To Örebro University

Background: The restructuring and decentralization of psychiatric services in Norway, aligning with global trends, has sparked debate on quality assurance. This study aimed to evaluate the psychometric properties of the Norwegian version of the Quality in Psychiatric Care - Inpatient Staff (QPC-IPS). Additionally, it sought to investigate the sociodemographic and work-related factors associated with staff perceptions of the quality of inpatient psychiatric care that they provide.

Material and methods: The Swedish QPC-IPS, a 30-item, 6-dimension tool, was thoroughly translated for the Norwegian psychiatric care setting. A web survey, including the QPC-IPS and sociodemographic and work-related items, was distributed to the mental health staff of two Norwegian health trusts, yielding 117 responses.

Results: The adapted version underwent confirmatory factor analysis, revealing a factor structure consistent with the original QPC-IPS and its versions in other languages. Staff generally reported high-quality care, with the highest for the secluded environment and the lowest for the secure environment. Positive associations were found between quality perceptions and factors, such as professional development, openness to quality assurance, and participation in quality work. Psychosocial environments and staff mental health were positively linked to quality-of-care dimensions and the staff recommendations correlated with their perception of patients' experiences of quality of care.

Conclusions: The Norwegian QPC-IPS demonstrated adequate psychometric properties, facilitating its use in assessing psychiatric care staff's perception of patients' experiences of quality of care. Insights from staff perspectives contribute to identifying areas for improvement in inpatient psychiatric care, thereby enhancing cross-cultural comparisons and theory development in this domain.

BACKGROUND: People with disabilities experience significant health inequities compared with the general population. Addressing these inequities requires the development and implementation of tailored interventions, but a gap often exists between recommended best practices and the actual care provided. Successful implementation is complex, involving multiple organizational factors. Assessing organizational readiness for change is crucial to overcome barriers and improve health outcomes for people with disabilities. This study aims to examine managers' perceptions of their organization's readiness for change regarding the implementation of interventions within disability healthcare in Sweden.

METHODS: This descriptive cross-sectional study employs an embedded mixed-methods approach. The primary approach for the overall study is based on quantitative data, while qualitative data is analyzed to provide supplementary deepened information. Both types of data were collected simultaneously through a web-based survey. The data analysis involves various statistical techniques for the quantitative data and inductive content analysis for the qualitative data.

RESULTS: Several key factors influence managers' perceptions of their organization's readiness for change, including gender, age, tenure, organizational type, managerial level, and experience. Enabling factors for implementation include trust-based leadership, staff involvement, motivation, and engagement. Barriers include complex processes, lack of support, resistance and fear, and insufficient time and resources.

CONCLUSIONS: This study highlights the complexity of organizational readiness for disability healthcare interventions, shaped by both individual and organizational factors. In particular, managerial characteristics, organizational dynamics, and resource availability play key roles. These findings suggest that a comprehensive strategy can strengthen healthcare organizations' ability to navigate implementation challenges effectively.

Young people have the right to participate in their habilitation process. The aim was to describe how young people with disabilities perceive participation in the habilitation process. Data collection was performed at child and youth habilitation centres in Sweden. A total of four interviews were conducted, two individual interviews and two group interviews. The transcribed data was analysed using inductive qualitative content analysis. The analysis reveals two generic categories: 'the right prerequisites must be provided to be able to participate' and 'adults' behaviour and attitudes are important for participation in the habilitation process'. The findings reveal that how young people perceive participation in the habilitation process is based on environmental factors, such as information, and that the professionals strive for the young people's voices to be heard by including them in planning. In conclusion, the important aspects of participation are a young person-friendly environment and individual support from adults. These aspects can provide a source of reference for professionals who want to develop strategies to promote young people's participation.

INTRODUCTION: Adults with Down syndrome (DS) are at a high risk for dementia, yet cognitive screening is complicated by premorbid intellectual disabilities. This study evaluated the feasibility of using eye-tracking technology as a screening tool.

METHODS: Ten adults with DS (five with dementia, five without) completed cognitive tasks while their eye movements were recorded. Feasibility was assessed through calibration success, gaze sample quality, and task completion.

