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Inställningen till vårdprogram bland personal inom barn- och ungdomspsykiatrin i Östergötland: en kompletterande intervjustudie
Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-3300-5516
2007 (Swedish)Report (Other academic)
Abstract [sv]

Utvärderingen av introduktionen av vårdprogram inom barn- och ungdomspsykiatrin i Östergötland (BUP i Östergötland) har pågått i omgångar sedan 1998. Det var då som den dåvarande ledningen tog kontakt med CMT för att initiera en utvärdering av ett utvecklingsarbete som just skulle påbörjas. Det går att hitta flera ovanliga inslag i de nu genomförda utvärderingsstudierna. För det första, att utvärderingen initierades i ett tidigt skede och utvärderarna inbjöds att följa arbetet från starten (vilket tyvärr inte alltid är fallet). För det andra att medlemmar i organisationen engagerat sig i arbetet och på olika sätt positivt underlättat detta (förekommer inte heller alltid). För det tredje, att enkätundersökningarna lades upp som totalundersökningar där all personal deltog (vanligtvis gör man olika slags urval). För det fjärde, att kvantitativa och kvalitativa metoder har kunnat kombineras i tre olika studier (trots diskussioner om ”metodtriangulering” under drygt 10 års tid är det fortfarande inte helt vanligt). Författaren riktar ett tack till de medarbetare vid BUP i Östergötland som ställt sin tid till förfogande för intervjuer. Ett särskilt tack riktas till referensgruppen för den aktuella studien: Marianne Helgesson, Per Gustafsson, Maria Varenhorst, och Birgitta Widén-Arana.

Linköping 2006-12-11

Peter Garpenby

Abstract [en]

Background

In 1998 the child and adolescent psychiatry service in the County Council of Östergötland initiated the process of developing their own evidence-based clinical guidelines. By 2006 seven guidelines had been formulated and were published. In 1999 (just before the first guideline was published) and again in 2003, the Center for Medical Technology Assessment (CMT) at Linköping University conducted surveys of the views of members of staff working in the child and adolescent psychiatry service on the process of guideline development and the usefulness of the guidelines. The two surveys indicated differences between professional groups in their evaluation of the usefulness. In order to provide further understanding of the results of the quantitative studies, a qualitative follow-up study was initiated.

Methods

In 2006 interviews were carried out with different categories of professionals working in child and adolescent psychiatry in clinical outpatient teams. A purposive sample of 17 professionals (5 psychiatrists, 6 psychologists and 6 social workers) were interviewed regarding their view of the local clinical guidelines (vårdprogram). The interviews addressed the issues of the application of knowledge in general in child and adolescent psychiatry, the criteria used in developing the clinical guidelines, personal experience of using the guidelines in clinical work, and the implementation of the guidelines in the local organisation.

Results

The views of the staff on the development and use of the clinical guidelines vary from those who regard evidence-based practice as the primary method the organisation should follow, to those who consider the guidelines of limited value as they only cover a minor part of the methods in use in child and adolescent psychiatry today. Few of the participants in the study used the guidelines as a “recipe book” in their daily clinical work Some of those interviewed felt uneasy about the implementation of guidelines as a type of standardised clinical practice. Irrespective of the participants’ view of the usefulness in their daily work, many acknowledged the potential of the guidelines as part of a larger process to enhance the development of knowledge in the local organisation. Obstacles to implementing such a process in the organisation were also recognised, mainly the lack of time for group discussions.

Conclusions

The findings highlight a situation in which the implementation of the guidelines depends to a large extent on the individual members of staff. Among the different professionals there are many who would like to see the guidelines become an integral part of a collective process of continuous learning.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2007. , 42 p.
Series
CMT Report, ISSN 0283-1228 (print), 1653-7556 (online) ; 2007:1
Keyword [en]
Child psychiatry, adolescent psychiatry
Keyword [sv]
Barnpsykiatri, ungdomspsykiatri
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-40748ISRN: LIU CMT RA/0701Local ID: 54030OAI: oai:DiVA.org:liu-40748DiVA: diva2:261597
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2014-10-27Bibliographically approved

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Inställningen till vårdprogram bland personal inom barn- och ungdomspsykiatrin i Östergötland : en kompletterande intervjustudie(320 kB)521 downloads
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CiteExportLink to record
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