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Duque Domínguez, A., R. Duque Domínguez, C. García Montero, L. Martín Díaz, M. Palomo Monge, E. Pérez Arévalo, M. D. L. N. Vaquero López, and A. Barreiro de Lucas. "Electroconvulsive therapy outpatient program recently established in a psychiatric day hospital." European Psychiatry 33, S1 (March 2016): S553—S554. http://dx.doi.org/10.1016/j.eurpsy.2016.01.2044.
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IntroductionECT outpatient program recently created in the Psychiatric Day Hospital in Ávila was designed to assess the safety and efficacy of continuation/maintenance electroconvulsive therapy (ECT) in patients after ECT remission.ObjectivesDescription of the activity and objectives of an ECT outpatient program in a Psychiatric Day Hospital.MethodsRetrospective cross-sectional descriptive Study. The three patients who received the continuation/maintenance electroconvulsive therapy during the 10 months this unit has been opened were chosen as a sample.ResultsFrom the opening of Psychiatric Day Hospital 10 months ago, 58 patients have been admitted; among them, three patients come to the hospital monthly to receive the electroconvulsive therapy, maintaining their psychopathological stability over time.ConclusionsWith the creation of this new program we considered three types of objectives:– therapeutic: a therapy applied in a more comfortable and satisfactory for the patient and family regime. To prevent relapse and exacerbations;– management: benefits on the best use of existing resources:– reduction in hospital admissions and readmissions,– decrease in the average stay,– reduction in visits to Emergency Services,– allow referrals from outpatient department,– individual monitoring of patients that complements the check at their Mental Health Team;– teaching, training and investigation.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Kent, M. Potvin, K. Busby, M. Johnston, J. Wood, and C. Docherty. "Predictors of outcome in a short-term psychiatric day hospital program." General Hospital Psychiatry 22, no. 3 (May 2000): 184–94. http://dx.doi.org/10.1016/s0163-8343(00)00061-x.
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Mackenzie, Corey S., Marsha Rosenberg, and Melissa Major. "Evaluation of a psychiatric day hospital program for elderly patients with mood disorders." International Psychogeriatrics 18, no. 4 (May 10, 2006): 631–41. http://dx.doi.org/10.1017/s1041610206003437.
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Background: Very little is known about the utility of psychiatric day hospitals for elderly adults with mood disorders. The objectives of this study were to evaluate a long-standing day-hospital program and to explore whether demographic and non-demographic patient characteristics were associated with treatment outcomes.Method: We used t-tests to compare retrospective admission and discharge data for 708 patients over a 16-year period, and multiple regression to examine predictors of improvement.Results: Depressed patients showed statistically and clinically significant improvements on the Geriatric Depression Scale and the Hamilton Depression Rating Scale. The number and severity of depressive symptoms at admission were strongly related to treatment outcomes. After controlling for initial levels of depression, demographic characteristics did not predict improvement, and axis I and II diagnoses modestly and inconsistently predicted improvement.Conclusions: A biopsychosocially-focused day-hospital treatment program was associated with improvements in depression in a large sample of elderly adults with mood disorders. Except for depression severity at admission, patient characteristics had very little impact on treatment outcomes, suggesting that day hospital programs are beneficial for a wide range of depressed elderly adults.
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Agbayewa, M. Oluwafemi. "A Psychiatric Clinic within a Geriatric Medical Day Hospital: Descriptive Study." Canadian Journal on Aging / La Revue canadienne du vieillissement 9, no. 1 (1990): 5–12. http://dx.doi.org/10.1017/s0714980800016044.
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ABSTRACTA survey of the first two years of a psychiatric clinic within a geriatric medical day hospital was undertaken to determine the role of such a clinic. Forty per cent of all day hospital attenders were referred for psychiatric evaluation: at least 80 per cent of these had major psychiatric diagnoses and 20 per cent had other conditions needing psychosocial intervention. Depression and dementia accounted for 62 per cent of all psychiatric referrals. Those who were referred to the psychiatric clinic were quite comparable to the unreferred group in age, sex, marital status, pre-retirement employment and source of referral to the day hospital. The outcomes of intervention at three, six and 12 months were similar in both groups but referred patients stayed longer in the program. It is concluded that such a clinic provides a necessary mental health service where it is needed.
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Vranješ, Janja, Daniela Petrić, Tanja Grahovac Juretić, and Zdravko Tovilović. "Quality of Life and Treatment Satisfaction of Hospitalized and Day Hospital Psychiatric Patients." Croatian nursing journal 5, no. 1 (August 23, 2021): 5–16. http://dx.doi.org/10.24141/2/5/1/1.
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Introduction. Day hospitals are becoming an increasingly common method of treatment for people with mental disorders in many Croatian psychiatric hospitals, but research examining their effectiveness is still rare. Aim. The aim of this study was to compare treatment satisfaction and quality of life between patients enrolled in a day hospital program and patients hospitalized on a psychiatric ward. Methods. The study design was cross-sectional with two outcome measures: treatment satisfaction and quality of life. The study sample consisted of 120 adult patients of the Clinic for Psychiatry of the University Hospital Centre Rijeka. The first group consisted of 60 patients included in the day hospital psychosocial program, while the second group consisted of 60 patients hospitalized on the inpatient ward. Results. Day hospital patients reported a significantly higher level of overall treatment satisfaction compared to hospitalized patients (mean rank: 55 vs. 17, p=0.000) and were significantly more satisfied in four out of seven different treatment domains: the explanations about treatment (mean rank: 68 vs. 53, p=0.013), carefulness and precision of medical examination (mean rank: 72 vs. 49, p=0.000), choices about treatment (mean rank: 67 vs. 57, p=0.027) and feeling of respect (mean rank: 68 vs. 53, p=0.010). Day hospital patients also reported a significant psychopaly higher level of overall subjective quality of life (mean: 4.26 vs. 3.71, p=0.005), being more satisfied with life in general (mean rank: 68 vs. 53, p=0,018), financial situation (mean rank: 67 vs. 54, p=0.046), accommodation (mean rank: 67 vs. 54, p=0.041), personal safety (mean rank: 68 vs. 53, p=0.014), people they live with or living alone (mean rank: 71 vs. 50, p=0.001), relationship with their family (mean rank: 49 vs. 53, p=0.000) and their mental health (mean rank: 69 vs. 52, p=0.008). Conclusion. Patients treated in the day hospital differed in the observed variables from those hospitalized on the ward, reporting higher levels of treatment satisfaction and higher subjective quality of life. Future studies should focus on different segments of day hospital programs and a broader set of outcomes.
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Nickel, Irmie. "Adapting Structured Learning Therapy for Use in a Psychiatric Adult Day Hospital." Canadian Journal of Occupational Therapy 55, no. 1 (February 1988): 21–25. http://dx.doi.org/10.1177/000841748805500104.
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Patients in an adult day hospital program were found to have difficulties in practising and transferring the new learning acquired in insight-oriented group psychotherapy to other life situations. This paper presents a method used by occupational therapists to help patients become more proficient in transferring their newly acquired insights and skills to their real life situations. The method is an adapted form of Structured Learning Therapy. Its development and rationale supporting its purpose and function is presented. This is followed by a discussion of the modifications necessary to make Structured Learning Therapy useful for the particular patient population found at the adult day hospital program described.
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Malla, Ashok K. "Day Treatment of Alcoholism: An Outcome Study." Canadian Journal of Psychiatry 32, no. 3 (April 1987): 204–10. http://dx.doi.org/10.1177/070674378703200309.
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Thirty-seven (27 male and 10 female) alcoholics, treated in a brief day program, were assessed on a number of alcohol related and psychosocial variables 15 months following the initial treatment. Thirty percent (30%) remained totally abstinent, another 30% reduced their drinking to less than 10%, and 35% showed a moderate reduction of 10 to 50% in their pre-treatment drinking. Significant reduction was reported by these patients in their utilization of health services for purposes of detoxification, psychiatric treatment, visits to the family physician, and emergency department. Improvement was also reported on employment status, legal problems, general emotional state and some symptoms suggestive of depression. These findings are discussed in the light of the viability of cost effective day treatment programs for alcoholism within the context of general hospital psychiatric services.
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Russell, Vincent, François Mai, Keith Busby, David Attwood, Marie Davis, and Monica Brown. "Acute Day Hospitalization as an Alternative to Inpatient Treatment." Canadian Journal of Psychiatry 41, no. 10 (December 1996): 629–37. http://dx.doi.org/10.1177/070674379604101005.
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Objective: This paper describes the administrative process by which the Ottawa General Hospital (OGH) closed 6 beds and used the staff and space resources thus released to set up an acute day hospital (ADH) for the treatment of 8 acutely ill psychiatric patients. Outcome data are presented on the first 160 patients admitted to the ADH. Methods: Demographic and clinical information including diagnostic (DSM-III-R; Global Assessment of Functioning [GAF]) and questionnaire data (Symptom Checklist-90 Revised [SCL-90R]; Beck Depression Inventory [BDI]; State-Trait Anxiety Inventory [STAI]; patient satisfaction) were obtained from 160 ADH patients at admission and discharge. Forty-two of these patients provided follow-up data 3 to 6 months postdischarge. The outcome of ADH patients was compared with that of a retrospectively obtained random sample (n = 100) of inpatients on selected diagnostic and demographic variables. Results: On clinician-rated and self-report clinical scales, ADH patients showed significant clinical improvement reflected in higher GAF scores and less psychological distress, depression, and anxiety at discharge relative to admission. There were no significant group differences in outcome indices except for shorter length of stay in the ADH group compared with inpatients. The ADH group rated the program highly in help received and quality of service. Short-term follow-up showed that gains made during treatment were maintained 3 to 6 months later. Conclusions: These results show that a time-limited day hospital program is clinically effective for acutely ill psychiatric patients and leads to a more efficient use of inpatient resources. We believe that partial hospitalization for the treatment of acute psychiatric disorders may have wide application in psychiatric hospital practice.
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Esturrenho, I. D. B., M. F. Urzal, S. Silva, and P. Duarte. "P.857 A psychiatric day hospital treatment program and its impact on psychopharmacological treatment." European Neuropsychopharmacology 29 (December 2019): S571. http://dx.doi.org/10.1016/j.euroneuro.2019.09.719.
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Pulido, Ricardo, Marco Monari, and Nicolino Rossi. "Institutional Therapeutic Alliance and Its Relationship With Outcomes in a Psychiatric Day Hospital Program." Archives of Psychiatric Nursing 22, no. 5 (October 2008): 277–87. http://dx.doi.org/10.1016/j.apnu.2007.07.003.
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Mueller, Nora E., Trishan Panch, Cathaleene Macias, Bruce M. Cohen, Dost Ongur, and Justin T. Baker. "Using Smartphone Apps to Promote Psychiatric Rehabilitation in a Peer-Led Community Support Program: Pilot Study." JMIR Mental Health 5, no. 3 (August 15, 2018): e10092. http://dx.doi.org/10.2196/10092.
