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Ngai CKH, Wu CST, Suen LKP. Structured Relapse Prevention Program for Chinese Patients in Hong Kong with Comorbidity of Substance Use and Mental Health Disorders: A Feasibility Study. J Psychoactive Drugs 2020; 52:56-65. [PMID: 31918627 DOI: 10.1080/02791072.2020.1713423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The prevalence rate of substance misuse is high among people with mental illnesses. This study adopted an individualized structured relapse prevention program (SRPP) by using an integrative motivational interviewing (MI) and cognitive behavioral therapy (CBT) approach for people with dual diagnosis, i.e., substance use disorder (SUD) comorbid with mental illnesses, in a Chinese population. This study assessed the feasibility of the SRPP and its preliminary effects to provide directions for future wide-scale trials. The program consisted of eight one-to-one interviews conducted weekly. Each interview lasted 1 h. MI was scheduled in the first session, followed by six sessions of CBT and a final session for concluding remarks. The high recruitment and retention rates of the participants indicated that the SRPP was feasible in Hong Kong. Preliminary results reflected a significant increase in self-efficacy to abstain from substance misuse and a decrease in the psychiatric symptoms among the participants with SUD. These effects were sustained 3 months after the intervention. A large sample size and the inclusion of a control group are warranted in future trials to determine the causal relationship between treatment and effect.
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Affiliation(s)
- Chris K H Ngai
- Substance Misuse Clinic, Department of Psychiatry, Hospital Authority, Pamela Youde Nethersole Eastern Hospital, Hong Kong East Cluster, Hong Kong Special Administrative Region of the People's Republic of China (HKSAR)
| | - Cynthia S T Wu
- School of Nursing, The Hong Kong Polytechnic University, HungHom, Hong Kong Special Administrative Region of the People's Republic of China (HKSAR)
| | - Lorna K P Suen
- School of Nursing, The Hong Kong Polytechnic University, HungHom, Hong Kong Special Administrative Region of the People's Republic of China (HKSAR)
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Brainard JS, Ford JA, Steel N, Jones AP. A systematic review of health service interventions to reduce use of unplanned health care in rural areas. J Eval Clin Pract 2016; 22:145-55. [PMID: 26507368 DOI: 10.1111/jep.12470] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2015] [Indexed: 11/26/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Use of unplanned health care has long been increasing, and not enough is known about which interventions may reduce use. We aimed to review the effectiveness of interventions to reduce the use of unplanned health care by rural populations. METHODS The method used was systematic review. Scientific databases (Medline, Embase and Central), grey literature and selected references were searched. Study quality and bias was assessed using Cochrane Risk of Bias and modified Newcastle Ottawa Scales. Results were summarized narratively. RESULTS A total of 2708 scientific articles, reports and other documents were found. After screening, 33 studies met the eligibility criteria, of which eight were randomized controlled trials, 13 were observational studies of unplanned care use before and after new practices were implemented and 12 compared intervention patients with non-randomized control patients. Eight of the 33 studies reported modest statistically significant reductions in unplanned emergency care use while two reported statistically significant increases in unplanned care. Reductions were associated with preventative medicine, telemedicine and targeting chronic illnesses. Cost savings were also reported for some interventions. CONCLUSION Relatively few studies report on unscheduled medical care by specifically rural populations, and interventions were associated with modest reductions in unplanned care use. Future research should evaluate interventions more robustly and more clearly report the results.
