ABSTRACT
OBJECTIVES: The purpose of this study was to compare results of patients', parents', and caregivers' (nursing staff and educators) (self-)assessments of quality of life, treatment outcomes, and satisfaction with inpatient treatment in a child and adolescent psychiatric hospital. In addition, the investigation included a comparison between admission and discharge of the three investigated groups. METHODS: The study considered adolescents at the Department of Child and Adolescent Psychiatry and Psychotherapy, Hinterbruehl, along with their parents and caregivers. Following questionnaires at admission and discharge were used: the Youth Self-Report (YSR) or Child Behavior Checklist (CBCL/4-18), Inventory for Assessing Quality of Life in Children and Adolescents (ILK), and Questionnaires of the Evaluation of Treatment (FBB). RESULTS: Adolescents (58 patients, aged 14-18 years, standard deviationâ¯= 1.06) with different psychiatric diagnoses consecutively admitted for a diagnostic or therapeutic stay were included. The quality of life score was significantly different between patients' and parents' rating at discharge. The results of the treatment satisfaction revealed no significant correlations between patients', parents', and caregivers' ratings. A reduction in the psychopathology between admission and discharge was measured in all groups of raters. In addition, an increase in quality of life between admission and discharge was observed in patients, parents, and caregivers. Treatment satisfaction was moderate in all groups of raters. CONCLUSION: The views of patients' treatment measured by patients themselves, parents, and caregivers during a psychiatric ward stay are different and more or less unrelated. This indicates that each group applies different criteria when assessing treatment satisfaction.
Subject(s)
Caregivers/psychology , Inpatients/psychology , Mental Disorders/psychology , Parents/psychology , Patient Admission , Patient Discharge , Patient Satisfaction/statistics & numerical data , Quality of Life , Adolescent , Female , Humans , Male , Surveys and QuestionnairesABSTRACT
BACKGROUND: The aim of this study was to compare the Operationalized Psychodynamic Diagnostics (OPD-CA) for children and adolescents with the modified version (OPD-CA-2) focusing on the mainly unchanged treatment conditions and the redesigned structure axis. METHODS: The patient sample consisted 371 inpatient children and adolescents with psychiatric disorders from 3 to 18 years. OPD-CA and OPD-CA-2 diagnostics were routinely performed by OPD-experienced raters. Statistical calculation included Cronbach's alpha (internal consistency) and confirmatory factor analysis. RESULTS: The OPD-CA-2 structure axis showed very good internal consistency (reliability) compared to the OPD-CA. We found satisfactorily good values for the treatment conditions with slightly higher average scores in the OPD-CA-2. Confirmatory factor analysis resulted in two models where the items on the OPD-CA-2 structure axis were stronger correlated than those of the OPD-CA. CONCLUSION: The OPD-CA-2 is a reliable and valid instrument for assessing treatment conditions and psychic structure in children and adolescents. The reorganization of the structure axis and the treatment conditions in the OPD-CA-2 resulted in a measurable improvement.
Subject(s)
Mental Disorders/diagnosis , Mental Disorders/therapy , Projective Techniques/statistics & numerical data , Psychometrics/statistics & numerical data , Adolescent , Austria , Child , Female , Humans , Infant , Male , Mental Disorders/psychology , Patient Admission , Psychoanalytic Theory , Reproducibility of ResultsABSTRACT
OBJECTIVE: This paper presents the advantages of making comprehensive diagnoses with OPD-KJ in a child and adolescent psychiatric sample. METHOD: In addition to the MAS and the ICD-10 diagnoses, three axes of the OPD-KJ, the conflict and structural axis as well the axis of treatment conditions, were assessed, in 61 inpatient child and adolescent psychiatric patients in Austria. RESULTS: There are significant gender differences in the importance of internalized, developmentally inhibitive conflicts. However, the structural level was low to moderate in all patients. Structural capacities such as dealing with negative emotions, self and object differentiation, and contact could be maintained only with substantial help from outside. Older patients were more motivated to obtain treatment and show more insight. Of importance were also links between the conflict axis and the treatment conditions. Patients who have been classified as control vs. submissive showed less treatment motivation, reduced motivation to change, and more gains than did patients with other conflicts. CONCLUSION: The study shows that, beyond the axis of treatment conditions, a comprehensive OPD-KJ diagnosis that gathered information from the assessment of the conflict and structural axis as well can provide useful information for treatment planning.
