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E-Thesis 465 views 338 downloads

The Impact of ‘Non-Clinical’ Patient Factors (NCpF) on Clinical Decision-making: Uncovering the Impact on Mental Health / LAUREN BURNS

Swansea University Author: LAUREN BURNS

DOI (Published version): 10.23889/SUthesis.60182

Abstract

This thesis aimed to understand the influence of non-clinical patient factors on mental health-related diagnostic, treatment, and referral decisions. Non-clinical patient factors are characteristics of the patient that are not known to be relevant for the clinical diagnosis or prognosis. Examples of...

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Published: Swansea 2022
Institution: Swansea University
Degree level: Doctoral
Degree name: Ph.D
Supervisor: Da Silva, Ana ; John, Ann
URI: https://cronfa.swan.ac.uk/Record/cronfa60182
first_indexed 2022-06-13T09:01:48Z
last_indexed 2022-06-14T03:18:49Z
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recordtype RisThesis
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spelling 2022-06-13T10:33:41.3738144 v2 60182 2022-06-13 The Impact of ‘Non-Clinical’ Patient Factors (NCpF) on Clinical Decision-making: Uncovering the Impact on Mental Health 9d7a7e4e6babc1706c2b0944db2c10d8 LAUREN BURNS LAUREN BURNS true false 2022-06-13 This thesis aimed to understand the influence of non-clinical patient factors on mental health-related diagnostic, treatment, and referral decisions. Non-clinical patient factors are characteristics of the patient that are not known to be relevant for the clinical diagnosis or prognosis. Examples of non-clinical patient factors in mental health care include gender, age, and socioeconomic status. Focus groups were conducted to understand the perceptions of patient’s mental health care experiences and identify any NCpF that varied from past literature. Then, using the Secure Anonymised Information Linkage Databank, administrative data for participants with a gold standard indicator of mental health were linked with their healthcare records to determine associations between NCpF and being diagnosed, treated, or referred for mental health-related conditions. Finally, an experimental clinical vignette study was conducted. General practitioners were invited to answer clinical decisions based on the clinical vignettes which depicted patients with bulimia, anxiety, and bipolar disorder. All participants saw one of each disorder, however they were randomly allocated to either male, female or a control condition for bulimia, young, old or control condition for age, or high- or low- socioeconomic status or no reference for bipolar disorder. Utilising a combined methodological approach, gender, age and socioeconomic status were found to impact the clinical decision-making process. The effect of this influence varied depending on the clinical decision and disorder type. This thesis demonstrated the feasibility of using administrative and health care records to study mental health-related clinical decision-making. E-Thesis Swansea Mental health, clinical decision-making, patient factors 9 6 2022 2022-06-09 10.23889/SUthesis.60182 COLLEGE NANME COLLEGE CODE Swansea University Da Silva, Ana ; John, Ann Doctoral Ph.D Economic and Social Research Council 2022-06-13T10:33:41.3738144 2022-06-13T09:58:19.4325489 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine LAUREN BURNS 1 60182__24288__8a1a10ef8f8f4e8a90e55eb932c68d6d.pdf Burns_Lauren_PhD_Thesis_Final_Redacted_Signature.pdf 2022-06-13T10:19:23.1615732 Output 6644169 application/pdf E-Thesis – open access true Copyright: The author, Lauren Burns, 2022. true eng
title The Impact of ‘Non-Clinical’ Patient Factors (NCpF) on Clinical Decision-making: Uncovering the Impact on Mental Health
spellingShingle The Impact of ‘Non-Clinical’ Patient Factors (NCpF) on Clinical Decision-making: Uncovering the Impact on Mental Health
LAUREN BURNS
title_short The Impact of ‘Non-Clinical’ Patient Factors (NCpF) on Clinical Decision-making: Uncovering the Impact on Mental Health
title_full The Impact of ‘Non-Clinical’ Patient Factors (NCpF) on Clinical Decision-making: Uncovering the Impact on Mental Health
title_fullStr The Impact of ‘Non-Clinical’ Patient Factors (NCpF) on Clinical Decision-making: Uncovering the Impact on Mental Health
title_full_unstemmed The Impact of ‘Non-Clinical’ Patient Factors (NCpF) on Clinical Decision-making: Uncovering the Impact on Mental Health
title_sort The Impact of ‘Non-Clinical’ Patient Factors (NCpF) on Clinical Decision-making: Uncovering the Impact on Mental Health
author_id_str_mv 9d7a7e4e6babc1706c2b0944db2c10d8
author_id_fullname_str_mv 9d7a7e4e6babc1706c2b0944db2c10d8_***_LAUREN BURNS
author LAUREN BURNS
author2 LAUREN BURNS
format E-Thesis
publishDate 2022
institution Swansea University
doi_str_mv 10.23889/SUthesis.60182
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description This thesis aimed to understand the influence of non-clinical patient factors on mental health-related diagnostic, treatment, and referral decisions. Non-clinical patient factors are characteristics of the patient that are not known to be relevant for the clinical diagnosis or prognosis. Examples of non-clinical patient factors in mental health care include gender, age, and socioeconomic status. Focus groups were conducted to understand the perceptions of patient’s mental health care experiences and identify any NCpF that varied from past literature. Then, using the Secure Anonymised Information Linkage Databank, administrative data for participants with a gold standard indicator of mental health were linked with their healthcare records to determine associations between NCpF and being diagnosed, treated, or referred for mental health-related conditions. Finally, an experimental clinical vignette study was conducted. General practitioners were invited to answer clinical decisions based on the clinical vignettes which depicted patients with bulimia, anxiety, and bipolar disorder. All participants saw one of each disorder, however they were randomly allocated to either male, female or a control condition for bulimia, young, old or control condition for age, or high- or low- socioeconomic status or no reference for bipolar disorder. Utilising a combined methodological approach, gender, age and socioeconomic status were found to impact the clinical decision-making process. The effect of this influence varied depending on the clinical decision and disorder type. This thesis demonstrated the feasibility of using administrative and health care records to study mental health-related clinical decision-making.
published_date 2022-06-09T20:24:49Z
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score 11.048302

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