (CRT) care in adult mental health services is intended to provide accessible and flexible short-term, intensive crisis intervention to service users experiencing a mental health crisis and involve their carers (next of kin). Research on users’ and especially carers’ experiences with CRT care is scarce and is mostly qualitative in nature.
Methods
Altogether, 111 service users and 86 carers from 28 Norwegian CRTs were interviewed with The Service User and Carer Structured Interviews of the CORE Crisis Resolution Team Fidelity Scale Version 2. Their experiences with different aspects of CRT care were reported with descriptive statistics, and differences between service users’ and carers’ experiences were analyzed with the Mann-Whitney U Test.
Results
The service users and carers reported that the CRT care mostly reflected their needs and what they wanted. The experiences of service users and carers were mostly similar, except for significant differences in received information and how the termination of CRT care appeared. Both groups experienced the organization of the CRT care as accessible, with continuity, reliability, and flexibility, but without a high intensity of care. Both groups found the content of the CRT care supportive, sensitive, with a choice of treatment type and a range of interventions beyond medication, but a lack of written treatment plans and discharge plans. Carers were rarely involved in discharge meetings. Regarding the role of CRTs within the care system, both groups agreed upon the lack of facilitation of early discharge from inpatient wards and lack of home treatment, but both groups confirmed some collaboration with other mental health services.
Conclusion
Service users and carers found that the CRTs were accessible, reliable, flexible, supportive, sensitive, and provided a range of interventions beyond medication. Limitations were lack of a high intensity of care, limited written treatment and discharge plans, limited provision of home treatment, and lack of gatekeeping of acute beds. Both groups experienced the CRT care as mostly similar, but with significant differences regarding involvement in care planning and discharge preparation.
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Ruud, Torleif & Friis, Svein
(2021).
Community-based Mental Health Services in Norway.
Consortium Psychiatricum.
ISSN 2712-7672.
2(1),
s. 47–54.
doi:
10.17816/CP43.
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Ruud, Torleif; Haugom, Espen Woldsengen; Pincus, Harold Alan & Hynnekleiv, Torfinn
(2021).
Measuring Seclusion in Psychiatric Intensive Care: Development and Measurement Properties of the Clinical Seclusion Checklist.
Frontiers in Psychiatry.
ISSN 1664-0640.
12.
doi:
10.3389/fpsyt.2021.768500.
Vis sammendrag
Background: Acute psychiatric units in general hospitals must ensure that acutely disturbed patients do not harm themselves or others, and simultaneously provide care and treatment and help patients regain control of their behavior. This led to the development of strategies for the seclusion of a patient in this state within a particular area separated from other patients in the ward. While versions of this practice have been used in different countries and settings, a systematic framework for describing the various parameters and types of seclusion interventions has not been available. The aims of the project were to develop and test a valid and reliable checklist for characterizing seclusion in inpatient psychiatric care. Methods: Development and testing of the checklist were accomplished in five stages. Staff in psychiatric units completed detailed descriptions of seclusion episodes. Elements of seclusion were identified by thematic analysis of this material, and consensus regarding these elements was achieved through a Delphi process comprising two rounds. Good content validity was ensured through the sample of seclusion episodes and the representative participants in the Delphi process. The first draft of the checklist was revised based on testing by clinicians assessing seclusion episodes. The revised checklist with six reasons for and 10 elements of seclusion was tested with different response scales, and acceptable interrater reliability was achieved. Results: The Clinical Seclusion Checklist is a brief and feasible tool measuring six reasons for seclusion, 10 elements of seclusion, and four contextual factors. It was developed through a transparent process and exhibited good content validity and acceptable interrater reliability. Conclusion: The checklist is a step toward achieving valid and clinically relevant measurements of seclusion. Its use in psychiatric units may contribute to quality assurance, more reliable statistics and comparisons across sites and periods, improved research on patients' experiences of seclusion and its effects, reduction of negative consequences of seclusion, and improvement of psychiatric intensive care.
Keywords: checklist; clinical seclusion checklist; emergency psychiatry; measurement properties; measuring; psychiatric acute wards; psychiatric intensive care; seclusion.
Copyright © 2021 Ruud, Haugom, Pincus and Hynnekleiv.
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Ruud, Torleif; Drake, Robert E.; Saltyte Benth, Jurate; Drivenes, Karin; Hartveit, Miriam & Heiervang, Kristin Sverdvik
[Vis alle 16 forfattere av denne artikkelen]
(2021).
The Effect of Intensive Implementation Support on Fidelity for Four Evidence‑Based Psychosis Treatments: A Cluster Randomized Trial.
Administration and Policy in Mental Health and Mental Health Services Research.
ISSN 0894-587X.
48,
s. 909–920.
doi:
10.1007/s10488-021-01136-4.
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Abstract
Purpose: Service providers need effective strategies to implement evidence-based practices (EBPs) with high fidelity. This study aimed to evaluate an intensive implementation support strategy to increase fidelity to EBP standards in treatment of patients with psychosis.
Methods: The study used a cluster randomized design with pairwise assignment of practices within each of 39 Norwegian mental health clinics. Each site chose two of four practices for implementation: physical health care, antipsychotic medication management, family psychoeducation, illness management and recovery. One practice was assigned to the experimental condition (toolkits, clinical training, implementation facilitation, data-based feedback) and the other to the control condition (manual only). The outcome measure was fidelity to the EBP, measured at baseline and after 6, 12, and 18 months, analyzed using linear mixed models and effect sizes.
Results: The increase in fidelity scores (within a range 1-5) from baseline to 18 months was significantly greater for experimental sites than for control sites for the combined four practices, with mean difference in change of 0.86 with 95% CI (0.21; 1.50), p = 0.009). Effect sizes for increase in group difference of mean fidelity scores were 2.24 for illness management and recovery, 0.68 for physical health care, 0.71 for antipsychotic medication management, and 0.27 for family psychoeducation. Most improvements occurred during the first 12 months.
Conclusions: Intensive implementation strategies (toolkits, clinical training, implementation facilitation, data-based feedback) over 12 months can facilitate the implementation of EBPs for psychosis treatment. The approach may be more effective for some practices than for others.
Keywords: Evidence-based practice; Fidelity scale; Implementation support; Mental health services; Psychoses.
© 2021. The Author(s).
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Piiksi Dahli, Mina; Saltyte Benth, Jurate; Haavet, Ole Rikard; Ruud, Torleif & Brekke, Mette
(2021).
Somatic symptoms and associations with common psychological diagnoses: a retrospective cohort study from Norwegian urban general practice.
Family Practice.
ISSN 0263-2136.
38(6),
s. 766–772.
doi:
10.1093/fampra/cmab038.
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Maybery, Darryl; Jaffe, Irene Casey; Cuff, Rose; Duncan, Zoe; Grant, Anne & Kennelly, Melissa
[Vis alle 10 forfattere av denne artikkelen]
(2021).
Mental health service engagement with family and carers: what practices are fundamental?
BMC Health Services Research.
ISSN 1472-6963.
