Measuring recovery-oriented rehabilitation language in clinical documentation to enhance recovery-oriented practice
Veronica De Monte,
Angus Veitch,
Frances Dark,
Carla Meurk,
Marianne Wyder,
Maddison Wheeler,
Kylie Carney,
Stephen Parker,
Steve Kisely,
Dan Siskind
Affiliations
Veronica De Monte
Mobile Intensive Rehabilitation Team, Metro South Addiction and Mental Health Service, Woolloongabba, Queenland, Australia
Angus Veitch
Department of Media and Communications, Swinburne University of Technology, Melbourne, Victoria, Australia
Frances Dark
Mobile Intensive Rehabilitation Team, Metro South Addiction and Mental Health Service, Woolloongabba, Queenland, Australia; and Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
Carla Meurk
Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia; and Queensland Centre for Mental Health Research, The Park, Wacol, Queensland, Australia
Marianne Wyder
Research and Learning Network, Metro South Addiction and Mental Health Service, Mt Gravatt, Queensland, Australia
Maddison Wheeler
Mobile Intensive Rehabilitation Team, Metro South Addiction and Mental Health Service, Woolloongabba, Queenland, Australia
Kylie Carney
Mobile Intensive Rehabilitation Team, Metro South Addiction and Mental Health Service, Woolloongabba, Queenland, Australia
Stephen Parker
Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia; and Research and Learning Network, Metro South Addiction and Mental Health Service, Mt Gravatt, Queensland, Australia
Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia; and Research and Learning Network, Metro South Addiction and Mental Health Service, Mt Gravatt, Queensland, Australia
Mobile Intensive Rehabilitation Team, Metro South Addiction and Mental Health Service, Woolloongabba, Queenland, Australia; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia; and Queensland Centre for Mental Health Research, The Park, Wacol, Queensland, Australia
Background Mental health services are encouraged to use language consistent with principles of recovery-oriented practice. This study presents a novel approach for identifying whether clinical documentation contains recovery-oriented rehabilitation language, and evaluates an intervention to improve the language used within a community-based rehabilitation team. Aims This is a pilot study of training to enhance recovery-oriented rehabilitation language written in care review summaries, as measured through a text-based analysis of language used in mental health clinical documentation. Method Eleven case managers participated in a programme that included instruction in recovery-oriented rehabilitation principles. Outcomes were measured with automated textual analysis of clinical documentation, using a custom-built dictionary of rehabilitation-consistent, person-centred and pejorative terms. Automated analyses were run on Konstanz Information Miner (KNIME), an open-source data analytics platform. Differences in the frequency of term categories in 50 pre-training and 77 post-training documents were analysed with inferential statistics. Results The average percentage of sentences with recovery-oriented rehabilitation terms increased from 37% before the intervention to 48% afterward, a relative increase of 28% (P < 0.001). There was no significant change in use of person-centred or pejorative terms, possibly because of a relatively high frequency of person-centred language (22% of sentences) and low use of pejorative language (2.3% of sentences) at baseline. Conclusions This computer-driven textual analysis method identified improvements in recovery-oriented rehabilitation language following training. Our study suggests that brief interventions can affect the language of clinical documentation, and that automated text-analysis may represent a promising approach for rapidly assessing recovery-oriented rehabilitation language in mental health services.
