Therapeutische Beziehung, Behandlungszufriedenheit und Affektveränderungen in Selbst- und Fremdeinschätzung bei Jugendlichen im Verlauf einer stationär-psychiatrischen Behandlung
Objective: Knowledge about the course in therapeutic alliance, patient satisfaction and motivation as well as emotional variability during in-patient psychiatric treatment is essential for a positive outcome. This longitudinal study describes inter-informant agreement between adolescent patients, therapists and nurses related to the process of these components, for different diagnostic subgroups. Method: A sample of N = 27 adolescents (17 females,10 males; aged 14 - 18 years, mean age 16.3) delivered altogether 580 data points during in-patient treatment in the KJP Ulm, Germany, between July and December 2005. Meanwhile therapists delivered 166 and nurses 806 data points. The patient questionnaires consisted of 10 respectively 27 questions at noontime and in the evening. Therapists and nurses questionnaires consisted of 13 questions. Patients and nurses answered the questionnaires twice daily, therapists after each therapy session. Results: Psychometric properties of most of the items and some subscales derived by factor analysis were good. Questioning twice daily during several months was practicable and brought valuable information about the course and variability in emotions, therapeutic alliance, motivation and satisfaction of different subgroups. Average motivation and satisfaction with treatment and therapeutic alliance was high and increased during the stay. Cross informant questioning showed good agreement regarding sadness and happiness, but low agreement regarding anger. Therapists and nurses answers often differed, pointing out the importance of frequent consultations between caregivers. Motivation to stay in treatment was best predicted by the subscales therapeutic alliance (positive correlation) and anger (negative correlation). Conclusion: Evaluation of process characteristics is feasible and should be further developed in clinical routine; regular feedback could optimize youth psychiatric in-patient treatment and improve outcome.
Erstellung / Fertigstellung
Normierte SchlagwörterStationäre psychiatrische Versorgung [GND]
Adolescent psychiatry [MeSH]
Patient satisfaction [MeSH]