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Domingue JL, Jacob JD. Discursive constructions of family functions in forensic psychiatry: A critical ethnographic perspective. Health (London) 2024; 28:526-541. [PMID: 37391908 PMCID: PMC11149389 DOI: 10.1177/13634593231185263] [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: 07/02/2023]
Abstract
Significant barriers remain regarding the implementation of family-centred approaches in the domain of forensic psychiatry despite their effectiveness at increasing adherence to treatment, improving attendance to medical appointments, decreasing readmission rates and reducing episodes of relapse. We attribute these barriers to a fundamental gap in our understanding of the family function and its role within the forensic psychiatric system. Despite requesting to be included and considered as partners, some families feel excluded and sidelined, which causes distress, incomprehension and disengagement. We approached this tension at the discursive level through a critical ethnography of the Review Board and the work of Foucault on psychiatric power, which provided us with a unique opportunity to understand how the role of families are constructed and sustained in the Canadian forensic psychiatric system. To do so, we mobilized data stemming from ethnographic observations and documentary artifacts entitled 'reasons for disposition'. Data analysis allowed us to identify two discursive constructions of familial functions: (1) families as repositories of information and (2) families as supervisory agents. These results have implications for health care professionals and administrators in forensic psychiatry who are increasingly adhering to family-centred care models without questioning what such care or what such family engagement entails.
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Sud D, Bradley E, Tritter J, Maidment I. The impact of providing care for physical health in severe mental illness on informal carers: a qualitative study. BMC Psychiatry 2024; 24:426. [PMID: 38844879 PMCID: PMC11154995 DOI: 10.1186/s12888-024-05864-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 05/23/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND People with severe mental illness (SMI) such as schizophrenia and bipolar disorder are at a substantially higher risk of premature death in that they die between 10 and 20 years earlier than the general population. Cardiovascular disease (CVD) and diabetes are the main potentially avoidable contributors to early death. Research that explores the experiences of people with SMI highlights their struggles in engaging with health professionals and accessing effective and timely interventions for physical health conditions. A consequence of such struggles to navigate and access physical healthcare results in many people with SMI relying heavily on support provided by informal carers (e.g., family members, close friends). Despite this, the experiences of informal carers, and the roles they undertake in relation to supporting the physical health and psychotropic medication use of people with SMI, remains under-researched. AIMS To explore the impacts of providing care for physical health in severe mental illness on informal carers. METHOD Thematic analysis of semi-structured interviews with eight informal carers of people with SMI in United Kingdom (UK) national health services. RESULTS Informal carers played an active part in the management of the patient's conditions and shared their illness experience. Involvement of informal carers was both emotional and practical and informal carers' own lives were affected in ways that were sometimes deeply profound. Informal carers were involved in both 'looking after' the patient from the perspective of doing practical tasks such as collecting dispensed medication from a community pharmacy (caring for) and managing feelings and emotions (caring about). CONCLUSIONS Providing care for the physical health of someone with SMI can be understood as having two dimensions - 'caring for' and 'caring about'. The findings suggest a bidirectional relationship between these two dimensions, and both have a cost for the informal carer. With appropriate support informal carers could be more actively involved at all stages of care without increasing their burden. This should be with an awareness that carers may minimise the information they share about their own needs and impacts of their role to spare the person they care and themselves any distress.
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Affiliation(s)
- Dolly Sud
- Aston University, Birmingham, United Kingdom.
- Leicestershire Partnership NHS Trust, Leicester, United Kingdom.
| | | | | | - Ian Maidment
- Leicestershire Partnership NHS Trust, Leicester, United Kingdom
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Vestphal TK, Tingleff EB, Jørgensen R, Rowaert S, Gildberg FA. Tilting at Windmills - A Qualitative Study about Family Caregiver Interactions and Perceptions in Forensic Mental Health Care. Issues Ment Health Nurs 2024; 45:322-330. [PMID: 38412043 DOI: 10.1080/01612840.2024.2308544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
In forensic mental health care (FMHC), family caregivers perceive themselves as burdened in their relationships with the service user (the family member with mental illness) and by difficult collaboration with healthcare professionals (HCPs). There is a political objective to involve this group in the care and treatment of the service user in mental health care. To improve family caregiver involvement in care and treatment in FMHC, research about their perceptions is needed. This study aims to explore family caregivers' perceptions of their interactions with the service user and HCPs. The method used was qualitative. Semi-structured, in-depth interviews with 12 family caregiver participants were carried out and analyzed thematically. The analysis resulted in three interrelated main themes: Strategies to normalize everyday living; Distrust of the quality of care; and Loss and grief. Family caregiver feelings of loss and grief may be suppressed, which additionally could prevent them from supporting the service user.
