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What determines the management of anxiety disorders and its improvement?
Author(s) -
Smolders Mirrian,
Laurant Miranda,
Van Wamel Anneke,
Grol Richard,
Wensing Michel
Publication year - 2008
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2007.00845.x
Subject(s) - anxiety , context (archaeology) , psychological intervention , thematic analysis , affect (linguistics) , psychology , set (abstract data type) , quality (philosophy) , quality management , health care , mental health , clinical psychology , medicine , psychiatry , qualitative research , business , marketing , computer science , political science , paleontology , social science , philosophy , communication , epistemology , sociology , biology , programming language , service (business) , law
Although anxiety disorders are highly prevalent, lack of correct diagnosis and related concerns about treatment are serious clinical problems. Several factors affect, positively or negatively, management of anxiety and its improvement. A literature review and thematic analysis was executed to obtain an overview of the types of determinants of anxiety care and its improvement. Methods Literature was identified from electronic database searching (January 1995–March 2006), contact with authors of studies, and searching of websites of organizations concerned with mental health. By using a template analysis approach, a set of strong themes relating to determinants of anxiety care and its improvement was identified. Results The 15 eligible studies identified 43 factors that impeded or facilitated optimal anxiety care and its improvement. Individual characteristics of both patients ( n = 13) and professionals ( n = 6) were most frequently reported as determinants of anxiety care and its improvement. A considerable number of factors were related to the organizational context ( n = 12), such as practice type and location. Some factors related to the social context ( n = 4), the economic context ( n = 2), or to the innovation itself ( n = 6) were identified. Conclusion The findings show that there is a multitude of barriers and facilitators to optimal anxiety care and its improvement. Some determinants are modifiable, and thus responsive to interventions. Examples are collaboration within and between organizations, financial resources and assignment of both an opinion leader and responsible staff. The quality of anxiety care can be improved by systematically designing innovation strategies which are tailored to a selection of the determinants identified in this study.