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Final report Empowerment Kilian (German)

Anhang I Ergebnisse der Fokusgruppenanalyse Teil 1

Anhang I Teil 2 Dimensionsdefinitionen EPAS

Anhang II Teil 1 EPAS Pretest Version

Anhang II Teil 2 EPAS Pilotversion
Anhang III Methodenbeschreibung IRT Analysen

Anhang IV Ergebnisse Pilotstudienauswertung Teil 1

Anhang IV Ergebnisse Pilotstudienauswertung Teil 2

Anhang V EPAS Feldtestversion

Anhang VI Ergebnisse der Feldteststudie

Anhang VII EPAS Endversion

 

Contact

Arbeitsgruppe Versorgungsforschung der Klinik für Psychiatrie und Psychotherapie II der Universität Ulm
Ludwig-Heilmeyer-Str. 2
89312 Günzburg

 

Principal investigator: 
PD Dr. Kilian, 

Universität Ulm, 
Tel.: 08221/96-2861, 
Fax: 08221/96-28160, 

 

Research fellow:

Dipl.-Psych. Christine Hertle,
Tel.: 08221/96-2877,
Fax: 08221/96-28164, 

 

Research fellow:

Dipl.-Psych. Susanne Hörand, 

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Development of a standardised procedure for the measurement of empowerment in the process of psychiatric treatment of patients with severe mental illnesses

A fundamental goal of modern psychiatric treatment is to foster an independent lifestyle and an autonomous dealing with the illness. This goal is also described with the English term "empowerment".

In the framework of this study, a questionnaire will be developed which enables an evaluation of the extent to which psychiatric treatment actually lives up to this goal.

In order to take into account different ideas on the theme of empowerment and to do justice to the life experience of patients with affective and schizophrenic disorders, group discussions with outpatients, their family members and experts take place. To measure possible differences through the influence of urban and rural living conditions, the groups are implemented both in the district of Günzburg and in Munich. Moreover, the group composition is balanced in terms of gender and age.

On the basis of the information gained, a questionnaire is in development which is examined and tested with several patient surveys. The final version should be implemented into routine care and thus contribute to quality assurance.

 

Background

Despite broad agreement on the central importance of empowerment for psychiatric treatment, so far, standardised procedures to measure empowerment in the psychiatric treatment process are lacking. Currently, therefore, there are only very few investigations of the question of the extent to which empowerment principles are actually implemented in the treatment of chronic mental illnesses. For psychiatric care research, the lack of suitable measurement methods means that a central component of the quality of the therapeutic process cannot be appropriately evaluated. Thus, on the one hand, the possibility to identify potential reasons for a lack of empowerment orientation of the psychiatric treatment process is lacking. On the other hand, it cannot be precisely determined what meaning empowerment actually has for the outcome of the treatment process.

 

Aim

The aim of the project is to develop and examine the psychometric properties of a standardised procedure for measuring empowerment in the process of the psychiatric treatment of patients with affective (ICD-10 F30-F39) and schizophrenic (ICD-10 F20-F29) disorders. The instrument should take into account various content-based dimensions of empowerment, but at the same time be suitable for use in routine care and thus not comprise more than 25 items.

 

Method

To generate the content-based dimensions and the item development, focus groups are conducted with outpatients, their family members and experts. Each focus group lasts for approximately 90 minutes. All sessions are recorded with an audio recording device and subsequently transcribed. In order to consider sociocultural and diagnosis-specific factors, the patient groups are divided according to city/country (Munich/Günzburg) and diagnosis (F2/F3).

Moreover, in terms of the group composition, care is taken to accomplish a balanced distribution of age and gender. On the basis of the qualitative content analyses of these data, the items and response scales of the pilot questionnaire are developed. For the selection of the items with the best psychometric properties, a pilot survey of 440 patients takes place. The questionnaire developed on the basis of the pilot study is then tested in a field test study of 400 patients with regard to its psychometric properties. In addition to the survey with the empowerment questionnaire, the impairment caused by the illness (HoNOS) and the subjective quality of life (WHOQOL-BREF) are measured. In the framework of a test phase, the questionnaire is tested in terms of its suitability as an instrument for quality assurance in routine care.

 

Current status

For the consideration of sociocultural factors, a total of 14 focus groups with 81 participants were conducted in parallel in Munich and the district of Günzburg. The content-analytical evaluation of the focus group transcripts resulted in 13 content-based dimensions. For these dimensions, 183 questionnaire items were formulated, which were tested in the framework of a feasibility test in 40 patients. On the basis of the results of the feasibility test, 81 items were selected for the pilot questionnaire. For the selection of the items with the best psychometric properties, a pilot survey took place in 445 patients, in Günzburg, Kempten, Immenstadt, Munich and Leipzig. The data gained from the pilot study were examined by means of exploratory factor analysis with regard to their content-based structure and by means of item-response analyses with regard to their psychometric properties. The field test questionnaire, which was produced on the basis of the results of the evaluations of the pilot study data, comprises the 6 content-based dimensions: 1) Coping with everyday life; 2) social relationships; 3) treatment; 4) medication; 5) self-efficacy expectancy/hope; 6) self-worth/acceptance, with a total of 38 items as well as two additional modules for employed patients and for patients with under-age children. The field test instrument is currently being examined in 400 patients in Günzburg, Kaufbeuren, Munich and Leipzig with regard to its psychometric properties. In the framework of a test phase, once the questionnaire is complete, it will be tested in terms of its suitability as an instrument for quality assurance in routine care.




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