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Background Management of severe and persistent mental illness is a complex, resource-intensive challenge for individuals, their families, treaters, and the health care system at large. Community-based rehabilitation, in which peer specialists provide support for individuals managing their own condition, has demonstrated effectiveness but has only been implemented in specialty centers. It remains unclear how the peer-based community rehabilitation model could be expanded, given that it requires significant resources to both establish and maintain. Objective Here, we describe the results from a study of one such program implemented within Waverley Place, a community support program at McLean Hospital, emphasizing psychiatric rehabilitation for individuals with severe and persistent mental illness, as well as describing the challenges encountered during the implementation of the program. Key questions were whether the patients could, and would, successfully use the app. Methods The smartphone app offered multiple features relevant to psychiatric rehabilitation, including daily task lists, activity tracking, and text messaging with peer specialists. A 90-day program of activities, goals, and content specific to the community support program was created on the basis of a prior pilot, in collaboration between members of the app development team (WellFrame), and peers, clinical, and research staff associated with the program. Hospital research staff recruited patients into the study, monitored peer and patient engagement, and handled all raw data acquired from the study. Results Of 100 people approached for the study, a total of 13 provided consent, of which 10 downloaded and used the app. Two patients were unable to complete the app installation. Five used the app regularly as part of their daily lives for at least 20 days of the 90-day program. We were unable to identify any specific factors (eg, clinical or demographic) that affected willingness to consent or engage with the app platform in the very limited sample, although the individuals with significant app use were generally satisfied with the experience. Conclusions Smartphone apps may become a useful tool for psychiatric rehabilitation, addressing both psychiatric and co-occurring medical problems. Individualizing functions to each patient and facilitating connection with a certified peer specialist may be an important feature of useful apps. Unlike prior reports emphasizing that patients with schizophrenia will adopt smartphone platforms, we found that implementation of digital tools into existing community support programs for severe and persistent mental illness has many challenges yet to be fully overcome to realize the potential benefits such apps could have to promote systematization and cost reduction for psychiatric rehabilitation.
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Gucci, F., and F. Marmo. "A study on the effectiveness of E-Mental Health in the treatment of psychosis: Looking to recovery." European Psychiatry 33, S1 (March 2016): S27—S28. http://dx.doi.org/10.1016/j.eurpsy.2016.01.846.
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IntroductionAn integrated program (Institutional Psychiatric Open Light Treatment) for psychosis and personality disorder was enriched with audiovisual functions provided through a dedicated website.The aim of the present study was to observe how and if these added functions support the patients in their daily living, influencing the quality of the recovery process.Recent studies highlighted how telemental health services are effective to provide access, improve basic outcome, facilitate empowerment of patients and be well-accepted (Hilty, 2013; Hailey, 2008) and how integrated community-based treatment, such as Community-Based Psychodynamic Treatment Program (Chiesa and Fonagy, 2009) or Assertive Community Treatment (Veldhuizen and Bahler, 2013) are effective in SMI.Telemental health services may become factors improving real-life functioning, integrating community-based treatment for psychosis and bettering social cognition, functional capacity, resilience, internalized stigma and engagement with mental health services, so positively affecting outcomes of psychosis treatment.MethodsAll patients admitted (May 2010–April 2015) were included. Aged between 18 and 65, with schizophrenia, psychosis, schizoaffective disorder, bipolar disorder, personality disorder.Some troubles with the website use (Voice2Voice) led to a second version, more friendly and simple to use (app2gether).App2gether provided several functions: audio/video conference rooms for patients or family (synchronous virtual space to interact, at scheduled time, with a psychologist, a psychiatrist or a peer support worker, in free groups); chat (asynchronous virtual space for any question or information).We considered primary outcomes proposed by Cochrane Collaboration (Shek, 2010): hospital admissions, days of hospitalization, day-hospital admissions, day-program attendance (e.g. weekly), treatment compliance (voluntary discharge or missing scheduled date).We considered, as secondary outcomes, variables closely associated with real-life functioning (Galderisi, 2015): global functioning (Italian translation of Global Assessment of Functioning Scale), quality of life (Short Form 36 item), social relationships (Personal and Social Performance), internalized stigma (Internalized Stigma Mental Illness Inventory), empowerment (Empowerment Scale).Patients were divided into four cohorts:– 1-using “app2gether” functions in the follow-up, attending day treatment program (n = 35);– 2-attending day treatment program (n = 52);– 3-attending transitional day-hospital program (n = 171);– 4-not included in the IPOLT-program (n = 188).Patients were included in the first group only based on their basic computer skills and fast Internet availability.ResultsAt first, we compared (2) and (3) with (4), as control group. For each patient, we considered an identical observation period before and after day-hospital admission (ANOVA, P < 0.05).We found a significant improvement in primary outcomes and global functioning, but not in other secondary outcomes, for the groups (2) and (3) compared with (4).Over 6-months observation, patients using “app2gether” functions in the follow-up showed:– a significantly decrease in hospital admissions and hospitalization length, compared to non-IPOLT-program group;– a reduction in day-hospital admissions and day-hospital attendance, compared to (2) and (3) groups;– a notable effect on secondary outcomes, compared to all other groups.ConclusionA dedicated website in the IPOLT-program supports patients in their living's place, does not interfere with daily activities, decreases social costs, encourages community integration and reduces stigma.Synchronous telepsychiatry allow a professionally modulated intervention in “here and now”; asynchronous contacts with specialists combine professional intervention with chances of autonomy and autoregulation. These services reduce costs, in terms of FTE (Full Time Equivalent), but not the efficacy.Future advances in the websites should be designed, simplifying the contact surface with the treating-team and reducing the social impact of therapeutic practice.A better understanding of the complex variables influencing real-life functioning and new sensitive tools to detect it are needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Desrosiers, Johanne, Réjean Hébert, Hélène Payette, Pierre-Michel Roy, Michel Tousignant, Sylvie Côté, and Lise Trottier. "A Geriatric Day Hospital: Who Improves the Most?" Canadian Journal on Aging / La Revue canadienne du vieillissement 23, no. 3 (2004): 217–28. http://dx.doi.org/10.1353/cja.2004.0031.
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ABSTRACTThis study compared the changes in some bio-psychosocial variables (functional independence, nutritional risk, pain, balance and walking, grip strength, general well-being, psychiatric profile, perception of social support, leisure satisfaction, and caregivers' feeling of burden) in four categories of clients during their program at a geriatric day hospital (GDH). The study also evaluated whether or not improvements, if any, were maintained 3 months after discharge. One-hundred-and-fifty-one people, categorized by primary reason for admission, were assessed at the GDH with reliable and valid tools, at admission and at discharge. Three months after discharge, they were reassessed with the same tools. Overall, two categories of clients, stroke / neurological diseases and musculoskeletal disorders / amputations, improved the most. For the gait disorders and falls group, only the functional independence score improved, but not at a clinically significant level. Finally, clients in the cognitive function disorders / psychopathologies group improved the most on their well-being scores and caregivers' burden decreased the most. All gains were maintained up to 3 months after discharge, except for leisure satisfaction. With the exception of clients who attended the GDH because of gait disorders and falls, the improvements and maintenance achieved in each category occurred in the domains where improvement had been hoped for, because of the particular disabilities in question and because of the nature of the GDH services offered.
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Ulus, F. "…And…Action!: Using Cinema and Film Clips in Partial Care/day Hospital Groups - Psychiatric Rehabilitation Settings." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)71293-3.
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Entertainment - education - empowerment through transactional analysis principles.St. Vincent Hospital, Erie, Pennsylvania, intensive outpatient program experience: September 2005 - October 2007.Three e’s in psycho-educational and open-ended group settings.Medication for response - remission - recovery stages of behavioral health / mental illness.Group movie therapy approach for rehabilitation stage [handling anger, alleviating anxiety, uplifting depression, formulating problem solving, improving judgment, helping to forgive and forgiven, experiencing with sense of humor, easing up suspicion and mistrust, promoting love and compassion, teaching assertive communication and relationship, overviewing prioritization, quieting down these trigger mechanisms in decreasing the morbidity of psychiatric syndromes].
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Alonso Díaz, R., E. Cortázar Alonso, H. Guillén Rodrigo, R. Remesal Cobreros, and S. Fuentes Márquez. "Mental health care to children and adolescents." European Psychiatry 33, S1 (March 2016): S343. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1208.
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Unit Mental Health Day Hospital Child and youthful, is a device of tertiary health care, integrated into the UGC Mental Health, led to intensive treatment of children and young people in the province of Huelva, with severe mental illness and who need specialized medical care.To first access to this unit, the person should be referred for specialized Pediatrics; by your psychiatrist or psychologist benchmark for mental health teams; or from the Hospitalization Unit, as it is a third-level device.When a patient was diagnosed with eating behavior disorder (TCA) is derived, an initial consultation with the child and parents, a first psychiatric evaluation, also by nutritional and Endocrinology Nursing is performed. After evaluation of these professionals, you can take the decision to begin an intensive outpatient treatment in which the patient would have frequent consultations with the psychiatrist, the nurse and endocrine.They may also decide inpatient hospitalization and this could be partial, to be held in the Day Hospital; or all, if the patient is under 14 years and hospitalization for psychiatric criteria indicated; the patient would enter Pediatrics. If he is over 14 years old, would join Hospitalization Unit.In Child and Adolescent Hospitalization Unit of Huelva patient it is included in a specific program for TCA where a psychiatric, endocrine, educational approach in the classroom is done. Coordination meetings with education, social services and early care centers that are also in contact with that child are also conducted.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Isaak, Valerie, Dana Vashdi, Dor Bar-Noy, Hava Kostisky, Shmuel Hirschmann, and Alexander Grinshpoon. "Enhancing the Safety Climate and Reducing Violence Against Staff in Closed Hospital Wards." Workplace Health & Safety 65, no. 9 (December 9, 2016): 409–16. http://dx.doi.org/10.1177/2165079916672478.
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This study examined the effectiveness of an intervention program to enhance unit safety climate and minimize employee risk of injury from patient violence. The intervention program, including a 3-day workshop, was offered to personnel on maximum security units of an Israeli psychiatric hospital. Safety climate was examined before and after the implementation of the intervention, and incidents of patient violence were investigated. Six months after the intervention, a significant improvement in employees’ perceptions of management’s commitment to safety as well as a marginally significant improvement in communication about safety issues were found. This study demonstrated that an intervention program to enhance safety climate was associated with a decrease in the number of aggressive incidents. The researchers concluded that this intervention program is likely to return a sense of safety to workers and reduce workplace violence.
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Duncan, Brent B., Steven R. Forness, and Carolyn Hartsough. "Students Identified as Seriously Emotionally Disturbed in School-Based Day Treatment: Cognitive, Psychiatric, and Special Education Characteristics." Behavioral Disorders 20, no. 4 (August 1995): 238–52. http://dx.doi.org/10.1177/019874299502000403.