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Affiliation(s)
- Tina Kirstine Vestphal
- Forensic Mental Health Research Unit Middelfart (RFM), Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Ellen Boldrup Tingleff
- Forensic Mental Health Research Unit Middelfart (RFM), Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Rikke Jørgensen
- Unit for Psychiatric Research, Psychiatry, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Sara Rowaert
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Frederik Alkier Gildberg
- Forensic Mental Health Research Unit Middelfart (RFM), Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
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Moran N, Naughton-Doe R, Wilberforce M, Wakeman E, Webber M. Supporting unpaid carers around hospital leave for people detained under the Mental Health Act (1983) in England: carer and practitioner perspectives. BMC Psychiatry 2024; 24:160. [PMID: 38395842 PMCID: PMC10885509 DOI: 10.1186/s12888-024-05602-9] [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: 09/06/2023] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND When an individual is detained in hospital it is important that they maintain contact with their family, friends and communities as these can be helpful for their well-being and recovery. Maintaining these relationships is also important to unpaid carers (family or friends), but they can be strained by carers' instigation of, or compliance with, the involuntary detention. Section 17 of the Mental Health Act (1983) in England and Wales allows for temporary leave from hospital, from an hour in the hospital grounds to going home for a few days. However, carers are not always involved in decisions around statutory s.17 leave, even where they are expected to support someone at home. This study aimed to explore how practice can be improved to better involve and support carers around s.17 leave. METHODS Semi-structured interviews and focus groups were held with 14 unpaid carers and 19 mental health practitioners, including four Responsible Clinicians, in three sites in England in 2021. The research explored views on what works well for carers around s.17 leave, what could be improved and the barriers to such improvements. Transcripts were analysed using reflexive thematic analysis. RESULTS Three themes were identified in the analysis: the need for carer support and the challenges surrounding provision; challenges with communication, planning and feedback around s.17 leave; and inconsistency in involving carers around s.17 leave. Permeating all themes was a lack of resources presenting as under-staffing, high demands on existing staff, and lack of time and capacity to work and communicate with carers. CONCLUSION Implications include the need for more funding for mental health services for both prevention and treatment; staff training to increase confidence with carers; and standardised guidance for practitioners on working with carers around s.17 leave to help ensure consistency in practice. The study concluded with the production of a 'S.17 Standard', a guidance document based on the research findings consisting of 10 steps for practitioners to follow to support the greater involvement and support of carers.
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Affiliation(s)
- Nicola Moran
- School for Business and Society, University of York, YO10 5DD, York, England.
