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  • Inpatients’ experiences with interdisciplinary treatment for substance dependence – results from a national survey 2013

PasOpp report

Inpatients’ experiences with interdisciplinary treatment for substance dependence – results from a national survey 2013

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About this publication

  • Year: 2013
  • ISSN (digital): 1890-1565
  • ISBN (digital): 978-82-8121-748-5

Key message

Key messages

The national user survey among adult inpatients in interdisciplinary treatment for substance dependence shows that there is a large potential for improvement in several of the areas the survey cover. This applies both to the institution the patients are admitted to, previous experiences with aftercare after discharge and services from the municipality.

The patients reported most positive experiences with:

  • Met with courtesy and respect,
  • Met at the institution in a satisfactory manner,
  • Felt safe in the institution.

There are large potential for improvement in the institutions in these areas:

  • Enough time for conversations and contact with the therapists (e.g. doctors, psychologists) and the personnel,
  • Experience of that the therapists/personnel have understood the patient’s situation,
  • Confidence in the therapists’/personnel’s professional competence,
  • Information about and influence on the treatment,
  • Treatment adapted to the patient’s needs,
  • Help with physical or psychological problems,
  • Satisfactory access to psychologist or medical doctor,
  • Activities in the institution,
  • The possibility for a private life,
  • Preparation for the time after discharge,
  • The patients more able through help and treatment to understand and master their dependency problems,
  • Cooperation with relatives or relations.

Follow-up/aftercare after discharge and help from the municipality are also areas which, according to the patients, have large potential for improvements.

The results from the qualitative comments complement and correspond to a large extent with the quantitative results.

Summary

Executive summary

Background

One of the aims in ”Oppdragsdokumentet” from the Ministry of Health and Care Services to the regional health authorities for 2013 was to conduct a user survey within interdisciplinary treatment for substance dependence in every hospital trust. The Norwegian Directorate of Health gave the Norwegian Knowledge Centre for the Health Services (NOKC) the task to plan and carry out the survey in the hospital trusts in 2013.

NOKC carried out a national questionnaire survey among adult inpatients, 16 years or older, in interdisciplinary treatment for substance dependence. Both public residential institutions and private residential institutions with a contract with the regional health authorities were included in the survey. Detoxification clinics were excluded. The survey was conducted in every institution, with one exception, during one day in week 37, 2013.

The survey was conducted to obtain systematic information about patient experiences within interdisciplinary treatment for substance dependence, as a basis for local quality improvement and national statistics.

Method

The survey was conducted among patients, 16 years or older, in residential institutions in interdisciplinary treatment for substance dependence. Both public residential institutions and private residential institutions with a contract with the regional health authorities were included in the survey. Detoxification clinics were excluded. All patients present in the included institutions received the questionnaire on the previously agreed upon day.

Unlike other patient and user experience surveys conducted at the NOKC, this particular survey was not conducted postally, but through distribution and handing in of the questionnaires at the institutions. NOKC sent questionnaires to every institution, while the institutions’ personnel distributed the questionnaires to their patients. The personnel also collected the completed questionnaires. The survey was conducted as an anonymous quality assurance project. The institutions did not register participating patients, and the NOKC could create an anonymous dataset without any personal data.

The utilized questionnaire is developed through standard methods by the NOKC and tested through a pilot survey. Two open questions were included at the last page of the questionnaire to complement the quantitative results. In one of these questions the patients were asked to write more about their experiences at the institution. The other question invited the patients to write more about their experiences with received help from the municipality.

The NOKC received information from the institutions about their number of patients on the day they carried out the survey: 1245 patients in 98 institutions. Two of the included institutions had no patients on the specific day. Out of the 1245 patients, 12 was excluded by the person responsible at the institutions (ethical considerations), 163 patients were not present at the institution when the survey was distributed. This gives a total of 175 patients who were excluded from the survey, and the corrected sample consisted of 1070 patients.

The NOKC received 978 completed questionnaires. The response rate was calculated to 91 percent.

Results

Reception and waiting time:

  • 43 percent of the respondents said that they ”not at all”, ”to a small extent” or ”to some extent” received information about the institution’s rules and regulations when they got there.
  • 24 percent replied in the three most negative categories on the question about whether they were received at the institution in a satisfactory manner.
  • 38 percent replied that they had to wait “yes, too long”, or “yes, quite long”, while 49 percent said they had to wait “but not long” to get an offer from the institution.