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In the continuum of services for students with emotional and behavioral problems, school-based day treatment programs are at the point at which maximum collaboration and coordination between school and mental health is typically involved. With shared diagnostic and program responsibility, a mutually identified student cohort, and frequent interaction across agency boundaries, this interface between school and mental health presents a unique opportunity to examine diagnostic similarities and differences between the two systems. Archival record searches were conducted to gather data regarding the diagnostic and treatment histories of 85 children and adolescents served in two exemplary school-based day treatment programs in California. Findings suggest a significant lag time between first symptoms, referral for services, and treatment; marked instability of psychiatric diagnoses over time; and lack of concordance between DSM diagnoses and IDEA SED characteristics. These data raise serious concerns regarding the availability of prevention and early intervention services, even in locales striving to develop a coordinated system-of-care approach to treatment. They also raise questions about the integrity and congruity of the psychiatric and educational diagnostic systems utilized by school and mental health personnel.
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Pulido, R., M. Monari, and N. Rossi. "Assessing Initial Patient’s Affective Disposition Towards the Hospitalization and the Treatment: A Validation Study." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)71110-1.
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The present work shows some preliminary results of a longitudinal study aimed at validating a psychometric instrument - the Subjective Distance Scale (SDS) - developed to assess the patient's affective nearness/remoteness towards/from the psychiatric treatment in a Day Hospital program. 55 day hospital patients were assessed at different moments of the treatment: At admission they were evaluated by means of the SDS, the SCL-90-R (patient's psychiatric symptoms) and the GAS (patient's mental health level). Institutional therapeutic alliance was assessed one week from admission (IWAI-p) and finally, patient's psychiatric symptoms were retested (SCL-90-R) at the end of the treatment and 3 months from discharge. The main results reveal good psychometric properties of the SDS: its factorial structure partially confirms the dimensions theoretically hypothesised; its internal consistency - total and most of its subscales - reach adequate reliability levels; and related to its predicted validity, the scale correlates with some important aspects of the treatment, like the quality of the early institutional alliance, the symptomatic improvement and the stability of the improvements in time. New studies with larger samples and conducted in additional psychiatric settings are necessary to guarantee the validity and reliability of the scale before it could be used as a clinical screening instrument.
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Schooler, Nina, Delbert Robinson, Patricia Marcy, Philipp Homan, Eric Achtyes, and John M. Kane. "O9.7. TECHNOLOGY ASSISTED RELAPSE PREVENTION PROGRAM REDUCES HOSPITALIZATION IN SCHIZOPHRENIA PATIENTS AT HIGH RISK FOR RELAPSE." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S23—S24. http://dx.doi.org/10.1093/schbul/sbaa028.054.
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Abstract Background Psychiatric hospitalization is a major driver of cost in the treatment of schizophrenia. During the first six months after a hospitalization, patients are at increased risk for return to the hospital. Targeting treatment during this period may be especially valuable. Mobilizing a range of treatment enhancements using both smart phones and computers to support patients by individualizing treatment to specific needs may be especially beneficial. The Improving Care Reducing Cost (ICRC) program sought to determine whether a novel, multicomponent, and technology-enhanced approach to relapse prevention in outpatients following a psychiatric hospitalization could reduce days spent in a hospital after discharge. Methods The ICRC study was a quasi-experimental clinical trial in outpatients with schizophrenia conducted between February 2013 and April 2015 at 10 sites in the US that provide both in and outpatient. Data were obtained from 89 participants who received usual relapse prevention services, followed by a second cohort of 349 participants who received technology-enhanced relapse prevention program. Both groups were followed for 6 months. Patients were between 18 and 60 years old; had a diagnosis of schizophrenia, schizoaffective disorder, or psychotic disorder not otherwise specified; and were currently hospitalized or had been hospitalized within the past 30 days at consent. The first cohort received usual care; the second cohort received the Health Technology Program (HTP) a technology-enhanced relapse prevention program. HTP included medication treatment guided by a computer decision support system for the prescriber, a smartphone application for patients that supported medication adherence and other coping strategies, a web-based patient and family psycho-educational intervention, and web-accessed cognitive behavioral therapy for paranoia and hallucinations. A mental health technology coach provided technical support, and developed a personalized, structured, relapse prevention plan with each participant that identified individual relapse precipitants and determined which HTP components should be employed to address them. All patients received computers and Android smartphones to insure access to the interventions. Days spent in a psychiatric hospital during 6 months after discharge was assessed. The Heinrichs Carpenter Quality of Life Scale was completed at baseline and six months. Results The study included 438 patients. Control participants (N = 89; 37 females) were enrolled first and received usual care for relapse prevention, and followed by 349 participants (128 females) who received the HTP. Days of hospitalization were reduced by 4 days (Mean days: b = -4.25, 95% CI: -8.29; -0.21, P = 0.039) during follow-up in the intervention condition compared to control. Finally, using Heinrichs Carpenter Quality of Life total score at month 6 as an outcome, we found no significant effect of HTP (β = 0.02, t (345) = 0.43, P = 0.668). Discussion Recently hospitalized patients with schizophrenia who received an integrated technology informed relapse prevention program (HTP) experienced fewer days in the hospital compared to those who received usual care in the six months following their discharge. Given the high patient burden and costs of even a single day spent in a psychiatric hospital, estimated at $1358 per day based on inflation adjusted results from a recent study, our findings imply total savings in psychiatric inpatient expenditures of $5772 during the first 6 months after discharge on average. However, reduction in hospitalization days did not result in a parallel improvement in functioning as assessed by the Quality of Life Scale. Although the control and experimental cohorts were comparable in many characteristics, the quasi–experimental design represented by sequential cohorts rather than a true concurrent randomized controlled trial represents a limitation. The results of the study suggest that technology enhanced treatments that are tailored to patient needs can be implemented in a range of clinical settings in the US to patients at high risk of hospitalization and that the intervention can reduce subsequent hospitalization days. Future research should address limitations in the current study design and will benefit from the development of technology applications that can be available on a single flexible platform.
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Ulfah, Nurbani. "Evaluasi Program Art Therapy Bagi Pasien Dual Diagnosis (NAPZA-Skizofrenia) di Rumah Sakit Ketergantungan Obat (RSKO) Jakarta." EMPATI: Jurnal Ilmu Kesejahteraan Sosial 4, no. 1 (June 6, 2015): 58–77. http://dx.doi.org/10.15408/empati.v4i1.9767.
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The main problem drug users with psychiatric disorders is the difficulty of communicating the reason they use drugs and express their feelings on the condition of the Counselor or Social Worker (Therapist). The existence of the program of art therapy for patients with drug with psychiatric disorders (dual diagnosis) is part of psychotherapy as an adjunct therapy in the form of art to channel emotions, express their feelings when communicate verbally is difficult, and to express themselves freely in order to improve their condition in the direction better in recovering. In an effort to redress for victims of drug abuse, especially for people with dual diagnosis due to drug addiction, the Drug Dependency Hospital (RSKO) is a reference center for rehabilitation using the Therapeutic Community (TC) based hospitals that have programs therapies to restore health and capabilities in the field of art, one through the art therapy program.Keywords: Evaluasi Program, Art Therapy, Dual Diagnosis (NAPZA-Skizofrenia), dan Pekerja Sosial Medis/Klinis.
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Zeeck, Almut, Katharina Endorf, Sebastian Euler, Laura Schaefer, Inga Lau, Kristina Flösser, Valeria Geiger, et al. "Implementation of mentalization‐based treatment in a day hospital program for eating disorders—A pilot study." European Eating Disorders Review 29, no. 5 (July 16, 2021): 783–801. http://dx.doi.org/10.1002/erv.2853.
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Dowling, M. J., Patrick Doyle, and S. P. Kennelly. "282 A Time to Wean: An Audit on Benzodiazepine and Z-drug Use Amongst Patients Attending a Geriatric Ambulatory Care Day Hospital." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.177.
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Abstract Background Benzodiazepine prescription is common among the Irish patient cohort. 23% of medical card holders have been prescribed a benzodiazepine or Z-drug, with a third of these being for a period longer than three months. This is despite these drugs being associated with addiction, falls, cognitive and psychomotor impairment, mood disorder, sleep automatism and drug interactions. We performed an audit looking at the repeat prescriptions of patients attending a geriatric day hospital. Methods The repeat prescriptions of all patients currently enrolled at a day hospital were analysed for benzodiazepines or Z-drugs. Medical records were then analysed to look for indication and whether these patients were currently attending psychiatric services. Subsequent to this, notices were placed in the patient consult room in direct line of sight of the registrar reminding them to consider weaning these drugs and detailing the negative side effects and guidelines for weaning from the Canadian National Pain Centre. Results 59 patients were enrolled at the day hospital when the audit was performed. 11 (19%) had either a benzodiazepine or Z-drug as part of their repeat prescription (benzodiazepine-5, Z-drug-5, both-1). The most common benzodiazepines prescribed were diazepam and clonazepam (2 patients on each). Of those prescribed a benzodiazepine, none were currently being weaned. Of those on benzodiazepines, 4 of 6 had a documented psychiatric diagnosis, and 1 of 6 had documented that they were currently attending psychiatric services. A re-audit three months later showed no change in those prescribed benzodiazepines (5/59), and a non-significant increase in those on Z-drugs (9/59, p=0.26). Conclusion This audit showed a significant number of patients attending our day hospital are being prescribed long term benzodiazepines or Z-drugs, and highlights that this setting is an opportune time and place to establish a supported program to wean people off these medications.
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Grizenko, Natalie, and Danielle Papineau. "A Comparison of the Cost-Effectiveness of Day Treatment and Residential Treatment for Children with Severe Behaviour Problems." Canadian Journal of Psychiatry 37, no. 6 (August 1992): 393–400. http://dx.doi.org/10.1177/070674379203700608.
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This study compares the cost of treating 23 children admitted to a residential treatment unit in a psychiatric hospital and 23 children admitted to the same unit after it was converted to a day treatment program, through a retrospective chart review. The two groups were similar in age, gender, diagnosis, severity of pathology, family functioning and support, the number of subjects who dropped-out, and treatment outcome. The average length of stay on the unit dropped from 19.6 to 6.1 months, and the average cost of treatment per child decreased from $61,412 to $9,213 (Canadian dollars, adjusted for inflation). The sharp decrease in treatment time with day treatment may be the result of close links with community schools and maintaining the child in the family and community. The cost savings can be attributed to the shorter hospital stays and the lower operating costs of day treatment. Implications of these findings will be discussed with respect to health care policy including the need to raise awareness of day treatment as a cost-effective alternative to residential hospital treatment.