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Affiliation(s)
| | - John A Ford
- Norwich Medical School, UEA, Norwich, Norfolk, UK
| | | | - Andy P Jones
- Norwich Medical School, UEA, Norwich, Norfolk, UK
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3
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Happell B, Platania-Phung C, Scott D. A systematic review of nurse physical healthcare for consumers utilizing mental health services. J Psychiatr Ment Health Nurs 2014; 21:11-22. [PMID: 23419025 DOI: 10.1111/jpm.12041] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2013] [Indexed: 11/29/2022]
Abstract
People with serious mental illness have higher rates of physical illness and are more likely to experience premature death than the general population. Nurse-led strategies to improve physical healthcare in mental healthcare services could potentially reduce these inequalities. However the extent of nurse involvement in physical healthcare (such as physical risk screening, health education and care co-ordination) in mental health settings is not known. A systematic review was conducted on nurse-led physical healthcare reported for consumers with serious mental illness (SMI) in mental health services, and their benefits. Electronic literature bases (CINAHL, Proquest, PsychINFO and Web of Science) were systematically searched, in conjunction with a manual search of literature reviews on physical healthcare in mental health services. Articles were included if they: (a) were published in the last 10 years; (b) were English language; (c) involved physical healthcare of adult consumers receiving mental healthcare services; and (d) reported nurse involvement in physical healthcare. Forty articles were included in the review. The distribution of types of care were: health education (47%), screening and/or monitoring (33.3%), care co-ordination and management (33.3%), lifestyle programme delivery (30.5%), follow-up actions to screening results (25%) and registers and data administration (5.5%). Overall, the evaluation of nurse-based physical healthcare is in early stages. Thus far, they appear to have positive implications for consumers with SMI.
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Affiliation(s)
- B Happell
- Centre for Mental Health Nursing Innovation, Institute for Health and Social Science Research, Rockhampton, Qld, Australia; School of Nursing and Midwifery, Central Queensland University, Rockhampton, Qld, Australia
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Gmel G, Venzin V, Marmet K, Danko G, Labhart F. A quasi-randomized group trial of a brief alcohol intervention on risky single occasion drinking among secondary school students. Int J Public Health 2012; 57:935-44. [DOI: 10.1007/s00038-012-0419-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 07/26/2012] [Accepted: 10/02/2012] [Indexed: 11/28/2022] Open
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Happell B, Davies C, Scott D. Health behaviour interventions to improve physical health in individuals diagnosed with a mental illness: a systematic review. Int J Ment Health Nurs 2012; 21:236-47. [PMID: 22533331 DOI: 10.1111/j.1447-0349.2012.00816.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Individuals diagnosed with mental illness experience high rates of morbidity and mortality as a result of poor physical health and unhealthy lifestyle behaviours. The aim of this paper is to systematically review the literature on health behaviour interventions to improve the physical health of individuals diagnosed with a mental illness. A systematic search strategy was undertaken using four of the major electronic databases. Identified articles were screened for inclusion, included articles were coded, and data were extracted and critically reviewed. A total of 42 articles were identified for inclusion. The most commonly targeted physical health behaviour was weight management. The majority of studies reported improvements in health behaviours following interventions. The findings provide evidence for the positive effect of health behaviour interventions in improving the physical health of individuals diagnosed with a serious mental illness. A focus on health behaviour interventions within the mental health nursing profession might lead to improvements in health behaviours and general health in consumers of mental health services.
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Affiliation(s)
- Brenda Happell
- Institute for Health and Social Science Research, School of Nursing and Midwifery, Central Queensland University Australia, Rockhampton, Queensland, Australia.
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Miller R, Mason SE. Open-ended and Open-door Treatment Groups for Young People with Mental Illness. ACTA ACUST UNITED AC 2012; 35:50-67. [PMID: 22427713 DOI: 10.1080/01609513.2011.587099] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The concept of open-ended groups is expanded to include an open-door model (OEOD) wherein members with severe mental illnesses, including schizophrenia disorders and bi-polar, can join, leave, and re-enter groups as their life circumstances dictate their availability and willingness for treatment. This model is grounded on the work of Schopler and Galinsky's (1984/2006) and Galinsky and Schopler's (1989) theses on the value and processes of open-ended groups and includes perspectives on mutual aid and group development. Groupwork with the OEOD format is illustrated with examples taken from a group of 79 participants diagnosed with first-episode schizophrenia/schizoaffective disorders, 40 of who had co-occurring substance abuse. Of the 79 participants in the OEOD group program, 70 (89%) remained in treatment for the maximum of 3 years. The over-all value of group treatment for this population is reviewed along with the small number of available publications on open-ended and open-door-type groups.
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Affiliation(s)
- Rachel Miller
- National Institute of Mental Health, Bethesda, MD, USA
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Nyamathi AM, Nandy K, Greengold B, Marfisee M, Khalilifard F, Cohen A, Leake B. Effectiveness of intervention on improvement of drug use among methadone maintained adults. J Addict Dis 2011; 30:6-16. [PMID: 21218306 DOI: 10.1080/10550887.2010.531669] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of this study is to evaluate the effectiveness of three interventions (individual motivational interviewing, group motivational interviewing, or nurse-led hepatitis health promotion) in reducing drug use. A randomized, controlled trial was conducted with 256 methadone maintained moderate-to-heavy alcohol-using adults attending one of five MM outpatient clinics. Drug use in the overall sample was significantly reduced from baseline to 6-month follow-up, as assessed by a 30-day recall (p < 0.0001), with a trend apparent for 6-month recall (p = 0.09). The group and individual programs revealed significant decreases in drug use at the 30-day recall.
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Affiliation(s)
- Adeline M Nyamathi
- University of California, Los Angeles, School of Nursing, Room 2-250, Factor Building, Box 951720, Los Angeles, CA 90095-1702, USA.
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Nyamathi A, Tyler D, Sinha K, Marfisee M, Cohen A, Greengold B. Predictors of hepatitis knowledge improvement among methadone maintained clients enrolled in a hepatitis intervention program. J Community Health 2010; 35:423-32. [PMID: 20358265 PMCID: PMC2926441 DOI: 10.1007/s10900-010-9266-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This randomized, controlled study (n = 256) was conducted to compare three interventions designed to promote hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination completion, among clients undergoing methadone maintenance treatment (MMT) in Los Angeles and Santa Monica. The participants were randomized into three groups: Motivational Interviewing-Single Session (MI-Single), Motivational Interviewing-Group (MI-Group), or Nurse-Led Hepatitis Health Promotion (HHP). All three treatment groups received the 3-series HAV/HBV vaccine. The MI sessions were provided by trained therapists, the Nurse-Led HHP sessions were delivered by a research nurse. The main outcome variable of interest was improvement in HBV and HCV knowledge, measured by a 6-item HBV and a 7-item HCV knowledge and attitude tool that was administered at baseline and at 6-month follow-up. The study results showed that there was a significant increase in HBV- and HCV-related knowledge across all three groups (p < 0.0001). There were no significant differences found with respect to knowledge acquisition among the groups. Irrespective of treatment group, gender (P = 0.008), study site (P < 0.0001) and whether a participant was abused as a child (P = 0.017) were all found to be predictors of HCV knowledge improvement; only recruitment site (P < 0.0001) was found to be a predictor of HBV knowledge. The authors concluded that, although MI-Single, MI-Group and Nurse-Led HHP are all effective in promoting HBV and HCV knowledge acquisition among MMT clients, Nurse-Led HHP may be the method of choice for this population as it may be easier to integrate and with additional investigation may prove to be more cost efficient.
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Affiliation(s)
- Adeline Nyamathi
- UCLA, School of Nursing, 700 Tiverton Avenue, Los Angeles, CA 90095-1702, USA.
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Wallace C, Galloway T, McKetin R, Kelly E, Leary J. Methamphetamine use, dependence and treatment access in rural and regional North Coast of New South Wales, Australia. Drug Alcohol Rev 2010; 28:592-9. [PMID: 19930011 DOI: 10.1111/j.1465-3362.2008.00016.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS To identify the sociodemographic, health, drug use patterns, treatment coverage and barriers to treatment among regular methamphetamine users in rural and regional North Coast of New South Wales. DESIGN AND METHODS A structured questionnaire was used to measure sociodemographic factors, health and well-being, drug use patterns, methamphetamine dependence, engagement in methamphetamine treatment and barriers to treatment. Participants were 140 regular methamphetamine users. Dependent and non-dependent participants were compared to identify factors associated with dependence. RESULTS Participants were predominantly in their thirties, male and had low levels of education, high levels of unemployment and polydrug use. Participants who were dependent on methamphetamine (59%) were more likely to report impaired mental health and to have been diagnosed with depression, anxiety and drug-induced psychosis. One quarter of dependent methamphetamine users had received treatment in the last year and half had ever received treatment. The main barriers to receiving treatment were a lack of perceived need or motivation to seek treatment and concerns about confidentiality. DISCUSSION AND CONCLUSIONS Methamphetamine users living on the North Coast of New South Wales require treatment options tailored to address a complex array of physical and psychological problems. The findings highlight the need for psychiatric support and improved coordination between mental health and drug and alcohol services in rural and regional areas.
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Affiliation(s)
- Cate Wallace
- Public Health Training and Development Branch, New South Wales Department of Health, North Sydney, Australia.
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Nyamathi A, Sinha K, Greengold B, Cohen A, Marfisee M. Predictors of HAV/HBV vaccination completion among methadone maintenance clients. Res Nurs Health 2010; 33:120-32. [PMID: 20143328 DOI: 10.1002/nur.20371] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This randomized, controlled study (N = 256) was conducted to compare three interventions designed to promote hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination completion among clients undergoing methadone maintenance (MM) treatment. Participants were recruited from five MM treatment sites in Southern California and randomized into three groups: Motivational Interviewing-Single (MI-Single), Motivational Interviewing-Group (MI-Group); and Nurse-Led Hepatitis Health Promotion (HHP). All were offered the three-series HAV/HBV vaccine. A total of 148 participants completed the vaccine. Groups did not differ in rate of vaccination completion (73.6%, HHP group, vs. 65% and 69% for the MI-Single and MI-Group, respectively). The equivalence of findings across groups suggests the value of including nurses with a comprehensive health focus in promoting vaccination completion.
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Affiliation(s)
- Adeline Nyamathi
- School of Nursing, University of California-Los Angeles, Box 951702, Los Angeles, CA 90095-1702, USA
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Hjorthøj C, Fohlmann A, Nordentoft M. Reprint of "Treatment of cannabis use disorders in people with schizophrenia spectrum disorders--a systematic review". Addict Behav 2009; 34:846-51. [PMID: 19604646 DOI: 10.1016/j.addbeh.2009.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2008] [Revised: 02/04/2009] [Accepted: 02/13/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Cannabis use disorders (CUD) are prevalent among people with schizophrenia spectrum disorders (SSD), with a range of detrimental effects, e.g. reduced compliance to medication and psychosocial interventions, and increased level of psychotic-dimension symptoms. The aim of this study was to review literature on treatments of CUD in SSD-patients. METHODS PubMed, PsycINFO, EMBASE, and The Cochrane Central Register of Controlled Trials were searched. RESULTS 41 articles were selected, 11 treating cannabis as a separate outcome. Contingency management was only effective while active. Pharmacological interventions appeared effective, but lacked randomized controlled trials (RCTs). Psychosocial interventions, e.g. motivational interviewing and cognitive behavior therapy (CBT), were ineffective in most studies with cannabis as a separate outcome, but effective in studies that grouped cannabis together with other substance use disorders. CONCLUSIONS Insufficient evidence exists on treating this form of dual-diagnosis patients. Studies grouping several types of substances as a single outcome may overlook differential effects. Future RCTs should investigate combinations of psychosocial, pharmacological, and contingency management.
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Hjorthøj C, Fohlmann A, Nordentoft M. Treatment of cannabis use disorders in people with schizophrenia spectrum disorders - a systematic review. Addict Behav 2009; 34:520-5. [PMID: 19268481 DOI: 10.1016/j.addbeh.2009.02.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2008] [Revised: 02/04/2009] [Accepted: 02/13/2009] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cannabis use disorders (CUD) are prevalent among people with schizophrenia spectrum disorders (SSD), with a range of detrimental effects, e.g. reduced compliance to medication and psychosocial interventions, and increased level of psychotic-dimension symptoms. The aim of this study was to review literature on treatments of CUD in SSD-patients. METHODS PubMed, PsycINFO, EMBASE, and The Cochrane Central Register of Controlled Trials were searched. RESULTS 41 articles were selected, 11 treating cannabis as a separate outcome. Contingency management was only effective while active. Pharmacological interventions appeared effective, but lacked randomized controlled trials (RCTs). Psychosocial interventions, e.g. motivational interviewing and cognitive behavior therapy (CBT), were ineffective in most studies with cannabis as a separate outcome, but effective in studies that grouped cannabis together with other substance use disorders. CONCLUSIONS Insufficient evidence exists on treating this form of dual-diagnosis patients. Studies grouping several types of substances as a single outcome may overlook differential effects. Future RCTs should investigate combinations of psychosocial, pharmacological, and contingency management.
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Affiliation(s)
- Peter R. Joyce
- Department of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, New Zealand
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