| | - Ruth Naughton-Doe
- School for Business and Society, University of York, YO10 5DD, York, England
| | - Mark Wilberforce
- School for Business and Society, University of York, YO10 5DD, York, England
| | - Emma Wakeman
- St Andrew's Healthcare, Billing Road, NN1 5DG, Northampton, England
| | - Martin Webber
- School for Business and Society, University of York, YO10 5DD, York, England
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Wong WK, Ho YWB, To KL, Bressington DT. Attitudes towards family involvement in nursing care among psychiatric nurses in Hong Kong: A cross-sectional descriptive study. J Psychiatr Ment Health Nurs 2023; 30:865-874. [PMID: 36947096 DOI: 10.1111/jpm.12920] [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: 09/10/2022] [Revised: 01/12/2023] [Accepted: 03/08/2023] [Indexed: 03/23/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Family-involved interventions can result in better outcomes than traditional mental health care for both service users and their families. Nurses' attitudes towards family involvement can affect family participation in care. Earlier studies on psychiatric nurses' attitudes towards family involvement in care report ambiguous findings. Hong Kong's unique integrated cultures may influence Hong Kong psychiatric nurses' attitudes towards family involvement in nursing care. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The majority of psychiatric nurses had positive views on family involvement in care in Hong Kong. Four variables (i.e. gender, clinical experience, nature of working unit and family nursing training) of psychiatric nurses are associated with their attitudes towards family involvement in care in Hong Kong. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Policy makers should develop strategies to increase psychiatric nurses' awareness of the importance of family involvement in patient care. Nurse educators help to design family nursing training to enhance psychiatric nurses' competence in collaborating with families of people suffering from mental disorders. ABSTRACT INTRODUCTION: In Hong Kong, involving the family in nursing care is still optional and mainly depends on nurses' attitudes and the willingness of the family. Hong Kong psychiatric nurses' attitudes towards family involvement in nursing care may be influenced by the unique integrated Eastern and Western cultures, however earlier studies report ambiguous findings. AIMS This study aimed to assess Hong Kong psychiatric registered nurses' attitudes towards family involvement in care and its associated factors. METHODS This study is a cross-sectional descriptive online survey with convenience sampling based on the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) instrument. RESULTS Most of the psychiatric nurses had supportive attitudes towards family involvement in care. Females with more clinical experience, working in a rehabilitation-related unit and having attended a family nursing education course were associated with positive attitudes towards family involvement in care. DISCUSSION The supportive attitude of psychiatric nurses may be explained by the shift of mental health nursing care from hospital care to community care in recent decades. IMPLICATIONS FOR PRACTICE Mental health nurse education and training in Hong Kong could place more emphasis on building family work skills, particularly for newly qualified nurses and those working in acute inpatient settings.
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Affiliation(s)
- Wai Kit Wong
- School of Nursing, Tung Wah College, Hong Kong, Hong Kong
| | - Ying Wai Bryan Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
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Vestphal TK, Gildberg FA, Jørgensen R, Rowaert S, Tingleff EB. Experiences of family caregivers in forensic mental health care-A qualitative evidence synthesis. J Psychiatr Ment Health Nurs 2023. [PMID: 36739887 DOI: 10.1111/jpm.12910] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/07/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT Internationally, research and policy agendas recommend that family caregivers of service users in mental health care be involved in care and treatment, to support the service user's recovery process. Family caregivers of service users in mental health care are often highly burdened. There is a lack of research-based knowledge about the experiences of family caregivers of service users in forensic mental health care (FMHC) and their involvement in care and treatment. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE This study indicates a persistent caregiver presence and/or caregiver advocacy in regard to care and treatment of the service user in FMHC. This study indicates that health care professionals (HCPs) might play a role in eliciting a persistent caregiver presence and/or caregiver advocacy. WHAT ARE THE IMPLICATIONS FOR PRACTICE HCPs need to develop their collaborative skills and be more willing to listen to and understand caregivers' persistent presence and/or advocacy. HCPs need to be more skilled to understand caregivers' and families' living with the complexities of mental illness and offence. HCPs are encouraged to adjust the involvement of family caregivers in care and treatment to FMHC. ABSTRACT Introduction There is a lack of research about experiences of family caregivers of service users in forensic mental health care (FMHC) and their involvement in care and treatment. Research shows that caregivers are burdened. Further knowledge is required, to provide a foundation for improving clinical practice. Aim To review research literature, to investigate existing knowledge about caregiver experiences and, secondly, caregivers' experiences of facilitators and barriers related to their involvement in care and treatment. Method Qualitative evidence synthesis undertaken in a thematic synthesis of thirteen peer-reviewed studies. Results The analysis identified three descriptive themes: violence against family; a great burden of responsibility; and difficult collaboration, together with an additional three analytical themes: bearing witness; persistent presence; and advocacy becomes necessary. Discussion Persistent caregiver presence and/or caregiver advocacy may be elicited by health care professionals' (HCPs') exclusion of caregivers from care and treatment. Caregivers' feelings of guilt in relation to the service user's offence may play an additional role in persistent presence and advocacy and, therefore, in HCPs' exclusion of them. Implications for Practice HCPs need to develop their collaboration with caregivers by their willingness to listen to caregivers to understand emotional complexities within families experiencing mental illness and offence.