RESULTS: Calibration was successful for most subjects (except one individual with dementia required five attempts and had low gaze sampling). Most subjects achieved 50%-88% gaze sample rates and completed testing with staff support. Subjects with dementia showed longer times to first fixation but similar fixation durations compared to those without dementia. Cognitive scores were lower in the dementia group but not significantly correlated with gaze quality.

DISCUSSION: Eye tracking may be a feasible method for cognitive screening in DS, but further validation is needed. HIGHLIGHTS: Eye-tracking may be a potential non-verbal method for cognitive screening in individuals with DS. Support from staff for engaging the subjects could be essential for maintaining attention on the computer screen.

AIM: The aim of the present study is to evaluate the psychometric properties and factor structure of the Quality in Psychiatric Care-Outpatient Staff (QPC-OPS) instrument and briefly describe the staff's views on the quality of care provided in general outpatient clinics as well as demographic and clinical factors associated with quality of care.

METHOD: The study employed a cross-sectional design to conduct a psychometric evaluation and survey of staff perspectives. A sample of 143 permanently employed members of staff in multiprofessional teams at 15 outpatient clinics in Sweden completed the QPC-OPS, which consists of 30 items covering eight dimensions of quality of care.

RESULTS: The QPC-OPS exhibited excellent psychometric properties, with a total alpha coefficient of 0.94, a test-retest reliability of 0.96 and a goodness-of-fit measure for the proposed model with a RMSEA value of 0.048. The staff's rating was generally high. Ratings were highest for Encounter and lowest for Accessibility. Staff who rated their own mental health as higher rated quality of care higher in most of the dimensions.

CONCLUSION: The Swedish QPC-OPS showed excellent psychometric properties and is a useful, inexpensive and simple way to evaluate the quality of care in outpatient care and contributes to health care improvement in the field of psychiatric care. The low quality of the dimension of Accessibility indicates an important area for improvement.

BACKGROUND: The therapeutic relationship has been identified as essential for ensuring high-quality care in psychiatric outpatient services, as highlighted in several studies. This study focuses on the content of interactions between patients and staff in psychiatric outpatient care, as well as the quality of care provided, as perceived by the patients. AIM: The aim of this study is to explore the relationship between these interactions and aspects of the perceived quality of care from the perspective of patients in psychiatric outpatient services.

METHODS: A sample of 706 patients from psychiatric outpatient clinics in Sweden completed the Verbal and Social Interaction Outpatient (VSI-OP) and the Quality in Psychiatric Care-Outpatient (QPC-OP) instruments. A structural equation model was conducted to explore these associations. The study was approved by the Regional Ethical Review Board in Uppsala, Sweden (Dnr. 2018/186).

RESULTS: The model revealed that the staff showing an interest in the patients' feelings, experiences and behaviour influences the patients' perceived quality of participation through an intricate network of mediator variables, including the staff's ability to establish a relationship, a good encounter, support and a high level of information to the patients. High levels of Participation/Empowerment indicate a high level of quality of care in a psychiatric outpatient context.

IMPLICATION FOR PRACTICE: The presented model provides an understanding of the associations between staff and patient interactions and perceived quality of care and sheds light on important aspects of quality of care from the perspective of the patients.

A review of the existing literature shows that although numerous factors influence the quality of care, only a few have been thoroughly investigated as potential mediators impacting mental health professionals' perceptions of quality in psychiatric inpatient care. This study aimed to explore how burnout mediates the relationship between individual characteristics, ward environment conditions and professionals' perceptions of the quality of psychiatric care patients receive. A total of 117 professionals from two Norwegian health trusts participated in the study. Data were collected through an online questionnaire comprising validated instruments measuring quality of care, job satisfaction, perceived stress and burnout while collecting background information on sociodemographic and work-related factors. The relationships between these variables were analyzed using univariate and multiple regression analyses. The results showed that professionals who were open for developing quality work, found their work stimulating, had sufficient time for tasks and were satisfied with their job reported lower levels of burnout. In turn, burnout was associated with lower perceived quality of participation and secure environment. Overall, professionals generally rated the quality of care as high. These findings provide insights for designing interventions to improve workplace conditions, reduce risk of burnout and enhance the quality in psychiatric inpatients settings.

