Patients' acceptability and implementation outcomes of a case management approach to encourage participation in colorectal cancer screening for people with schizophrenia: a qualitative secondary analysis of a mixed-method randomised clinical trial

Objectives We examined the efficacy of case management (CM) interventions to encourage participation in colorectal cancer screening for patients with schizophrenia. This study aimed to clarify patients' acceptability of the intervention and the helpful components of the intervention. Simultaneously, the study aimed to determine the acceptability, appropriateness and feasibility of the intervention from the perspective of psychiatric care providers. Study design and setting This study was a secondary qualitative analysis of a mixed-method randomised controlled trial that evaluated the efficacy of the CM approach to encourage participation in cancer screening for people with schizophrenia. The intervention comprised education and patient navigation for colorectal cancer screening. Interviews were conducted with patients who received the intervention and staff from two psychiatric hospitals in Japan who delivered the intervention. Participants Of the 172 patients with schizophrenia who participated in the trial, 153 were included. In addition, three out of six providers were included. Data collection and analysis Using a structured interview, the case manager asked participants about patient acceptability and the helpful components of the intervention. Content analysis was conducted for the responses obtained, and the number of responses was tabulated by two researchers. For the interviews with the providers, opinions obtained from verbatim transcripts were extracted and summarised. Results Forty-three of the 56 patients perceived that the intervention was acceptable. For the intervention component, inperson counselling with an explanation of the screening process by psychiatric care providers was most frequently reported by the patients as helpful (48 of the 68 respondents). Psychiatric care providers evaluated the intervention as acceptable, appropriate and easy to understand and administer. However, providing the intervention to all patients simultaneously was considered difficult with the current human resources. Conclusions This study showed that the CM intervention was perceived as acceptable by patients and acceptable and appropriate by psychiatric care providers

トクベツ シエン ガッコウ キョウイン ヨウセイ ニ オケル ジッセンテキ シドウリョク ト キョウドウセイ ノ コウジョウ ニ ムケタ チイキ ノ トクベツ シエン ガッコウ ト レンケイ シタ PBL ノ トリクミ : ダイガクセイ ノ マナビ ト ガッコウ ゲンバ エ ノ コウカ ノ ケンショウ

教員養成大学において、教員に求められる資質能力である実践的指導力や協働性の向上に向けて、PBLの取組が取り入れられつつある。特別支援学校教員養成においては、PBLの観点での授業の取組の有効性について、必ずしも十分に検討されていない。筆者らは、地域の知的障害特別支援学校と連携を図り、特別支援教育専門科目である「知的障害教育論Ⅱ」の科目において、PBLの枠組みを用いた実践を試みた。支援学校生徒と大学生の交流活動を学生らが計画した。履修者を対象とし、教員の資質能力に関する学びと課題について事後アンケートを実施した。その結果、交流活動に参加した学生と参加しなかった学生のいずれにおいても、実践的指導力および協働性に関して肯定的な結果が得られた。特別支援学校の教員を対象とした事後アンケートからは、参加生徒の学習意欲の向上や教員による生徒の実態把握の再確認の機会となるといった有効性が示された