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Affiliation(s)
- Tina Kirstine Vestphal
- Department of Regional Health Research, Forensic Mental Health Research Unit Middelfart (RFM), Faculty of Health Sciences, University of Southern Denmark, Middelfart, Denmark.,Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
| | - Frederik Alkier Gildberg
- Department of Regional Health Research, Forensic Mental Health Research Unit Middelfart (RFM), Faculty of Health Sciences, University of Southern Denmark, Middelfart, Denmark.,Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark
| | - Rikke Jørgensen
- Unit for Psychiatric Research, Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Sara Rowaert
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Gent, Belgium
| | - Ellen Boldrup Tingleff
- Department of Regional Health Research, Forensic Mental Health Research Unit Middelfart (RFM), Faculty of Health Sciences, University of Southern Denmark, Middelfart, Denmark.,Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Middelfart, Denmark.,OPEN, Odense Patient data Explorative Network Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Middelfart, Denmark
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Heginbotham L, Baugh G, Lefeber T, Friehling L, Barnhart C, Miller LA, Moore L, Cottrell L. A parent-led, patient-centered medical home model instruction for interprofessional undergraduate and graduate learning opportunities. MEDICAL EDUCATION ONLINE 2022; 27:2012105. [PMID: 34919018 PMCID: PMC8725748 DOI: 10.1080/10872981.2021.2012105] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/14/2021] [Accepted: 11/25/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Despite national efforts to establish patient-centered medical homes (PCMH), 57.3% of children with special health care needs are receiving care that does not meet medical home criteria. Project DOCC, a national curriculum designed by parents of children with disabilities or chronic disease, has shown documented strengths in medical resident learner education of children with special health care needs from the parent perspectives for over a decade. Because of the importance of PCMH and the need to provide compassionate care, our team adapted the curriculum to incorporate team-based learning in the rural setting. MATERIALS AND METHODS Reading materials were distributed to learners prior to an in-person workshop at which time, learners reviewed a video and discussed PCMH materials to identify elements of the PCMH. Learners then engaged with parent mentors across three breakout sessions. A final group reflection was completed to review and discuss efforts providers would take to establish and maintain the PCMH in their own practice. Baseline and post-workshop PCMH perceptions and parent mentor reflections were collected and compared using t-test comparisons. RESULTS Learner knowledge, perceptions, and comfort significantly increased after the workshop. Parent mentor comments also highlighted an increased understanding for the provider. Discussion: The adapted PCMH curriculum significantly impacted learner outcomes using a feasible approach that fit nicely within health professional curricula and limited resources of the rural setting. Parents enjoyed the opportunity to serve as mentors and valued the instruction format.
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Affiliation(s)
- Lori Heginbotham
- Center for Excellence in Disabilities, West Virginia University, Morgantown, WV, USA
| | - Gina Baugh
- Director of the Wv Office of Interprofessional Education, West Virginia University School of Pharmacy, Morgantown, WV, USA
| | - Timothy Lefeber
- Department of Pediatrics, West Virginia University, Morgantown, WV, USA
| | - Linda Friehling
- Department of Pediatrics, West Virginia University, Morgantown, WV, USA
| | - Christy Barnhart
- Nursing Workshop, West Virginia University Adult Health Department
| | - Lee Ann Miller
- West Virginia University, Patient Safety Simulation Center (WV STEPS), Morgantown, WV, USA
| | - Lucas Moore
- Center for Excellence in Disabilities, West Virginia University, Morgantown, WV, USA
| | - Lesley Cottrell
- Center for Excellence in Disabilities, West Virginia University, Morgantown, WV, USA
- Department of Pediatrics, West Virginia University, Morgantown, WV, USA
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Tingleff EB, Rowaert S, Vinding S, Vestphal TK, Wilson R, Gildberg FA. "It's still our child". A qualitative interview study with parent carers in forensic mental health. Arch Psychiatr Nurs 2022; 41:124-131. [PMID: 36428040 DOI: 10.1016/j.apnu.2022.07.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/21/2022] [Accepted: 07/09/2022] [Indexed: 11/02/2022]
Abstract
The purpose of this study was to explore the experiences and perceptions of parents in forensic mental health services with regard to their cooperation with healthcare professionals and their role as parent carers. 15 participants were interviewed using qualitative, in-depth interviews and transcripts were analysed thematically. The identified themes were 'Medical dominance', 'Interactions with healthcare professionals', and 'Advocating for their daughter/son'. The themes were associated with the overall theme 'perceived impact on the parents' everyday lives'. The results suggest that parent carers perceive a malalignment between the institutional medicalised treatment focus and the need for an integrated holistic approach, which would include them as partners.
