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Developing and evaluating psychological provision in the acute hospital setting for patients with chronic respiratory disease

Published online by Cambridge University Press:  01 August 2017

Graham R Thew ,
Jackie MacCallam ,
Paul M Salkovskis  and
Jay Suntharalingam
Graham R Thew*
Affiliation:
Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath BA1 3NG, UK Department of Psychology, University of Bath, Claverton Down, Bath BA2 7AY, UK
Jackie MacCallam
Affiliation:
Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath BA1 3NG, UK
Paul M Salkovskis
Affiliation:
Department of Psychology, University of Bath, Claverton Down, Bath BA2 7AY, UK
Jay Suntharalingam
Affiliation:
Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath BA1 3NG, UK
*
*Author for correspondence: Graham Thew; present address: Oxford Centre for Anxiety Disorders and Trauma, The Old Rectory, Paradise Square, Oxford OX1 1TW, UK. E-mail: graham.thew@psy.ox.ac.uk
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Abstract

Physical health outcomes for patients with long-term conditions can be significantly affected by their psychological wellbeing; those experiencing psychological difficulties are less able to manage symptoms, have a poorer quality of life, and more frequent hospital admissions. National guidance recommends the assessment and treatment of psychological difficulties secondary to respiratory disease, but implementation of this across services is inconsistent. Here, we describe the process and findings of a 9-month study integrating psychological assessment and intervention into an acute respiratory department. The aim of this provision was to provide appropriate interventions for both in-patients and out-patients with identified psychological needs, and to evaluate the impact of these across a range of outcome domains. Psychological assessment and intervention was flexibly implemented as clinically appropriate within the context of the wider multidisciplinary team. Hospital admissions data were collated, and feedback obtained from both patients and staff. Results highlighted that psychological provision was well received by both patients and staff, and was associated with improved patient experiences and a greater focus on holistic care. Of the 73 patients receiving psychology input with at least 1 month of follow-up data, 75% showed a reduction in their admission frequency following intervention. The estimated savings to the wider NHS exceeded the costs of providing psychology input. In light of existing literature, national guidance, and the present findings, we highlight the need for those commissioning and managing respiratory services to consider the various potential benefits of integrating psychological provision for a patient group with high levels of psychological need.

Keywords

respiratoryservice developmentservice evaluationhospital admissionslong-term conditions
Type
Service models and forms of delivery
Information
the Cognitive Behaviour Therapist , Volume 10 , 2017 , e5
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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