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Psychiatr Prax 2025; 52(01): 26-34
DOI: 10.1055/a-2406-9128
DOI: 10.1055/a-2406-9128
Originalarbeit
Entwicklung eines vorläufigen Best Practice Modells für stationsäquivalente psychiatrische Behandlung aus Sicht von Nutzer*innen: Konsensprozess mit partizipativen Anteilen
Developing An Initial Best Practice Model For Inpatient Equivalent Psychiatric Home Treatment From The Perspective Of Service Users: Consensus Process With Participatory Features Fördermittel Die Studie wurde finanziert vom Innovationsfonds des Gemeinsamen Bundesausschusses (G-BA); Förderkennzeichen: 01VSF19048.
Zusammenfassung
Ziel Die stationsäquivalente Behandlung (StäB) ist neuartig in Deutschland und bedarf daher einer Qualitätsentwicklung. Es wird ein Best Practice Modell (BPM) für StäB aus Sicht von Nutzer*innen erarbeitet.
Methodik 1. Sammeln und Ordnen der Evidenz zu Qualitätskriterien (Literaturrecherche; n=55 Interviews), 2. Qualitative Inhaltsanalyse und Formulierung von Kriterien; 3. Konsentierung und Gruppierung der Kriterien (modifiziertes Delphi-Verfahren).
Ergebnisse Es wurden 58 Best Practice Kriterien in 8 Gruppen entwickelt: 1. Information, Zugang und Krisenmanagement; 2. Rahmen der Behandlung, Behandlungsende und Kontinuität; 3. Terminplanung, Organisation der Kontakte und Flexibilität; 4. Praktische Unterstützung und Aktivierung; 5. Behandlungs- und Therapieangebote; 6. Behandlungsteam und Mitarbeiter*innen; 7. Angehörige, Bezugspersonen und Community und 8. Privatsphäre und Verhalten im häuslichen Umfeld.
Schlussfolgerung Das BPM gibt erste Hinweise für eine nutzer*innenfokussierte Überprüfung der Umsetzung von StäB.
Abstract
Aim Inpatient-Equivalent Home Treatment (IEHT) for mental health is new in Germany and therefore requires quality development. A best practice model (BPM) for IEHT is being developed from a service user perspective.
Methods 1. Collection and organization of evidence (literature review; n=55 interviews with service users), 2. qualitative analysis and formulation of criteria; 3. consensus and grouping of criteria (Delphi process).
Results 58 Best practice criteria were developed in 8 groups: 1. Information, access and crisis management; 2. Treatment framework, end of treatment and continuity; 3. Scheduling, organization of contacts and flexibility; 4. Practical support and activation; 5. Treatment and therapy services; 6. Treatment team and staff; 7. Relatives, caregivers and community; and 8. Privacy and behavior in the home environment.
Conclusion The BPM provides initial guidance for a user-centered assessment of the implementation of IEHT.
Schlüsselwörter
Stationsäquivalente Behandlung - Home Treatment - Crisis Resolution - Teams - Fidelity Scale - Partizipative ForschungKeywords
Inpatient equivalent home treatment - home treatment - crisis resolution - teams - fidelity scale - participatory researchPublication History
Received: 31 January 2024
Accepted: 29 August 2024
Article published online:
09 October 2024
© 2024. Thieme. All rights reserved.
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Literatur
- 1 Längle G, Gottlob M, Elsässer-Gaißmaier H-P. Umsetzung des § 115d PsychVVG: Stationsäquivalente Behandlung – Die nächsten Schritte. Psychiat Prax 2017; 44: 417-419
- 2 AG StäB des Referats Gemeindepsychiatrie der DGPPN (Stand: 07 / 2023).
