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Öz HS, Ayhan D, Öz F. Effects of Telenursing on Drug Attitudes, Self-Efficacy, and Quality of Life in Individuals With Schizophrenia: A Randomized Controlled Trial. J Psychosoc Nurs Ment Health Serv 2024:1-10. [PMID: 38709104 DOI: 10.3928/02793695-20240423-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
PURPOSE During the coronavirus disease 2019 pandemic, health services offered to individuals diagnosed with mental disorders were interrupted, and use of alternative methods, such as telenursing, came to the forefront. METHOD Sixty-four individuals with schizophrenia participated in the current randomized controlled trial that evaluated whether a telenursing intervention affected their drug attitudes, self-efficacy, and quality of life. Pretest, posttest, and follow-up measurements were obtained for experimental and control groups from May to August 2021. Data were collected via a Personal Information Form, Drug Attitude Inventory-10, Self-Efficacy Scale, and World Health Organization Quality of Life Questionnaire-Short Form. RESULTS Upon comparison of scores obtained by the experimental and control groups in pretest, posttest, and follow-up measurements, it was discerned that telenursing positively affected drug attitudes of participants in the experimental group and enhanced their quality of life. Although there was an increase in self-efficacy levels of the experimental group compared to the control group, the difference was not statistically significant. CONCLUSION Telenursing is an effective intervention for the improvement of drug attitudes and quality of life but is not satisfactory for the improvement of self-efficacy in individuals with schizophrenia. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].
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Karabulut B, Uslu E. Schizophrenia and medication adherence: Associated factors. Arch Psychiatr Nurs 2024; 49:47-54. [PMID: 38734454 DOI: 10.1016/j.apnu.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/07/2023] [Accepted: 01/23/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Schizophrenia is a chronic condition that requiring maintenance treatment with antipsychotic medication. Medication adherence is essential to improve the symptoms of this health problem reduce relapses and readmissions and achieve treatment goals. The rate of challenges associated with medication adherence in schizophrenia is reported to be 26.5-85.1 %. PURPOSE This study was conducted to determine factors associated with medication adherence in individuals diagnosed with schizophrenia. METHODS A descriptive correlational research design was used. The study was completed with a total of 162 participants diagnosed with schizophrenia, between February-June 2021, at a Community Mental Health Center. Regression analysis (Model: enter and stepwise) was used to determine associated factors. RESULTS The mean medication adherence score of individual diagnosed with schizophrenia indicated that more than half of the participants (52 %) had poor medication adherence. In individual diagnosed with schizophrenia, medication attitudes, level of internalized stigma, the status of regular attendance to appointments, belief in recovery, and using medicines as prescribed were complicating factors for medication adherence (p < 0.05). CONCLUSIONS Medication adherence in individuals with diagnosed schizophrenia may be multifactorial. Mental health professionals should consider associated factors and implement a personalized treatment plan in this direction for strengthening adherence to medication treatment.
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Affiliation(s)
| | - Esra Uslu
- Department of Psychiatric Nursing, Eskis(ş)ehir Osmangazi University, Eskis(ş)ehir, Turkey; Eskis(ş)ehir Osmangazi University, Faculty of Health Sciences, 26040 Odunpazarı, Eskis(ş)ehir, Turkey.
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Domingue JL, Murata L, Ukagwu C, Pryer B, Patel S, Neves J, Iqbal T. Exploring Clients' Experiences of Transitioning Mental Health Nursing Care from an In-Person to a Virtual Format due to the COVID-19 Pandemic. Can J Nurs Res 2024; 56:69-80. [PMID: 38092681 PMCID: PMC10804682 DOI: 10.1177/08445621231221033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
The onset of the COVID-19 pandemic led mental health professionals to change the way they engaged with clients, often replacing in-person consultations with virtual ones via telephone or videoconferencing. While studies have investigated the delivery of virtual physical health care, only a handful have investigated the delivery of virtual mental health. These specifically focussed on the outcomes of virtual care whether experiential, practical, or empirical. The transition from in-person to virtual care delivery due to the COVID-19 pandemic has been unexplored. Accordingly, the purpose of the study was to: (1) Explore the experiences of clients who had to transition from an in-person to a virtual provision of mental health care due to the COVID-19 pandemic, and; (2) Explore the nurses' experiences of this technological transition. Using an interpretive phenomenology methodology, semi-structured interviews were conducted with nurses and clients who have experienced the in-person to virtual transition of service delivery at a tertiary mental health hospital in Ontario, Canada. In this article, we focus on the results stemming from our interviews with clients. The themes generated from the analysis of client experiences are 1) the psychosocial impact of the COVID-19 pandemic on clients, (2) mixed feelings of clients towards nursing care delivered via technological means and (3) the role of nurses regarding transitioning of in-person care to technology-mediated care. These findings are relevant as mental health care hospitals are considering how they will deliver services once concerns with the transmission of the COVID-19 virus are resolved.
