ABSTRACT
Psycho-educational groups (PEGs) have been shown to be a particularly effective form of treatment for patients classified under the rubric of severely and persistently mentally ill (SPMI). However, recent surveys suggest that certain professionals, such as nurses and clinical psychologists, called on to conduct these groups may have limited to no training. This study tested three methods (self-instructional, workshop, and workshop plus clinical supervision) designed to provide on-the-job training to practicing clinicians. Specifically, training was based on two manuals; one that operationalized the basic knowledge and skills needed to run an effective PEG and the second being a commonly used PEG program for symptom management targeted at SPMI patients. Eight nurses from four adult units at a state psychiatric hospital initially received self-instructional or workshop training and then conducted a 12-session symptom management PEG composed of four to five SPMI patients (e.g., schizophrenia, schizoaffective or major depression disorders). In a second wave of additional training, nurses received workshop training or clinical supervision and then conducted a second PEG. Differences between training methods were assessed by nurse- and patient-completed measures that tapped the knowledge and skills emphasized in the symptom management and PEG (nurses only) manuals. Results indicated limited support for the superiority of the workshop method on the nurse measures alone. Implications for training working professionals in group treatments and assessing outcomes with chronic SPMI patients are discussed.
Subject(s)
Health Education , Leadership , Mental Disorders/therapy , Psychiatric Nursing/education , Psychiatric Nursing/standards , Psychology, Clinical/education , Psychology, Clinical/standards , Psychotherapy, Group/methods , Teaching/methods , Adult , Female , Health Services Needs and Demand , Hospitalization , Hospitals, Psychiatric , Humans , Length of Stay/statistics & numerical data , Male , Mental Disorders/nursing , Mental Disorders/rehabilitation , Professional Competence , Severity of Illness IndexABSTRACT
Although a great deal has been written about the importance of patient education, few replications of past research have been conducted to increase clinicians' confidence in the conclusions of previous studies. This is especially true of studies conducted in clinical settings where findings may or may not be generalizable to other institutions. This partial replication study tested whether previous findings about patient education in an outpatient setting were applicable to an inpatient setting using a modified version of the instrument. A 1998 study published in this journal suggested that differences may exist between the perceived health education needs of outpatients and their health care providers. In this partial replication, we examined the differences between the educational needs of inpatients and those perceived by their attending nurses. As in the original study, we found discrepancies between patients' actual needs and nurses' perceptions of those needs, supporting the importance of assessing patients' health educational needs in the treatment planning process.
Subject(s)
Attitude of Health Personnel , Attitude to Health , Inpatients/psychology , Mental Disorders/psychology , Needs Assessment/organization & administration , Patient Education as Topic/organization & administration , Adaptation, Psychological , Adult , Chronic Disease , Cost of Illness , Hospitals, Psychiatric , Hospitals, State , Humans , Mental Disorders/prevention & control , Nursing Assessment , Nursing Methodology Research , Nursing Staff, Hospital/psychology , Outpatients/psychology , Psychiatric Nursing/organization & administration , Self Care , Self Concept , Severity of Illness Index , Stereotyping , Surveys and Questionnaires , UtahABSTRACT
The purpose of this article is to describe a procedure to assist in selecting outcome measures for inpatients treated at a state psychiatric hospital. The procedure combines evidence-based criteria from the literature, instruments shown to be sensitive to change in clinical trials, and the perspectives of a multidisciplinary team of researchers, administrators, providers, and patient advocates. Recent efficacy and effectiveness studies were used to identify recurrently used outcome instruments. A computerized search of more than 30 bibliographic databases, such as PsycINFO, MEDLINE, Social SciSearch, and ERIC, was conducted for articles published between 1990 and 2002. Comparisons of the most frequently used instruments were made on seven criteria proposed as best-practice indicators, including sensitivity to change and robust psychometrics. The sample produced 110 measures. Rater-completed instruments were represented more often than patient-completed ones. However, considerable variability across both methods was found on the criteria. The limited resources associated with publicly funded inpatient facilities led to a recommendation to select at least one rater-completed and one patient-completed instrument.
Subject(s)
Mental Disorders/diagnosis , Mental Disorders/rehabilitation , Outcome Assessment, Health Care , Psychiatric Status Rating Scales , Brief Psychiatric Rating Scale , Evidence-Based Medicine , Hospitals, Psychiatric , Hospitals, State , Humans , Surveys and Questionnaires , United StatesABSTRACT
This article describes the collaborative effort of a team of discipline directors, administrators, and academicians to create a systematic program to enhance the group competencies of a large clinical staff working at a state hospital. The effects of the program were tested by a quasi-experimental field study. Quantitative measures of group process provided limited support for program effectiveness. Stronger support came from qualitative inquiry. The development and effectiveness of the program is examined within a larger context of group programs housed in large health care organizations.