- 3 Murphy S, Irving CB, Adams CE. et al. Crisis intervention for people with severe mental illnesses. Cochrane Database Syst Rev 2012; CD001087
- 4 National Institute for Health and Care Excellence (Great Britain). Surveillance Report 2017: Prevention and Management (2014) NICE Guideline CG178. Psychosis and schizophrenia in adults. National Institute for Health and Care Excellence (UK); 2017
- 5 Stulz N, Wyder L, Maeck L. et al. Home treatment for acute mental healthcare: randomised controlled trial. Br J Psychiatry 2020; 216: 323-330
- 6 Cornelis J, Barakat A, Blankers M. et al. The effectiveness of intensive home treatment as a substitute for hospital admission in acute psychiatric crisis resolution in the Netherlands: a two-centre Zelen double-consent randomised controlled trial. Lancet Psychiatry 2022; 9: 625-635
- 7 Schwarz J, Hemmerling J, Kabisch N. et al. Equal access to outreach mental health care? Exploring how the place of residence influences the use of intensive home treatment in a rural catchment area in Germany. BMC Psychiatry 2022; 22: 826
- 8 Schwarz J, Bechdolf A, Hirschmeier C. et al. Ich sehe es tatsächlich als Zwischenschritt“ – eine qualitative Analyse der Implementierungsbedingungen und -hürden von Stationsäquivalenter Behandlung in Berlin und Brandenburg. Psychiat Prax 2021; 48: 193-200
- 9 Schwarz J, Wolff J, Heinze M. et al. How to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis. Front Psychiatry 2023; 14: 1166197
- 10 Schwarz J, Geissler M, Küsel M. et al. Genesungsbegleitung und stationsäquivalente Behandlung. Eine qualitative Studie. Nervenheilkunde 2020; 39: 731-738
- 11 Gottlob M, Holzke M, Raschmann S. et al. Stationsäquivalente Behandlung – Wie geht das? Umsetzungsstrategien aus acht psychiatrischen Fachkliniken und -abteilungen in Deutschland. Psychiat Prax 2021;
- 12 Klocke L, Brieger P, Ketisch E. et al. Stationsäquivalente Behandlung – Vergleich von Direktaufnahmen mit Überweisungen von psychiatrischen Stationen. Psychiat Prax 2021;
- 13 Weinmann S, Spiegel J, Baumgardt J. et al. Stationsäquivalente Behandlung (StäB) im Vergleich mit vollstationärer Behandlung: 12-Monats-Follow-up einer gematchten Kohortenstudie. Psychiat Prax 2021;
- 14 Boyens J, Hamann J, Ketisch E. et al. Vom Reißbrett in die Praxis – Wie funktioniert stationsäquivalente Behandlung in München?. Psychiat Prax 2021; 48: 269-272
- 15 Raschmann S, Götz E, Hirschek D. et al. StäB – Wie bewerten Patientinnen und Patienten die neue Behandlungsform?. Psychiat Prax 2022; 49: 46-50
- 16 Nikolaidis K, Weinmann S, Döring S. et al. Stationsäquivalente Behandlung (StäB) im Vergleich mit vollstationärer Behandlung: 12-Monats-Follow-up Ergebnisse einer mittels Propensity-Score gematchten retrospektiven Kohortenstudie. Psychiat Prax 2023;
- 17 Längle G, Raschmann S, Heinsch A. et al. Stößt die Behandlung zu Hause auf größere Zufriedenheit? Ergebnisse zur Zufriedenheit der an der Behandlung beteiligten Personengruppen im Rahmen der multizentrischen AKtiV-Studie. Psychiat Prax 2023;
- 18 Weinmann S, Nikolaidis K, Längle G. et al. Premature termination, satisfaction with care, and shared decision-making during home treatment compared to inpatient treatment: A quasi-experimental trial. Eur Psychiatry 2023; 66: e71
- 19 Lloyd-Evans B, Bond GR, Ruud T. et al. Development of a measure of model fidelity for mental health Crisis Resolution Teams. BMC Psychiatry 2016; 16: 427
