Jackie Wales, Nicola Brewin, Iain Williamson, Jakub Štický, Rachael Lawrence and Alison Eivors
Effective transitions from child and adolescent to adult services are important for continuity of care for patients with eating disorders. This study aims to examine the relative…
Abstract
Purpose
Effective transitions from child and adolescent to adult services are important for continuity of care for patients with eating disorders. This study aims to examine the relative importance of a series of statements about the transition process, elicited from an earlier service evaluation, from the perspectives of patients, parents/carers and clinicians.
Design/methodology/approach
Twenty-eight participants completed a Q-sort task ranking 40 statements, developed from an earlier study, using a normal distribution pattern on a scale, which ranged from strongly agree to strongly disagree, to identify their priorities for transition. Analysis resulted in the extraction of four factors explaining 52% of the variance.
Findings
Four distinct factors were elicited: “parents and carers need including too”, “facilitating effective transfer between services”, “supporting the patient through transition” and providing “timely, patient-centred care”. The study enabled similarities and differences in priorities to be observed for the three respondent groups.
Practical implications
These rankings, noting the differences between the respondent groups, can be used to inform the development of effective transition protocols. This study suggests these protocols should ensure a person-centred approach; timely planning; include parents/carers; provide continuous care and have good transfer of information and sensible timing of transitions. Differences in priorities/opinions can be addressed through open communication channels.
Originality/value
To the best of the authors’ knowledge, this is the first UK-wide study examining priorities for transition from the perspectives of patients, parents/carers and clinicians.
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Keywords
Jackie Wales, Nicola Brewin, Karima Susi, Alison Eivors, Debbie Whight and Rheanne Leatherland
There is a dearth of research on what constitutes effective transfer of care from children’s and young people services to adult services for patients with eating disorders (EDs…
Abstract
Purpose
There is a dearth of research on what constitutes effective transfer of care from children’s and young people services to adult services for patients with eating disorders (EDs) in the UK. Transition has implications for continuity of care and particularly for early intervention which has the best prognosis. The purpose of this paper is to understand the experience of transition and identify facilitators and barriers to this.
Design/methodology/approach
Qualitative methodology was used. Focus groups (n = 4) were held with clinicians (n = 22) working in Child and Adolescent Mental Health Services or adult ED services. Individual interviews were conducted with patients (n = 5) who had commenced/completed transition to adult services and with parents/carers (n = 6) of patients invited for interview.
Findings
A number of factors may facilitate or impede transition and can be grouped into the broad themes of communication, managing the differences between services and timing of transition. Improvements in communication, clear explanation of service differences and flexibility around the timing of transitions may enhance the experience for patients and parents/carers.
Research limitations/implications
The service evaluation was limited to transition between two specialist ED services in one geographical location. The findings provide the basis for a wider research study to examine which factors are most important when planning transition from the perspectives of patients, parents/carers and clinicians.
Originality/value
This is the first study examining ED transitions in the UK. It provides valuable insight of the experience of service users and carers and highlights potential improvements when planning transitions for this patient group.
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Alison Byrne and Lorraine Swords
Mental health difficulties are often stigmatised because of situated ways of talking that become taken-for-granted “truths”. Against this backdrop, identities of those affected…
Abstract
Purpose
Mental health difficulties are often stigmatised because of situated ways of talking that become taken-for-granted “truths”. Against this backdrop, identities of those affected are constructed. The purpose of this paper is to explore identities of former inpatients at an Irish Child and Adolescent Mental Health Service.
Design/methodology/approach
Ten young people (aged 18-22) participated in discussions and their discourse was analysed using a critical discursive perspective.
Findings
Three key identities emerged: a hidden identity, a misunderstood identity and the struggle for a re-claimed identity.
Research limitations/implications
Findings indicate the power of discourse in creating stigma and the need for mental health professionals to draw on empowering discourses to help service-users construct positive identities. The importance of involving service-users in research is also implicated.
Originality/value
This research involves service-users who are increasingly, although not traditionally, involved in research. Use of qualitative methodology allows their voices to be heard and gives meaning to their experiences.