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Battle, Cynthia L., and Margaret M. Howard. "A mother–baby psychiatric day hospital: History, rationale, and why perinatal mental health is important for obstetric medicine." Obstetric Medicine 7, no. 2 (January 10, 2014): 66–70. http://dx.doi.org/10.1177/1753495x13514402.
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Background Women frequently experience depression, anxiety, or other mental health concerns during pregnancy and postpartum, impacting her and her infant’s health. Patients who require management of medical conditions during the perinatal period are even more likely to experience depression and anxiety compared to those without comorbid medical issues. Despite the availability of effective treatments, perinatal mental health utilization rates are strikingly low. Methods To address common treatment barriers, we developed a specialized mother–baby day hospital for women with psychiatric distress during the peripartum. In this report, we summarize findings from 800 patient satisfaction surveys collected from women treated at the program between 2007 and 2012. Results Findings suggest that women are highly satisfied with the treatment received, often noting that the inclusion of the baby in their treatment is a highly valued feature of care. Conclusion The relevance of perinatal mental health services for patients who are followed by obstetrical medicine specialists is discussed.
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Shannon, Lisa M., Afton Jackson Jones, Jennifer Newell, and Connie Payne. "Examining Individual Characteristics and Program Performance to Understand Two-Year Recidivism Rates Among Drug Court Participants: Comparing Graduates and Terminators." International Journal of Offender Therapy and Comparative Criminology 62, no. 13 (April 30, 2018): 4196–220. http://dx.doi.org/10.1177/0306624x18769602.
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Drug courts strive to break the cycle of substance use and crime by providing community-based treatment and rehabilitation. The purpose of the present study was to (a) identify significantly different factors between program participants (i.e., graduates/terminators) that may affect recidivism and (b) examine these significant individual and program performance factors associated with two-year recidivism. Secondary data were examined for a stratified random sample of drug court participants ( N = 534). Examining any two-year post-program recidivism (defined as an arrest, conviction, or incarceration), over one third (37.6%) of graduates and almost all program terminators (95.3%) had two-year post-program recidivism ( p < .001). For the overall sample, age, outpatient treatment, marital status, number of times treated for a psychiatric problem in a hospital, substance use (i.e., past-30-day cocaine use and intravenous opiate use), number of positive drug tests, and receiving any sanction/therapeutic response were associated with two-year post-program recidivism. Further analyses suggested age and outpatient treatment were particularly important for program graduates. Findings provide information for early targeting of resources to drug court participants most at risk of poorer post-program outcomes by identifying factors known at program entry and indicators during program participation.
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McDonagh, James G., William Blake Haren, Mary Valvano, Anouk L. Grubaugh, Frank C. Wainwright, Colette H. Rhue, Christine M. Pelic, Christopher G. Pelic, Renee Koval, and Janet A. York. "Cultural Change: Implementation of a Recovery Program in a Veterans Health Administration Medical Center Inpatient Unit." Journal of the American Psychiatric Nurses Association 25, no. 3 (July 4, 2018): 208–17. http://dx.doi.org/10.1177/1078390318786024.
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INTRODUCTION:The Freedom Commission’s recommendations, Substance Abuse and Mental Health Services Administration’s framework, and policy directives on recovery-oriented services have fueled the recovery transformation. Mental health recovery services have been implemented in a broad range of outpatient settings. However, psychiatric inpatient units remained embedded in the traditional model of care. AIMS: The purpose of this article is to describe an ongoing quality improvement implementation of recovery services in a Veterans Health Administration acute psychiatric inpatient unit. METHOD: An interprofessional Partnership for Wellness delivered 4 to 6 hours per day of evidence-based recovery and holistic population-specific health programs. Veteran, system, and program indicators were measured. RESULTS: Preliminary indicators over a 2-year period suggest that Veterans rated group content and relevance high, pre–post psychiatric rehospitalization rates decreased by 46%, and fidelity to recommended strategies was high. CONCLUSIONS: The project success reflects strong leadership, a partnership of committed staff, effective training, and an organizational culture exemplifying excellence in Veteran services and innovation.
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Tomko, John R., Nadeem Ahmed, Koushik Mukherjee, Rebecca S. Roma, Donna DiLucente, and Karen Orchowski. "Evaluation of a Discharge Medication Service on an Acute Psychiatric Unit." Hospital Pharmacy 48, no. 4 (April 2013): 314–20. http://dx.doi.org/10.1310/hpj4804-314.
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Background Nonadherence with medication is a major factor that influences acute psychiatric hospital readmission. Pharmacists can positively influence rapid psychiatric readmission due to nonadherence by counseling patients and providing filled prescriptions on discharge. Objective This study is a retrospective evaluation of a pharmacist-driven discharge medication service for hospitalized psychiatric patients. Measured outcomes include a comparison of rapid readmissions pre and post implementation. Rapid readmissions between the concurrent study group and excluded group were also compared. Methods From October 2010 to November 2011, home-destined subjects being discharged from the hospital's behavioral health unit were provided filled psychiatric prescriptions for self-administration upon discharge, coupled with medication counseling. A series of statistical comparisons were made between the 2 prior years' overall rapid readmissions. This was subsequently compared with the overall rapid readmission rate during the study year. The study group's rapid readmissions were then compared to the overall rapid readmission rate of the study year as well as to the concurrent excluded group. Results Thirty-day hospital readmissions were found to be significantly decreased in studied subjects compared to total rapid readmissions during the previous year ( P = .004) and to the excluded group ( P = .020). Conclusion Immediate availability of prescriptions upon discharge, coupled with development of therapeutic alliances with patients, removes some of the barriers to patient medication adherence in the discharged, acute psychiatric patient. The program provided positive outcomes with regard to decreased frequent, rapid readmission to the acute care psychiatric unit due to medication nonadherence.
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Puspitasari, Ajeng J., Dagoberto Heredia, Brandon J. Coombes, Jennifer R. Geske, Melanie T. Gentry, Wendy R. Moore, Craig N. Sawchuk, and Kathryn M. Schak. "Feasibility and Initial Outcomes of a Group-Based Teletherapy Psychiatric Day Program for Adults With Serious Mental Illness: Open, Nonrandomized Trial in the Context of COVID-19." JMIR Mental Health 8, no. 3 (March 11, 2021): e25542. http://dx.doi.org/10.2196/25542.
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Background In the context of the COVID-19 pandemic, many behavioral health services have transitioned to teletherapy to continue delivering care for patients with mental illness. Studies that evaluate the outcome of this rapid teletherapy adoption and implementation are pertinent. Objective This single-arm, nonrandomized pilot study aimed to assess the feasibility and initial patient-level outcomes of a psychiatric transitional day program that switched from an in-person group to a video teletherapy group during the COVID-19 pandemic. Methods Patients with transdiagnostic conditions who were at risk of psychiatric hospitalization were referred to the Adult Transitions Program (ATP) at a large academic medical center in the United States. ATP was a 3-week intensive outpatient program that implemented group teletherapy guided by cognitive and behavioral principles delivered daily for 3 hours per day. Feasibility was assessed via retention, attendance rate, and rate of securing aftercare appointments prior to ATP discharge. Patients completed standardized patient-reported outcome measures at admission and discharge to assess the effectiveness of the program for improving quality of mental health, depression, anxiety, and suicide risk. Results Patients (N=76) started the program between March and August of 2020. Feasibility was established, with 70 of the 76 patients (92%) completing the program and a mean attendance of 14.43 days (SD 1.22); also, 71 patients (95%) scheduled at least one behavioral health aftercare service prior to ATP discharge. All patient-level reported outcomes demonstrated significant improvements in depression (95% CI –3.6 to –6.2; Cohen d=0.77; P<.001), anxiety (95% CI –3.0 to –4.9; Cohen d=0.74; P<.001), overall suicide risk (95% CI –0.5 to –0.1; Cohen d=0.41; P=.02), wish to live (95% CI 0.3 to 1.0; Cohen d=0.39; P<.001), wish to die (95% CI –0.2 to –1.4; Cohen d=0.52; P=.01), and overall mental health (95% CI 1.5 to 4.5; Cohen d=0.39; P<.001) from admission to discharge. Conclusions Rapid adoption and implementation of a group-based teletherapy day program for adults at risk of psychiatric hospitalization appeared to be feasible and effective. Patients demonstrated high completion and attendance rates and reported significant improvements in psychosocial outcomes. Larger trials should be conducted to further evaluate the efficacy and effectiveness of the program through randomized controlled trials.
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Páv, M., M. Hollý, M. Cendelínová, J. Gojda, and J. Polák. "SOMA Score, cardiovascular risk screening tool for psychiatric patients." European Psychiatry 33, S1 (March 2016): s284—s285. http://dx.doi.org/10.1016/j.eurpsy.2016.01.763.
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IntroductionLife expectancy of patients with severe mental illness (SMI) is two decades shorter than that of general population. The most important cause of death are cardiovascular diseases (CVD).ObjectivesThere is a need for CVD risk screening tools development and validation in the context of the Czech Republic.AimsMethodological approach to a CVD risk screening, risk stratification and specific life-style interventions development is presented. In a context of the psychiatric hospital with c. 7000 admissions per year.MethodsThere are no concise data on CVD risk of psychiatric patients in the Czech Republic so cross-sectional analysis of one day hospitalized patients was performed.ResultsA sample of 1056 pts. was obtained. Database allowed extraction data on CVD risk factors (RF): diagnosis, age, sex, BMI and blood pressure (BP). The most common diagnosis were F20 and F10. Multicriterial analysis according to diagnosis (frequency of highest BMI and BP) showed the worst results in the F20 followed by F10 group. Would we define the CVD RF as BMI ≥ 30, age ≥ 65, sBP ≥ 140, dBP ≥ 90, then no RF is present in 368, one in 238, two in 191, three in 92 and four RF in 33 pts. Two step screening protocol was developed – SOMA score. Variables and cut-offs for positivity were set based on the results.ConclusionMethodological process of SOMA score screening is presented as well as consecutive health care interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.AcknowledgementThe study was realized in a framework of SOMA project, Program CZ11 Initiatives in public health care, Norway grants, NF-CZ11-OV-2-030-2015.
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Zayas, Luis H., Mary E. Evans, Luis Mejia, and Orlando Rodriguez. "Cultural-Competency Training for Staff Serving Hispanic Families with a Child in Psychiatric Crisis." Families in Society: The Journal of Contemporary Social Services 78, no. 4 (August 1997): 405–12. http://dx.doi.org/10.1606/1044-3894.798.
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As part of a research demonstration project focusing on children's psychiatric crises and their families, a cultural-competency training program was developed for staff delivering home-based crisis Intervention. The authors describe the training program, which was intended to teach culturally competent practice with Hispanic children and families. Training consisted of a day-long workshop, follow-up meetings with staff, and a half-day ‘booster’ session six months after the initial workshop. The workshop covered essential elements of Hispanic cultural diversity, values, family structure, interpersonal relations, child-rearing beliefs and practices, and points of interventions. Follow-up meetings provided counselors with the opportunity to discuss Issues and experiences not covered in the first workshop and allowed trainers to monitor the counselors' incorporation of culturally competent principles of practice. In the booster session, trainers addressed issues raised by counselors at the follow-up meetings in a more organized manner and addressed new, emergent issues.