21(1),
s. 1–11.
doi:
10.1186/s12913-021-07104-w.
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Background:
Substantial and important benefits flow to all stakeholders, including the service user, when mental health services meaningfully engage with carers and family members. Government policies around the world clearly supports inclusiveness however health service engagement with family and carers remains sporadic, possibly because how best to engage is unclear. A synthesis of currently used surveys, relevant research and audit tools indicates seven core ways that families and carers might be engaged by health services. This study sought to confirm, from the perspective of family and carers, the importance of these seven health service engagement practices.
Methods:
In a mixed method online survey, 134 family members and carers were asked what they received and what they wanted from mental health services. Participants also quantified the importance of each of the seven core practices on a 0–100 point likert scale.
Results:
Almost 250 verbatim responses were deductively matched against the seven themes, with additional unaligned responses inductively categorised. The findings triangulate with multiple diverse literatures to confirm seven fundamental engagement practices that carers and family want from health services. Conceptually, the seven practices are represented by two broad overarching practice themes of (i) meeting the needs of the family member and (ii) addressing the needs of the service user.
Conclusion:
Policy, clinical practice, training and future research might encompass the seven core practices along with consideration of the intertwined relationship of family, carers and the service user suggested by the two broader concepts.
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Fröding, Regina; Clausen, Hanne Kristin; Saltyte Benth, Jurate; Ruud, Torleif; Slade, Mike & Heiervang, Kristin Sverdvik
(2021).
The importance of personal recovery and perceived recovery support among service users with psychosis.
Psychiatric Services.
ISSN 1075-2730.
72(6),
s. 661–668.
doi:
10.1176/APPI.PS.202000223.
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Objective: More knowledge is needed about whether personal recovery, as defined by the CHIME framework (connectedness, hope, identity, meaning and purpose, and empowerment), is considered important by service users with psychosis. This study examined the importance of personal recovery for a large, heterogeneous group of service users with psychosis and their perceived support from clinicians for personal recovery.
Methods: This cross-sectional study used baseline data from 321 service users with psychosis from 39 clinical units across Norway. The INSPIRE Measure of Staff Support for Personal Recovery (based on CHIME) was used to examine personal recovery and perceived support provided for recovery. Twenty support-for-recovery items were each rated on importance (yes or no) and on the extent of support received (5-point scale). Bivariate and multiple linear regression models assessed variables associated with rated importance and support. Results: Most service users rated personal recovery items as important, regardless of their symptomatology and functioning. Previous experience with Illness Management and Recovery, knowledge about coping with stress and illness, and having a plan for early detection and prevention of relapse were significantly associated with higher perceived support. Higher self-reported depressive symptoms, lower score on the Global Assessment of Functioning symptom subscale, and male sex were significantly associated with less perceived support.
Conclusions: Most service users with psychosis found personal recovery important, regardless of symptomatology and functioning, which has implications for clinical practice and provides empirical evidence that recovery-oriented treatments are relevant for most service users with psychosis in various mental health services.
Keywords: PROM; Recovery; Schizophrenia; service user.
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Tveit, Ole Gunnar; Ruud, Torleif; Hanssen-Bauer, Ketil; Haavet, Ole Rikard & Hussain, Ajmal
(2021).
An explorative study of factors associated with treatment in specialized mental health care centers among GP patients in Norway.
BMC Health Services Research.
ISSN 1472-6963.
21(1),
s. 1–9.
doi:
10.1186/s12913-021-06982-4.
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Background: Effectiveness and efficiency are part of the quality of care for mental health problems, and treatment should thus be performed at the right level of care. Norwegian guidelines specify which patients should be given priority for treatment in specialized mental health care (SMHC) centers, but there is a lack of agreement on which patients should actually receive SMHC. In this study we wanted to examine what factors (patient and GP characteristics) were related to GP patients who received treatment in SMHC centers.
Methods: Inthisretrospectivecohortstudy,welookedat12monthsofdatafromelectronichealthrecordsfromsix GP and SMHC centers of hospitals in the catchment area. We included all patients who had been treated at any of the GP centers during the 12-month period (N=18032). We fit a generalized linear mixed model to explore which factors were related to patients receiving treatment in SMHC centers. Further exploration was performed to study the effects of gender and contact frequency.
Results: Wefoundthat4.6%ofallGPpatientsand18.4%oftheGPpatientswithamentalhealthproblemswere treated in SMHC centers. There were more women than men among the GP-patients (56% vs 44%) and in SMHC centers (55% vs 45%), women with mental health problems were more severely ill than men. However, after adjusting for other factors men were more likely to be treated in SMHC centers (OR: 1.44). Patients with frequent GP contact were more likely to be treated in SMHC centers. The GP characteristics age, gender and specialization did not relate to patients receiving treatment in SMHC centers.
Conclusions: MenweremorelikelytobetreatedinSMHCcentersthanwomen,whichmayimplythattheyhave different thresholds for entering SMHC centers. GP characteristics were not related to receiving treatment in SMHC centers. More specific knowledge is needed to determine whether men and women currently receive treatment at the lowest possible level of care.
Keywords: Psychiatricspecialistservices,Mentalhealthcare,Healthcareutilization,Norway
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Birkeland, Bente; Weimand, Bente; Ruud, Torleif; Maybery, Darryl & Vederhus, John-Kåre
(2021).
Perceived family cohesion, social support, and quality of life in patients undergoing treatment for substance use disorders compared with patients with mental and physical disorders.
Addiction science & clinical practice.
ISSN 1940-0632.
16(1),
s. 1–9.
doi:
10.1186/s13722-021-00252-8.
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Purpose:
Support from family and other social network elements can be important in helping patients to cope with practical and emotional consequences of diseases. The aim of the study was to examine perception of family and social support and quality of life (QoL) in patients undergoing treatment for substance use disorders (SUDs). We compared them with patients in treatment for mental disorders (MDs) and physical disorders (PDs).
Methods:
We used data from a national multicenter study that recruited patients (N = 518) from three treatment domains; SUD treatment units, MD treatment units, and PD treatment units (severe neurological conditions or cancer). Data on family cohesion, social support, and QoL were compared across patient groups. In addition, data on health variables was collected. We used a multiple linear regression procedure to examine how health and support variables were associated with QoL.
Results:
Family cohesion and social support in the SUD and MD groups were rated at similarly low levels, substantially lower than in the PD group. The SUD group exhibited a somewhat lower QoL than did the PD group, but their QoL was still in the near-to-normal range. In contrast, the MD group had markedly low QoL. When examining factors associated with QoL, we found that greater family cohesion and social support were positively associated with QoL. Mental distress was the strongest factor, and was negatively associated with QoL (beta − 0.15, 95% CI = − 0.17/− 0.14, p < 0.001).
Conclusion:
Service providers need to be aware of the weaker networks and less regulatory family and/or social support available to patients with SUDs. Providers should focus consistently on the social networks of patients and include patients’ families in treatment processes.