- 20 Yates J, Stanyon M, Challis D. et al. Developing a model of best practice for teams managing crisis in people with dementia: a consensus approach. BMC Psychiatry 2020; 20: 505
- 21 Perleth M, Jakubowski E, Busse R. What is „best practice“ in health care? State of the art and perspectives in improving the effectiveness and efficiency of the European health care systems. Health Policy 2001; 56: 235-250
- 22 Melnyk BM, Fineout-Overholt E. Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice. Lippincott Williams & Wilkins; 2011
- 23 Gelhorn HL, Sexton CC, Classi PM. Patient preferences for treatment of major depressive disorder and the impact on health outcomes: a systematic review. Prim Care Companion CNS Disord 2011; 13: PCC.11r01161
- 24 Street RL, Elwyn G, Epstein RM. Patient preferences and healthcare outcomes: an ecological perspective. Expert Rev Pharmacoecon Outcomes Res 2012; 12: 167-180
- 25 Subramanian S, De Moor K, Fiedler M. et al. Towards enhancing ecological validity in user studies: a systematic review of guidelines and implications for QoE research. Quality and User Experience 2023; 8: 6
- 26 Baumgardt J, Schwarz J, Peter Svon. et al. Aufsuchende Krisenbehandlung mit teambasierter und integrierter Versorgung (AKtiV). Nervenheilkunde 2020; 39: 739-745
- 27 Baumgardt J, Schwarz J, Bechdolf A. et al. Implementation, efficacy, costs and processes of inpatient equivalent home-treatment in German mental health care (AKtiV): protocol of a mixed-method, participatory, quasi-experimental trial. BMC Psychiatry 2021; 21: 173
- 28 von Peter S, Glück R, Göppert L. et al. How do users experience psychiatric care? The value of participatory-collaborative research. Psychiat Prax 2022; 49: 8-10
- 29 Diamond IR, Grant RC, Feldman BM. et al. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol 2014; 67: 401-409
- 30 Mueser KT, Torrey WC, Lynde D. et al. Implementing evidence-based practices for people with severe mental illness. Behav Modif 2003; 27: 387-411
- 31 Torrey WC, Lynde DW, Gorman P. Promoting the implementation of practices that are supported by research: the National Implementing Evidence-Based Practice Project. Child Adolesc Psychiatr Clin N Am 2005; 14: 297-306 ix
- 32 Schwarz J, Scheunemann S, von Peter S. et al. How service users experience intensive psychiatric home treatment and what they expect from it: collaborative process evaluation study (to be submitted). BMC Psychiatry. 2024
- 33 Mayring P. Qualitative Inhaltsanalyse: Grundlagen und Techniken. 12. Aufl. Weinheim: Bergstr: Beltz; 2015
- 34 Reiter A, Fischer B, Kötting J. et al. QUALIFY: Ein Instrument zur Bewertung von Qualitätsindikatoren. Zeitschrift für ärztliche Fortbildung und Qualität im Gesundheitswesen – German Journal for Quality in Health Care 2008; 101: 683-688
- 35 CORE Research Group. core Crisis Resolution Team Fidelity Scale Version 2. Im Internet: https://www.ucl.ac.uk/core-study/sites/core-study/files/fidelity-scale-final-pdf_0.pdf
- 36 Schwarz J, Zeipert M, Ignatyev Y. et al. Implementation and stakeholders’ experiences with Home Treatment in Germany's integrative and flexible psychiatric care models - A mixed-methods study. Psychother Psychosom Med Psychol 2020; 70: 65-71
- 37 GKV-SV. Vereinbarung zur stationsäquivalenten Behandlung nach §115d Abs. 2 SGB V vom 01.08.2017. Im Internet: https://www.gkv-spitzenverband.de/media/dokumente/krankenversicherung_1/krankenhaeuser/psychiatrie/2017_08_01_KH_Vereinbarung_StaeB_115_d_Abs_2_SGB_V_Unterschriftenfassung.pdf Stand: 26.11.2017
