Reluctance on the part of mental health professionals constitutes an important barrier to patient participation in care. In order to stimulate person-centeredness in the inpatient care of persons with psychotic illness, we developed and tested an educational intervention for hospital staff (including psychiatrists) at all four wards at the Psychosis Clinic, Sahlgrenska University Hospital in Gothenburg, Sweden. The intervention was co-created by professionals, patients, and researchers using a participatory approach. In addition to lectures and workshops, staff created and implemented small projects to increase person-centeredness on their own wards. A primary focus was to establish a partnership between patient and staff by capturing and utilizing the patient’s narrative to support active engagement in the care process. This included the development of a person-centered care plan. We hypothesized that the intervention would be associated with increased patient empowerment (primary outcome) and satisfaction with care (secondary outcome). A before and after design was used to test group differences in patient empowerment (Empowerment Scale) and consumer satisfaction (UKU-ConSat Rating Scale). All patients receiving inpatient psychosis care during measuring periods were eligible if meeting inclusion criteria of schizophrenia spectrum disorder, age > 18, and ability to comprehend study information. Severe cognitive deficit and inadequate Swedish language skills were exclusion criteria. Data on possible confounding variables including overall health (EQ-5D), symptom burden (PANSS), and functional ability (GAF) were collected alongside outcome measures. ANCOVAs with overall health as a confounding variable showed no group differences regarding empowerment before (n = 50) versus after (n = 49) intervention, sample mean = 2.87/2.99, p = .142, eta2 = .02, CI = -.27–.04. Consumer satisfaction (n = 50/50) was higher in the post-implementation group (4.46 versus 11.71, p = .041 eta2 = .04, CI = -14.17– -.31). The hypothesis regarding the primary outcome, empowerment, was not supported. An increase in the secondary outcome, satisfaction, was observed, although the effect size was small, and results should be interpreted with caution. Findings from this staff educational intervention can inform the development of future studies aimed at improvement of inpatient care for persons with severe mental illness. The trial was retrospectively registered at ClinicalTrials.gov June 9, 2017, identifier: NCT03182283

中文翻译：

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努力以人为本的精神病护理：基于医院的多专业教育干预的结果

精神卫生专业人员的不情愿构成了患者参与护理的重要障碍。为了在精神病患者的住院治疗中激发以人为本，我们在瑞典哥德堡萨尔格伦斯卡大学医院精神病诊所为所有四个病房的医院工作人员（包括精神科医生）开发并测试了一种教育干预措施。干预是由专业人员，患者和研究人员采用参与式方法共同创建的。除讲座和讲习班外，员工还创建并实施了一些小型项目，以提高他们在病房中以人为本的意识。主要重点是通过捕捉和利用患者的叙述来支持患者积极参与护理过程，从而在患者与工作人员之间建立合作关系。这包括制定以人为本的护理计划。我们假设该干预将与增加患者的权能（主要结果）和护理满意度（次要结果）相关。前后设计用于测试患者授权（增强量表）和消费者满意度（UKU-ConSat评分量表）上的组差异。如果符合精神分裂症谱系障碍的入选标准，年龄大于18岁且具有理解研究信息的能力，则在测量期间接受住院精神病护理的所有患者均符合条件。严重的认知缺陷和瑞典语能力不足是排除标准。收集与可能的混淆变量有关的数据，包括总体健康状况（EQ-5D），症状负担（PANSS）和功能能力（GAF）以及结果指标。以整体健康状况为混杂变量的ANCOVA在干预前（n = 50）与干预后（n = 49）的赋权无明显差异，样本均值= 2.87 / 2.99，p = .142，eta2 = .02，CI =-。 27-.04。实施后组的消费者满意度（n = 50/50）较高（4.46对11.71，p = .041 eta2 = .04，CI = -14.17- -.31）。不支持关于主要结果授权的假设。尽管效果的影响很小，但观察到次要结局（满意度）有所提高，因此应谨慎解释结果。从员工的教育干预中发现的结果可以为今后旨在改善重症精神病患者住院治疗的研究提供信息。该试验已于2017年6月9日在ClinicalTrials.gov上进行回顾性注册，标识为：