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Hasselberg, Nina Eide; Holgersen, Katrine Høyer; Uverud, Gunn-Marit; Siqveland, Johan; Lloyd-Evans, Brynmor & Johnson, Sonia
[Vis alle 7 forfattere av denne artikkelen]
(2021).
Fidelity to an evidence-based model for crisis resolution teams: a cross-sectional multicentre study in Norway.
BMC Psychiatry.
ISSN 1471-244X.
21.
doi:
10.1186/s12888-021-03237-8.
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Background: Crisis resolution teams (CRTs) are specialized multidisciplinary teams intended to provide assessment and short-term outpatient or home treatment as an alternative to hospital admission for people experiencing a mental health crisis. In Norway, CRTs have been established within mental health services throughout the country, but their fidelity to an evidence-based model for CRTs has been unknown.
Methods: We assessed fidelity to the evidence-based CRT model for 28 CRTs, using the CORE Crisis Resolution Team Fidelity Scale Version 2, a tool developed and first applied in the UK to measure adherence to a model of optimal CRT practice. The assessments were completed by evaluation teams based on written information, interviews, and review of patient records during a one-day visit with each CRT.
Results: The fidelity scale was applicable for assessing fidelity of Norwegian CRTs to the CRT model. On a scale 1 to 5, the mean fidelity score was low (2.75) and with a moderate variation of fidelity across the teams. The CRTs had highest scores on the content and delivery of care subscale, and lowest on the location and timing of care subscale. Scores were high on items measuring comprehensive assessment, psychological interventions, visit length, service users’ choice of location, and of type of support. However, scores were low on opening hours, gatekeeping acute psychiatric beds, facilitating early hospital discharge, intensity of contact, providing medication, and providing practical support.
Conclusions: The CORE CRT Fidelity Scale was applicable and relevant to assessment of Norwegian CRTs and may be used to guide further development in clinical practice and research. Lower fidelity and differences in fidelity patterns compared to the UK teams may indicate that Norwegian teams are more focused on early interventions to a broader patient group and less on avoiding acute inpatient admissions for patients with severe mental illness.
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Fröding, Regina; Clausen, Hanne Kristin; Saltyte Benth, Jurate; Ruud, Torleif; Slade, Mike & Heiervang, Kristin S.
(2021).
Relationship between satisfaction with mental health services, personal recovery and quality of life among service users with psychosis: a cross-sectional study.
BMC Health Services Research.
ISSN 1472-6963.
21(1).
doi:
10.1186/s12913-021-06409-0.
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Background: Mental health policy internationally emphasizes patient centredness and personal recovery. This study investigated the relationship between satisfaction with mental health services among service users with psychosis in Norway, and personal recovery, perceived support for personal recovery, and quality of life.
Methods: Cross-sectional data were collected from 292 service users diagnosed with psychosis from 39 clinical sites across Norway. Satisfaction with services was assessed using the Client Satisfaction Questionnaire-8. A linear mixed model was estimated to explore the relationship between satisfaction with services and preselected covariates, and to control for confounding factors.
Results: A large majority of participants (89%) reported moderate-to-high levels of satisfaction. Satisfaction with services was positively associated with perceived support for personal recovery, but not with personal recovery or quality of life. In addition, service users under a Community Treatment Order (CTO) were significantly less satisfied than those who were not.
Conclusions: Satisfaction levels among service users were higher compared with similar, international studies. Those who feel supported in their personal recovery were more satisfied with the care they receive, which support the need for implementation of recovery-oriented practices for service users with psychosis. However, satisfaction with services was not related to service user-rated quality of life or level of personal recovery; thus, more follow-up studies are needed. The lower satisfaction of service users placed under CTOs shows the importance of targeted interventions to improve satisfaction with services among this group.
Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
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Saltyte Benth, Jurate; Fröding, Regina; Ruud, Torleif; Clausen, Hanne Kristin & Heiervang, Kristin S.
(2021).
The INSPIRE Support sub-scale: A critical view of the psychometric properties focusing on dimensionality.
Current Psychology.
ISSN 1046-1310.
doi:
10.1007/s12144-021-01916-z.
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The statistical methods previously used for assessing dimensionality of the INSPIRE Support sub-scale are often not valid, which may lead to inaccurate conclusions. The first aim of this paper was to present and discuss the methods for assessing the dimensionality of the scale. The second aim was to illustrate these methods using data from a Norwegian translation of the INSPIRE Support sub-scale. Exploratory factor analysis with several extraction and rotation methods was used to identify the dimensionality of the scale. Cronbach’s alpha and omega coefficient were employed to assess the internal consistency. Using the recognized statistical approach, there was no clear structure found in the Support sub-scale, indicating that the scale might be one-dimensional. While single items or sum score of the INSPIRE Support sub-scale might cover important aspects of the personal recovery concept, there is no evidence of the five CHIME dimensions of this scale as published earlier. A more thorough assessment is called for, and results from studies using the five dimensions should be interpreted with caution.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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Hestmark, Lars; Heiervang, Kristin S.; Pedersen, Reidar; Hansson, Kristiane Myckland; Ruud, Torleif & Romøren, Maria
(2021).
Family involvement practices for persons with psychotic disorders in community mental health centres – a cross-sectional fidelity-based study.
BMC Psychiatry.
ISSN 1471-244X.
21,
s. 1–11.
doi:
10.1186/s12888-021-03300-4.
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Klevan, Trude Gøril; Karlsson, Bengt Eirik; Hasselberg, Nina Eide & Ruud, Torleif
(2021).
‘No service is an island’: experiences of collaboration with crisis resolution teams in Norway.
Journal of Interprofessional Care.
ISSN 1356-1820.
s. 1–7.
doi:
10.1080/13561820.2021.1888900.
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Crisis resolution teams (CRTs) are a community-based service targeting adults experiencing acute mental health crises. The rationale for the development of CRTs is both value and efficacy based, suggesting that CRTs should contribute to the humanizing of mental health services and replace some acute hospital-based services with services in the community. Despite the collaborative nature of CRT work, how professionals from health and social services experience collaboration with CRTs is scantly explored. In the current study, semi-structured focus group interviews with eight different groups of 44 clinicians collaborating with CRTs in Norway were conducted. Data were analyzed using thematic analysis and categorized into four themes: (1) ‘The accessible experts’, (2) ‘A broad and deep expertise’, (3) ‘Doing it together’ and (4) ‘Toward a new culture?’. The themes elaborate on issues related to the content and organization of CRT services, emphasizing the need for CRTs to be able to contribute their professional expertise in accessible, flexible and collaborative ways. A diversity in the knowledge base and in how services are organized may pose a challenge in interprofessional mental health crisis collaboration and mutual expectations. The study suggests that a shift toward a value-based and coherent mental health and social system could be a purposeful direction.
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Frøkedal, Hilde; Stifoss-Hanssen, Hans; deMarinis, Valerie; Ruud, Torleif; Visser, Anja & Sørensen, Torgeir
(2021).
Participation in existential groups led by Norwegian healthcare chaplains: Relations to psychological distress, crisis of meaning and meaningfulness.
The international journal for the psychology of religion.
