Patients’ Experience of Patient-Reported Outcomes, Continuous Feedback, and a Solution-Focused Approach (Using DIALOG+) in Psychosis Care in Sweden

Abstract

Background Involving patients in their care and including them in continuous follow-up is a challenge. This challenge is often compounded by a lack of self-reported outcome measures. Incorporating such measures could aid healthcare professionals in collaboratively designing care plans and adjusting treatments as therapy progresses. Previous research highlights the positive impact of continuous feedback based on treatment outcomes and problem-solving methodology in routine psychiatric care. DIALOG + is a digitally supported conversational tool designed to enhance the therapeutic effectiveness of patient-clinician meetings by incorporating continuous self-reported outcomes and a solution-focused approach. The objective of this study was to investigate the disparities in patients' experiences when using DIALOG + compared to standard treatment and to examine the implications for clinical use within a Swedish setting. Methods A qualitative study was designed to describe patients’ experiences using DIALOG + in psychosis outpatient care in Sweden. A convenience sample of patients who used DIALOG + three times or more was included in the study. Individual semi-structured interviews were conducted with ten patients. The interviews were analysed using reflexive thematic analysis. Results The analysis identified two themes: 'The supportive features of DIALOG+' and 'Providing a constructive structure'. These themes consist of six sub-categories: Expanded the understanding of my health; Moving toward improvement; Provided memory support; Empowering participation; Distinguishing DIALOG + as a constructive complement, and Experiences of the digital tool. Conclusion The structure of DIALOG+, including continuous feedback and the solution-focused approach, seems to enhance person-centred care for patients with psychotic disorders, fostering shared decision-making and aiding memory support. It also facilitates a collaborative understanding of the patients’ health concerns and personal goals, which shows that DIALOG + could be useful as a tool to develop care plans that are more tailored to the patients’ needs. Despite some concerns about structured dialogues, DIALOG + holds promise for improving patient-clinician interactions and treatment outcomes in psychosis care in Sweden. Additional research is planned, which will include an exploration of clinicians' experiences with DIALOG + as well as observational and effectiveness studies.