Implementation of a familyfocused approach in adult somatic care - PowerPoint PPT Presentation

Bild Towe Hennix Implementation of a familyfocused approach in adult somatic care Kerstin Åkerlund, MSSc, Karolinska university hospital, Stockholm, Sweden

Presentation Background to the study  Results of study 2013-2015  Implementation activities as a result of the study  Implementation of a familyfocused approach in adult somatic care 2 2nd International Young Carers Conference 2017-05-30

Interviews with staff and families Implementation of a familyfocused approach in adult somatic care 3 2nd International Young Carers Conference 2017-05-30

Interviews with staff A difficult issue to inform children about No time for asking I ´ m not used to talking to children about the children This is a familymatter! Where can I refer when I lift the lid? Is there any evidence this is helpful? Implementation of a familyfocused approach in adult somatic care 4 2nd International Young Carers Conference 2017-05-30

Interview with parents It ´ s not enough to give the informatio – they also need Someone to talk to about We never get to their feelings Talking about Bad the sickness consciense … There are limits to what you can do when you are at crisis yourself My first thought when I got my diagnose: What will happen to my children? Implementation of a familyfocused approach in adult somatic care 5 2nd International Young Carers Conference 2017-05-30

Interview with partners What about me - I also need information What shall I do with my worries about my partner, my children and myself? I don ´ t want to worry the kids Difficult matters never spoken about in the family I have to be there for everyone Implementation of a familyfocused approach in adult somatic care 6 2nd International Young Carers Conference 2017-05-30

Interview with children Silence spreads in the family When I heard an ambulance It ´ s a hassle with I had to go and check mum Staff at home Information makes you less worried She doesn`t understand that I am a part of the whole picture Implementation of a familyfocused approach in adult somatic care 7 2nd International Young Carers Conference 2017-05-30

Conclusion of the situation in Stockholm In Stockholm 6000 children under 18 with have a parent with  a serious Neurological illness. They dont ´ t get the councelling and support from healthcare.  Need for evidense based methods for support.  Implementation of a familyfocused approach in adult somatic care 8 2nd International Young Carers Conference 2017-05-30

Information to patients and children Implementation of a familyfocused approach in adult somatic care 9 2nd International Young Carers Conference 2017-05-30

Background – a pilot study 2012-14 Insurance medicine department Department of Neurology Kristina Alexandersson Kerstin Åkerlund, project manager  MSSc, licenced psychotherapist, Professor  Head of unit for councelling and support Petter Tinghög Tuula Lumikukka PhD   Licenced nurse, Neurological outpatient clinic Katharina Fink Neurologist, PhD  Implementation of a familyfocused approach in adult somatic care 10 2nd International Young Carers Conference 2017-05-30

New procediors Education Intervention from 2011 Information Adequate Improved family The Identification of about support to climate and patients with decirable childrens families who psychic health of children scenario rights need it children Survey to Data Patient Staff Record participants collection survey survey review in 3 methods 2012-14 Needs Implementation of a familyfocused approach in adult somatic care 11 2nd International Young Carers Conference 2017-05-30

Results staff survey 53% answered: (63% doctors , 47% nurses) 100 90 80 70 60 Totalt Total 50 Läkare Doctors Sjuksköterskor Nurses 40 30 20 10 0 Did you get information about your obligations to Do you ask about the children? Har du fått information om att du ska identifiera om Brukar du alltid eller ofta fråga patienterna om ask about the children? patienter har minderåriga barn? han/hon har minderåriga barn? Implementation of a familyfocused approach in adult somatic care 12 2nd International Young Carers Conference 2017-05-30

Results patients survey 100 90 80 70 60 50 Totalt Total 40 MS patienter MS patients 30 20 10 0 Patienten har inte fått information Don ´ t know about their Need more support as a sick Patienten anser inte ha det stöd som Patienten anser inte att deras barn My children need more support as children ´ s right to information om sitt barns rätt till stöd parent: behövs för att utöva sin föräldraroll next a kin har det stöd de behöver för att hantera situationen med en sjuk and support : förälder Implementation of a familyfocused approach in adult somatic care 13 2nd International Young Carers Conference 2017-05-30

Children with clinically significant symprtoms, parent ´ s version of SDQ (cut off >11) 90 80 70 60 Barn till neurologiska patienter (n=28) Children in this survey n=28 50 Barn till MS patienter (n=17) As above; with parents with MS n=17 Referenspopulation (n=257) Ref.population n= 257 40 Klinisk referenspopulation (n=221) Clinic.ref.pop. N=221 30 20 10 0 Implementation of a familyfocused approach in adult somatic care 14 2nd International Young Carers Conference 2017-05-30

Record review documentation following routine if patients have children? 2012 2013 20% 17% Somewhere Somewhere 4% 2% In the right place In the right place Implementation of a familyfocused approach in adult somatic care 15 2nd International Young Carers Conference 2017-05-30

Three methods Let ´ s talk about the children • Conversation with parents about their children Beardslee ´ s family intervention • With the whole family BRA • Conversation with the children Implementation of a familyfocused approach in adult somatic care Ny kunskap om utsatta barn 2015 16 2nd International Young Carers Conference 2017-05-30

Conclusion  Routines for documentation are not followed Patients are not aware of their childrens right ´ s  Both patients and their children seem to have a need for further councelling  and support Need for continued studies about methods for support  Need for further implementation stratgies  Implementation of a familyfocused approach in adult somatic care 17 2nd International Young Carers Conference 2017-05-30

Model for implementation 2015 New keyword for Medical record  Target behaviour of staff, that is possible to measure   Implementationplan, out of 3 identified hindrances Implementation of a familyfocused approach in adult somatic care 18 2nd International Young Carers Conference 2017-05-30

1. Problem : Lack of support from the leaders Solution: Information about the: – routines for documentation in the clinic – result of the study – strategy of implementation 2. Problem: Patients are lacking knowledge and motivation regarding their right to get support Solution: Poster in the waiting room Further information about where to turn for help Information to staff in meetings Children ´ s corner in all units at the clinic are looked over 3. Problem: Culture at the clinic doesn ´ t support the matter Solution: Poster directed to staff in staff areas Card with routine and advice in all rooms for meeting with patinets Pins for children ´ s Ombudman New keyword added in medical record Implementation of a familyfocused approach in adult somatic care 19 2nd International Young Carers Conference 2017-05-30

Thank you for your attention! kerstin.akerlund@sll.se Implementation of a familyfocused approach in adult somatic care 20 2nd International Young Carers Conference 2017-05-30