ISSN 1050-8619.
s. 1–15.
doi:
10.1080/10508619.2020.1844966.
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Spirituality groups led by healthcare chaplains have been found to aid patients’ recovery processes in US psychiatric units. In Norway, existential groups (EGs) led by healthcare chaplains and co-led by healthcare staff members are offered at psychiatric units; these groups share commonalities with spirituality groups, group psychotherapy, existential therapy and clinical pastoral care, facilitating patients’ reflections regarding existential, spiritual and religious issues. The study aimed to examine associations between patients’ participation and topics discussed in the EGs and their experiences of psychological distress, crisis of meaning and meaningfulness. A cross-sectional design was applied among 157 patients attending EGs led by healthcare chaplains across Norway. Multivariate regression analyses assessed the strength of possible associations, adjusted for relevant demographical variables. Significant association was found between lengthier EG participation and lower levels of psychological distress, while discussion topics concerning religious and spiritual issues were significantly associated with the experience of meaningfulness.
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Clausen, Hanne Kristin; Ruud, Torleif; Odden, Sigrun; Saltyte Benth, Jurate; Heiervang, Kristin S. & Stuen, Hanne Kilen
[Vis alle 7 forfattere av denne artikkelen]
(2020).
Improved Rehabilitation Outcomes for Persons With and Without Problematic Substance Use After 2 Years With Assertive Community Treatment—A Prospective Study of Patients With Severe Mental Illness in 12 Norwegian ACT Teams.
Frontiers in Psychiatry.
ISSN 1664-0640.
11.
doi:
10.3389/fpsyt.2020.607071.
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Background: Persons with severe mental illness often face difficulties in accessing and receiving adequate services enabling them to live independently. Many have co-occurring substance use problems that increase the risk of adverse outcomes. Community-based service models have been implemented around the world, including assertive community treatment (ACT), but the knowledge of rehabilitation outcomes in different subgroups is limited. We aimed to explore rehabilitation outcomes among patients suffering severe mental illness with and without substance use problems who had received ACT services for at least 2 years. Additionally, we compared differences in changes between the two groups. Methods: A total of 142 patients who received services for 2 years from the first 12 Norwegian ACT teams were included. Eighty-four (59%) had problematic substance use, while 58 (41%) did not. Data regarding housing, activity, symptoms, functioning, and subjective quality of life were collected upon enrollment into ACT and at 2 years of follow-up. Clinician-rated scales and self-report questionnaires were used. Changes within the two groups and differences in change between the groups were assessed using generalized linear mixed models. Results: Both groups were more likely to have good housing, higher level of functioning, and less anxiety and depressive symptoms after 2 years. The odds of good housing among participants with problematic substance use increased only after adjusting for age and gender. Participants with problematic substance use had less severe symptoms, particularly negative and manic symptoms, while participants without problematic substance use reported improved satisfaction with life in general. Neither group experienced a change in having a meaningful daily activity, positive symptoms, practical and social functioning, or subjective quality of life. The reduction of manic symptoms in the substance use group was the only difference between the groups. Conclusion: After 2 years, patients with and without problematic substance use experienced improvements in several important domains. Furthermore, the improvements were similar in both groups for most outcomes. This may suggest that ACT has a place in the continued effort toward integrated and comprehensive community services empowering patients with severe mental illness to achieve and sustain an independent life, including marginalized groups with severe substance use.
Keywords: activity; assertive community treatment; co-occurring substance use; functioning; housing; psychiatric symptom; quality of life; severe mental illness.
Copyright © 2020 Clausen, Ruud, Odden, Benth, Heiervang, Stuen and Landheim.
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Haugom, Espen Woldsengen; Stensrud, Bjørn; Beston, Gro; Ruud, Torleif & Landheim, Anne
(2020).
Mental health professionals’ experiences with shared decision-making for patients with psychotic disorders: a qualitative study.
BMC Health Services Research.
ISSN 1472-6963.
20(1).
doi:
10.1186/s12913-020-05949-1.
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Background: Shared decision-making (SDM) is a process whereby clinicians and patients work together to select treatments based on both the patient's preferences and clinical evidence. Although patients with psychotic disorders want to participate more in decisions regarding their care, they have limited opportunities to do so because of various barriers. Knowing about health professionals' experiences with SDM is important toward achieving successful implementation. The study aim was to describe and explore health professionals' SDM experiences with patients with psychotic disorders.
Methods: Three focus group interviews were conducted, with a total of 18 health professionals who work at one of three Norwegian community mental health centres where patients with psychotic disorders are treated. We applied a descriptive and exploratory approach using qualitative content analysis.
Results: Health professionals primarily understand the SDM concept to mean giving patients information and presenting them with a choice between different antipsychotic medications. Among the barriers to SDM, they emphasized that patients with psychosis have a limited understanding of their health situation and that time is needed to build trust and alliances. Health professionals mainly understand patients with psychotic disorders as a group with limited abilities to make their own decisions. They also described the concept of SDM with little consideration of presenting different treatment options. Psychological or social interventions were often presented as complementary to antipsychotic medications, rather than as an alternative to them.
Conclusion: Health professionals' understanding of SDM is inconsistent with the definition commonly used in the literature. They consider patients with psychotic disorders to have limited abilities to participate in decisions regarding their own treatment. These findings suggest that health professionals need more theoretical and practical training in SDM.
Keywords: Mental health care; Mental health professionals; Psychotic disorders; Shared decision-making.
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Andersson, Helle Wessel; Lilleeng, Solfrid; Ruud, Torleif & Ose, Solveig Osborg
(2020).
Substance use among patients in specialized mental health services in Norway: prevalence and patient characteristics based on a natinal census.
Nordic Journal of Psychiatry.
ISSN 0803-9488.
s. 1–11.
doi:
10.1080/08039488.2020.1817553.
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Purpose
The aim of this study was to investigate the clinical and demographic variation in the prevalence of substance use among the general psychiatric population in Norway.
Methods
A national census in psychiatric institutions and outpatient clinics was conducted. Data were returned for 2358 inpatients (response rate, 65%) and 23,167 outpatients (response rate, 60%). Substance use was measured based on substance use disorder diagnosis or reported substance use in the last 4 weeks (alcohol 2–4 days a week or more frequently/illicit drug use). Regression analyses controlling for demographic and sociodemographic characteristics were carried out.
Results
Substance use was identified in 32.4% of inpatients and 13.9% of outpatients. The most frequently reported substances used were alcohol, sedatives and cannabis. Among inpatients, the prevalence of substance use was highest in patients with schizophrenia, personality disorders and anxiety disorders. Among outpatients, the prevalence was highest in patients with schizophrenia and other psychoses. Inpatients with anxiety disorders and outpatients with schizophrenia and other psychoses had a significantly higher risk of substance use than other patients. In both samples, the prevalence of substance use was higher among males, 24 to 29-year-olds and the most socially deprived.
Conclusions
This study provides further knowledge about patients at risk for co-morbid substance abuse and poor treatment outcomes. Clinicians may consider targeting patients with schizophrenia and other psychoses, young males and those who are socially deprived in efforts to prevent emerging substance abuse and improve outcomes.
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Rugkåsa, Jorun; Tveit, Ole Gunnar; Berteig, Julie; Hussain, Ajmal & Ruud, Torleif
(2020).
Collaborative care for mental health: a qualitative study of the experiences of patients and health professionals.
BMC Health Services Research.
ISSN 1472-6963.
20(844),
s. 1–10.
doi:
10.1186/s12913-020-05691-8.
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Background:Health policy in many countries directs treatment to the lowest effective care level and encouragescollaboration between primary and specialist mental health care. A number of models for collaborative care havebeen developed, and patient benefits are being reported. Less is known about what enables and preventsimplementation and sustainability of such models regarding the actions and attitudes of stakeholders on theground. This article reports from a qualitative sub-study of a cluster-RCT testing a model for collaborative care inOslo, Norway. The model involved the placement of psychologists and psychiatrists from a community mentalhealth centre in each intervention GP practice. GPs could seek their input or advice when needed and referpatients to them for assessment (including assessment of the need for external services) or treatment.Methods:We conducted in-depth qualitative interviews with GPs (n= 7), CMHC specialists (n= 6) and patients (n=11) in the intervention arm. Sample specific topic guides were used to investigate the experience of enablers andbarriers to the collaborative care model. Data were subject to stepwise deductive-inductive thematic analysis.Results:Participants reported positive experiences of how the model improved accessibility. First,co-locationmade GPs andCMHC specialists accessible to each other and facilitated detailed, patient-centred case collaboration and learning throughcomplementary skills. The threshold for patients’access to specialist care was lowered, treatment could commence early,and throughput increased. Treatment episodes were brief (usually 5–10 sessions) and this was too brief according to somepatients. Second,having experienced mental health specialists in the teamand on the front line enabled early assessment ofsymptoms and of the type of treatment and service that patients required and were entitled to, and who could be treatedat the GP practice. This improved both care pathways and referral practices. Barriers revolved around the organisation ofcare. Logistical issues could be tricky but were worked out. The biggest obstacle was the funding of health care at astructural level, which led to economic losses for both the GP practices and the CMHC, making the model unsustainable.Conclusions:Participants identified a range of benefits of collaborative care for both patients and services. However, thefunding system in effect penalises collaborative work. It is difficult to see how policy aiming for successful, sustainablecollaboration can be achieved without governments changing funding structures.
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Ruud, Torleif; Drivenes, Karin; Drake, Robert E.; Haaland, Vegard Øksendal; Landers, Matthew & Stensrud, Bjørn
[Vis alle 9 forfattere av denne artikkelen]
(2020).
The Antipsychotic Medication Management Fidelity Scale: Psychometric properties.
Administration and Policy in Mental Health and Mental Health Services Research.
ISSN 0894-587X.
doi:
10.1007/s10488-020-01018-1.
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The paper describes the Antipsychotic Medication Management Fidelity Scale and its psychometric properties, including interrater reliability, frequency distribution, sensitivity to change and feasibility. Fidelity assessors conducted fdelity
reviews four times over 18 months at eight sites receiving implementation support for evidence-based antipsychotic medication management. Data analyses shows good to fair interrater reliability, adequate sensitivity to change over time and good
feasibility. At 18 months, item ratings varied from poor to full fdelity on most items. Use of the scale can assess fdelity to
evidence-based guidelines for antipsychotic medication management and guide eforts to improve practice. Further research
should improve and better calibrate some items, and improve the procedures for access to information.
Trial registration: ClinicalTrials.gov Identifer: NCT03271242.
Keywords Psychosis · Antipsychotic medication · Implementation · Evidence-based practice · Fidelity scale
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Odden, Sigrun; Landheim, Anne; Clausen, Hanne Kristin; Stuen, Hanne Kilen; Heiervang, Kristin Sverdvik & Ruud, Torleif
(2019).
Model fidelity and team members' experiences of assertive community treatment in Norway: A sequential mixed-methods study.
International Journal of Mental Health Systems.
ISSN 1752-4458.
13(65),
s. 1–12.
doi:
10.1186/s13033-019-0321-8.
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Abstract
Background: Assertive community treatment (ACT) is an evidence-based treatment for people with severe mental
illness, and this model is used widely throughout the world. Given the various adaptations in different contexts, we
were interested in studying the implementation and adaptation of the ACT model in Norway. The first 12 Norwegian
ACT teams were established between 2009 and 2011, and this study investigated the teams’ model fidelity and the
team members’ experiences of working with ACT.
Methods: To investigate implementation of the ACT model, fidelity assessments were performed 12 and 30 months
after the teams started their work using the Tool for Measurement of Assertive Community Treatment (TMACT).
Means and standard deviations were used to describe the ACT teams’ fidelity scores. Cohen’s effect size d was used
to assess the changes in TMACT scores from the first to second assessment. Qualitative focus group interviews were
conducted in the 12 teams after 30 months to investigate the team members’ experiences of working with the ACT
model.
Results: The fidelity assessments of the Norwegian teams showed high implementation of the structural and organizational
parts of the ACT model. The newer parts of the model, the recovery and evidence-based practices, were less
implemented. Four of the six subscales in TMACT improved from the first to the second assessment. The team members
experienced the ACT model to be a good service model for the target population: people with severe mental
illness, significant functional impairment, and continuous high service needs. Team members perceived some parts of
the model difficult to implement and that it was challenging to find effective ways to collaborate with existing health
and social services.
Conclusion: The first 12 Norwegian ACT teams implemented the ACT model to a moderate degree. The ACT model
could be implemented in Norway without extensive adaptations. Although the team members were satisfied with
the ACT model, especially the results for their service users, inclusion of the ACT team to the existing service system
was perceived as challenging.
Keywords: Assertive community treatment, Model fidelity, Team members, Tool for Measurement of Assertive
Community Treatment (TMACT), Implementation
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Haugom, Espen Woldsengen; Ruud, Torleif & Hynnekleiv, Torfinn
(2019).
Ethical challenges of seclusion in psychiatric inpatient wards: a qualitative study of the experiences of Norwegian mental health professionals.
BMC Health Services Research.
ISSN 1472-6963.
19(879).
doi:
10.1186/s12913-019-4727-4.
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Abstract
BACKGROUND:
Seclusion is an invasive clinical intervention used in inpatient psychiatric wards as a continuation of milieu therapy with vast behavioural implications that raise many ethical challenges. Seclusion is in Norway defined as an intervention used to contain the patient, accompanied by staff, in a single room, a separate unit, or an area inside the ward. Isolation is defined as the short-term confinement of a patient behind a locked or closed door with no staff present. Few studies examine how staff experiences the ethical challenges they encounter during seclusion. By making these challenges explicit and reflecting upon them, we may be able to provide better care to patients. The aim of this study is to examine how clinical staff in psychiatric inpatient wards describes and assess the ethical challenges of seclusion.