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Affiliation(s)
- Ellen Boldrup Tingleff
- Forensic Mental Health Research Unit Middelfart (RFM), Department of Regional Health Research, Faculty of Health Science, University of Southern Denmark, Denmark; Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Denmark; Nursing Education, Vejle, and Health Sciences Research Center, UCL University College, Denmark; OPEN, Odense Service user data Explorative Network, Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Denmark.
| | - Sara Rowaert
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Belgium
| | - Stinne Vinding
- Nursing Education, Vejle, and Health Sciences Research Center, UCL University College, Denmark
| | - Tina Kirstine Vestphal
- Forensic Mental Health Research Unit Middelfart (RFM), Department of Regional Health Research, Faculty of Health Science, University of Southern Denmark, Denmark; Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Denmark
| | - Rhonda Wilson
- School of Nursing and Midwifery, College of Health, Medicine, and Wellbeing, The University of Newcastle, Australia; School of Nursing, Massey University, New Zealand
| | - Frederik Alkier Gildberg
- Forensic Mental Health Research Unit Middelfart (RFM), Department of Regional Health Research, Faculty of Health Science, University of Southern Denmark, Denmark; Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Denmark
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Ho LL, Li Y, Gray R, Ho GWK, Bressington D. Experiences and views of carers regarding the physical health care of people with severe mental illness: An integrative thematic review of qualitative research. J Psychiatr Ment Health Nurs 2022; 29:774-787. [PMID: 34714949 DOI: 10.1111/jpm.12804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/04/2021] [Accepted: 10/25/2021] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: People with severe mental illness (SMI) have high rates of physical illnesses, and carers are core partners in managing their physical health. Qualitative research on carers' views/experiences of physical health care is limited, and there is no published systematic review that synthesizes the current evidence. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Carers' views from seven articles were synthesised into nine themes and six subthemes describing their perceived facilitators, barriers and roles regarding the physical health care of people with SMI. Carers' voiced similar concerns to those previously identified by professionals and service users, particularly in relation to poor service access/responsiveness and communication difficulties with healthcare professionals. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses should be aware of the risk of diagnostic overshadowing and ensure they are both responsive and sensitive to carers concerns about the physical health of people with SMI. It is essential for mental health nurses to actively involve carers in managing physical health, especially in formulating physical healthcare plans and providing clear practical advice/information. ABSTRACT: Introduction People with severe mental illness (SMI) have high rates of physical illnesses. Informal carers are core partners in addressing these issues, however research on their views/experiences is limited and there is no systematic review published on the topic. Aim This integrative thematic review explored the experiences and views of carers on physical health care in SMI by synthesizing the existing qualitative research findings. Methods Six databases were searched from 2000 to 2021. Data were extracted and synthesised using thematic integrative analysis. The quality of included studies was assessed with the JBI Critical Appraisal Checklist. Results Five studies were included. Nine themes were identified conceptualising carers' perceived facilitators, barriers and roles regarding physical health care for people with SMI. Discussion Carers felt that receiving practical help and a specialised role for mental health nurses would facilitate better physical health care. Lack of coordination/communication and poor service access/responsiveness were common barriers, often compounded by diagnostic overshadowing. Carers are involved in promoting healthy lifestyles, monitoring physical health and supporting access to services. Implications for Practice Mental health nurses should ensure they are responsive to carers' concerns and proactively support them to promote the physical health of people with SMI.
