scholarly journals An Exploration of Pediatricians’ Personal Value on Mental Health: Experience with Integrated Healthcare and its Impact on Physicians’ Lives

2020 ◽  
Author(s):  
Bridget Anton ◽  
Jason Reynolds
Keyword(s):  
Mental Health ◽  
Behavioral Health ◽  
Healthcare Setting ◽  
Medical Setting ◽  
Structured Interviews ◽  
Integrated Healthcare ◽  
Behavioral Healthcare ◽  
Healthcare Settings ◽  
Healthcare Model ◽  
Physician Stress

An integrated healthcare model incorporates behavioral health services into a medical setting to address patients’ physical, emotional, and behavioral healthcare concerns. The integrated healthcare model has been associated with positive patient satisfaction and health outcomes, yet limited studies have examined, using qualitative methods, physicians’ experiences of working alongside behavioral health consultants (BHCs) in integrated healthcare settings. Data was gathered through semi-structured interviews with pediatricians (N=4) working in an integrated healthcare model. Participants shared that as pediatricians they received personal, educational, and organizational benefits from an integrated healthcare model. Pediatricians also reported increased knowledge in effectively addressing mental health concerns for their patients and decreased physician stress-levels. Results of pediatricians’ experiences working in an integrated healthcare setting are discussed with regard to their implications for clinical practice and research.

Integrating eHealth within a transforming healthcare setting: a qualitative study into values, challenges, and prerequisites. (Preprint)

2021 ◽  
Author(s):  
Karin CAG Lorenz-Artz ◽  
Joyce JPA Bierbooms ◽  
Inge MB Bongers
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Healthcare Service ◽  
Healthcare Setting ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Community Based ◽  
Access To Treatment ◽  
Healthcare Settings

BACKGROUND The EU has stated that mental health care services should become more person-centered and community-based. eHealth may contribute to this change by allowing clients to take an active, decision-making role in their healthcare service. In the Netherlands, five organizations currently use the open dialogue (OD) approach, which is an example of a person-centered and community-based healthcare service. OD is a unique approach to organizing care and therapeutic intervention for people who need mental health support. One of these Dutch organizations has integrated the OD approach with eHealth. OBJECTIVE The aim of this study is to help the transition towards person-centered and community-based care models by improving our understanding of eHealth and by showing how eHealth can best be integrated into a transforming healthcare service. The objective is to better understand the value of eHealth within OD practice, and to define the challenges and prerequisites for implementing eHealth within this transforming practice. METHODS This qualitative, practice-oriented field study is part of a pilot project of an ambulatory OD team in a Dutch mental health care institute. In total, 29 semi-structured interviews were held with clients, social network members, and OD professionals between December 2017 and March 2019. We used a thematic coding approach for analyses. RESULTS eHealth was considered mainly beneficial outside the treatment meetings as it improves communication, simplifies planning of treatment meetings, and provides a broader access to treatment. Videoconferencing was considered an acceptable alternative if someone could not attend treatment meetings in person. Several challenges were identified regarding the implementation of eHealth into OD practices: (1) a lack of trust and interest in eHealth, (2) a lack of knowledge about eHealth, (3) the strong conviction that face-to-face contact is needed for effective care, (4) normative pressure to offer eHealth, and (5) introducing eHealth during the start-up of a new OD team. This study has highlighted the multi-level complexity of implementing eHealth and has identified several prerequisites for successful implementation on individual, organization, society, and digital-product levels. CONCLUSIONS The benefits and challenges of eHealth have been identified as well as the prerequisites for its implementation. An important dilemma is to what extent eHealth should be used in healthcare settings when the client is not motivated to use it. We need to find the balance between using eHealth and letting clients refuse to use it. Interviewees emphasized the relevance of a continuous dialogue about eHealth to improve understanding of the possibilities and limitations of eHealth within healthcare settings that are transitioning towards client-centered and network-oriented care, such as OD.

scholarly journals Tenacious assumptions of person-centred care? Exploring tensions and variations in practice

2016 ◽  
Vol 22 (1) ◽  
pp. 54-71 ◽  
Author(s):  
Öncel Naldemirci ◽  
Doris Lydahl ◽  
Nicky Britten ◽  
Mark Elam ◽  
Lucy Moore ◽  
...  
Keyword(s):  
Healthcare Delivery ◽  
Communication Disorders ◽  
Structured Interviews ◽  
Verbal Expression ◽  
Migrant Communities ◽  
Healthcare Settings ◽  
Healthcare Model ◽  
The University ◽  
Knowledge Claims ◽  
The Ideal

In recent decades, the ‘tenacious assumptions’ of biomedicine regarding the neutrality and universality of its knowledge claims have been significantly challenged by the growth of new collaborative and patient-focused models of Healthcare delivery. In this article, we discuss and critically reflect upon one such alternative Healthcare model developed at the University of Gothenburg Centre for Person-Centred Care in Sweden. This centre uses three clinical routines of narrative, partnership and documentation to provide Healthcare to people recognized as unique individuals rather than patients. Person-centred care in Gothenburg and more broadly is based on the assumption that a person is independently capable of reasoning and verbal expression and willing to provide clear and genuine narratives and cooperate with Healthcare professionals. However, we argue that by emphasizing individual capabilities of reasoning and verbal expression, an unnecessarily limited conception of personhood risks being imposed on these routines. Drawing upon semi-structured interviews with researchers in three very different Gothenburg Centre for Person-Centred Care research projects – about healthy ageing in migrant communities, neurogenic communication disorders, and psychosis – we highlight that how persons are recognized as unique and capable varies significantly in practice across different Healthcare settings. Thus, we assert that person-centred care’s own potentially tenacious assumptions about the attributes of personhood risk distracting attention away from the variety of creative ways that professionals and persons promisingly find for translating the ideal of person-centred care into practice.