METHODS:
This study was based on 149 detailed written descriptions of episodes of seclusion from 57 psychiatric wards. A descriptive and exploratory approach was used. Data were analysed using qualitative content analysis.
RESULTS:
The main finding is that the relationship between treatment and control during seclusion presents several ethical challenges. This is reflected in the balance between the staff's sincere desire to provide good treatment and the patients' behaviour that makes control necessary. Particularly, the findings show how taking control of the patient can be ethically challenging and burdensome and that working under such conditions may result in psychosocial strain on the staff. The findings are discussed according to four core ethical principles: autonomy, beneficence, non-maleficence, and justice.
CONCLUSION:
Ethical challenges seem to be at the core of the seclusion practice. Systematic ethical reflections are one way to process the ethical challenges that staff encounters. More knowledge is needed concerning the ethical dimensions of seclusion and alternatives to seclusion, including what ethical consequences the psychosocial stress of working with seclusion have for staff.
KEYWORDS:
Coercion; Ethics; Health professionals/mental health staff; Mental health services; Open-area seclusion; Seclusion; Shielding
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Kann, Inger Cathrine; Dahli, Mina Piiksi & Ruud, Torleif
(2019).
Ny samhandlingsmodell for pasienter med psykiske lidelser: Påvirkes sykefravær eller arbeidsavklaringspenger?
Arbeid og Velferd.
ISSN 1504-8217.
Vis sammendrag
We have investigated whether closer collaboration at general practitioner centres in the treatment of mental disorders has affected the number of days with sickness absence and work assessment allowance. The collaboration model consisted of a psychologist and a psychiatrist working part-time at the centre and in collaboration with services in the borough. The model was tested at one general practitioner centre in each of three boroughs in Groruddalen in Oslo, while three centres in the same boroughs constitute the control group.
The purpose of the collaboration model is for patients to have a better overall health service, with earlier identification of mental health problems, faster access to health care, more effective dialogue between the health services and increased assistance in the primary health care without having to be referred to the specialist health services. Identification of mental health problems in more patients and earlier intervention can probably contribute to a greater proportion of sickness absence being linked to diagnoses of mental health problems, but more adequate treatment can probably also limit long-term sick leave and drop-out from working life.
We find that fewer people are on sick leave in the intervention group, but still see an increase in the number of sick days of almost 4 per cent, due to increased duration of sick leave and reduced use of graded sick leave. We also find an 8 percent reduction in the number of days with work clarification money. Both the increase in the number of sick days and the reduction in days with work assessment allowance are among those with mental disorders, which suggests that the change is due to the intervention.
Closer collaboration between the primary health care and mental health services may be able to improve the health service, with earlier identification and treatment of mental health problems. Although sickness absence is increased, it is conceivable that earlier and more targeted interventions will prevent mental health problems from developing into more serious and prolonged disorders and to prevent transition to work clarification or disability benefits.
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Lau, Bjørn; Shiryaeva, Olga; Ruud, Torleif & Victor, Mattias Erik
(2019).
What Are They Returning To? Psychosocial Work Environment as a Predictor of Returning to Work Among Employees in Treatment for Common Mental Disorders: A prospective observational pre–post study.
PLOS ONE.
ISSN 1932-6203.
14(4).
doi:
10.1371/journal.pone.0215354.
Fulltekst i vitenarkiv
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Ådnanes, Marian; Kalseth, Jorid; Ose, Solveig Osborg; Ruud, Torleif; Rugkåsa, Jorun & Puntis, Stephen Robert
(2019).
Quality of life and service satisfaction in outpatients with severe or non-severe mental illness diagnoses.
Quality of Life Research.
ISSN 0962-9343.
28(3),
s. 713–724.
doi:
10.1007/s11136-018-2039-5.
Fulltekst i vitenarkiv
Vis sammendrag
Purpose Our study investigated quality of life (QoL) in patients with severe or non-severe mental illness diagnoses (SMI and non-SMI) and the association between QoL and service satisfaction measured as patients’ perception of continuity of care (CoC), therapeutic relationship, and unmet service needs.
Methods
We conducted a national cross-sectional survey among 3836 mental health outpatients, of whom 1327 (34.6%)responded. We assessed QoL with the Manchester Short Assessment of Quality of Life (MANSA), CoC with the CONTINUUM, the therapeutic relationship with the Therapeutic Relationship in Community Mental Health Care (STAR-P) and developed a simple scale to measure unmet service needs.
Results
Outpatients with SMI (n = 155) reported significantly better QoL than those with non-SMI (n = 835) (p = 0.003). In
both groups, QoL was positively associated with cohabitation (p = 0.007 for non-SMI and p = 0.022 for SMI), good contact
with family and friends (p < 0.001 for both) and positive ratings of CoC (p < 0.001 for non-SMI and p = 0.008 for SMI). A positive association between QoL and therapeutic relationship (p = 0.001) and a negative association between QoL and unmet needs for treatment (p = 0.009) and activity (p = 0.005) was only found in the non-SMI group.
Conclusion
Our study highlights the important differences between those with SMI and those with non-SMI in their reported QoL and in the relationship between QoL and service satisfaction, with only non-SMI patients’ QoL influenced by the therapeutic
relationship and unmet needs for treatment and activity. It also shows the importance of continuity of care and social
factors for good QoL for both groups.
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Hagen, Kristine Amlund; Hilsen, Marit; Kallander, Ellen Katrine & Ruud, Torleif
(2018).
Health-related quality of life (HRQoL) in children of ill or substance abusing parents: examining factor structure and sub-group differences.
Quality of Life Research.
ISSN 0962-9343.
doi:
10.1007/s11136-018-2067-1.
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Kallander, Ellen Katrine; Weimand, Bente; Ruud, Torleif; Becker, Saul; Van Roy, Betty & Hanssen-Bauer, Ketil
(2018).
Outcomes for children who care for a parent with a severe illness or substance abuse.
Child & Youth Services.
ISSN 0145-935X.
39(4),
s. 228–249.
doi:
10.1080/0145935X.2018.1491302.
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Nyttingnes, Olav; Ruud, Torleif; Norvoll, Reidun; Rugkåsa, Jorun & Hanssen-Bauer, Ketil
(2018).
A cross-sectional study of experienced coercion in adolescent mental health inpatients.
BMC Health Services Research.
ISSN 1472-6963.
18(389).
doi:
10.1186/s12913-018-3208-5.
Fulltekst i vitenarkiv
Vis sammendrag
Background
Involuntary care and coercive measures are frequently present in mental healthcare for adolescents. The purpose of this study was to examine to what extent adolescents perceive or experience coercion during inpatient mental health care, and to examine predictors of experienced coercion.
Methods
A cross-sectional sample of 96 adolescent inpatients from 10 Norwegian acute and combined (acute and sub-acute) psychiatric wards reported their experienced coercion on Coercion Ladder and the Experienced Coercion Scale in questionnaires. Staff reported use of formal coercion, diagnoses, and psychosocial functioning. We used two tailed t-tests and mixed effects models to analyze the impact from demographics, alliance with parents, use of formal coercion, diagnostic condition, and global psychosocial functioning.
