Evaluation of a New Recovery-oriented Model of Care on Psychiatric Inpatient Wards.
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 700
- 试验地点
- 1
- 主要终点
- Coercive measures
研究概览
简要总结
This project will study the effects of a major reorganization of psychiatric inpatient wards. This reorganization will affect many aspects of day-to-day work, with the aim of improving the individualization of care, the integration of relatives and the participation of the patients in treatment planning. This new organization will initially involve a first pilot ward, before being extended to other wards.
The aim of this project is to understand whether this new organization has positive effects on the use of coercive measures, the average length of stay, the improvement in patients' clinical condition, as well as on patient satisfaction, their perception of coercion, the wards' atmosphere on the unit and patients' personal recovery.
All patients admitted to three wards of the Division of adult psychiatry of the Geneva University Hospital aged 18 and over, with a good knowledge of French and being treated for any type of diagnosis except dementia, are invited to take part in the study. They will be assessed at discharge regarding the selected outcomes. The study will last 18 months: during the first 9 months, the new model will be applied on the pilot ward, and the wo other wards will serve as comparison wards. After 9 months, the model will also be applied to these other two wards.
详细描述
The project is designed as a prospective, observational study, supporting the planned reorganization of inpatient care with the implementation of a new recovery-oriented model of care. As part of this reorganization, the new model will be first implemented as a pilot on a first acute psychiatric ward. After nine months, it is planned to be generalized to two comparable other acute wards. These two wards will serve within the current project as a comparison group to assess the effects of the new model.
Patients hospitalized on these three wards will be included in the study over a period of 18 months, covering the initial implementation of the model and its subsequent extension to the other two wards.
Three psychiatric wards of the Division of adult Psychiatry (SPA) will participate in the study. These wards are dedicated to general psychiatric admissions following a sectorization plan and operate with an open-door policy, wherein the wards' doors are uninterruptedly open between 7:30 am. and 11 pm. Patients aged 18 to 65 with all types of diagnosis at the exception of primary substance-abuse disorders and dementia, which are mainly treated in other divisions, are treated on these wards.
All patients admitted to these wards during the study period will be considered for participation. All diagnoses will be included, except for dementia. Patients who are not able to give their written consent to participation and/or with insufficient knowledge of French will be excluded from the trial.
Patient fulfilling the inclusion criteria will be contacted before discharge and offered to participate in the study. They will be informed in writing of the purpose of the study and their written consent will be collected.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients hospitalized in one of the three participating wards
排除标准
- •Incapacity to give informed consent
- •Insufficient knowledge of French
结局指标
主要结局
Coercive measures
时间窗: For each included participant at discharge from hospital, throughout the study (18 months)
Number, type and duration of used coercive measures (seclusion or forced medication)
次要结局
- Symptom burden(For each included participant at discharge from hospital, throughout the study (18 months))
- Patients' satisfaction(For each included participant at discharge from hospital, throughout the study (18 months))
- Length of stay(For each included participant at discharge from hospital, throughout the study (18 months))
- Length of stay under involuntary status(For each included participant at discharge from hospital, throughout the study (18 months))
- Ward atmosphere(For each included participant at discharge from hospital, throughout the study (18 months))
- Recovery-orientation of services(For each included participant at discharge from hospital, throughout the study (18 months))
- Personal recovery(For each included participant at discharge from hospital, throughout the study (18 months))
- Subjective coercion 2(For each included participant at discharge from hospital, throughout the study (18 months))
- Subjective coercion 1(For each included participant at discharge from hospital, throughout the study (18 months))
研究者
Alexandre Wullschleger, MD
Principal investigator
University Hospital, Geneva