Einbeziehung von Bezugspersonen im Rahmen eines psychiatrisch-stationären Behandlungsverlaufes: Eine repräsentative Befragung von Patienten, Bezugspersonen und den behandelnden Psychiatern

Aims Studies on the frequency of caregiver involvement in representative inpatient samples are scarce. The aim of our study was to conduct a representative survey on caregiver involvement in routine inpatient care involving all 3 parties (patients, caregivers, psychiatrists). Therefore, we performed face-to-face interviews consisting of open-ended questions to gain a deeper understanding of when and how caregivers are involved in care treatment and identify which topics are mainly discussed. Methods This cross-sectional survey included inpatients from 55 acute psychiatric wards across 10 psychiatric hospitals, their treating psychiatrists and, when possible, their caregivers. In total, we performed semi-structured face-to-face interviews with 247 patients, their treating psychiatrists and 94 informal caregivers. Each psychiatrist named 2-3 patients that were almost ready to be discharged. After a patient had given its informed consent, the interview was performed by a researcher. In addition, the psychiatrist and, when possible, the primary caregiver outlined by the patient, were also interviewed. Results According to the interviewed patients and psychiatrists contact between caregiver and psychiatrist had taken place in only one third of the patient cases. Predictors for physician-caregiver-contact included the patient's diagnosis, the number of previous inpatient stays and the respective hospital. According to psychiatrists the most frequent subjects of discussion with caregivers involved therapeutic issues and organizational and social-psychiatric topics (e. g. work, living and social support). In fact, patients and caregivers stated that the psychiatric treatment and the diagnostic classification of the mental illness were the most frequent topics of conversation. For all three groups the most often cited reason for missed caregiver involvement was the subjective perception that a caregiver was not in fact needed. Conclusion Whether caregivers were contacted and involved during an inpatient stay strongly depended on the individual hospital. The frequency of involvement of caregivers can certainly be increased by changing processes and structures in hospitals. All three parties (patients, caregivers, and psychiatrists) most often stated that the caregiver was not involved in the treatment because they thought it was unnecessary. Therefore, because evidence demonstrates the positive effect of caregivers' involvement on the therapeutic process but also on the well-being of the caregiver, it is necessary to increase awareness of this evidence among all three stakeholder groups.