Results
High experienced coercion was reported by a third of all patients. In a mixed effects model, being under formal coercion (involuntary admission and / or coercive measures); a worse relationship between patient and parent; and lower psychosocial functioning, significantly predicted higher experienced coercion. Twenty-eight percent of the total sample of patients reported a lack of confidence and trust both in parents and staff.
Conclusions
Roughly one third of patients in the sample reported high experienced coercion. Being under formal coercion was the strongest predictor. The average scores of experienced coercion in subgroups are comparable with adult scores in similar care situations. There was one exception: Adolescents with psychosis reported low experienced coercion and almost all of them were under voluntary care.
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Lofthus, Ann-Mari; Weimand, Bente; Ruud, Torleif; Rose, Diana & Heiervang, Kristin Sverdvik
(2018).
"This is not a life anyone would want" - A qualitative study of Norwegian ACT users' experience With mental Health treatment.
Issues in Mental Health Nursing.
ISSN 0161-2840.
39(6),
s. 519–526.
doi:
10.1080/01612840.2017.1413459.
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Klevan, Trude Gøril; Karlsson, Bengt Eirik; Ness, Ottar; Grant, Alec & Ruud, Torleif
(2018).
Between a rock and a
softer place - A discourse
analysis of helping cultures
in crisis resolution teams.
Qualitative Social Work.
ISSN 1473-3250.
17(2),
s. 252–267.
doi:
10.1177/1473325016668962.
Vis sammendrag
Crisis resolution teams are a community-based service, targeting adults experiencing
acute mental health crises. The rationale for the development of crisis resolution teams
is both value and efficacy-based: crisis resolution teams should contribute to the humanizing
of mental health services and to enhanced efficacy. This diversity in purpose
appears to affect the practices of help that are offered by crisis resolution teams,
which research has shown to vary greatly. A discursive approach recognizes that practices
are shaped by external paradigms and structures, and clinicians’ construction of
professional identities and practices through their talk and meaning making. Thus, this
study used a discursive psychological approach to identify discourses through which
crisis resolution team clinicians talk about and understand helpful help in mental health
crises. Focus group interviews with clinicians from eight crisis resolution teams revealed
two broad and contradictory discourses: helpful help as something ‘‘made’’ with crisis
resolution team workers as creators of collaborative and innovative practices, andhelpful help as something ‘‘given’’ with the crisis resolution team workers as representatives
of a predefined specialist mental health service culture. The contradictions
between these discourses reflect the diverse rationale for the development of crisis
resolution teams and the possible tensions and pressures under which crisis resolution
team work is conducted. In this overall context, the study further critically examined
the tensions between the discourse of constructing new practices, and existing practices
constituted by the specialist mental health services’ traditional discourse. Failing to
constantly reflect upon and question these tensions in collaboration with service users,
carers, and other services can impair creativity and the development of humanizing
helpful help
Se alle arbeider i Cristin
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Hestmark, Lars; Romøren, Maria; Heiervang, Kristin Sverdvik; Hansson, Kristiane Myckland; Ruud, Torleif & Saltyte Benth, Jurate
[Vis alle 9 forfattere av denne artikkelen]
(2023).
Correction to: Implementation of Guidelines on Family Involvement for Persons with Psychotic Disorders (IFIP): A Cluster Randomised Controlled Trial (Administration and Policy in Mental Health and Mental Health Services Research, (2023), 50, 3, (520-533), 10.1007/s10488-023-01255-0).
Administration and Policy in Mental Health and Mental Health Services Research.
ISSN 0894-587X.
doi:
10.1007/s10488-023-01291-w.
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Haavet, Ole Rikard; Ruud, Torleif & Brekke, Mette
(2022).
GPs’ identification of patients with mental distress: a coupled questionnaire and cohort study from norwegian urban general practice.
BMC Primary Care.
ISSN 2731-4553.
doi:
10.1186/s12875-022-01865-x.
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Ruud, Torleif & Friis, Svein
(2022).
Continuity of care and therapeutic relationships as critical elements in acute psychiatric care.
World Psychiatry.
ISSN 1723-8617.
21(2),
s. 241–242.
doi:
10.1002/wps.20965.
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Maybery, Darryl; Reupert, Andrea; Jaffe, Irene Casey; Cuff, Rose; Duncan, Zoe & Dunkley-Smith, Addy
[Vis alle 11 forfattere av denne artikkelen]
(2022).
Getting the FACS: A Protocol for Developing a Survey Instrument to Measure Carer and Family Engagement with Mental Health Services.
International Journal of Environmental Research and Public Health (IJERPH).
ISSN 1661-7827.
19(23).
doi:
10.3390/ijerph192316279.
Vis sammendrag
Government policies recommend, and all stakeholders benefit, when mental health services meaningfully engage with carers and family. However, health service engagement with carers is inadequate, and often non-existent with children whose parents are service users. There are seven fundamental ways that carers and families want to be integrated with and engaged by health services
but current survey instruments do not capture these seven engagement practices. This protocol describes the development of two closely aligned Family and Carer Surveys (FACS) to measure engagement of service users in mental health services. The new measures are based on the seven engagement themes and a conceptual distinction between the carer and family, with particular focus on where the service user is a parent. The instruments will be developed in five stages; (1) item
generation (2) Cognitive pretesting of survey (3) preliminary item content quantitative assessment (4) psychometric analysis of a large data collection and (5) selection of items for short form instruments. These steps will operationalise the seven fundamental ways that families and carers want to be engaged with mental health services, thereby providing valid and reliable measures for use in
research and benchmarking of carer and family engagement.
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Linde, Janniche; Schmid, Marit Therese; Ruud, Torleif; Skar-Fröding, Regina & Biringer, Eva Aaker
(2022).
Correction: Social Factors and Recovery: A Longitudinal Study of Patients with Psychosis in Mental Health Services (Community Mental Health Journal, (2022), 10.1007/s10597-022-01007-8).
Community mental health journal.
ISSN 0010-3853.
doi:
10.1007/s10597-022-01024-7.
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Dahli, Mina Piiksi; Brekke, Mette; Ruud, Torleif & Haavet, Ole Rikard
(2019).
Forekomst og distribusjon av psykologiske diagnoser og relatert hyppighet av konsultasjoner i norsk allmennpraksis. .
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Birkeland, Bente; Høie, Magnhild; Ruud, Torleif & Weimand, Bente
(2019).
Quality of life – why does it matter? Perceived quality of life in partners of patients undergoing treatment in physical health, mental health, or substance use disorder units: a crosssectional study.
Vis sammendrag
To explore (1) differences in socio-demographic, social/familial, and health variables, and perceived quality of life (QoL) among partners of patients with physical illness, mental illness, or substance use disorders (SUD); and (2) identify factors associated with QoL.
Why is this important?
Studies comparing the QoL between partners to patients in different illness populations seems to be limited, especially when they share parenthood for children. Examining the partner's QoL, and factors associated with QoL is important to get a broadened picture of these families’ situation and needs in times of parental illness.
