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PasOpp-rapport

Inpatients’ experiences with interdisciplinary treatment for substance dependence – results from a national survey 2014

  • Year: 2014
  • Authors
  • ISSN (digital): 1890-1565
  • ISBN (digital): 978-82-8121-906-9


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Key message

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

The patients reported most positive experiences with:

• The way they were met at the institution

• To be met with courtesy and respect

• To feel safe in the institution

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

• Enough time for conversations and contact with the therapists and the personnel

• Benefits of group therapy or medical treatment

• 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

• Co-operation with relatives or relations

Follow-up/aftercare after discharge and help from the municipality are also areas with a large potential for improvements.

The results from the qualitative comments correspond well both with the topics in the questionnaire and with the quantitative results.

 

Summary

Executive summary

Background

Patient experiences within interdisciplinary treatment for substance dependence is one of the directing parameters from the Ministry of Health and Care Services to the regional health authorities for 2014. 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 2014.

The purpose of the survey was to obtain systematic information regarding 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. The survey was conducted in all institutions during one day in week 37, 2014. All patients present in the included institutions received the questionnaire on a previously agreed upon day. A responsible person at the institutions could exclude patients due to ethical considerations.

The survey was carried out while the patients were admitted to residential institutions within interdisciplinary treatment for substance dependence. This method implied that the NOKC sent a given number of questionnaires to each institution, while the institutions’ personnel distributed the questionnaires to their patients. The personnel also collected the completed questionnaires. The survey was conducted as a cross-sectional survey, i.e. all patients in each institution were asked to participate on the same day. The survey was an anonymous quality assurance project. The institutions did not register participating patients, and the NOKC could create an anonymous dataset without any personal data, other than what the patients replied to background questions in the questionnaire.

The questionnaire was developed through the NOKC’s standard methods and tested through a pilot survey. It was identical with the questionnaire utilized in last year’s survey in the same population. The patients were asked to write more about their experiences at the institution and previous experiences with received help from the municipality in two open questions in the questionnaire.

The NOKC received information from the institutions regarding their number of patients on the day they carried out the survey: 1279 patients in 101 institutions. Five of the included institutions did not participate in the survey. Out of the 1279 patients, 23 were excluded by the person responsible at the institutions (ethical considerations), 143 patients were not present at the institution when the survey was distributed. This gives a total of 166 patients who were excluded from the survey, and the corrected sample consisted of 1113 patients.

The NOKC received 1017 completed questionnaires. The response rate was calculated to 91 percent.

Results

Reception and waiting time

• 40 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 arrived.

• 23 percent replied in the same three categories to the question about whether they were received at the institution in a satisfactory manner.

• 32 percent replied that they had to wait “yes, too long”, or “yes, quite long”, while 54 percent said that they had to wait “but not long” to get an offer from the institution.

The therapists/personnel

• 48 percent of the patients replied that they “not at all”, “to a small extent” or “to some extent” have had enough time for conversations and contact with the therapists/personnel.

• 43 percent replied in the same three categories to the question about whether the therapists/personnel have understood the patient’s situation or not.

• 40 percent replied in the same three categories to a question about whether they had confidence in the therapists’/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.

• 21 percent replied in the same three categories on a question about whether they have been met with courtesy and respect or not.

• 27 percent said that they “many times” or “some times” have been treated patronizingly or offensively by the therapists/personnel.

The treatment

• 60 percent said they had “no benefit”, “little benefit” or “some benefit” from medical treatment at the institution.

• 35 percent replied on the overarching question about treatment that they had “no benefit”, “little benefit” or “some benefit” 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, felt that the treatment has been adapted to the patient’s need and have had influence on their own treatment.

• 65 and 63 percent replied that they “not at all”, “to a small extent” or “to some extent” have received help for their psychological or physical problems, respectively.

• 54 and 55 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

• 48 percent assessed the activities at the institution as “not at all”, “to a small extent” or “to some extent” satisfactory.

• 44 percent replied in the same three categories on the question about how satisfactory the possibility for a private life was.

• 33 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.

• 30 percent assessed their satisfaction with the meals at the institution in the same three categories.

• 17 percent replied that they “not at all”, “to a small extent” or “to some extent” have felt safe at the institution.

Preparation for the time after discharge

• 72 percent replied that they “not at all”, “to a small extent” or “to some extent” felt that the therapists/personnel had helped them with practical issues for the time after discharge.

• 65 and 66 percent, respectively, replied that the therapists/personnel had “not at all”, “to a small extent” or “to some extent” facilitated for further treatment and prepared the patient for the time after discharge.

• 61 percent replied in the same three categories regarding whether the therapists/personnel had helped so that the patient could have a meaningful life after discharge.

Other assessments

• 73 percent of the patients meant that the therapists/personnel had “not at all”, “to a small extent” or “to some extent” co-operated well with the patient’s relatives or relations.

• Between 41 and 46 percent said that the help and treatment at the institution “not at all”, “to a small extent” or “to some extent” have given them faith in a better life after discharge, and made them more able to understand and master their dependency problem.

• 34 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

• 66 percent had been admitted at an institution prior to this admission.

• 86 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

• 77 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 it is, according to the patients, a large potential for improvement in several areas the survey covers. This includes both the institutions the patients were admitted to when they filled out the questionnaire, and 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, however the results from the 2014-survey corresponds to a large extent with the results from the 2013-survey in the same population. Results that stand out positively are related to the way the patients were received at the institution, to be met with courtesy and respect by the therapists/personnel and to feel safe at the institution.