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Outcome Measures in Mental Health Physiotherapy A Clinician’s Perspective

This article explores the application of outcome measures in mental health physiotherapy, including commonly used metrics, setting baselines, and understanding the relevance of outcomes. It also discusses the challenges of clustering mental and behavioral problems and the importance of individualized treatment.

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Outcome Measures in Mental Health Physiotherapy A Clinician’s Perspective

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  1. Outcome Measures in Mental Health PhysiotherapyA Clinician’s Perspective By Jean Picton-Bentley Lead Physiotherapist Ross FarmerHead of Physiotherapy & Clinical Exercise

  2. Aims • Application of outcome measures to a mental health setting • Commonly used metrics • Setting baselines & understanding our practice • National comparison vs individual patients

  3. MH Outcome Measures • Outcomes are important... ... but are they relevant? • Do they explain why our interventions work?

  4. HoNAS / Clustering • Overactive, aggressive, disruptive or agitated behaviour • Non-accidental self injury • Problem-drinking or drug-taking • Cognitive problems • Physical illness or disability problems • Problems associated with hallucinations and delusions

  5. HoNAS / Clustering 7. Problems with depressed mood 8. Other mental and behavioural problems 9. Problems with relationships 10. Problems with activities of daily living 11. Problems with living conditions 12. Problems with occupation and activities 13. Strong unreasonable beliefs occurring in non-psychotic disorders only

  6. What we do... ...setting baselines • South London & Maudsley • Why do people refer to MH physiotherapy? • What do people refer to MH physiotherapy? • TIM study; band / contact time • Is there an unmet need within psychosis? • CPMH National Audit

  7. Healthcare Quality • Healthcare involves interaction between medical professionals and patients. Each have a role to play Donabedian 1968 • 3 key viewpoints / stakeholders; physicians, purchasers & patients McGlynn 1997 • Healthcare can be viewed as; • Structure conduit to healthcare • Process clinician/patient relationship • Outcome care provided & manner received Campbell et al. 2000 Patient Satisfaction Systematic Review 2012

  8. Social Constructivism • “A theory which explains how apparently neutral or biologically determined social decisions are created by contemporary social values, beliefs and attitudes” • E.g. Professionalization • Even after legitimate power has been lost, power gains can still be made by maintaining a mass appeal and a wide ranging morale terrain Halliday 1985

  9. Legislation • NHS core principles: should meet the needs of everyone NHS Choices • Conflict between meeting the needs of the individual and that of the nation Campbell et al. 2000 • NHS patient survey commenced 1997 The New NHS • NICE introduced 1998 A First Class Service • LINks The Local Government Involvement Act 2007

  10. Individualised Treatment / PROMs / Patient Centred Goals / Service user involvement

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