Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug 10;20(1):734.
doi: 10.1186/s12913-020-05617-4.

Patient-appraised beneficial moments during inpatient psychiatric treatment

Cosima Locher  1   2   3   4 , Ramin Mansour  5 , Helen Koechlin  6   7 , Stefan Büchi  5
Affiliations

Patient-appraised beneficial moments during inpatient psychiatric treatment

Cosima Locher et al. BMC Health Serv Res. .

Abstract

Background: Psychiatric inpatients receive a multidisciplinary treatment approach, covering psychiatry, nursing, occupational therapy, and psychology. Research findings reveal that the effectiveness of any treatment is associated with three types of factors: specific (e.g., treatment techniques), common (e.g., clinician-patient relationship, patients' expectations) and extra-therapeutic. However, there is little published research on the factors and events which inpatients themselves consider to be beneficial ('beneficial moments').

Methods: Inpatients (N = 107) of a psychiatric clinic completed a questionnaire to elicit their appraisal of beneficial moments. A qualitative content analysis was applied. The coding procedure was conducted independently by two authors.

Results: Self-appraised beneficial moments were found in five areas: therapy-specific components (number of quotations, N = 204), positive relationships (N = 140), clinical setting and environment (N = 52), inpatients' new insights (N = 36), and factors unrelated to either therapy or the clinic (N = 30). In total, 44% of the quotations were related to specific factors, 49% to common factors, and 7% to extra-therapeutic factors.

Conclusions: Inpatients judge both specific and common factors as crucial for the therapeutic benefit they gain during their stay at the clinic. Our results differ from meta-analytical findings, where the impact of specific factors on symptom improvement has shown to be much smaller (i.e., 17%) than appraised by patients in our study (i.e., 44%). Our study underlines the importance of a patient-centred care approach as well as shared decision making and patient-clinician communication. For clinical practice, knowledge of inpatients' perspectives on beneficial moments is crucial in order to reinforce precisely these therapeutic components.

Keywords: Beneficial moments; Common factors; Content analysis; Inpatients; Qualitative; Specific factors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no financial interest or potential conflicts of interest.

Figures

Fig. 1
Fig. 1
Number of Quotations for Main Themes. Note. Black bars are specific factors, grey bars are common factors and bright bars are extra-therapeutic factors
Fig. 2
Fig. 2
a Ranking of how important different factors are in treatment: Inpatients’ perspectives (N = 107) Note. Based on the main themes of the questionnaire. b Ranking of how important different factors are in treatment: Meta-analytic research findings in out- and inpatients (N = 2′805). Note. Factors outside the therapy = extra-therapeutic factors; non-specific factors = common factors. Reprinted from “The efficacy of non-directive supportive therapy for adult depression: a meta-analysis.” Clinical psychology review, 32 (4), 280–291, Copyright (2012), with permission from Elsevier
See this image and copyright information in PMC

References

    1. Bowers L, Chaplin R, Quirk A, Lelliott P. A conceptual model of the aims and functions of acute inpatient psychiatry. J Ment Health. 2009;18(4):316–325.
    1. Black N. Why we need observational studies to evaluate the effectiveness of health care. BMJ. 1996;312(7040):1215. - PMC - PubMed
    1. Paterson C, Karatzias T, Dickson A, Harper S, Dougall N, Hutton P. Psychological therapy for inpatients receiving acute mental health care: a systematic review and meta-analysis of controlled trials. Br J Clin Psychol. 2018;57:453–472. - PubMed
    1. Wampold BE, Imel ZE. The great psychotherapy debate: the evidence for what makes psychotherapy work. New York: Routledge; 2015.
    1. Leichsenring F, Rabung S, Leibing E. The efficacy of short-term psychodynamic psychotherapy in specific psychiatric disorders: a meta-analysis. Arch Gen Psychiatry. 2004;61(12):1208–1216. - PubMed