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Affiliation(s)
- Jean-Laurent Domingue
- University of Ottawa, Ottawa, ON, Canada
- Royal Ottawa Health Care Group, Ottawa, ON, Canada
| | - Lisa Murata
- Royal Ottawa Health Care Group, Ottawa, ON, Canada
| | | | - Billie Pryer
- Royal Ottawa Health Care Group, Ottawa, ON, Canada
| | - Shruti Patel
- Royal Ottawa Health Care Group, Ottawa, ON, Canada
| | | | - Tariq Iqbal
- Royal Ottawa Health Care Group, Ottawa, ON, Canada
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Wu T, Xiao X, Yan S, Fang Y, Wang M, Zu F, Zhang Y, Qian R. Digital health interventions to improve adherence to oral antipsychotics among patients with schizophrenia: a scoping review. BMJ Open 2023; 13:e071984. [PMID: 37977861 PMCID: PMC10660841 DOI: 10.1136/bmjopen-2023-071984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVES To assess the current evidence on the potential of digital health interventions (DHIs) to improve adherence to oral antipsychotics among patients with schizophrenia by assessing the methodologies, feasibility and effectiveness of DHIs as well as the perceptions of relevant stakeholders. DESIGN The scoping review was conducted based on the methodologies outlined by Levac et al and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. DATA SOURCES PubMed, Embase, Web of Science, Scopus, CINAHL, PsycINFO and the Cochrane Library were searched in August 2023 to identify relevant publications from the previous decade. ELIGIBILITY CRITERIA Studies published in English focused on improving medication adherence among adult patients with schizophrenia or schizoaffective disorder via DHIs were selected. Protocols, editorials, comments, perspectives, reviews, correspondence and conference abstracts were excluded. DATA EXTRACTION AND SYNTHESIS The extracted data included general information about the study, framework, participants, features and strategies of DHIs, measurement tools for adherence used, and main findings. RESULTS In total, 64 studies were included in the qualitative synthesis. Features used in DHIs to improve medication adherence included phone calls, text messages, mobile apps, sensors, web-based platforms and electronic devices. Strategies included medication reminders and monitoring, providing medication-related information and suggestions, other illness management suggestions and individual support. Texting and mobile apps were commonly used as medication reminders and monitoring methods. Additionally, the use of sensors combined with other digital technologies has garnered significant attention. All the interventions were considered acceptable and feasible, and several were assessed in pilot trials. Preliminary findings suggest that DHIs could enhance medication adherence in patients with schizophrenia. However, further validation of their effectiveness is required. CONCLUSION DHIs are a promising approach to enhancing medication adherence among patients with schizophrenia. Future interventions should be interactive, focusing on user preference, experience and privacy.
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Affiliation(s)
- Tao Wu
- Department of Nursing, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xu Xiao
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Shirui Yan
- Department of Nursing, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yuanyuan Fang
- Department of Nursing, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Min Wang
- Department of Adult Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Fengying Zu
- Department of Adult Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yanhong Zhang
- Department of Nursing, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Ruilian Qian
- Department of Nursing, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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de Vargas D, Ramírez EGL, Pereira CF, de Oliveira SR. Telenursing in mental health: effect on anxiety symptoms and alcohol consumption during the COVID-19 pandemic. Rev Lat Am Enfermagem 2023; 31:e3932. [PMID: 37283418 PMCID: PMC10243443 DOI: 10.1590/1518-8345.6172.3932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 02/26/2023] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVE (1) A remote intervention with a positive impact on reducing anxiety and alcohol use. (2) Nursing as a protagonist of preventive care in mental health (3) A low-cost intervention that covers several population groups. (4) Telenursing in mental health as a care strategy during COVID-19. to investigate the effect of a remote intervention on anxiety symptoms and alcohol use in users of the Primary Health Care service. METHOD a quasi-experimental study conducted with 1,270 participants who answered the Alcohol Use Disorders Identification Test and the State-Trait Anxiety Inventory-6. Of these, 1,033 interviewees scored for moderate/severe anxiety symptoms (STAI-6 > 3) and moderate/severe risk alcohol use (AUDIT-C > 3), and received the interventions via telephone calls with follow-up periods lasting seven and 180 days. For data analysis, a mixed-effects regression model was used. RESULTS the effect of the intervention performed was positive in reducing anxiety symptoms between T0 and T1 (µ=1.6, p<0.001) and in reducing the alcohol use pattern between T1 and T3 (µ=1.57, p<0.001). CONCLUSION the follow-up results suggest a positive effect of the intervention in reducing anxiety and the alcohol use pattern, which tends to be maintained over time. There is diverse evidence that the intervention proposed can be an alternative for preventive care in mental health, in situations where accessibility of the user or the professional is compromised.