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Huthwaite, Mark, Jane Elmslie, Susanna Every-Palmer, Eve Grant, and Sarah E. Romans. "Obesity in a forensic and rehabilitation psychiatric service: a missed opportunity?" Journal of Forensic Practice 19, no. 4 (November 13, 2017): 269–77. http://dx.doi.org/10.1108/jfp-03-2017-0007.
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Purpose The purpose of this paper is to study weight changes during psychiatric hospitalization, so as to identify “obesogenic” features in a mixed (forensic and rehabilitation) inpatient service. Design/methodology/approach An observational study of psychiatric inpatients, gathering sociodemographic, clinical, weight, dietary and sleep information and an actigraphic assessment. Findings A total of 51 patients, aged 19-68, 40 males, participated at a median of 13 months after their admission. When studied, only 6 percent had a healthy weight, 20 percent were overweight and three quarters (74 percent) were obese. The mean Body Mass Index (BMI) was 35.3 (SD: 8.1). At admission, only three patients (8.3 percent) had healthy BMIs and over the course of their hospital stay, 47 percent gained further weight. A high proportion was physically inactive and half slept more than nine hours a day. Participants received high calorie diets and half (53 percent) smoked cigarettes. Practical implications Although antipsychotic medication is known to cause weight gain, this should not be seen in isolation when attempting to explain psychiatric inpatient obesity. An inpatient admission is an opportunity to provide a healthier eating environment, health education and assertively promote less sedentary behavior and healthier sleep habits. Social implications Obesity adds to the burden of this already significantly disadvantaged group of patients. Originality/value The results confirm earlier research showing that forensic and rehabilitation psychiatric inpatients as a group are obese, gain weight while in hospital and often smoke. The authors add data demonstrating that they are often physically inactive, sleep excessively and consume an unhealthy diet despite the provision of health focused interventions as an integral part of their inpatient program.
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Nilakantam, Sathish Raju, Shivanand Manohar, Suman S. Rao, M. Dayananda, Supriya Mathur, H. Basavanna Gowdappa, Guruswamy Mahadevappa, Rajesh Raman, and T. S. Sathyanarayana Rao. "Setting Up Psychosexual Medicine Unit: Insights From a Private University-Based Medical College Hospital." Journal of Psychosexual Health 2, no. 2 (April 2020): 179–85. http://dx.doi.org/10.1177/2631831820939464.
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Introduction: Sexual health issues are highly prevalent but are underdiagnosed and underrecognized in day-to-day clinical practice. The lack of awareness of the specific health care needs of the patients with sexual dysfunctions and resource limitations might be certain reasons why many hospitals are not been equipped with the sexual health care units. There is paucity of specialized psychosexual health care services across the country. Trained interdisciplinary team with prepared environment in sexual medicine is the need of the hour. We started this psychosexual medicine unit with an emphasis on sexual wellness to deliver comprehensive sexual health care which will be a primary care linkage to patients presenting with symptoms of sexual disorders, so also treatment emergent sexual dysfunction in psychiatry and other medical and surgical branches. Aim: To portray the methods, opportunities, and challenges that we experienced in establishing a specialty psychosexual medicine facility as a different unit in a private university-based medical college and hospital in Mysuru, India. Methods: This triweekly psychosexual medicine unit is situated in the Outpatient Division of Psychiatry and is staffed with a multidisciplinary group of health care professionals. Structured survey tools and proforma are utilized to assess all patients. Case conclusions are made according to International Classification of Diseases, Tenth Revision, symptomatic/clinical explanations and diagnostic recommendations, and furthermore Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) when required. Patient care included interventions in the form of psychotherapy and pharmacotherapy. Results: It is possible to set up a functional psychosexual medicine facility as a different unit with a trained interdisciplinary group of professionals. Patient-centered approach is vital in our care plan and management. Postgraduate students and internees posted in psychiatry division have been undertaking rotations respectively as per their duty rota. There is also a robust academic program that includes once-weekly seminars pertaining to topics of psychosexual health and monthly journal club gatherings interchanging with seminars on sexual health and well-being appraisal devices. Conclusion: By investing on improving infrastructure and available human resources, the specialty psychosexual medicine unit was established. The psychosexual medicine unit not only gave chances for a more comprehensive assessment of individuals with sexual disorders but also improved training and education for residents with focused interdisciplinary research in the field of sexual medicine. It portrays a versatile model that can be replicated in settings of similar type.
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Cheung, P., I. Schweitzer, V. Tuckwell, and K. C. Crowley. "A Prospective Study of Aggression among Psychiatric Patients in Rehabilitation Wards." Australian & New Zealand Journal of Psychiatry 30, no. 2 (April 1996): 257–62. http://dx.doi.org/10.3109/00048679609076103.
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Objective: The aim of the study was to determine, among patients in rehabilitation wards, the prevalence and nature of aggressive behaviour and the relationship between aggressive behaviour and patient characteristics and ward factors. Method: The aggressive behaviour of all 220 inpatients within the rehabilitation program of a large psychiatric hospital in Victoria was assessed using the Staff Observation Aggression Scale. Results: Physical assaults occurred at a rate of 97.6 per 100 patients per year. About 40% of all incidents appeared to be unprovoked. Most physical incidents involved use of body parts and use of a weapon was uncommon. Aggression was most often directed at a staff member. Serious injury was rare. Aggressive behaviour was correlated with gender and duration of admission for the whole sample; however, there were different correlates of aggressive behaviour for different ward populations and different types of aggression. As for ward variables, time of day but not patient/staffing level was associated with aggressive behaviour. Conclusions: There was a high rate of aggressive behaviour among patients in rehabilitation wards; this should be taken into consideration in the planning of their community placement. The findings also caution against aggregating different ward populations and types of aggressive behaviour for research.
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Palumbo, D., S. Landi, P. Margolies, A. J. Salerno, A. Cleek, E. Castaldo, and A. Mucci. "A Hybrid Effectiveness-implementation Trial of Wellness Self-management Program for Patients with Severe Mental Illness in an Italian Day Hospital Setting." European Psychiatry 41, S1 (April 2017): S96. http://dx.doi.org/10.1016/j.eurpsy.2017.01.298.
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IntroductionWellness self-management is an adaptation and expansion of the illness management and recovery, an internationally recognized best practice. WSM is a recovery-oriented, curriculum-based practice designed to help adults with severe mental health problems make decisions and take action to manage symptoms and improve their quality of life.ObjectivesIn the present study, the Italian translation of the WSM was implemented and validated. Moreover, the impact of its application in a day hospital setting on cognitive functions, psychopathology, personal resources and real-life functioning with respect to treatment as usual (TAU) was investigated.AimsThe study was aimed at assessing the effectiveness of a semi-structured version of WSM in a day hospital setting in patients with severe mental illness.MethodsFourteen patients with a diagnosis of severe mental illness were recruited and randomly assigned to either WSM or TAU. WSM participants attended four 2-hour sessions per week for 1 month, including lessons selected on the basis of the goals of participants. Both groups received weekly planned treatment in the day-hospital setting and continued their pharmacotherapy.ResultsThe two groups of patients were comparable for age, education, cognitive functioning and psychopathological severity. WSM produced a significantly greater improvement in neurocognition, psychopathology, personal resources and real-life functioning with respect to TAU.ConclusionsOur results offer promising preliminary evidence that the use of WSM provides an effective complement to current mental health treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Van Praag, H. M. "Anchorpoints: an introspective." Acta Neuropsychiatrica 9, no. 2 (June 1997): 38–46. http://dx.doi.org/10.1017/s0924270800036759.
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This, then, is what it has been all about. Today I mark the end of an academic career that ranged over 45 years. 1952 was the starting point. In that year, as a medical student, I was accepted as a research assistent by Prof. G.G.J. Rademaker, a neurophysiologist and at the time head of the Department of Neurology at the Academic Hospital in Leiden. The neurological research period was followed by a mycological one. Having received my MD degree and doing my military service, I was asked to carry out a study into the prevalence, prevention and treatment of mycological infections in military personel. For this reason I worked for more than 1, 5 years in Baarn at the section Medical Mycology of the Phytopathological Laboratory, an interacademic institution of the Universities of Amsterdam and Utrecht (1956-1958). Immediately after the military service I became a resident in psychiatry and started – together with the biochemist Prof. B. Leijnse – a research program into the biological determinants of depression. The period of psychiatric investigation lasted until this very day, albeit in different locations, i.e. Rotterdam, Groningen, Utrecht, New York and Maastricht respectively.
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Miguel-Cruz, Antonio, Anna-Maria Ladurner, Megan Kohls-Wiebe, and David Rawani. "The Effects of 3D Immersion Technology (3Scape) on Mental Health in Outpatients From a Short-Term Assessment, Rehabilitation, and Treatment Program: Feasibility Protocol for a Randomized Controlled Trial." JMIR Research Protocols 10, no. 9 (September 14, 2021): e25017. http://dx.doi.org/10.2196/25017.
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Background Mental health conditions are prevalent among Canadians and are a leading cause of disability. Each year, 1 in 5 Canadians experiences a mental health issue. A total of 5% of people aged ≥65 years perceive their mental health as fair or poor, and 6.3% of them have mood disorders. Regarding older adults with cognitive impairments such as dementia, up to 40%-50% of them experience depression at some point. We believe that older adults can benefit significantly from information and telecommunication technologies as a strategy for improving mental health conditions such as depression and anxiety, while simultaneously improving their quality of life. 3Scape Systems Inc is an Alberta-based private company that has produced a series of specialized 3D videos designed to simulate real-life events and engage individuals living with mental health disorders and cognitive impairments such as dementia. Objective This study aims to explore the trial design and effects of 3Scape videos on older adults’ symptoms of depression and anxiety and the efficacy of this technology in improving the quality of life of patients attending the Short-Term Assessment, Rehabilitation, and Treatment Psychiatry Day Hospital program at Glenrose Rehabilitation Hospital and to provide data to estimate the parameters required to design a definitive randomized controlled trial. Methods The trial will use a randomized controlled design comprising 15 intervention participants and 15 control group participants. The participants will be adults aged ≥65 years who are cognitively intact or have minimal cognitive impairment (ie, Montreal Cognitive Assessment score ≥18), and are clients of the Short-Term Assessment, Rehabilitation, and Treatment Psychiatry Day Hospital program at Glenrose Rehabilitation Hospital. This study’s primary outcome variables are related to clients’ depressive and anxiety symptoms and their quality of life. The control group will receive the standard of care (ie, the Short-Term Assessment, Rehabilitation, and Treatment Psychiatry Day Hospital program at Glenrose Rehabilitation Hospital). The intervention group will receive the same standard of care as the control group and will use 3Scape Systems videos for therapeutic activities. Results Our study is currently on hold because of the COVID-19 pandemic. The recruitment process is expected to resume by November 2021, and the primary impact analysis is expected to be conducted by February 2022. Conclusions This study will provide valuable information such as the measurement of comparative intervention effects, perception of older adults and mental health therapists about the 3Scape Systems, the associated costs of treatment, and product costs. This will contribute to the evidence planning process, which will be crucial for the future adoption of 3Scape Systems. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 93685907; https://www.isrctn.com/ISRCTN93685907. International Registered Report Identifier (IRRID) PRR1-10.2196/25017
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Damásio, Virgínia Faria, Viviane Da Costa Melo, and Karla Bernardes Esteves. "Atribuições do enfermeiro nos serviços de saúde mental no contexto da reforma psiquiátrica." Revista de Enfermagem UFPE on line 2, no. 4 (September 25, 2008): 425. http://dx.doi.org/10.5205/reuol.329-11493-1-le.0204200813.