scholarly journals Attitudes and opinions of Oral healthcare professionals on screening for Type-2 diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rodrigo Mariño ◽  
Andre Priede ◽  
Michelle King ◽  
Geoffrey G. Adams ◽  
Diego Lopez
Keyword(s):  
Type 2 Diabetes ◽  
Oral Health ◽  
Healthcare Professionals ◽  
Healthcare Setting ◽  
Successful Implementation ◽  
Medical Screening ◽  
Structured Interviews ◽  
Healthcare Settings ◽  
Collaboration And Communication

Abstract Background As part of a larger study on the identification of undiagnosed Type 2 diabetes (T2D), and prediabetes patients in dental settings, this study explored oral healthcare professionals’ (OHP) attitudes with respect to the relevance and appropriateness of screening for prediabetes/T2D in general oral healthcare settings. It also aims to gain a deeper understanding of OHPs’ concerns and perceived barriers to screening for T2D. Methods Semi-structured interviews were conducted with 11 OHPs: eight dentists, two dental hygienists and one oral health therapist. Interviews were audio recorded, transcribed verbatim and analysed using thematic analysis. Results Themes that emerged from the interviews were organised under three major categories: 1) Implementation: OHPs willingness to screen for prediabetes/T2D; 2) Barriers to implementation of screenings; subdivided into: a) lack of knowledge and formal training about T2D screening methodology; b) concerns about patients’ awareness and acceptance of T2D screening in oral healthcare settings; c) costs and reimbursement for the time and resources required to screen patients; and d) legal and scope of practice; and 3) Collaboration and communication between OHPs and General practitioners (GP). Conclusions The oral healthcare setting was considered as appropriate for medical screening, and OHPs were willing to participate in screening for prediabetes/T2D. Nonetheless, for the successful implementation of a screening programme, several barriers need to be addressed, and effective medical screening would require collaboration between oral health and medical and other health professionals, as well as clarification of legal and reimbursement issues.

Acceptability of an mHealth App for Youth with Substance Use and Mental Health Needs: An Iterative, Mixed Methods Design (Preprint)

2021 ◽  
Author(s):  
Zachary William Adams ◽  
Miyah Grant ◽  
Samantha Hupp ◽  
Taylor Scott ◽  
Amanda Feagans ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Behavioral Health ◽  
Developmentally Appropriate ◽  
Treatment Engagement ◽  
Structured Interviews ◽  
Outpatient Psychotherapy ◽  
Health Concerns ◽  
Mobile Health Applications ◽  
Mental Health Concerns

BACKGROUND Developmentally appropriate tools are needed that improve behavioral health treatment engagement and outcomes for youth with substance use disorders (SUDs) and mental health disorders. Mobile health applications may augment or replace psychotherapy components, but few have been developed specifically for youth with SUDs following user-guided design principles, which may limit their appropriateness and utility. OBJECTIVE This study involved the user-centered, iterative development and initial user testing of a web-based app for adolescents with SUDs and mental health concerns. METHODS Adolescents aged 14-17 with past-year involvement in outpatient psychotherapy and behavioral health clinicians with adolescent SUD treatment caseloads were recruited. Across two assessment phases (alpha: 10 youth, 10 clinicians; beta: 10 youth, 10 clinicians), participants viewed an app demonstration and completed semi-structured interviews and questionnaires about app content and functionality. RESULTS Participants expressed positive impressions of the app and its potential utility in augmenting outpatient therapy for youth with SUDs and mental health concerns. Noted strengths included valuable educational content, useful embedded resources, and the variety of activities. Adolescents and clinicians favored the app over conventional (paper-and-pencil) modalities, citing convenience and familiarity. The app was found to be user-friendly and likely to improve treatment engagement. Adolescents suggested including privacy settings, and clinicians recommended more detailed instructions and simplified language. CONCLUSIONS The novel app developed here appears to be a promising, acceptable, and highly scalable resource to support for adolescents with SUDs and mental health concerns. Future studies should test the efficacy of such apps in enhancing treatment engagement and outcomes.

Using integrated behavioral healthcare to address behavioral health disparities in underserved populations.

2019 ◽  
Vol 5 (4) ◽  
pp. 374-389 ◽  
Author(s):  
Kristen O'Loughlin ◽  
Emily K. Donovan ◽  
Zach Radcliff ◽  
Mark Ryan ◽  
Bruce Rybarczyk
Keyword(s):  
Health Disparities ◽  
Behavioral Health ◽  
Underserved Populations ◽  
Behavioral Healthcare

Formulating another’s report of troubles in peer support

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Christopher Pudlinski
Keyword(s):  
Mental Health ◽  
United States ◽  
Community Mental Health ◽  
Conversation Analysis ◽  
Peer Support ◽  
Mental Health System ◽  
The United States ◽  
Telephone Support ◽  
Healthcare Settings ◽  
Professional Perspective

This study stems from an interest in peer support talk, an underexplored area of research, and in how supportive actions such as formulated summaries function in comparison to more professional healthcare settings. Using conversation analysis, this study explores 35 instances of formulations within 65 calls to four different ‘warm lines’, a term for peer-to-peer telephone support within the community mental health system in the United States. Formulations can be characterized across two related axes: client versus professional perspective, and directive versus nondirective. The findings show that formulations within peer support were overwhelmingly nondirective, in terms of meeting institutional agendas to let callers talk. However, formulations ranged from client-oriented ones that highlight or repeat caller reports to those which transform caller reports through integrating past caller experiences or implicit caller emotions. These tactics are found to have similarities to how formulations function in professional healthcare settings.

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