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Affiliation(s)
- Lok-Lam Ho
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Richard Gray
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Grace W K Ho
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Daniel Bressington
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
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Fahmi M, Georges T, Leaune E, Chalancon B, Chasles V, Blain J, Chauliac N. Patients' and relatives' views on unmet mental health care needs through a qualitative study: Symptoms are a major barrier. Int J Ment Health Nurs 2022; 31:1249-1259. [PMID: 35794730 DOI: 10.1111/inm.13036] [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] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
Abstract
Unmet needs in mental health care are a prominent issue and concern almost half of people with such disorders. Psymobile is a mobile outreach psychiatric team whose objective is to facilitate access to psychiatric services. Its intervention is at the request of relatives or social workers, making it possible to encounter situations of long-standing unmet needs. Our objective was to understand the barriers to accessing mental health care as perceived by patients and their relatives. We conducted a qualitative study with patients and their relatives using face-to-face semi-structured interviews and a hierarchical thematic analysis. Four major themes were identified: psychological and behavioural barriers, socio-economic barriers, structural barriers and physical barriers. Anosognosia or lack of insight is cited as a primary barrier, as are fear of stigma, and former negative experiences. The complexity of the French care system and the lack of literacy about mental illnesses were also emphasized by the participants. Physical determinants, such as the distance to healthcare facilities, were rarely mentioned. As a conclusion, outreach teams appear to be an appropriate way to address the issue of unmet mental health care needs when they provide psychiatric care.
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Affiliation(s)
- Morgan Fahmi
- Permanence d'accès aux soins de santé (PASS), Centre Hospitalier le Vinatier, Bron, France
| | | | - Edouard Leaune
- Pôle de psychiatrie des urgences, Centre Hospitalier le Vinatier, Bron, France.,Institut de Recherches Philosophiques de Lyon, Université Jean Moulin Lyon 3, Lyon, France
| | - Benoit Chalancon
- Pôle de psychiatrie des urgences, Centre Hospitalier le Vinatier, Bron, France
| | - Virginie Chasles
- Département de géographie-aménagement, Université Jean Moulin Lyon 3, Lyon, France.,UMR 5600 - Environnement, Ville, Société, CNRS, Lyon, France
| | - Jeffrey Blain
- Ecole Supérieure des Professions Immobilières Réflexions et Recherches (ESPI2R), Lyon, France
| | - Nicolas Chauliac
- Regional Centre for Psychotrauma, Hospices Civils de Lyon (Lyon University Hospitals), Lyon, France.,Psymobile, Centre hospitalier le Vinatier, Bron, France.,Research on Healthcare Performance (RESHAPE), INSERM U1290 and Claude Bernard Lyon 1 University, Lyon, France
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Moyo N, Jones M, Kushemererwa D, Arefadib N, Jones A, Pantha S, Gray R. Service User and Carer Views and Expectations of Mental Health Nurses: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11001. [PMID: 36078717 PMCID: PMC9517907 DOI: 10.3390/ijerph191711001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/21/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Service users' views and expectations of mental health nurses in a UK context were previously reviewed in 2008. The aim of this systematic review is to extend previous research by reviewing international research and work published after the original review. Five databases were searched for studies of any design, published since 2008, that addressed service user and carer views and expectations of mental health nurses. Two reviewers independently completed title and abstract, full-text screening and data extraction. A narrative synthesis was undertaken. We included 49 studies. Most included studies (n = 39, 80%) were qualitative. The importance of the therapeutic relationship and service users being supported in their personal recovery by mental health nurses were core themes identified across included studies. Service users frequently expressed concern about the quality of the therapeutic relationship and indicated that nurses lacked time to spend with them. Carers reported that their concerns were not taken seriously and were often excluded from the care of their relatives. Our critical appraisal identified important sources of bias in included studies. The findings of our review are broadly consistent with previous reviews however the importance of adopting a recovery approach has emerged as a new focus.
