[How does Home Treatment Work out in Practice? A Qualitative Study Among Patients, Relatives, and Staff]

Psychiatr Prax. 2018 Nov;45(8):405-411. doi: 10.1055/a-0665-6094. Epub 2018 Aug 27.
[Article in German]

Abstract

Objective: To identify effective components of home treatment (HT) and to evaluate the implementation of a new HT team from a service user perspective.

Methods: Experiences of patients, relatives and staff were assessed using semi-structured interviews and an online questionnaire. Thematic analysis was applied to determine key themes.

Results: 25 interviews and 70 questionnaires were analysed. Four key themes emerged: individualisation, proximity to daily life, conceptual aspects, and requirements (for patients and for the service model). Major challenges for the implementation of HT were the suitability for HT, time of referral to HT, and handing over of responsibility from hospital staff to the HT team.

Conclusion: Essential requirements for HT are no-harm agreements, patients' ability to maintain daily routines, and shared responsibility between patients and staff. Implementing HT within an existing care system should be accompanied by sufficient information on the new service model for other service providers involved. This may be achieved through HT team members visiting hospital wards and outpatient facilities, illustrating functioning and limitations of HT using case reports.

Ziel der studie: Identifikation von Wirkmechanismen und von Faktoren für eine erfolgreiche Umsetzung von Home Treatment (HT) aus Stakeholder-Sicht.

Methoden: Thematische Analyse halbstrukturierter Interviews mit Patienten, Angehörigen und Mitarbeitenden, Online-Umfrage mit Mitarbeitenden.

Ergebnisse: 25 Interviews und 70 Fragebögen wurden analysiert.

Schlussfolgerung: Zentrale Themen sind: Individualisierung und Alltagsnähe der Behandlung, Behandlungskonzept sowie Anforderungen. Herausforderungen für die Umsetzung betreffen Indikationsstellung, Zuweisungszeitpunkt und Verantwortungsübernahme.

MeSH terms

  • Ambulatory Care*
  • Germany
  • Humans
  • Mental Disorders / therapy*
  • Qualitative Research
  • Referral and Consultation*
  • Surveys and Questionnaires
  • Unemployment*