Construction of the Therapeutic Alliance Between Inpatient Psychiatric Patients and Nurses (ATIASP)

Levers and Brakes to the Therapeutic Alliance Between Patients in Hospital Full-time Psychiatric and Nurses and Caregivers

Clarify the determinants of the construction of a Therapeutic Alliance (AT) between paramedical staff (nurses and caregivers ) and adult patients in a functional unit of full-time general psychiatric Whether the quality of Therapeutic Alliance influences the continued support outpatient , after completion of full-time hospitalization.

Study Overview

• Status: Completed
• Conditions: Psychiatric Diseases

Detailed Description

This is a prospective, observational, multicenter inpatient units Parisian full time of the Etablissement Public Health White House (spread over 4 sites).

The study seeks to collect, on the one hand the level of AT obtained at the end of hospitalization in general adult psychiatry and, secondly, to understand how this one was built.

The AT will be measured:

• Firstly by the self-administered questionnaire STAR-P, translated into French by the "translation / back-translation" method.
• Secondly through semi-structured qualitative interviews, conducted at discharge by a health care setting or a specially trained and who did not participate directly in the patient's care included. Indeed, the questionnaires allow, through scales to measure the AT quantitative way through proposals (items) presented as so, and look for associations with some predefined decisive.

However, it is difficult to explore more complex combination of mechanisms. Conducting interviews can meet this goal. An interview grid will be conducted and organized around the search for representations and affects related relational patient / nurse(s) and caregiver(s) in the context of hospital care. The interviews will be recorded and fully transcribed. A thematic analysis will be conducted to identify the objects and themes. The inclusions in this qualitative analysis will stop when reaching the saturation process. In this type of study, it is generally necessary to include thirty people to reach saturation.

Finally, semi-structured group interviews (focus group) will be conducted by co-investigators and doctoral student psychologist caregivers with the discussion topic imposed: the AT construction. They will be directed to paramedics caregivers (nurses and caregivers) are not part of the investigation team conducting research but actively involved in care. Their goal will be to harvest their representations regarding the quality of the therapeutic relationship they're trying to build with patients. A focus group will be conducted by site (4 sites), with 5 to 12 volunteers per group.

• Study Type: Observational
• Enrollment (Actual): 240

Contacts and Locations

Study Locations

• France
  • Paris, France, 75018
    • EPS Maison Blanche

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

adult patient suffer from pyschiatric diseases except perversion disorder or paranoia

Description

Inclusion Criteria:

• adult patient (>18 years old)
• Adult psychiatric inpatients

Exclusion Criteria:

• Patients carrying perversion disorder or paranoia
• Patients trust whose legal representative refuses participation in the survey
• patients non covered by the french health system
• non consenting patients

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Therapeutic Alliance score overall with self-administered questionnaire STAR-P	AT score overall, committed to using the self-administered questionnaire STAR-P particularly suitable for "patients with severe psychiatric disorders" (Rebecca, 2007).	day 0

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of patients reviewed in outpatient psychiatric consultation		three months after hospital discharge.
AT evaluated in patients using semi-structured interviews	AT evaluated in patients using semi-structured interviews (20-40 minutes), led with an interview grid: research of representations and affects related relational patient / nurse (s) and caregiver ( s) under hospital care.	day 0
AT evaluated in / nurse (s) and caregiver(s)	AT evaluated in / nurse (s) and caregiver (s), through focus group: Research performances and determinants of therapeutic alliance with caregivers.	month 6
Determinants of AT studied	socio-demographic characteristics (age, sex, socio-professional category (CSP), educational level, profession last exercised, wage level; Marital Status; Place of birth); primary psychiatric diagnosis (ICD-10); Companion diagnostics; Total number of psychiatric hospitalizations prior to the study; which stays in Difficult Patient Unit (UMD) in Free Care, in care without consent, or at the request of a representative of the state); Stay in therapeutic isolation room during hospitalization; Length of hospital stay; Supported by a referent nurse; Highlights in the treatment period and that could presuppose an impact on the quality of care	day 0
intermediate score STAR-P: score of positive collaboration		day 0
intermediate scores STAR-P: positive contribution score		day 0
intermediate scores STAR-P: uncooperative intake score of the nursing team and caregiver		day 0

Collaborators and Investigators

• Sponsor: Assistance Publique - Hôpitaux de Paris
• Investigators: Principal Investigator: Jean-Manuel Morvillers, PhD, centre hospitalier Maison Blanche

Study record dates

Study Major Dates

• Study Start (Actual): November 6, 2015
• Primary Completion (Actual): January 11, 2018
• Study Completion (Actual): June 1, 2018

Study Registration Dates

• First Submitted: March 16, 2016
• First Submitted That Met QC Criteria: May 9, 2016
• First Posted (Estimate): May 11, 2016

Study Record Updates

• Last Update Posted (Actual): August 13, 2018
• Last Update Submitted That Met QC Criteria: August 10, 2018
• Last Verified: July 1, 2018

More Information

Terms related to this study

• Keywords: severe mental illness; nursing; therapeutic alliance; psychiatric diseases
• Additional Relevant MeSH Terms: Mental Disorders
• Other Study ID Numbers: PHRIP 1300036N

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

IPD Plan Description

At the end of the study, patient could be informed of result of the study if they wish.

No individual result will be communicate.