To review the longitudinal trajectories - and the factors influencing their development - of mental health problems in children with neurodevelopmental disabilities. Systematic review methods were employed. Searches of six databases used keywords and MeSH terms related to children with neurodevelopmental disabilities, mental health problems, and longitudinal research. After the removal of duplicates, reviewers independently screened records for inclusion, extracted data (outcomes and influencing factors), and evaluated the risk of bias. Findings were tabulated and synthesized using graphs and a narrative. Searches identified 94,662 unique records, from which 49 publications were included. The median publication year was 2015. Children with attention deficit hyperactivity disorder were the most commonly included population in retrieved studies. In almost 50% of studies, trajectories of mental health problems changed by < 10% between the first and last time point. Despite multiple studies reporting longitudinal trajectories of mental health problems, greater conceptual clarity and consideration of the measures included in research is needed, along with the inclusion of a more diverse range of populations of children with neurodevelopmental disabilities.

INTRODUCTION: The rising prevalence of autism spectrum disorder (ASD) among children poses significant challenges for healthcare services. Research has underscored the crucial role of children's involvement in their healthcare. However, due to the intricate nature of ASD, marked by communication and social interaction differences, healthcare providers face challenges in tailoring their services to accommodate these children. This project aims to explore the impact of two distinct needs assessment models on children's participation in the needs assessment process.

METHODS AND ANALYSIS: We will conduct a prospective observational study comparing responses from children subjected to two different needs assessment procedures: survey-based and meeting-based. Supplementary data will be collected from the children's parents/guardians and healthcare professionals. Data collection methods will include questionnaires, interviews and document analysis of individual habilitation plans. We aim to recruit 120 children aged 7-17 diagnosed with ASD but without intellectual disability, with 60 undergoing the survey-based needs assessment and 60 undergoing the meeting-based assessment. The primary outcome measure will be the perception of participation in the needs assessment procedure. Secondary outcomes will include the children's quality of life and mental health; the parents' knowledge of their child's strengths, abilities and special needs; and the parents' perception of the quality of collaboration with the healthcare team.

ETHICS AND DISSEMINATION: The study received ethics approval from the Swedish Ethical Review Authority on 4 March 2024 (reference number 2024-00227-01). All children and their caregivers will receive both verbal and written information about the study before being asked to provide written informed consent to participate. The findings will be disseminated through publication in peer-reviewed journals and presentation at conferences. Additionally, a popular science report summarising the data and its interpretation will be published.

TRIAL REGISTRATION NUMBER: NCT06381856.

Background: The implementation of interventions in clinical practices is a challenge across healthcare settings, particularly in the field of habilitation. To improve access to research-based treatment, there is a need to understand and explain factors affecting the implementation of interventions. The purpose of this systematic review is to identify, appraise and synthesise staff experience of the implementation of interventions for adults with congenital disabilities into a comprehensive overview.

Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, we conducted a search using the Medline, CINAHL, PsycINFO, Sociological Abstract, Applied Social Sciences Index and Abstracts (ASSIA) and Web of Science databases. To be eligible, studies had to have collected data (qualitative or quantitative) that specifically addressed the implementation process.

Findings: Of the 5430 studies initially retrieved, eight met the inclusion criteria. Staff-identified barriers and facilitators, as well as strategies and outcomes, were grouped into three themes: (1) conditions for implementation, (2) acceptability of interventions and (3) approach for change. The most commonly cited barriers and facilitators were organisation structure and culture, financial and personnel resources, relevance of interventions, and communication and collaboration.

Conclusions: When implementing an intervention, it is necessary to consider barriers and facilitators across all three identified themes to increase the likelihood of implementation success. The compiled results of the included studies provide insights that further our understanding of implementation and our knowledge of the influence of factors on the implementation of interventions within habilitation settings. This review highlights knowledge gaps and areas for future study in the context of habilitation implementation.