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Affiliation(s)
- Nompilo Moyo
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
- Victorian Tuberculosis Program, Melbourne Health, Melbourne, VIC 3000, Australia
| | - Martin Jones
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
- Department of Rural Health, University of South Australia, Whyalla Campus, Whyalla Norrie, SA 5608, Australia
- IIMPACT in Health, University of South Australia, Adelaide, SA 5000, Australia
| | - Diana Kushemererwa
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
| | - Noushin Arefadib
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
| | - Adrian Jones
- Faculty of Life Sciences, Wrexham Glyndwr University, Wrexham LL11 2AW, UK
| | - Sandesh Pantha
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
| | - Richard Gray
- School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
- Department of Rural Health, University of South Australia, Whyalla Campus, Whyalla Norrie, SA 5608, Australia
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12
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Smith T, Wells L, Jones K, Jaouich A, Rush B. Assessing the Perception of Family and Caregivers' Experience with Mental Health and Substance Use Services. Int J Ment Health Addict 2022:1-16. [PMID: 35937612 PMCID: PMC9344803 DOI: 10.1007/s11469-022-00863-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 11/29/2022] Open
Abstract
Standardized client feedback surveys encourage a culture of continuous quality improvement, allow for comparison of results over time and across similar types of service providers, and encourage use of evidence-based practices. Recognizing the importance of family and other caregivers in supporting people accessing services for mental health and substance use challenges, a standardized perception-of-care tool (the Ontario Perception of Care Tool for Mental Health and Addictions, OPOC-MHA) was adapted to collect feedback specific to the caregiver experience with these services. A collaborative process engaged a broad range of mental health and/or addiction providers, family advisory networks, and family members and caregivers to identify themes, specific items, and implementation approaches. The final version of the tool evolved through an iterative process of pilot testing and stakeholder feedback. Family member and caregiver perceptions of care will identify service areas in need of improvement, contribute to quality improvement initiatives, and facilitate the comparison of findings over time.
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Affiliation(s)
- Tayla Smith
- Provincial System Support Program, Center for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada
| | - Leslie Wells
- Provincial System Support Program, Center for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada
| | - Kelsey Jones
- Provincial System Support Program, Center for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada
| | | | - Brian Rush
- Provincial System Support Program, Center for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada
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13
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Naughton-Doe R, Moran N, Wakeman E, Wilberforce M, Bennett L, Webber M. Interventions that support unpaid carers of adult mental health inpatients: a scoping review. J Ment Health 2022:1-17. [PMID: 35532039 DOI: 10.1080/09638237.2022.2069702] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Unpaid carers of adult mental health inpatients often lack support for their well-being and feel excluded from decisions about patient care. AIMS This scoping review aimed to: synthesise the peer-reviewed literature evaluating the outcomes of brief interventions for unpaid carers of adult mental health inpatients, identify transferable lessons for evidenced-informed practice, and establish future research priorities. METHODS PRISMA scoping review guidelines were followed to search 12 databases using predefined search terms. Two reviewers independently screened papers and applied exclusion/inclusion criteria. Studies were included if they evaluated the impact or outcomes of interventions. Two reviewers extracted data and assessed study quality. Data were synthesised to categorise types of interventions and evidence for their outcomes. RESULTS 16 papers met the inclusion criteria, and five types of interventions were identified: those that aimed to (1) increase carer involvement in inpatient care; (2) facilitate organisational change to increase carer support and involvement; (3) provide carers with support; (4) deliver psychoeducation and offer support; and (5) reduce carer stress and improve coping skills. CONCLUSIONS Whilst evidence of intervention effectiveness was promising, the quality of studies was generally weak. More research is needed to develop an evidence-informed approach to supporting carers during inpatient stays.
