1
|
Noda Y, Asano K, Shimizu E, Hirano Y. The mediating effect of symptoms of posttraumatic stress disorder and depression on the relationship between personality traits and quality of life in emergency service workers. Compr Psychiatry 2022; 116:152327. [PMID: 35643052 DOI: 10.1016/j.comppsych.2022.152327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 05/07/2022] [Accepted: 05/13/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Emergency service workers are often exposed to fatalities during accidents or disasters. Therefore, they may be more prone to experiencing posttraumatic stress disorder (PTSD) and depression. It has been shown that these comorbid disorders are related to personality traits and quality of life (QOL). METHODS We hypothesized that mental disorders, such as symptoms of PTSD and depression, mediate the relationship between personality traits, as measured on the 10-Item Personality Inventory (TIPI), and QOL, as measured on the MOS 36-item Short-Form Health Survey (SF-36). RESULTS Participants were aged 23-61 years. Questionnaires were sent to 373 participants, 220 of whom returned responses. A direct effect was found between two subscales of the TIPI (Extraversion and Emotional stability) and mental component summary scores of the SF-36 (Extraversion: β = 0.154, p < .001; Emotional stability: β = 0.179, p < .001), which indicated partial mediation. A significant indirect effect was revealed between two personality traits and mental health summary scores (Extraversion: β = 0.058, p < .001; Emotional stability: β = 0.087, p < .001). We also found a direct effect of extraversion scores of the TIPI on role/social component summary scores of the SF-36 (β = 0.084, p < .05). However, none of the 95% confidential intervals was significant, which indicated full mediation, and the indirect effect was significant (β = 0.023, p < .01). Sensitivity analysis indicated that a direct effect between extraversion scores of the TIPI and role/social component summary scores of the SF-36 was significant, which indicated partial mediation. CONCLUSIONS The findings of direct and indirect effects highlight the importance of identifying effective methods for protecting individuals from developing symptoms of PTSD and depression; moreover, they may help improve QOL. The capacity of dealing with incidents among emergency service workers may vary depending on their personality traits. Therefore, the screening of mental health states that includes a personality trait inventory may be valuable.
Collapse
Affiliation(s)
- Yoshikazu Noda
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan; Department of Nursing, Teikyo University of Science, 34-1 Senjumotomachi, Adachi-ku, Tokyo 120-0041, Japan.
| | - Kenichi Asano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, 1-1 Yamadaoka, Suita, Osaka 565-0871, Japan; Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 268-0856, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, 1-1 Yamadaoka, Suita, Osaka 565-0871, Japan
| |
Collapse
|
2
|
Relationships Among Structures, Team Processes, and Outcomes for Service Users in Quebec Mental Health Service Networks. Int J Integr Care 2020; 20:12. [PMID: 32565762 PMCID: PMC7292103 DOI: 10.5334/ijic.4718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: Few studies have identified and compared profiles of mental health service networks (MHSN) in terms of structures, processes, and outcomes, based on cluster analyses and perceptions of team managers, MH professionals and service users. This study assessed these associations in Quebec metropolitan, urban and semi-urban MHSN. Methods: A framework adapted from the Donabedian model guided data management, and cluster analyses were used to identify categories. Study participants included team managers (n = 45), MH professionals (n = 311) and service users (n = 327). Results: For all three MHSN, a common outcome category emerged: service users with complex MH problems and negative outcomes. The Metropolitan network reported two categories for structures (specialized MH teams, primary care MH teams) and processes (senior medical professional, psychosocial professionals), and outcomes (middle-age men with positive outcomes, older women with few MH problems). The Urban and Semi-urban networks revealed one category for structures (all teams) and service user (young service users with drug disorders), but two for processes (psychosocial professionals: urban, all professionals: semi-urban). Conclusion: The Metropolitan MHSN showed greater heterogeneity regarding structures and team processes than the other two MHSN. Service user outcomes were largely associated with clinical characteristics, regardless of network configurations for structures and team processes.