The therapists/personnel

  • 45 percent of the patients replied that they ”not at all”, ”to a small extent”, or “to some extent” have hade enough time for conversations and contact with the therapists/personnel.
  • 42 percent said that they experience that the therapists/personnel ”not at all”, ”to a small extent” or ”to some extent” have understood the patient’s situation.
  • 42 percent replied in the same categories on a question about whether they had confidence in the therapist’/personnel’s professional competence or not.
  • 38 percent said that one of the therapists/personnel ”not at all”, ”to a small extent” or ”to some extent” have had the main responsibility for the patient.
  • 20 percent replied that they ”not at all”, ”to a small extent” or ”to some extent” have been met with courtesy and respect.
  • 44 percent said that they “many times”, “some times” or “one time” have been treated patronizing or offensive by the therapists/personnel.

The treatment

  • 58 percent said they had ”no profit”, ”little profit” or ”some profit” from treatment with medications at the institution.
  • 36 percent replied on the overarching question about treatment that they had ”no profit”, ”little profit” or ”some profit” from the treatment at the institution.
  • Approximately half of the patients said that they ”not at all”, ”to a small extent” or ”to some extent” have had satisfactory information about the treatment, influence on own treatment and experienced that the treatment have been adapted to the patients’ needs.
  • 59 and 61 percent replied that they ”not at all”, ”to a small extent” or ”to some extent” have received help with their physical or psychological problems, respectively.
  • 55 and 53 percent replied that they ”not at all”, ”to a small extent” or ”to some extent” have had satisfactory access to a psychologist or medical doctor, respectively.

The environment and activities

  • 17 percent of the patiens replied that they ”not at all”, ”to a small extent” or ”to some extent” have felt safe at the institution.
  • 32 percent said that the institution ”not at all”, ”to a small extent” or ”to some extent” had facilitated contact with other patients in a satisfactory manner.
  • 51 percent assessed the activities at the institution as ”not at all”, ”to a small extent” or ”to some extent” satisfactory.
  • 29 percent replied that the meals at the institution were ”not at all”, ”to a small extent” or ”to some extent” satisfactory.
  • 45 percent replied that they ”not at all”, ”to a small extent” or ”to some extent” were satisfied with the possibility for a private life.

Preparation for the time after discharge

Between 60 and 70 percent replied that the therapists/personnel ”not at all”, ”to a small extent” or ”to some extent” have prepared the patient for the time after discharge, helped the patient with practical issues for the time after discharge, facilitated for further treatment and helped so that the patient could have a meaningful life after discharge.

Other assessments

  • 72 percent of the patients meant that the therapists/personnel had ”not at all”, ”to a small extent” or ”to some extent” cooperated well with the patient’s relatives or relations.
  • More than 40 percent said that the help and treatment at the institution ”not at all”, ”to a small extent” or ”to some extent” made them more able to understand and master their dependency problem.
  • 38 percent replied that the help and the treatment had all in all been ”not at all”, ”to a small extent” or ”to some extent” satisfactory.

Previous admissions

  • 68 percent had been admitted at an institutions previous of this admission.
  • 88 percent replied that the follow-up/aftercare after discharge was ”not at all”, ”to a small extent” or ”to some extent” satisfactory.

Help from the municipality where you live

  • 78 percent replied that they assessed the help previously received from the municipality as ”not at all”, ”to a small extent” or ”to some extent” satisfactory.
  • The dependence adviser and the primary care doctor were stated as the most important bodies/persons.

Conclusion

The survey showed that according to the patients there are large potentials for improvement in several areas. This includes both the institutions the patients are currently admitted to, previous experiences with aftercare after discharge and services received from the municipality. The results are poorer than what is usual in the NOKC’s national user experience surveys, but share some similarities with a national survey among users of residential institutions in mental health care conducted in 2005. There are some areas with good results, e.g. that the patients feel safe at the institution and that they are met with courtesy and respect by the therapists/personnel. The results from the qualitative comments complement and correspond to a large degree with the quantitative results.