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Affiliation(s)
- Divane de Vargas
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
| | - Erika Gisseth León Ramírez
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil
- Universidade de Guarulhos, Guarulhos, SP, Brasil
- Becaria de la Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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Edwards AM, Petitt JC, Kumar S, Levin JB, Sajatovic M. Pre COVID-19 Pandemic Use of Telemedicine for Adherence Promotion in Patients with Psychotic Disorders: A Literature Review. Patient Prefer Adherence 2022; 16:2559-2565. [PMID: 36133077 PMCID: PMC9482952 DOI: 10.2147/ppa.s373309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Given the increasing use of telepsychiatry and to serve as a reference point informing future research, our team evaluated the literature on the use of telepsychiatry for medication adherence promotion prior to the COVID-19 pandemic among patients with psychotic disorders. METHODS A search of PubMed, Cochrane, Web of Science, CINAHL, and PsycINFO was conducted using PRISMA guidelines to identify telepsychiatry interventions to enhance medication adherence in patients with primary psychotic disorders. Both quantitative and qualitative data were extracted from the identified articles including study characteristics, interventions, and outcomes. RESULTS In total, 230 articles were obtained through electronic literature search, and 4 articles were eventually retained that met inclusion criteria. All 4 articles were randomized controlled trials, were adjuncts to in-person usual care, used telephone platforms and targeted medication adherence. Compared to treatment as usual, 3 out of 4 studies found medication adherence was improved and 2 out of 4 studies found improved medication attitudes. Telepsychiatry appeared to be acceptable to patients with psychotic disorders. DISCUSSION In the pre-Covid-19 literature, telepsychiatry appears promising as an adjunct to usual care for increasing medication adherence among individuals with schizophrenia/schizoaffective disorder. However, given the limited number of papers and exclusive use on telephone-only to deliver telepsychiatry, additional research specific to telepsychiatry for patients with psychosis is needed.
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Affiliation(s)
- Alyssa M Edwards
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jordan C Petitt
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Sanjana Kumar
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jennifer B Levin
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- University Hospitals of Cleveland Medical Center, Department of Psychiatry, Cleveland, OH, USA
| | - Martha Sajatovic
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- University Hospitals of Cleveland Medical Center, Department of Psychiatry, Cleveland, OH, USA
- Correspondence: Martha Sajatovic, University Hospitals of Cleveland Medical Center, Department of Psychiatry, 10524 Euclid Ave, Cleveland, OH, 44106, USA, Email
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Curto M, Fazio F, Ulivieri M, Navari S, Lionetto L, Baldessarini RJ. Improving adherence to pharmacological treatment for schizophrenia: a systematic assessment. Expert Opin Pharmacother 2021; 22:1143-1155. [PMID: 33543659 DOI: 10.1080/14656566.2021.1882996] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Introduction: Poor adherence to pharmacological treatment is prevalent in schizophrenia, affecting more than half of patients at some time, with increased risks of clinical worsening, adverse outcomes, suicide, and increased resource utilization including hospitalization, with higher costs.Areas Covered: This review considers factors associated with treatment-nonadherence among schizophrenia patients, with a systematic evaluation of interventions aimed at improving adherence with an emphasis on evidence arising from their testing.Expert opinion: Several interventions have addressed factors empirically associated with treatment-nonadherence, including various drug-, patient - and clinical services-associated factors. They include long-acting injected (LAI) drug formulations, behavioral interventions, and technology-supported methods. Use of LAI antipsychotics and behavioral techniques aimed at incorporating medicine-taking into daily routines with electronic monitoring have been assessed relatively extensively. Mobile, digital applications including medication monitoring systems and artificial intelligence-based interactions are emerging but have been tested in few trials of limited quality with inconclusive results. Randomized, controlled, blinded trials based on clinically representative samples are needed to evaluate not only adherence, but also to test for clinically meaningful and sustained clinical benefits in schizophrenia patients, who are especially difficult to treat.
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Affiliation(s)
- Martina Curto
- Department of Mental Health, Rome, Italy.,International Consortium for Mood Psychotic & Mood Disorders Research, McLean Hospital, Belmont, MA, USA
| | - Francesco Fazio
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, NY, USA
| | - Martina Ulivieri
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, NY, USA
| | - Serena Navari
- Department of Mental Health, Colleferro (Rome), Italy
| | - Luana Lionetto
- Advanced Molecular Diagnostics Unit, Sant'Andrea Hospital, Rome, Italy
| | - Ross J Baldessarini
- International Consortium for Mood Psychotic & Mood Disorders Research, McLean Hospital, Belmont, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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