Identifying the determinants of perceived quality in outpatient child and adolescent mental health services from the perspectives of parents and patients
Identifying the determinants of perceived quality in outpatient child and adolescent mental health services from the perspectives of parents and patients
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DOI：
10.1007/s00787-017-0985-z
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发表时间：
2017-10-01
影响因子：
6.4
通讯作者：
Urben, Sebastien
中科院分区：
文献类型：
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作者：
Kapp, Carole;Perlini, Thomas;Urben, Sebastien
这项横断面调查采用多信息视角，探讨了影响儿童和青少年心理健康服务 (CAMHS) 门诊环境中感知质量（即治疗联盟和满意度）的因素。共有 1433 名在门诊或已经就诊（退出）的参与者（父母，n = 770 和患者，n = 663）参与了这项研究。结果指标是满意度（客户满意度调查问卷）和治疗联盟（帮助联盟调查问卷）。这些质量指标的决定因素包括社会人口变量（例如年龄、性别和母亲的社会经济地位）、与困难程度相关的因素（咨询的原因数量、将孩子转介到 CAMHS 的人数）、治疗开始的方法（同意咨询、第一次就诊时感到放心）、组织友好性（秘书、候诊室、第一次预约的等待时间）以及治疗的组织（就诊的频率）。会议、提问时间、更换治疗师）。一开始的治疗方法、电话的可及性、对治疗频率的满意度以及有足够的时间提问是从两个角度（患者和家长）一致解释质量指标的因素。相反，社会人口统计学变量以及困难程度以及与组织友好性和治疗组织相关的因素（治疗频率、治疗师更换）与质量指标无关。本研究从患者和家长的角度确定了质量指标的关键决定因素，应考虑这些因素来提高 CAMHS 护理质量。首次预约应仔细准备，临床医生应将护理重点放在患者和家长的需求和期望上。
This cross-sectional survey adopting a multiple-informant perspective explores the factors that influence perceived quality (i.e., therapeutic alliance and satisfaction) in an outpatient setting within child and adolescent mental health services (CAMHS). A total of 1433 participants (parents, n = 770, and patients, n = 663) attending or having attended (drop-out) outpatient units participated in the study. The outcome measures were satisfaction (Client Satisfaction Questionnaire) and the therapeutic alliance (Helping Alliance Questionnaire). The determinants of these quality indicators were socio-demographic variables (e.g., age, gender, and mother's socio-economic status), factors related to the extent of difficulties (number of reasons for the consultation, number of people who referred the child to the CAMHS), the approach to treatment at outset (agreeing to the consultation, feeling reassured at the first appointment), the organizational friendliness (secretary, waiting room, waiting time for the first appointment) and the organization of the therapy (frequency of sessions, time for questions, change of therapist). The approach to treatment at outset, accessibility by phone, satisfaction with the frequency of the sessions and having enough time for questions were the factors that consistently explain the quality indicators from both perspectives (patients and parents). In contrast, the socio-demographic variables as well as the extent of difficulties and factors related to the organizational friendliness and the organization of the therapy (frequency of sessions, change of therapist) were not related to the quality indicators. This study identifies key determinants of the quality indicators from the perspective of patients and parents that should be considered to improve CAMHS care quality. First appointments should be carefully prepared, and clinicians should centre care on the needs and expectations of patients and parents.