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ABSTRACTObjective: to describe and to identify nurse’ attributions in the mental health services according to the Psychiatric Reform. Methodology: descriptive and exploratory study, from qualitative approach, developed by recent literature review, in which we searched articles from the Virtual Health Library (BVS), and also the collection of Scielo. The analyses were done by pre and selective readings, and also textual and interpretative investigation of the selected texts. Results: it had been found 7544 publications. We limited the choice to those articles related with the nurse’s attributions and the assistance in the Mental Health Services after the Psychiatric Reform. We selected 34 articles. We defined three categories from the readings: Nursing in the Psychiatric Reform, Strategies for the Psychosocial Rehabilitation, Nurse’s Attributions Mental Health Services. We have observed that the more referred articles to the following Mental Health Services: Daily Hospital, Emergence Care, Specific Day Centres, Family Health Program Therapeutic Residential Services.,Conclusion: This research let us realize that most of the characteristics of nursing attributions in the mental health services owns to the replacement of the asylum model for different services such as Psychosocial Attention Center (CAPS), Day-Hospital, Group Homes and basic attention partnership. Descriptors: nursing; mental health; psychiatric reform. RESUMO Objetivo: descrever e identificar as atribuições do enfermeiro nos serviços de saúde mental nos preceitos da Reforma Psiquiátrica. Métodos: pesquisa descritiva e exploratória, de abordagem qualitativa, por meio de revisão sistemática de literatura, no qual pesquisamos artigos na Biblioteca Virtual da Saúde, do banco de dados do Scielo. Os artigos foram analisados após pré-leitura, leitura seletiva, análise textual e interpretativa. Resultados: foram encontradas 7544 publicações. A escolha ficou limitada àqueles artigos que abordavam as atribuições e a assistência do enfermeiro nos Serviços de Saúde Mental após a Reforma. Foram selecionados 34 artigos. A partir da análise textual foram definidas três categorias: Enfermagem na Reforma Psiquiátrica, Estratégias para a Reabilitação Psicossocial e Atribuições do enfermeiro nos serviços de Saúde Mental. Observamos que os Serviços de Saúde Mental mais relatados nos artigos foram: Hospitais-Dia, Unidade de Internação psiquiátrica em Hospital Geral, Centro de Atenção Psicossocial, Programa de Saúde da Família, Serviços Residenciais Terapêuticos. Conclusão: percebemos que as atribuições do enfermeiro nos serviços de saúde mental apresentaram diversas características devido à substituição do modelo manicomial por outros equipamentos como Centro de Atenção Psicossocial, Hospitais-Dia, Serviços Residenciais Terapêuticos e integração com atenção básica. Descritores: enfermagem; saúde mental; reforma psiquiátrica.RESUMENObjetivo: describir et identificar las funciones del enfermero en los servicios de salud mental bajo normas de lo preceptos de la reforma psiquiátricos. Metodología: realizamos una investigación descriptiva y exploratoria con abordaje cualitativo, a través de examen bibliográfico, en el cual buscamos artículos en la biblioteca virtual de salud (BVS), en la base de datos del Scielo. Los artículos fueron analizados con una pre-lectura, lectura selectiva, y el análisis literal e interpretativo de los textos elegidos. Resultados: fueron encontradas 7544 publicaciones. Los resultados quedaron limitados a aquellos artículos que abordaban las atribuiciones y la assistencia de los enfermeros en los Servicios de Salud Mental amen de la Reforma. Fueron selecionados 34 articulos. A partir del análisis textual fueron definidas tres categorias: Enfermeria em la Reforma Psiquiátrica, Estratégias para a Reabilitacion Psicosocial e Atribuiciones del enfermero en los servicios de Salud Mental. Observamos que los Servicios de saúde Mental mas relatados en los artículos fueron: Hospitales-Dia, Unidades de Internacion psiquiátrica en Hospital General, Centro de Atencion Psicosocial, Programa de Salud de la Família, Servicios Residenciales Terapeuticos. Conclusión: con esta investigación percibimos que las atribuciones del enfermero presentán diversas características en los servicios de salud mental debido a la substitución del modelo manicomial para los otros equipamientos como el centro de cuidado psicosocial (CAPS), el Hospital-Día, los servicios residenciales terapéuticos (SRT) y atención básica. Descriptores: enferméria; salud mental; reforma psiquiátrica.
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Naruse, Takashi, Ayaka Kitano, Hiroshige Matsumoto, and Satoko Nagata. "A Logic Model for Evaluation and Planning in an Adult Day Care for Disabled Japanese Old People." International Journal of Environmental Research and Public Health 17, no. 6 (March 20, 2020): 2061. http://dx.doi.org/10.3390/ijerph17062061.
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Adult day care (ADC) provides various services for meeting clients’ needs. Based on the mini-Delphi method with 46 ADC staff and the discussions with eight ADC administrators, this study developed and finalized a comprehensive logic model to represent the elements of ADC. For the three basic structures of a logic model—inputs/activities, outputs, and outcomes—the model contained seven core categories and 23 sub-categories. The ADC inputs/activities consisted of two core categories: “Place to stay” and “Intervention from staff”. These inputs/activities caused two kinds of outputs: “Clients’ experiences” and “Families’ experiences”. “Accumulating experiences” with repeated ADC visits was established as the link between the ADC outputs and outcomes, which were “Clients’ change” and “Families’ change”. ADC centers provide various experiences for their clients and their caregivers, ranging from the fulfillment of needs for fundamental care to psychiatric care and self-actualization. Improving various model-related inputs/interventions can produce better experiences and outcomes. The model can guide ADC administrators, policymakers, and researchers in the evaluation of a heterogeneous ADC service program that is community-based, thereby ensuring optimal care for clients with an efficient use of resources.
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Endtner, K., M. Hänni, and W. Tschacher. "Emotion regulation - a transdiagnostic approach." European Psychiatry 26, S2 (March 2011): 1305. http://dx.doi.org/10.1016/s0924-9338(11)73010-3.
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IntroductionPsychotherapy research shows that problems in emotion regulation are at the core of many different psychiatric disorders. Greenberg and colleagues distinguish between two categories of emotion regulation problems: emotional under- and overregulation. Whereas the first category is associated with diminished impulse control, the second is constituted of difficulties in perceiving and expressing emotions.ObjectiveIs it possible to validate the clinical concept of emotional underregulation and overregulation?AimsPatients of a psychotherapy day clinic attended a specific group therapy program aimed at improving emotion regulation. The program included interventions to control impulses as well as interventions focussing on a more appropriate perception and expression of emotions.MethodsThe evaluation of the program was based on pre-post comparisons of standard questionnaires and on repeated assessments of therapy processes using session reports.ResultsResults of about 50 patients attending the group therapy program will be presented. Different clusters depending on a patient's position on the two emotion regulation dimensions were found. Each cluster represented a unique pattern of emotion regulation.DiscussionIt was possible to validate the clinical construct of emotional underregulation and overregulation. The results contribute to a transdiagnostic approach to emotion regulation.
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Shah, Tanya, and Kate Essad. "Non-physiological Speech Disturbance in Teen Athletes with Concussion: A Case Series." Neurology 93, no. 14 Supplement 1 (September 30, 2019): S24.3—S25. http://dx.doi.org/10.1212/01.wnl.0000581072.76335.aa.
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ObjectiveThis report is intended to share unique patient cases featuring a common but inadequately researched problem in adolescents with concussion.BackgroundDespite evidence associating concussion with increased risk of mental illness, the literature has limited information examining functional speech disorder as a sequala of concussion in teen athletes [Table 1].Design/MethodsA PubMed search was completed using the following key words: functional speech disorder, conversion disorder, concussion, pediatrics. A total of five articles resulted and were reviewed.ResultsA 14yo female with a concussion from volleyball had a protracted course of recovery due to anxiety. Months later, she was struck by a tennis ball without a second concussion. She developed a non-physiologic stutter and atasia-abasia. She recovered with cognitive behavioral therapy (CBT). A 16yo female with history of depression sustained a concussion playing soccer with an associated slurred speech. Two weeks later, her initial concussion symptoms resolved however she began stuttering. She was treated by adjusting her psychiatric medications. Two years later she sustained another concussion which caused a reoccurrence of stuttering. Symptoms improved after a partial day program with psychiatry and intensive speech therapy. An 18yo male wrestler with no psychiatric history suffered a concussion. He developed catatonia with echolalia. He was unable to participate in CBT, however symptoms have partially improved with diazepam.ConclusionsThis series highlights pediatric athletes presenting with functional speech disorders after concussion or an event triggering anxiety of concussion. The development of conversion disorder of speech was independent of any pre-disposing psychiatric history. Psychological treatment with CBT or medication successfully improved conditions in all cases. Providers should counsel patients and families of potential stress-response symptoms that can occur with concussion. Ongoing research is needed to establish patterns of these conditions and provide evidenced based guidelines to best direct treatment of these young athletes.
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Barnes, Louise, Deborah Bennett, Charlotte Bryson, Sita Diehl, Trish Hayes, Craig Anne Heflinger, Liz Ledbetter, et al. "Tennessee’s Youth in Juvenile Justice Facilities." Californian Journal of Health Promotion 3, no. 2 (June 1, 2005): 144–58. http://dx.doi.org/10.32398/cjhp.v3i2.1772.
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In order to assess the prevalence of mental health and substance abuse among youth in one state’s juvenile justice facilities, a survey was conducted of 40 Tennessee facilities. A total of 1215 youth were being held on the “one day census” that was taken as part of the survey. The survey documented many mental health and substance abuse issues: 1) 53 percent of the youth in juvenile justice facilities were experiencing mental health problems; 2) 15 percent were taking some type of psychiatric medicine while in the juvenile justice facility; 3) 42 percent were known to have substance abuse problems; and 4) 30 percent had co-occurring mental health and substance use problems. Policy and program recommendations based on these findings are discussed.
