Understanding the referral process to the medical psychology department; a mixed-method approach

Psychological and physical conditions often occur together, having a cumulative negative influence on each other. These comorbidities influence the quality of life, reduce life expectancy, and increase the healthcare burden. There is a need for interprofessional collaboration to manage the complexity and this burden. A difference exists between the medical departments at Zaans Medical Centre in the number of referrals done by the healthcare providers to the medical psychology department, and it is unclear why this difference exists. The study aims to gain a comprehensive understanding of the referral process to the medical psychology department and the discrepancies between departments. It also aims to explore factors that could possibly affect the referral rate. The predicting factors being examined in the study are the presence of a medical psychologist at the multidisciplinary consultation, the education of the healthcare provider about psychological symptoms, the ability of...Show morePsychological and physical conditions often occur together, having a cumulative negative influence on each other. These comorbidities influence the quality of life, reduce life expectancy, and increase the healthcare burden. There is a need for interprofessional collaboration to manage the complexity and this burden. A difference exists between the medical departments at Zaans Medical Centre in the number of referrals done by the healthcare providers to the medical psychology department, and it is unclear why this difference exists. The study aims to gain a comprehensive understanding of the referral process to the medical psychology department and the discrepancies between departments. It also aims to explore factors that could possibly affect the referral rate. The predicting factors being examined in the study are the presence of a medical psychologist at the multidisciplinary consultation, the education of the healthcare provider about psychological symptoms, the ability of interprofessional communication of the healthcare provider, and the feeling of shared accountability of the healthcare provider. It is hypothesized that all predictor factors positively influence the referral rate. The data is collected through a Likert Scale, with the accountability variable being analysed through a qualitative method. 13 participants are interviewed through a semi-structured interview, with a separate dataset on the number of referrals also used in the analysis. The covariates used in this study include age, gender, and years of experience in the field of specialisation of the participants. A linear regression is performed to test the quantitative hypotheses. No significant results are found; therefore, no relationships are found between the predictor variables and the referral rate. The qualitative analysis consists of three main themes: full responsibility, partial, and no responsibility of the patient’s psychological condition. Possible explanations of the results include a small sample size and different predictor variables such as a stigma on psychological having a greater effect on the referral rate. The limitations to the study are the small sample size, subjective measures as the Likert scale filled in by the participant, and potential Dunning-Kruger effect and self-enhancement bias due to overestimating their skills or positively self-rating their work. For future studies a larger sample size, objective measures such as how often the departments meet added to the data, more in depth study on other predictor variables such as stigma of the healthcare provider, could help gain a more in-depth understanding of the referral rate.Show less

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Understanding the referral process to the medical psychology department; a mixed-method approach