TITLE

Implementing clinical guidelines in psychiatry: a qualitative study of perceived facilitators and barriers

AUTHOR(S)
Forsner, Tord; Hansson, Johan; Brommels, Mats; Wistedt, Anna Åberg; Forsell, Yvonne
PUB. DATE
January 2010
SOURCE
BMC Psychiatry;2010, Vol. 10, Special section p1
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Translating scientific evidence into daily practice is complex. Clinical guidelines can improve health care delivery, but there are a number of challenges in guideline adoption and implementation. Factors influencing the effective implementation of guidelines remain poorly understood. Understanding of barriers and facilitators is important for development of effective implementation strategies. The aim of this study was to determine perceived facilitators and barriers to guideline implementation and clinical compliance to guidelines for depression in psychiatric care. Methods: This qualitative study was conducted at two psychiatric clinics in Stockholm, Sweden. The implementation activities at one of the clinics included local implementation teams, seminars, regular feedback and academic detailing. The other clinic served as a control and only received guidelines by post. Data were collected from three focus groups and 28 individual, semi-structured interviews. Content analysis was used to identify themes emerging from the interview data. Results: The identified barriers to, and facilitators of, the implementation of guidelines could be classified into three major categories: (1) organizational resources, (2) health care professionals' individual characteristics and (3) perception of guidelines and implementation strategies. The practitioners in the implementation team and at control clinics differed in three main areas: (1) concerns about control over professional practice, (2) beliefs about evidence-based practice and (3) suspicions about financial motives for guideline introduction. Conclusions: Identifying the barriers to, and facilitators of, the adoption of recommendations is an important way of achieving efficient implementation strategies. The findings of this study suggest that the adoption of guidelines may be improved if local health professionals actively participate in an ongoing implementation process and identify efficient strategies to overcome barriers on an organizational and individual level. Getting evidence into practice and implementing clinical guidelines are dependent upon more than practitioners' motivation. There are factors in the local context, e.g. culture and leadership, evaluation, feedback on performance and facilitation, -that are likely to be equally influential.
ACCESSION #
48499883

 

Related Articles

  • Diagnosis Postponed: Shenjing Shuairuo and the Transformation of Psychiatry in Post-Mao China. Lee, Sing // Culture, Medicine & Psychiatry;Sep1999, Vol. 23 Issue 3, p349 

    Building on Arthur Kleinman�s seminal work in Hunan, this paper examines the social context in which shenjing shuairuo (neurasthenia), a ubiquitous psychiatric disease in China prior to 1980, is contested, marginalized, and reconstituted as the popular Western disease of depression among...

  • Subsyndromal depression: prevalence, use of health services and quality of life in an Australian population. Goldney, Robert D.; Fisher, Laura J.; Dal Grande, Eleonora; Taylor, Anne W. // Social Psychiatry & Psychiatric Epidemiology;Apr2004, Vol. 39 Issue 4, p293 

    Background:. A study of the prevalence, use of services and quality of life of those with subsyndromal depression in a random and representative Australian population. Methods:. A face-to-face Health Omnibus survey of 3010 respondents administered the mood module of the PRIME-MD and the SF-36...

  • Collaborative's next focus will be depression.  // GP: General Practitioner;10/27/2003, p16 

    Depression is likely to be the next subject that the National Primary Care Development Team will focus on. Up until now, the team has worked on access to primary care, CHD, COPD and diabetes. The team's head, Derbyshire, England GP Sir John Oldham, said: 'Depression is an area I think we would...

  • The person in the patient. Santhouse, Alastair M. // BMJ: British Medical Journal (International Edition);11/1/2008, Vol. 337 Issue 7677, p1058 

    The author comments on treating patients in psychiatry. He finds that psychiatrists can have flawless paperwork yet fail to understand a patient's problem. He believes that advances in molecular psychiatry can exacerbate the problem of forgetting the person. He explains that a growing number of...

  • Somatic perception, cultural differences and immigration: results from administration of the Modified Somatic Perception Questionnaire (MSPQ) to a sample of immigrants. Bragazzi, Nicola Luigi; Del Puente, Giovanni; Natta, Werner Maria // Psychology Research & Behavior Management;2014, Vol. 7, p161 

    The number of immigrants in Italy has doubled every 10 years from 1972 and Genoa hosts two large communities of immigrants from South America and Africa. We investigated differences in the somatic perception between immigrants and Italians and between South Americans and Africans living in the...

  • Acculturation, Bicultural Identity and Psychiatric Morbidity in Young Turkish Patients in Germany. Soygüt, Gonca; Çakir, Zehra // Turkish Journal of Psychiatry;2009, Vol. 20 Issue 2, p1 

    Objective: This study was designed to examine, with the use of Berry's acculturation concept (2003), personal selfesteem and collective esteem in the acculturation of young Turks in Germany. Further, it was aimed to examine whether ethnic identity is linked to better mental health. Method:...

  • Query.  // CMAJ: Canadian Medical Association Journal;5/8/2007, Vol. 176 Issue 10, p1548 

    The article relates the author's experience in having a marital breakup and professional stress. He believes that the two were interrelated triggers on mental depression and he felt that he actually is suffering from an actual disease. When he was treated by a psychiatrist he was not given any...

  • ECT associated musical hallucinations in an elderly patient: a case report. Janakiraman, Raguraman; Wildgoose, Keith; Seelam, Kalyan // Annals of General Psychiatry;2006, Vol. 5, p10 

    Electro Convulsive Therapy (ECT) is a medical treatment for severe mental illness in which small, carefully controlled electricity is applied to the brain. This electric stimulation is done in conjunction with anesthesia and muscle relaxant medications to produce a mild generalized seizure. This...

  • Mental health literacy and attitudes in a Swedish community sample - investigating the role of personal experience of mental health care. Dahlberg, Karin M.; Waern, Margda; Runeson, Bo // BMC Public Health;2008, Vol. 8 Issue 1, p8 

    Background: Mental ill health is a common condition in the general population, yet only about half of those with a mental disorder have treatment contact. Personal experience may affect attitudes, which in turn influence the help-seeking process. This study investigated differences in mental...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics