1
|
Ramírez SM, Cabarique C, Ortiz N, Uribe-Restrepo JM, Bird V, Priebe S, Gómez-Restrepo C. Experience with the use of the DIALOG+ intervention in patients with severe mental illness in outpatient services in Colombia. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2024; 53:32-40. [PMID: 38653659 DOI: 10.1016/j.rcpeng.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 01/03/2022] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Severe mental disorders can cause significant and lasting distress for patients and their families and generate high costs through the need for care and loss of productivity. This study tests DIALOG+, an app-based intervention to make routine patient-clinician meetings therapeutically effective. It combines a structured evaluation of patient satisfaction with a solution-focused approach. METHODS We conducted a qualitative study, based on a controlled clinical trial, in which 9 psychiatrists and 18 patients used DIALOG+ monthly over a six-month period. Semi-structured interviews were used to explore the experiences of participants and analysed in an inductive thematic analysis focusing on the feasibility and effects of the intervention in the Colombian context. RESULTS Experiences were grouped into five overall themes: a) impact of the intervention on the consultation and the doctor-patient relationship; b) impact on patients and in promoting change; c) use of the supporting app, and d) adaptability of the intervention to the Colombian healthcare system. CONCLUSIONS DIALOG+ was positively valued by most of the participants. Participants felt that it was beneficial to the routine consultation, improved communication and empowered patients to take a leading role in their care. More work is required to identify the patient groups that most benefit from DIALOG+, and to adjust it, particularly to fit brief consultation times, so that it can be rolled out successfully in the Colombian healthcare system.
Collapse
Affiliation(s)
- Sandra Milena Ramírez
- Departamento de Clínicas Médicas, Pontificia Universidad Javeriana, Cali, Colombia; Departamento de Psiquiatría, Universidad del Valle, Cali, Colombia; Hospital Departamental Psiquiátrico Universitario del Valle, Cali, Colombia
| | - Camilo Cabarique
- Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Natalia Ortiz
- Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Victoria Bird
- Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Stefan Priebe
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary, University of London, Londres, United Kingdom
| | - Carlos Gómez-Restrepo
- Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia; Departamento de Psiquiatría y Salud Mental, Pontificia Universidad Javeriana, Bogotá, Colombia; Hospital Universitario San Ignacio, Bogotá, Colombia.
| |
Collapse
|
2
|
Schneider CH, Parambath S, Young JJ, Jain S, Slater H, Sharma S, Kopansky-Giles D, March L, Briggs AM. From Local Action to Global Policy: A Comparative Policy Content Analysis of National Policies to Address Musculoskeletal Health to Inform Global Policy Development. Int J Health Policy Manag 2023; 12:7031. [PMID: 37579444 PMCID: PMC10125103 DOI: 10.34172/ijhpm.2022.7031] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 11/26/2022] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Global policy to guide action on musculoskeletal (MSK) health is in a nascent phase. Lagging behind other non-communicable diseases (NCDs) there is currently little global policy to assist governments to develop national approaches to MSK health. Considering the importance of comparison and learning for global policy development, we aimed to perform a comparative analysis of national MSK policies to identify areas of innovation and draw common themes and principles that could guide MSK health policy. METHODS Multi-modal search strategy incorporating a systematic online search targeted at the 30 most populated nations; a call to networked experts; a specified question in a related eDelphi questionnaire; and snowballing methods. Extracted data were organised using an a priori framework adapted from the World Health Organization (WHO) Building Blocks and further inductive coding. Subsequently, texts were open coded and thematically analysed to derive specific sub-themes and principles underlying texts within each theme, serving as abstracted, transferable concepts for future global policy. RESULTS The search yielded 165 documents with 41 retained after removal of duplicates and exclusions. Only three documents were comprehensive national strategies addressing MSK health. The most common conditions addressed in the documents were pain (non-cancer), low back pain, occupational health, inflammatory conditions, and osteoarthritis. Across eight categories, we derived 47 sub-themes with transferable principles that could guide global policy for: service delivery; workforce; medicines and technologies; financing; data and information systems; leadership and governance; citizens, consumers and communities; and research and innovation. CONCLUSION There are few examples of national strategic policy to address MSK health; however, many countries are moving towards this by documenting the burden of disease and developing policies for MSK services. This review found a breadth of principles that can add to this existing work and may be adopted to develop comprehensive system-wide MSK health approaches at national and global levels.
Collapse
Affiliation(s)
- Carmen Huckel Schneider
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Sarika Parambath
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - James J. Young
- Center for Muscle and Joint Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Swatee Jain
- Sydney Musculoskeletal, Bone & Joint Health Alliance, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Helen Slater
- Curtin School of Allied Health, and Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Saurab Sharma
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia
| | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada
- Department of Family & Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Lyn March
- Florance and Cope Professorial Department of Rheumatology, Royal North Shore Hospital and Kolling Institute, University of Sydney, Sydney, NSW, Australia
| | - Andrew M. Briggs
- Curtin School of Allied Health, and Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| |
Collapse
|
3
|
Brown S, Sprague C, Lindsay AC. Understanding perinatal mental illness as a governance concern in South Africa through health provider perspectives. Glob Public Health 2022; 17:3519-3532. [PMID: 36735659 DOI: 10.1080/17441692.2022.2129727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Women in South Africa experience a disproportionately high prevalence of common perinatal mental disorders (CPMDs). These disorders often remain a silent burden and a complex health, social, and policy concern, both nationally and globally. Moreover, policy efforts to address this concern have been fragmented. Greater understanding of the governance of perinatal mental illness is needed to address this complex issue. No research to date has focused explicitly on the importance of 'issue framing' to advance governance for perinatal mental health. We sought to achieve a more nuanced understanding of clinical governance and issue framing for perinatal mental health in South Africa by interviewing 24 key informants with expertise in perinatal mental illness. Dominant themes encompassed: framing of perinatal mental health determines its priority; perinatal mental health is not prioritised due to competition from other health concerns; and, screening policy responses are shaped by the framing. We found that understanding the varying views influencing perinatal mental illness provides insights into how experts frame the problem. Findings suggest that a better understanding of policy implementation and responses in South Africa is important in guiding research, policy, and practice, while improving the governance of perinatal mental illness.
Collapse
Affiliation(s)
- Shelley Brown
- Department of Conflict Resolution, Human Security, and Global Governance, McCormack Graduate School, University of Massachusetts Boston, Boston, MA, USA.,Department of Health Sciences, Boston University, Boston, MA, USA
| | - Courtenay Sprague
- Department of Conflict Resolution, Human Security, and Global Governance, McCormack Graduate School, University of Massachusetts Boston, Boston, MA, USA.,Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Ana Cristina Lindsay
- Department of Exercise and Health Sciences, Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| |
Collapse
|