Factors influencing the admission decision for Medical Psychiatry Units: A concept mapping approach
Autoři:
P. J. Caarls aff001; M. A. van Schijndel aff001; G. van den Berk aff003; A. D. Boenink aff004; D. Boerman aff002; J. G. Lijmer aff003; A. Honig aff003; M. Terra aff004; A. Thijs aff004; B. Verwey aff002; J. A. van Waarde aff002; J. van Wijngaarden aff005; J. J. van Busschbach aff001;
Působiště autorů:
Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands
aff001; Rijnstate Hospital, Arnhem, The Netherlands
aff002; Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
aff003; Amsterdam University Medical Center, Amsterdam, The Netherlands
aff004; Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands
aff005
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0221807
Souhrn
Objective
Medical Psychiatry Units (MPUs), also known as Complexity Intervention Units (CIUs), provide care for complex patients suffering from both psychiatric and physical disorders. Because there is no consensus on the indications for admission to an MPU, daily practice and effectiveness research are hampered. This study therefore used a concept mapping approach to investigate which organizational and medical factors determine the decision to admit a patient to an MPU.
Methods
The first step of the concept mapping approach was to create a list of factors determining MPU admission from literature. Secondly, clinical experts sorted and ranked these factors. The sorted and ranked data were then analyzed, and a draft conceptual framework was created. A final conceptual MPU admission framework was then drawn during an expert consensus meeting and recommendations for implementation were suggested.
Results
Thirteen clinical experts defined 90 factors from literature, which were sorted and ranked by 40 experts from 21 Dutch hospitals. This concept mapping approach resulted in a five-cluster solution for an MPU admission framework based on: 1. Staff competencies and organizational pre-requisites; 2. Patient context; 3. Patient characteristics; 4. Medical needs and capabilities; and 5. Psychiatric symptoms and behavioral problems. Furthermore, three inclusion and two exclusion criteria were formulated to help the clinicians decide whether or not to admit patients to an MPU. These criteria can be implemented in daily practice.
Conclusion
Implementing the five criteria derived from this conceptual framework will help make the admission decision for complex patients with psychiatric and physical disorders to an MPU more correct, consistent, and transparent.
Klíčová slova:
Medicine and health sciences – Mental health and psychiatry – Health care – Health care providers – Medical doctors – Physicians – Nurses – Health care facilities – Hospitals – Patients – Inpatients – People and places – Population groupings – Professions – Medical personnel – Geographical locations – Europe – Social sciences – Economics – Economic analysis – Cost-effectiveness analysis – Biology and life sciences – Neuroscience – Cognitive science – Cognitive psychology – Decision making – Cognition – Psychology
Zdroje
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