- 38 Beeker T, Glück RK, Ziegenhagen J. et al. Designed to Clash? Reflecting on the Practical, Personal, and Structural Challenges of Collaborative Research in Psychiatry. Front Psychiatry 2021; 12: 1069
- 39 Morant N, Lloyd-Evans B, Lamb D. et al. Crisis resolution and home treatment: stakeholders’ views on critical ingredients and implementation in England. BMC Psychiatry 2017; 17: 254
- 40 Hopkins C, Niemiec S. Mental health crisis at home: service user perspectives on what helps and what hinders. J Psychiatr Ment Health Nurs 2007; 14: 310-318
- 41 Adamczyk L. A Collaborative Investigation of the Experiences of Elders Using an Older Adult Home Treatment Team: From Understanding to Action. University of East London. 2020
- 42 Wyder L, Fawcett C, Hepp U. et al. Wie gelingt Home Treatment in der Praxis? Eine qualitative Studie unter Einbezug von Patienten, Angehörigen und Mitarbeitenden. Psychiat Prax 2018; 45: 405-411
- 43 Rubio L, Lever Taylor B, Morant N. et al. Experiences of intensive home treatment for a mental health crisis during the perinatal period: A UK qualitative study. Int J Ment Health Nurs 2021; 30: 208-218
- 44 Middleton H, Shaw R, Collier R. et al. The dodo bird verdict and the elephant in the room: A service user-led investigation of crisis resolution and home treatment. Health Sociol Rev 2011; 20: 147-156
- 45 Hasselberg N, Klevan TG, Weimand B. et al. Similarities and differences between service users’ and carers' experiences of crisis resolution teams in Norway: a survey. BMC Psychiatry 2022; 22: 266
- 46 Giménez-Díez D, Maldonado Alía R, Rodríguez Jiménez S. et al. Treating mental health crises at home: Patient satisfaction with home nursing care. J Psychiatr Ment Health Nurs 2020; 27: 246-257
- 47 Carpenter RA, Tracy DK. Home treatment teams: what should they do? A qualitative study of patient opinions. J Ment Health 2015; 24: 98-102
- 48 Goldsack S. Experiencing a Recovery-Oriented Acute Mental Health Service: Home Based Treatment from the Perspectives of Service Users. Their Families and Mental Health Professionals. New Zealand Mental Health Commission. 2005
- 49 Rhodes P, Giles SJ. „Risky business“: a critical analysis of the role of crisis resolution and home treatment teams. J Ment Health 2014; 23: 130-134
- 50 Kalucy R, Thomas L, Lia B. et al. Managing increased demand for mental health services in a public hospital emergency department: a trial of „Hospital-in-the-Home“ for mental health consumers. Int J Ment Health Nurs 2004; 13: 275-281
- 51 Mötteli S, Schori D, Menekse J. et al. Patients’ experiences and satisfaction with home treatment for acute mental illness: a mixed-methods retrospective study. J Ment Health 2022; 31: 757-764
- 52 Hubbeling D, Bertram R. Hope, happiness and home treatment: a study into patient satisfaction with being treated at home. Psychiatr Bull (2014) 2014; 38: 265-269
- 53 Khalifeh H, Murgatroyd C, Freeman M. et al. Home treatment as an alternative to hospital admission for mothers in a mental health crisis: a qualitative study. Psychiatr Serv 2009; 60: 634-639
- 54 Nelson LJ, Miller PK, Ashman D. „Dale“: an interpretative phenomenological analysis of a service user’s experience with a crisis resolution/home treatment team in the United Kingdom. J Psychiatr Ment Health Nurs 2016; 23: 438-448
- 55 Klevan T, Karlsson B, Ruud T. “At the extremities of life” – Service user experiences of helpful help in mental health crises. Am J Psychiatr Rehabil 2017; 20: 87-105