Extrait

Background and study aims The benefit of psychiatric treatment is strongly influenced by the quality of the relationship between the psychiatrist and the patient. This can be an even stronger effect than the effect of medication or other treatments. The quality of psychiatrist-patient communication also influences adherence to treatment. However, communication often breaks down in consultations with psychotic patients because their unusual experiences (e.g., hallucinations, delusions) lie outside of ordinary human experience. Until recently, there was a lack of evidence about good communication with such patients. In previous studies we have shown that effective psychiatrist communication with psychotic patients depends on how well psychiatrists try to understand the patient’s psychotic experiences. Moreover, we have shown that this leads to a better patient outcome (i.e., higher patient satisfaction), a better therapeutic relationship and treatment adherence, and fewer relapses. We will use our findings to develop a new intervention to train psychiatrists in communicating with patients who experience hallucinations and delusions. The training package will be developed with and delivered in collaboration with service users and psychiatrists. Psychiatrists will learn specific communicative strategies to help them reach a shared understanding with their patients about psychotic symptoms. We will test the training package to assess feasibility and determine how we could conduct a larger study using these methods. We will identify whether psychiatrists can improve their communication skills through training, whether they can use these skills appropriately in consultations with psychotic patients, and whether this improves patient clinical outcomes. Who can participate? Higher/advanced psychiatric trainees and patients aged 18 - 65 with schizophrenia or schizoaffective disorder. What does the study involve? Psychiatrists are randomly allocated to one of two groups. One group undergoes the training programme and the other does not. The training programme consists of four training sessions taking place one week apart and lasting 4 hours each. During the training period, at least one consultation with a participating patient per psychiatrist is recorded for training purposes. These consultations are viewed and psychiatrists receive and discuss feedback in the training sessions. There are also follow-up sessions four and eight weeks after the fourth training session. At the end of the training the next consultation between each participating psychiatrist and patient is recorded and assessed. What are the possible benefits and risks of participating? Not provided at time of registration Where is the study run from? Newham Centre for Mental Health, East London NHS Foundation Trust and North East London NHS Foundation Trust (UK) When is the study starting and how long is it expected to run for? March 2010 to March 2013 Who is funding the study? National Institute for Health Research (NIHR) (UK) Who is the main contact? Rose McCabe [email protected]

Critère d'inclusion

• Schizophrenia / Schizoaffective disorder

Liens

• ictrp
• isrctn