E-Thesis 364 views 252 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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Swansea
2022
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| Institution: | Swansea University |
| Degree level: | Doctoral |
| Degree name: | Ph.D |
| Supervisor: | Da Silva, Ana ; John, Ann |
| URI: | https://cronfa.swan.ac.uk/Record/cronfa60182 |
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| 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 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. |
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| Keywords: |
Mental health, clinical decision-making, patient factors |
| College: |
Faculty of Medicine, Health and Life Sciences |