Collapse
|
3
|
Fleury MJ, Sabetti J, Bamvita JM, Grenier G. Modeling variables associated with personal recovery among service users with mental disorders using community-based services. Int J Soc Psychiatry 2019; 65:123-135. [PMID: 30791820 DOI: 10.1177/0020764019831310] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Mental health research is evolving toward the identification of conceptual models and associated variables, which may provide a better understanding of personal recovery, given its importance for individuals affected by mental disorders (MDs). AIMS This article evaluated personal recovery in a sample of adults with MDs using an adapted conceptual framework based on the Andersen behavioral model, which evaluates predisposing, enabling and needs factors in service use. METHODS The study design was cross-sectional and included 327 mental health service users recruited across four local health service networks in Quebec (Canada). Data were collected using seven standardized instruments and participant medical records. Structural equation modeling was performed. RESULTS Quality of life (QOL), an enabling factor, was most strongly associated with personal recovery. Health behavior variables associated with recovery included the following: use of alcohol services, having a family physician, consulting a psychologist, use of food banks, consulting fewer professionals and not using drug services. Regarding needs factors, higher numbers of needs, lower severity of unmet health, social and basic needs and absence of mood disorders were also associated with personal recovery. No predisposing factors emerged as significant in the model. CONCLUSION Findings suggest that QOL, needs variables and comprehensive service delivery are important in personal recovery. Services should be individualized to the health, social and basic needs of service users, particularly those with mood disorders or co-occurring mental health/substance use disorders.
Collapse
Affiliation(s)
- Marie-Josée Fleury
- 1 Department of Psychiatry, McGill University, Montreal, QC, Canada.,2 Douglas Mental Health University Institute Research Centre, Montreal, QC, Canada
| | - Judith Sabetti
- 2 Douglas Mental Health University Institute Research Centre, Montreal, QC, Canada.,3 School of Social Work, McGill University, Montreal, QC, Canada
| | - Jean-Marie Bamvita
- 2 Douglas Mental Health University Institute Research Centre, Montreal, QC, Canada
| | - Guy Grenier
- 2 Douglas Mental Health University Institute Research Centre, Montreal, QC, Canada
| |
Collapse
|
4
|
Almeda N, García-Alonso CR, Salinas-Pérez JA, Gutiérrez-Colosía MR, Salvador-Carulla L. Causal Modelling for Supporting Planning and Management of Mental Health Services and Systems: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030332. [PMID: 30691052 PMCID: PMC6388254 DOI: 10.3390/ijerph16030332] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/19/2019] [Accepted: 01/19/2019] [Indexed: 12/17/2022]
Abstract
Mental health services and systems (MHSS) are characterized by their complexity. Causal modelling is a tool for decision-making based on identifying critical variables and their causal relationships. In the last two decades, great efforts have been made to provide integrated and balanced mental health care, but there is no a clear systematization of causal links among MHSS variables. This study aims to review the empirical background of causal modelling applications (Bayesian networks and structural equation modelling) for MHSS management. The study followed the PRISMA guidelines (PROSPERO: CRD42018102518). The quality of the studies was assessed by using a new checklist based on MHSS structure, target population, resources, outcomes, and methodology. Seven out of 1847 studies fulfilled the inclusion criteria. After the review, the selected papers showed very different objectives and subjects of study. This finding seems to indicate that causal modelling has potential to be relevant for decision-making. The main findings provided information about the complexity of the analyzed systems, distinguishing whether they analyzed a single MHSS or a group of MHSSs. The discriminative power of the checklist for quality assessment was evaluated, with positive results. This review identified relevant strategies for policy-making. Causal modelling can be used for better understanding the MHSS behavior, identifying service performance factors, and improving evidence-informed policy-making.