What are the main discussion points you will raise in this presentation?
• No QoL differences between groups but poorer scores on income/work for SUD-partners • 13 % had markedly low QoL indicating a very difficult situation • QoL covers domains in addition to strict health outcomes• Brief QoL tools might give valuable information about partners’ needs for support
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Bjerke, Espen; Gjelstad, Kari & Ruud, Torleif
(2019).
Færre tvangsinnleggelser i psykisk helsevern?
Tidsskrift for Den norske legeforening.
ISSN 0029-2001.
139(4),
s. 339–341.
doi:
10.4045/tidsskr.18.0657.
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Ruud, Torleif; Selbekk, Anne Schanche; Løvås, Maren; Faugli, Anne & Kufås, Elin
(2017).
Life situation and available support for children and partners/spouse of persons with substance use problems.
PROSPERO International prospectie register of systematic reviews.
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Ruud, Torleif; Birkeland, Bente; Faugli, Anne; Hagen, Kristine Amlund; Hilsen, Marit & Kallander, Ellen Katrine
[Vis alle 13 forfattere av denne artikkelen]
(2021).
Barn som pårørende. Resultater fra oppfølgingsundersøkelsen.
Helsedirektoratet .
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Victor, Mattias Erik; Lau, Bjørn; Ruud, Torleif & Lerdal, Anners Vetle
(2020).
Patient characteristics and factors associated with post-treatment work participation in a Norwegian return to work programme for common mental disorders.
Universitetet i Oslo.
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Kyte Fjellstad, Ingrid & Ruud, Torleif
(2020).
Rapport om utvikling og utprøving av skjemaet
«Pasienters erfaringer fra psykiatriske døgnavdelinger for eldre»
(PEPDE)
.
Akershus universitetssykehus.
Vis sammendrag
Sammendrag
Formålet har vært å utvikle et pålitelig spørreskjema/intervjuskjema om pasienterfaringer ved
alderspsykiatrisk avdeling, slik at dette kan brukes i arbeid med kvalitetsforbedring og i forskning.
Bakgrunn: Ledelsen og ansatte ved alderspsykiatrisk døgnavdeling, Akershus universitetssykehus HF (Ahus)
ønsket informasjon om pasienters erfaringer med behandlingstilbudet. Vi gjorde en pilotundersøkelse med
to eksisterende spørreskjema om pasienterfaringer i psykiatriske døgnavdelinger for voksne, men fant at
disse ikke fungerte for målgruppen. Ved litteratursøk fant vi heller ikke noe skjema om pasienterfaringer
ved alderspsykiatriske avdelinger, og vi besluttet derfor å utvikle et eget skjema for målgruppen.
Skjemautvikling og datainnsamling: Vi utviklet et intervjuskjema/spørreskjema på bakgrunn av
litteraturgjennomgang, erfaringene fra utprøvingen av de to skjemaene for voksne, diskusjoner i en
referansegruppe, og kunnskap og egne erfaringer med utvikling av spørreskjema/intervjuskjema.
Skjemaet dekket de temaene som vi fant ved litteraturgjennomgang av forhold som kunne ha betydning for
alderspsykiatriske døgnpasienter. Utkastet til et eget skjema for alderspsykiatriske pasienter ble så utprøvd
i et samarbeid mellom alderspsykiatriske avdelinger ved helseforetak. I alt 151 pasienter ble intervjuet om
sine erfaringer ved bruk av skjemaet, og det ble også registrert hvordan pasientene og intervjuerne
opplevde spørsmålene og skjemaet. Skjemaet som ble prøvd ut er med som vedlegg bakerst i rapporten.
Analyser, vurderinger og revisjon av skjemaet: Kommentarene fra pasienter og intervjuere ble
gjennomgått, og uegnede spørsmål ble ikke tatt med i videre analyser og vurderinger. Vi gjorde så
psykometriske analyser av spørsmål med gradert svarskala for å identifisere hvilke tema (faktorer) disse
dekket og undersøkte den interne konsistensen mellom spørsmål om samme tema. Vi vurderte også om
noen av spørsmålene burde reformuleres for å gjøre dem lettere å forstå. Ved en samlet vurdering basert
på de nevnte forhold utformet vi så et kortere og bedre skjema som kunne fungere som spørreskjema og
intervjuskjema om pasienters erfaringer i alderspsykiatriske døgnavdelinger.
Utprøving og vurdering av ferdig skjema: Det ferdige skjemaet har så vært brukt rutinemessig i flere år ved
Alderspsykiatrisk avdeling ved Ahus for tilbakemeldinger fra pasienter og som ledd i videreutviklingen av
avdelingen. Vi fikk tilgang til en anonymisert del av dette materialet og har gjort psykometriske analyser av
hvordan det ferdige reviderte skjemaet og spørsmålene i dette fungerer. De 20 spørsmålene i det ferdige
skjemaet er dokumentert å gi pålitelige målinger av pasientenes erfaringer av medbestemmelse, bedring,
relasjoner og om de har mottatt informasjon om pasientrettigheter. Svært få ubesvarte spørsmål tyder på
at spørsmål og svarskala er godt forståelige.
Ferdig skjema med veiledning: Skjemaet Pasienters erfaringer fra psykiatriske døgnavdelinger for eldre
(PEPDE) med en kort orientering om utviklingen og en veiledning om bruk er med som vedlegg i rapporten.
Skjemaet med orienteringen og veiledningen er også tilgjengelig på http://www.helsebiblioteket.no
En engelsk versjon (Patients Experiences from Psychiatric Departments for Elderly, PEPDE) vil bli publisert i
en vitenskapelig artikkel om skjemaet og utviklingen av skjemaet. Skjemaet er gjort tilgjengelig med
Creative Commons lisens (lenke nederst på skjemaet) og kan brukes fritt så lenge utvikleren krediteres, at
skjemaet ikke distribueres i endret form, og at det ikke brukes kommersielt.
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Selbekk, Anne Schanche; Faugli, Anne; Kufås, Elin; Løvås, Maren & Ruud, Torleif
(2019).
Kunnskapsoppsummering om situasjon og hjelp til barn og partnere av personer med rusproblemer.
Akershus universitetssykehus.
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Ruud, Torleif; Rognaldsen, Maren; Haugom, Espen Woldsengen & Hynnekleiv, Torfinn
(2019).
Hva er skjerming? Utvikling av kunnskapsbasert og pålitelig måling av skjerming i døgnavdelinger i psykisk helsevern.
Akuttnettverket.
-
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Ruud, Torleif & Weimand, Bente
(2018).
Helsehjelp til barn i barneverninstitusjoner
i Helse Sør-Øst. Evaluering av et prosjekt med tre pilotprosjekter og et forslag til en nasjonal modell for samhandling om bedre helsehjelp ved barneverninstitusjoner fra psykisk helsevern for barn og unge.
Helse Sør-Øst og Helsedirektoratet.
Se alle arbeider i Cristin
Publisert
13. apr. 2011 11:44
- Sist endret
23. jan. 2016 13:02
