Developing guidelines for caring for psychiatric patients with the risk of committing violence. By using participatory case management in the community

Abstract

 Objective : 1) To study the situation of patients with mental illness in the group at risk of committing violence (SMI-V) in the community of Nangiu Subdistrict. 2) To develop guidelines for caring for patients with psychiatric illness who are at risk of committing violence. by using participatory case management in the community and 3) to study the results of care for psychiatric patients at risk of committing violence. By using participatory case management in the community. Methods : This research is participatory action research5. By using the concept of continuous quality improvement (Continuous Quality Improvement: CQI) as a mechanism for improving quality.  and the concept of service quality assessment of Edward Deming Cycle6 to evaluate structural relationships.  Process and results  Education is divided into cycles. Each cycle is divided into 3 phases. Phase 1 is an analysis of the care situation for psychiatric patients at risk of committing violence. From the perspective of service users and health care providers Phase 2 is the development of a service system for caring for patients with psychiatric illnesses who are at risk of committing violence in families with psychiatric patients. Phase 3 is evaluating the results of care for patients with psychiatric illnesses who are at risk of committing violence. and collected data using in-depth interviews.  Participatory and non-participant observation  workshop  group chat  data analysis  Qualitative data used content analysis. Quantitative data used descriptive statistics. Results : Four important issues were found from service providers and service users as follows: 1) Continuity of data It was found that service users reflected on receiving information that was not specific to their problems and care needs. 2) Continuity of administration Found a problem in the lack of information transfer between teams. and health care providers and family members Including the lack of participation in care planning. and guidelines for caring for psychiatric patients at risk of committing violence. Lack of understanding in using assessment tools 3) Continuity of care within the community It was found that the relationship of patients and families to the community affects their participation in patient care. 4) In terms of continuity of care within the health team, it was found that The health team does not have clear divisions of roles and responsibilities. Lack of understanding of teamwork Lack of recording information for communication Including the lack of skills in evaluating problems and participation in planning and common goals. Conclusion : Results of the development of the care service system In families with psychiatric patients, it was found that the results of care performance scores of health care providers in families with psychiatric patients has increased more than before the development  The mean scores after the operation were higher than before the operation (Mean 4.80 and Mean = 2.83), respectively, resulting in increased satisfaction levels of service users. It was found that the mean satisfaction score after the operation was higher than the satisfaction score before the operation (Mean = 4.4 and Mean = 3.8), respectively.