Collapse
Affiliation(s)
- Nerea Almeda
- Universidad Loyola Andalucía, Department of Psychology, C/ Energía Solar 1, 41014 Seville, Spain.
| | - Carlos R García-Alonso
- Universidad Loyola Andalucía, Department of Quantitative Methods, C/ Energía Solar 1, 41014 Seville, Spain.
| | - José A Salinas-Pérez
- Universidad Loyola Andalucía, Department of Quantitative Methods, C/ Energía Solar 1, 41014 Seville, Spain.
| | | | - Luis Salvador-Carulla
- Centre for Mental Health Research, Research School of Population Health, Australian National University, 63 Eggleston Rd, Acton ACT 2601, Australia.
| |
Collapse
|
5
|
Simo B, Bamvita JM, Caron J, Fleury MJ. Predictors of mental health service use among individuals with high psychological distress and mental disorders. Psychiatry Res 2018; 270:1122-1130. [PMID: 30360914 DOI: 10.1016/j.psychres.2018.10.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/24/2018] [Accepted: 10/08/2018] [Indexed: 02/06/2023]
Abstract
This study identified predictors of mental health service use over 12 months among 746 individuals with mental disorders and high psychological distress from a catchment area in southwest Montreal, Quebec (Canada). Data collected in 2011 and 2014 were analyzed using Andersen's Behavioral Model of Health Services Use. A hierarchical logistic regression identified predictors of mental health service use. In all, 29% of participants reported using mental health services in the previous 12 months. Three key enabling variables predicted mental health service use: having a family doctor, previous experience with mental health services, and employment. Self-perception of mental health, stressful events, and unmet needs marginally (Needs factors: non-clinical variables) were also associated with the outcome variable. Mental health service utilization depends primarily on organization of the health system, and patient perceptions of its condition (non-clinical needs). Mental health policy should focus on increasing the availability of services and professionals, especially family doctors. Other measures for encouraging service use and overall population wellbeing include raising public awareness around the signs and symptoms of mental illness as a way to promote more rapid response to patient needs, and protecting workplace mental health by reducing stress and stigma toward individuals affected by mental distress.
Collapse
Affiliation(s)
- Béatrice Simo
- École de santé publique, Université de Montréal, 7101 av. du Parc, Montreal, QC H3X1X9, Canada
| | - Jean-Marie Bamvita
- Douglas Mental Health University Institute Research Centre, 6875 LaSalle Blvd, Montreal, QC H4H 1R3, Canada
| | - Jean Caron
- Douglas Mental Health University Institute Research Centre, 6875 LaSalle Blvd, Montreal, QC H4H 1R3, Canada; Department of Psychiatry, McGill University, 1033, Pine Avenue West, Montreal, QC H3A 1A1, Canada
| | - Marie-Josée Fleury
- Douglas Mental Health University Institute Research Centre, 6875 LaSalle Blvd, Montreal, QC H4H 1R3, Canada; Department of Psychiatry, McGill University, 1033, Pine Avenue West, Montreal, QC H3A 1A1, Canada.
| |
Collapse
|
6
|
Fleury MJ, Grenier G, Bamvita JM, Vallée C, Farand L, Chiocchio F. Évaluation du Plan d’action en santé mentale (2005-2015) : intégration et performance des réseaux de services. SANTE MENTALE AU QUEBEC 2018. [DOI: 10.7202/1048892ar] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cet article présente les résultats d’un programme de recherche visant à : 1) évaluer l’implantation de la réforme en santé mentale (SM) et ses facteurs favorisant ou entravant dans 11 réseaux locaux de services et la performance d’équipe en SM ; 2) cerner dans quatre réseaux les processus influençant la qualité des services d’équipe ; 3) analyser dans ces mêmes réseaux les effets des structures et des processus d’équipe sur les usagers. Les objectifs de la réforme en SM n’ont été que partiellement atteints dans les réseaux. Les résultats montrent qu’une plus grande utilisation d’outils et d’approches cliniques et des interactions fréquentes entre les équipes et les organisations améliorent la performance. De même, divers processus d’équipe comme l’autonomie, la participation aux processus décisionnels et le partage des connaissances incitent à la performance des professionnels et à la qualité des services. L’intensité des besoins des usagers réduit la capacité des services à répondre aux besoins. Enfin, le rétablissement et la qualité de vie sont fortement corrélés à la continuité et à la diversité des services offerts. Différentes recommandations sont formulées afin d’améliorer les services dont la promotion de cultures organisationnelles plus orientées sur les résultats et la collaboration, le soutien et la formation des professionnels sur l’intégration de pratiques basées sur les données probantes, l’augmentation de l’autonomie des professionnels et leur implication dans les décisions, ainsi que la formalisation de stratégies d’intégration. Enfin, un soutien biopsychosocial diversifié et continu d’intensité variable est recommandé pour améliorer le rétablissement et la qualité de vie des usagers.
