Development of a novel outcome measure for forensic mental health services
<p>Forensic mental health services provide care to people in secure psychiatric hospitals and specialised community teams. Such services are typically low-volume and high cost, often highly restrictive and average length of stay is long. Measuring the outcomes of care is important to safeguard...
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| Format: | Thesis |
| Language: | English |
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2021
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| _version_ | 1826316398088945664 |
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| author | Ryland, H |
| author2 | Fazel, S |
| author_facet | Fazel, S Ryland, H |
| author_sort | Ryland, H |
| collection | OXFORD |
| description | <p>Forensic mental health services provide care to people in secure psychiatric hospitals and specialised community teams. Such services are typically low-volume and high cost, often highly restrictive and average length of stay is long. Measuring the outcomes of care is important to safeguard patients and the public, monitor progress, inform treatment plans and support service evaluation. Despite this, little is known about which outcomes are most important and existing outcome measures have focused on clinical risk and symptoms, neglecting functioning and quality of life, with limited patient input to their design or reporting. The overall aim of this study was to develop a new empirically-based outcome measure for forensic mental health services. Over four hundred existing instruments were identified and the quality of ten was assessed in detail. The evidence base for their use as outcome measures in forensic mental health services was limited. Clinicians judged these same ten instruments to be unsatisfactory in terms of content validity. Thematic analysis was used to develop an outcomes framework based on patient interviews and multi-stakeholder focus groups. Forty-two outcomes were identified in the six domains of ‘about me, my quality of life, my health, my safety and risk, my life skills and my progress’. In a Delphi process to prioritise these outcomes eight of the top fifteen outcomes were shared between patients/carers and professionals. Based on these results, a new outcome measure, the FORensic oUtcome Measure (FORUM), was developed, including both patient reported and clinician reported questionnaires. In a sample of 62 patients and 35 clinicians encouraging evidence of validity and reliability was established. Feedback from both patients and clinicians indicate that the FORUM is easy to use, comprehensive and relevant. These results indicate that the FORUM is a promising new instrument to measure outcomes in forensic mental health services.</p> |
| first_indexed | 2024-03-06T21:10:05Z |
| format | Thesis |
| id | oxford-uuid:3dd33e98-39d7-4623-b12f-7d03678f937a |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-12-09T03:44:26Z |
| publishDate | 2021 |
| record_format | dspace |
| spelling | oxford-uuid:3dd33e98-39d7-4623-b12f-7d03678f937a2024-12-07T15:53:15ZDevelopment of a novel outcome measure for forensic mental health servicesThesishttp://purl.org/coar/resource_type/c_db06uuid:3dd33e98-39d7-4623-b12f-7d03678f937aPsychiatryEnglishHyrax Deposit2021Ryland, HFazel, SFitzpatrick, RCook, J<p>Forensic mental health services provide care to people in secure psychiatric hospitals and specialised community teams. Such services are typically low-volume and high cost, often highly restrictive and average length of stay is long. Measuring the outcomes of care is important to safeguard patients and the public, monitor progress, inform treatment plans and support service evaluation. Despite this, little is known about which outcomes are most important and existing outcome measures have focused on clinical risk and symptoms, neglecting functioning and quality of life, with limited patient input to their design or reporting. The overall aim of this study was to develop a new empirically-based outcome measure for forensic mental health services. Over four hundred existing instruments were identified and the quality of ten was assessed in detail. The evidence base for their use as outcome measures in forensic mental health services was limited. Clinicians judged these same ten instruments to be unsatisfactory in terms of content validity. Thematic analysis was used to develop an outcomes framework based on patient interviews and multi-stakeholder focus groups. Forty-two outcomes were identified in the six domains of ‘about me, my quality of life, my health, my safety and risk, my life skills and my progress’. In a Delphi process to prioritise these outcomes eight of the top fifteen outcomes were shared between patients/carers and professionals. Based on these results, a new outcome measure, the FORensic oUtcome Measure (FORUM), was developed, including both patient reported and clinician reported questionnaires. In a sample of 62 patients and 35 clinicians encouraging evidence of validity and reliability was established. Feedback from both patients and clinicians indicate that the FORUM is easy to use, comprehensive and relevant. These results indicate that the FORUM is a promising new instrument to measure outcomes in forensic mental health services.</p> |
| spellingShingle | Psychiatry Ryland, H Development of a novel outcome measure for forensic mental health services |
| title | Development of a novel outcome measure for forensic mental health services |
| title_full | Development of a novel outcome measure for forensic mental health services |
| title_fullStr | Development of a novel outcome measure for forensic mental health services |
| title_full_unstemmed | Development of a novel outcome measure for forensic mental health services |
| title_short | Development of a novel outcome measure for forensic mental health services |
| title_sort | development of a novel outcome measure for forensic mental health services |
| topic | Psychiatry |
| work_keys_str_mv | AT rylandh developmentofanoveloutcomemeasureforforensicmentalhealthservices |