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Restek-Petrovic, B., A. Bogovic, G. Majda, M. Nina, and F. Igor. "Effectiveness of Treatment of Young Psychotic Patients on Psychotherapeutic Inpatient Unit." European Psychiatry 41, S1 (April 2017): S265. http://dx.doi.org/10.1016/j.eurpsy.2017.02.081.
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IntroductionThe psychotherapeutic unit for psychotic patients in Psychiatric hospital Sveti Ivan, Zagreb, Croatia provides psychotherapeutic and psychosocial treatment for mostly young psychotic patients. Psychotherapeutic program has basically psychodynamic frame and patients participate in small and medium groups. Also, they participate in workshops based on cognitive behavioral principles (anti-stigma, self-concept, emotion, relationships, goals, stress), psycho-education, therapeutic community, work and occupational therapy, recreational therapy.AimThe aim of this study was to determine effectiveness of this comprehensive program during hospitalization of individuals with first psychotic episode on psychotherapeutic ward. We evaluated the possible changes during treatment in attitudes towards drugs, in quality of life, insight and self-esteem.MethodsParticipants were 37 individuals with first psychotic episode, average age: 25.1. They fulfilled: Drug attitude inventory (DAI-10), The World Health Organization Quality of Life (WHOQOL), Insight scale and Rosenberg's Self-Esteem Scale at the beginning of treatment and at discharge from the hospital.ResultsResults show tendency of more positive attitude towards drugs at discharge, as well as tendency of better self-esteem, statistically significant more satisfaction with physical health (P = 0.004), psychological health (P = 0.004) and with environment (P = 0.001), and statistically significant better quality of life (P = 0.000). There was no significant difference in insight.ConclusionDuring psychotherapeutic treatment of individuals with first psychotic episode, positive changes were observed. So, our findings indicate importance of implementing such a comprehensive program in treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Stalekar, V., and N. Jovanovic. "the Experience of art in Psychotherapy - How to see Angel in the Marble and Curve to set him Free?" European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)71285-4.
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Michelangelo said "I saw angel in the marble and carved until I set him free.", as he didn’t see himself creating something new, but unwrapping beauty that was already there. Art and psychotherapy have many things in common - both are based on relationships and sincerity, communicate through interpretation, creativity and imagination. Experience of art - as mode of learning about reality and one's inner world - can be incorporated into psychotherapy. Our Day hospital program includes psychodynamic analytic oriented group psychotherapy, psychoeducation, sociotherapy and art workshop. the latter implies patients’ artistic creation and visits to museums. It stimulates patients’ relationships with art and brings back a need for esthetic experience which can have protective and reparative role. Here we present several clinical vignettes, thus showing specific relations between psychotherapy and patients’ experience of art; and give an overview of psychiatric patients’ works stored in artistic collections (from Prizhorn until now), as well as art brut, and new psychotherapeutical technique - art therapy. Taking into account analytic and iconographic interpretations, we discuss their similarities and ask - what does a patient achieve by interpreting unconscious contents and what does interpretation of art mean to a recipient? Art and psychotherapy undoubtedly have an impact on us - they cause not only a direct physical reaction, but a sense of pursuit of meaning and contemplation leading to cognition. Every work of art leaves empty space for recipient to fill in. We believe this encourages an integrative process which is also aim of psychotherapy.
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Shaikh, Asad, Khushbu Shah, and Joel Idowu. "109 Hyperthyroidism-induced Psychosis." CNS Spectrums 25, no. 2 (April 2020): 270–71. http://dx.doi.org/10.1017/s1092852920000279.
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Objective:To describe the presence of psychotic symptomatology in a patient with hyperthyroidismAbstract:Psychiatric-spectrum symptoms associated with thyrotoxicosis has been well reported in the past. However, psychosis in a patient with a thyroid nodule is a rare find. Here, the case of twenty four-year-old, single, unemployed, Albanian American male with self-reported history of Attention Deficit Disorder (ADD) and Cannabis use disorder was brought in to the Comprehensive Psychiatric Emergency Program (CPEP) due to new onset psychosis. Patient was paranoid, disorganized with labile mood. He had poor insight, judgement and impulse control. The event coincided with a period of unemployment in his life and new onset of hallucinations from past few days. He was brought in to the hospital after he was found pacing and having lack of sleep. Patient was treated with antipsychotic for acute psychosis. He was started on Risperidone initially to which he did not respond to. Blood work showed low TSH and elevated T4. Physical exam was noted for palpable thyroid nodule. Further labs resulted in high thyroid peroxidase antibody. Ultrasound of thyroid with color flow showed single nodule in the left lobe and iodine uptake activity localized to the left lobe. Patient was started on Methimazole 5 mg along with Haldol 5mg orally twice a day which improved his symptoms tremendously. Patient was stabilized and after 1 week was discharged on Haldol 5 mg by mouth two times a day for Psychosis, Cogentin 1 mg by mouth two times a day for extrapyramidal system (EPS), and Methimazole 5 mg by mouth daily for overactive thyroid nodule.Conclusion:Psychosis associated with thyroid nodule is rare but possible. The onset of psychotic syndrome is an important clinical element whose underlying medical cause must be promptly clarified. Psychosis can present in a number of ways and can have different causes. Apart from psychiatric causes, underlying medical causes should always be considered. In this case it was important to get a full clinical history of the patient as well as complete physical examination. The differential diagnosis of a psychotic disorder in light of a medical disease should always be considered in order to promptly diagnose and treat the underlying cause to reduce the morbidity and possibly the mortality associated with it.
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Ramirez Gaite, M., E. Gundendorfer-Mag. FH, and W. Hrubos. "Intensive Case Management (ICM) Project in Eastern Lower Austria: A Description." European Psychiatry 41, S1 (April 2017): s248. http://dx.doi.org/10.1016/j.eurpsy.2017.02.031.
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IntroductionOur ICM Project was implemented in 2012, with the primary objective of preventing hospitalizations and unburdening services. Here, we present a description.ObjectivesICM is a type of multi-professional assertive community treatment (ACT) and case management, although our concept has a stronger focus on social work than ACT and uses less resources. It aims at patient's stabilization at home, better life quality, less inpatient/residential treatments, and more access to crisis intervention.MethodsPresently we have 118 spots. Target groups are persons with severe psychiatric conditions at high risk for institutionalization or already institutionalized, including heavy users of mental health services. An initial eligibility assessment is required. At least 3 workers are providing a minimum of 2 h face-to-face contact per week per person. Care is offered predominantly at home environment and anchored in: careful distance-closeness ratio, structured and restructuring, autonomy enhancing, respectful, non-judgmental, confidential, regularity and commitment. Each treatment plan is individualized and based on two axes: intensive assistance and day-structure. It comprises comprehensive psychiatric treatment, counselling, assistance in everyday life, support groups, crisis management and interdisciplinary organizational meetings.ResultsThe program was evaluated in 2014 using the CANSAS and FLZ scales and its effectiveness was validated. Most significant improvements were found in day-structure, housing, social contacts and performance, nutrition, and psycho-education. Life satisfaction improvement was found mostly in areas of general health, performance, relaxation and autonomy.ConclusionsSince its implementation ICM has steadily expanded. Further research tools are currently being developed. Results will be presented in future publications.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Syamsudin, Achmad, Ah Yusuf, and Mundakir Mundakir. "Gambaran Kepercayaan Diri Perawat dalam Mengatasi Agresi Pasien di Rumah Sakit Jiwa." Jurnal Penelitian Kesehatan "SUARA FORIKES" (Journal of Health Research "Forikes Voice") 11, no. 4 (June 1, 2020): 407. http://dx.doi.org/10.33846/sf11417.
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Background: Nurses as the staff who are around 24 hours near the patient to provide nursing care are very at risk of experiencing unexpected behavior in the form of aggressive behavior. This can affect the nurse's confidence in patient care, absenteeism, and turnover. Methods: This research was a quantitative research using a descriptive-analytic approach, to found a description of demographic and the level of confidence of nurses in conducting aggressive behavior management. Results: Based on the respondent demographic characteristics, it was found that the majority of respondents were male, aged >35 years old, educated with Associate’s degree, had work periods ranging from >5-10 years, were level 2 of clinical nurses, were civil servants, and work in the VIP room. The majority of nurses' confidence in dealing with patient aggression was at a "moderate" level and there were no nurses who have a "good" confidence level. Conclusion: It was identified as the need for efforts to increase nurses' confidence in overcoming patient aggression in the East Java Provincial Government Mental Hospital. Efforts that need to be done include organizing a training program on aggressive behavior management and creating standards for aggressive behavior management for psychiatric inpatients. The goal is that nurses have guidance and direction in taking preventative measures and effective aggressive patient management. So that nurses' competency and confidence increases and can accelerate the patient's recovery.
Keywords: nurses’ confidence; aggression; violence; psychiatric inpatients; psychiatric nursing
ABSTRAK
Latar belakang: Perawat sebagai tenaga yang selama 24 jam berada didekat pasien untuk memberikan asuhan keperawatan sangat beresiko mengalami perilaku tak terduga dalam bentuk perilaku agresif. Hal tersebut dapat memengaruhi kepercayaan diri perawat dalam melakukan perawatan pasien, ketidakhadiran, dan turnover. Metode: Penelitian ini merupakan desain penelitian kuantitatif dengan menggunakan pendekatan deskriptif analitik, untuk mengetahui gambaran tentang demografi dan bagaimana tingkat kepercayaan diri perawat dalam melakukan manajemen perilaku agresif. Hasil: Berdasarkan karakteristik demografi responden didapatkan hasil bahwa mayoritas responden berjenis kelamin laki-laki, berusia >35 tahun, berpendidikan Diploma III, memiliki lama kerja berada pada rentang >5-10 tahun, berada pada tingkat perawat klinis 2 (PK 2), berstatus kepegawaian sebagai PNS, dan bertempat kerja di Ruang VIP. Mayoritas kepercayaan diri perawat dalam mengatasi agresi pasien berada pada tingkatan “Sedang” dan tidak adanya perawat yang mempunyai tingkat kepercayaan diri “Baik”. Kesimpulan: Teridentifikasi perlu adanya upaya peningkatan kepercayaan diri perawat dalam mengatasi agresi pasien di Rumah Sakit Jiwa Pemerintah Provinsi Jawa Timur. Upaya yang perlu dilakukan diantaranya dengan menyelenggarakan program pelatihan tentang manajemen perilaku agresif dan pembuatan standar manajemen perilaku agresif pasien ODGJ. Tujuannya agar perawat mempunyai panduan dan arahan dalam melakukan tindakan pencegahan serta pengelolaan pasien agresif yang efektif. Sehingga kompetensi dan kepercayaan diri perawat meningkat dan dapat mempercepat kesembuhan pasien.