Collapse
Affiliation(s)
- Marie-Josée Fleury
- Ph. D., Professeure titulaire, Département de psychiatrie, Université McGill, chercheure, Centre de recherche de l’Hôpital Douglas, Montréal
| | - Guy Grenier
- Ph. D., Chercheur associé, Centre de recherche de l’Hôpital Douglas, Montréal
| | - Jean-Marie Bamvita
- M.D., Ph. D., Professionnel de recherche, Centre de recherche de l’Hôpital Douglas, Montréal
| | - Catherine Vallée
- M.D., Ph. D., Professeure agrégée, Département de réadaptation, Université Laval, chercheure, Centre de recherche sur les soins et les services de première ligne de l’Université Laval
| | - Lambert Farand
- M.D., Ph. D., Professeur agrégé, Département de gestion, évaluation et politique de santé, École de santé publique de l’Université de Montréal (ESPUM), chercheur, Institut de recherche de l’ESPUM, Montréal
| | - François Chiocchio
- Ph. D., Professeur agrégé, École de gestion Telfer, Université d’Ottawa ; Chaire de recherche Montfort sur l’organisation des services de santé
| |
Collapse
|
7
|
Fortin M, Bamvita JM, Fleury MJ. Patient satisfaction with mental health services based on Andersen's Behavioral Model. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:103-114. [PMID: 29056085 PMCID: PMC5788132 DOI: 10.1177/0706743717737030] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The purpose of this article was to assess the satisfaction of adult patients who received mental health services (MHS) in healthcare networks staffed by multidisciplinary professionals and offering a range of MHS, and to identify variables associated with patient satisfaction. METHODS This cross-sectional study included 325 patients with mental disorders (MDs) among 4 Quebec health service networks. Data were collected using 9 standardized instruments and participant medical records. A 3-factor conceptual framework (predisposing, enabling, and needs-related factors) based on Andersen's Behavioral Model was used, integrating sociodemographic, clinical, needs-related, service utilization, social support, and quality-of-life (QOL) variables. An adjusted multiple linear regression model was performed. RESULTS The global mean score for patient satisfaction was 4.11 (minimum: 2.0; maximum: 5.0). Among the enabling factors, continuity of care, having a case manager, and help received from services were positively associated with patient satisfaction, whereas being hospitalized was negatively associated. Among the needs-related factors, the number of needs was negatively associated with satisfaction. CONCLUSIONS Findings demonstrated higher levels of satisfaction among patients who received good continuity of care and well-managed, frequent services in relation to their needs. Dissatisfaction was higher for patients with serious unmet needs or those hospitalized, which underlines the importance of taking these particular variables into account in the interest of improving MHS delivery and patient recovery.
Collapse
Affiliation(s)
- Marilyn Fortin
- 1 Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,2 Douglas Hospital Research Centre, Montreal, Quebec, Canada
| | | | - Marie-Josée Fleury
- 1 Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,2 Douglas Hospital Research Centre, Montreal, Quebec, Canada
| |
Collapse
|
8
|
Fleury MJ, Grenier G, Bamvita JM. Associated and mediating variables related to quality of life among service users with mental disorders. Qual Life Res 2017; 27:491-502. [DOI: 10.1007/s11136-017-1717-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 11/24/2022]
|