Kata kunci: kepercayaan diri perawat; perilaku agresif; perilaku kekerasan; pasien gangguan jiwa; keperawatan jiwa
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Hidalgo-Mazzei, D., M. Reinares, A. Mateu, A. Murru, C. D. M. Bonnín, E. Vieta, and F. Colom. "Initial usability and feasibility evaluation of the SIMPLe Smartphone application to monitor and psychoeducate bipolar patients." European Psychiatry 33, S1 (March 2016): S122. http://dx.doi.org/10.1016/j.eurpsy.2016.01.150.
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BackgroundThe SIMPLe project was designed with the aim of developing a smartphone application (i.e. app) to monitor and psychoeducate subjects with bipolar disorder through highly personalized messages from both passive and active data. The project was based on a face-to-face group program, which has an increasing scientific evidence of its efficacy and cost-effectiveness reducing bipolar disorder relapses.AimsAn initial feasibility study was conducted to evaluate the usability and satisfaction of an Android version of the SIMPLe app 1.0.MethodsThe SIMPLe feasibility study was conducted from March 2015 to June 2015. The participation in the study was offered to a consecutive sample of adult patients diagnosed of bipolar disorder I, II or NOS (not otherwise specified) attending the outpatient mental health clinic of the Hospital Clinic of Barcelona, Spain.ResultsThe participation in the study was offered to 72 stable bipolar patients. Forty-three subjects were enrolled in the study. Since the day the patients were enrolled in the study, the rate of completed tests was 0.74 per day and 1.13 per week. Nine emergency alerts were received through the application and notified to the reference patients’ psychiatrists. Ninety-five percent of the initial participants remained actively using the app and no relapses were identified during the 3 months of the study.ConclusionThese preliminary results suggest a high feasibility of the SIMPLE app based on the rates of tasks completed and retention.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Chiu, Mary, Tim Pauley, Virginia Wesson, Dunstan Pushpakumar, and Joel Sadavoy. "Evaluation of a problem-solving (PS) techniques-based intervention for informal carers of patients with dementia receiving in-home care." International Psychogeriatrics 27, no. 6 (January 23, 2015): 937–48. http://dx.doi.org/10.1017/s1041610214002798.
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ABSTRACTBackground:The value of care provided by informal carers in Canada is estimated at $26 billion annually (Hollander et al., 2009). However, carers’ needs are often overlooked, limiting their capacity to provide care. Problem-solving therapy (PST), a structured approach to problem solving (PS) and a core principle of the Reitman Centre CARERS Program, has been shown to alleviate emotional distress and improve carers’ competence (Chiu et al., 2013). This study evaluated the effectiveness of problem-solving techniques-based intervention based on adapted PST methods, in enhancing carers’ physical and emotional capacity to care for relatives with dementia living in the community.Methods:56 carers were equally allocated to a problem-solving techniques-based intervention group or a control arm. Carers in the intervention group received three 1 hr visits by a care coordinator (CC) who had been given advanced training in PS techniques-based intervention. Coping, mastery, competence, burden, and perceived stress of the carers were evaluated at baseline and post-intervention using standardized assessment tools. An intention-to-treat analysis utilizing repeated measures ANOVA was performed on the data.Results:Post-intervention measures completion rate was 82% and 92% for the intervention and control groups, respectively. Carers in the intervention group showed significantly improved task-oriented coping, mastery, and competence and significantly reduced emotion-oriented coping, burden and stress (p < 0.01–0.001). Control carers showed no change.Conclusion:PS techniques, when learned and delivered by CCs as a tool to coach carers in their day-to-day caregiving, improves carers’ caregiving competence, coping, burden, and perceived stress. This may reduce dependence on primary, psychiatric, and institutional care. Results provide evidence that establishing effective partnerships between inter-professional clinicians in academic clinical health science centers, and community agencies can extend the reach of the expertise of specialized health care institutions.
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Pessoa Júnior, João Mário, and Francisco Arnoldo Nunes de Miranda. "Historical record of an extinct and intermediary service in mental health: reconstituted and recalled scenery by collaborators." Revista de Enfermagem UFPE on line 6, no. 2 (January 7, 2012): 480. http://dx.doi.org/10.5205/reuol.2052-14823-1-le.0602201231.
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ABSTRACT Objective: to narrate the historical record of an extinct Psychiatric Day Hospital, in Natal/RN, through multidisciplinary team professionals and professors who used it as field of disciplinary practices. Method: documental and qualitative study based on oral narrative thematic technique following the phases: respondent’s authorization, interview recording, transcription, material textualization and transcreation. Documents, inherent administrative rules, general reports of activities and interviews from fifteen collaborators, who used this service, will be used. This comprises 13 professionals of the multidisciplinary team and two professors from Nursing and Medicine undergraduation. Collected histories will be organized according to chosen and associated technique by respecting their phases and the corpus elaboration which will be submitted to ALCEST computing program, prioritizing thus the vital aspect for formation of analysis categories and the classes elected by it. Ethical principles in research are respected, being approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte under the protocol number 38/08 and CAAE: 0041.0.051.000-08. Expected results: the study aims at contributing to discussing the structure of mental health system of the mentioned town, having as starting point the model transition process of mental hospital/hospice care to the psychosocial one, focusing on the extinction of an intermediary service for the construction of other model of communitarian bases. Descriptors: mental health; day hospitals; nursing. RESUMO Objetivo: narrar a trajetória de um hospital-dia (HD) psiquiátrico extinto no município de Natal/RN através dos profissionais da equipe multidisciplinar e dos professores que o utilizaram como campo de práticas disciplinares. Método: estudo documental e qualitativo, respaldado na técnica da história oral temática, seguindo as fases: autorização do depoente, gravação da entrevista, transcrição, a textualização e a transcriação do material. Utilizar-se-á documentos, portarias inerentes, relatórios gerais de atividades e entrevistas com quinze colaboradores que utilizaram esse serviço, sendo 13 profissionais da equipe multidisciplinar e dois docentes da graduação da área da saúde, Enfermagem e Medicina. As histórias coletadas serão organizadas conforme a técnica escolhida associada respeitada respeitando-se suas etapas e para a preparação do corpus o qual será submetido ao programa informático ALCESTE, priorizando o tom vital para a formação das categorias de análise e das classes elegidas por ele. Respeitam-se os princípios éticos em pesquisa, sendo aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte sob protocolo n°38/08 e CAAE: 0041.0.051.000-08. Resultados esperados: o estudo se propõe a contribuir no para o debate da estruturação da rede de saúde mental do referido município, partindo do processo de transição do modelo de atenção manicomial/asilar para o psicossocial, focalizando a extinção de um serviço intermediário para a construção de outro modelo de bases comunitárias. Descritores: saúde mental; hospitais-dia; enfermagem. RESUMEN Objetivo: narrar la trayectoria de un hospital diurno (HD) psiquiátrico extinguido en el municipio de Natal/RN a través de los profesionales del equipo multidisciplinar y de los profesores que lo utilizaron como campo de prácticas disciplinarias. Método: estudio documental y cualitativo, respaldado en la técnica de la historia oral temática, siguiendo las fases: autorización del testimonio, grabación de la entrevista, trascripción, textualización y trascripción del material. Se emplearán documentos, circulares inherentes, informes generales de actividades y entrevistas a quince colaboradores que emplearon este servicio, integrado por 13 profesionales del equipo multidisciplinario y dos docentes de graduación del área de Sanidad, Enfermería y Medicina. Los testimonios recogidos se organizarán según la técnica elegida asociada, respetando sus etapas y para la preparación del corpus, que será procesado a través del programa informático ALCESTE, priorizando el tono vital para la formación de las categorías de análisis y de las clases elegidas por este. Se respetan los principios éticos de investigación, habiéndose aprobado por el Comité de Ética en Investigación de la Universidade Federal de Rio Grande do Norte bajo protocolo nº38/08 y CAAE: 0041.0.051.000-08. Resultados esperados: el estudio pretende enriquecer el debate de la estructuración de la red sanitaria mental del referido municipio, partiendo del proceso de transición del modelo de atención de manicomio/ asilo hacia el psicosocial, por medio en la extinción de un servicio intermediario para partir hacia la construcción de otro modelo de bases comunitarias. Descriptores: Salud mental; hospitales de dia; enfermería.
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Remy, Andre-Jean, Hakim Bouchkira, Jeremy Hervet, Arnaud Happiette, and Hugues Wenger. "Successful Cascade of Care and Cure HCV in 5382 Drugs Users: How Increase HCV Treatment by Outreach Care, Since Screening to Treatment." Journal of Digestive Disorders and Diagnosis 1, no. 4 (May 29, 2019): 27–35. http://dx.doi.org/10.14302/issn.2574-4526.jddd-19-2770.
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Introduction In France 33% of patients didn’t take care of hepatitis C because there were no diagnosed. Drug injection was main contamination route of hepatitis C virus (HCV) in France. French guidelines were to treat all inmates and drug users, even fibrosis level. Access of HCV screening, care and treatment in drugs users, prisoners and homeless was low in France. They were considered as difficult to treat populations. All these patients need specific support. Hepatitis Mobile Team (HMT) was created in July 2013 to increase screening care and treatment of hepatitis B and C patients. HMT was composed of hepatologist, nurses, social workers and health care worker. Objective increase outreach screening care treatment access and cure of our target population. Patients and methods Target population was drugs users, prisoners, homeless, precarious people, migrants and psychiatric patients. We proposed part or all of our services to our 42 medical and social partners: HCV HBV screening by DBS (dried blood test); outside DBS and FIBROSCAN in converted van; Outreach open center; Drug users information and prevention, Free blood tests in primary care;, Staff training; Social screening and diagnosis; Mobile liver stiffness Fibroscan in site; Advanced on-site specialist consultation; Easy access to pre-treatment commission; Low cost mobile phones for patients; Individual psycho-educative intervention sessions; Collective educative workshops; Peer to peer educational program; Specific one day hospitalizations. All services were free for patients and for partners. Results from 2013 July to 2018 December, we did 8382 DBS for 5382 people (3053 HCV DBS) and 2302 Fibroscan*. HCV new positive rate was 21.3%. Our HCV active file was 651patients included these 24.8% new patients screened by DBS; 98% realized HCV genotype, HCV viral load and FIBROSCAN. DAA treatment was proposed to 96%; 95% started treatment, 4% were lost follow up or refused treatment. After treatment, there was 7 relapse and 3 reinfections by drug injection and cured rate of 94%. Sociological evaluation showed that 4 program qualities for patients: free access, closeness (outside hospital), speed (of the results) and availability (of nurse and social workers). Conclusions: Specific follow-up of drugs users and other HCV high-risk patients including screening, early detection, diagnosis and treatment increase rate of treated and cured patients, with low rate of relapse and reinfections.