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Affiliation(s)
- Ruth Naughton-Doe
- International Centre for Mental Health Social Research, Department of Social Policy and Social Work, University of York, York, England
| | - Nicola Moran
- International Centre for Mental Health Social Research, Department of Social Policy and Social Work, University of York, York, England
| | | | - Mark Wilberforce
- Social Policy Research Unit, Department of Social Policy and Social Work, University of York, York, UK
| | | | - Martin Webber
- International Centre for Mental Health Social Research, Department of Social Policy and Social Work, University of York, York, England
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14
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Naslund JA, Deng D. Addressing Mental Health Stigma in Low-Income and Middle-Income Countries: A New Frontier for Digital Mental Health. ETHICS, MEDICINE, AND PUBLIC HEALTH 2021; 19:100719. [PMID: 35083375 PMCID: PMC8786211 DOI: 10.1016/j.jemep.2021.100719] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
BACKGROUND Mental health stigma is a major barrier to seeking help, and leads to poor quality of life and social withdrawal for individuals living with mental illness. These concerns are especially severe in low-income and middle-income countries (LMICs) that face a disproportionate share of the global burden of mental illnesses. With growing access to digital technologies in LMICs, there may be new opportunities to address mental health stigma. This review considers the potential for emerging digital technologies to advance efforts to challenge mental health stigma in LMICs. METHODS Promising digital strategies to reduce mental health stigma were identified through searching the peer-reviewed literature. Drawing from the Mental Illness Stigma Framework, these studies of digital strategies were grouped into three categories: 1) protest; 2) education, and 3) contact. RESULTS These three categories align with established stigma reduction programs. Digital strategies could expand the reach of or complement existing efforts. There are challenges with digital stigma reduction strategies, including the need for cultural adaptation of these programs to diverse contexts and settings, consideration of reliable measurement of mental health related stigma, and risks that digital media could perpetuate the spread of misinformation and exacerbate concerns pertaining to mental health stigma. CONCLUSION This review highlights the promise of technology for addressing mental health stigma in LMICs. This is imperative in the face of growing demand for mental health services owing to the economic and social impacts of the COVID-19 pandemic, and the increasing reliance on digital platforms among individuals in most countries.
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Affiliation(s)
- John A. Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Davy Deng
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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15
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Saleem S, Baig A, Sajun S, Bird V, Priebe S, Pasha A. A mixed methods exploration of the role of multi-family groups in community treatment of patients with depression and anxiety in Pakistan. Int J Ment Health Syst 2021; 15:78. [PMID: 34666798 PMCID: PMC8524208 DOI: 10.1186/s13033-021-00500-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/23/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND An open, non-controlled trial was conducted to explore the feasibility, experiences and outcomes of multi-family groups in community mental health care of patients with depression and anxiety. METHODS The study was conducted in community settings within the catchment area of a free of cost primary care center in Karachi, Pakistan. 30 patients with symptoms of depression and anxiety, their caregivers and 3 lay counsellors were recruited enrolled in the study between May-September 2019. Patients were enrolled for monthly multi-family group meetings conducted over 6 months in groups of 5-6 patients and 1-2 nominated caregivers each. Meetings were facilitated by the non-specialist trained counsellors. The primary outcome was quality of life (assessed using Manchester Short Assessment of Quality of Life) and secondary outcomes were symptoms of depression and anxiety (assessed on Aga Khan University Depression and Anxiety Scale), social outcomes (Social Outcome Index), and caregiver burden (Burden Assessment Scale). Change in all measures was assessed pre and 6-month post intervention using t-test. In-depth interviews were conducted with 7 patients, 7 caregivers and the 3 lay counsellors. RESULTS A total of 36 family intervention meetings were conducted with six groups with a total of 30 patients, 34 caregivers and 3 counsellors. Between baseline and the end of the intervention, subjective quality of life increased significantly from 3.34 to 4.58 (p < 0.001, 95% CI 0.93-1.54). Self-reported depression and anxiety scores reduced from 34.7 to 19.5 (p < 0.001, 95% CI 10.8-19.8) and the Social Outcome Index improved from 3.63 to 4.52 (p < 0.001, 95% CI 0.39-1.39). There was no change in family burden. Participants reported that the group meetings were seen as a safe space for shared learning, and that the experience helped improve self-regulation of emotions and behaviors and instilled a sense of belonging. CONCLUSION Multi-family groups in community treatment of common mental health disorders facilitated by non-specialist mental health service providers is feasible, experienced positively and has the potential for large and positive effects on subjective quality of life, self-reported depression and anxiety, and objective social outcomes. TRIAL REGISTRATION ISRCTN, ISRCTN12299326. Registered 05 June 2019. Retrospectively registered, https://doi.org/10.1186/ISRCTN12299326 .
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Affiliation(s)
- Saniya Saleem
- Interactive Research and Development, Karachi, Pakistan. .,Global Health Directorate, Indus Hospital and Health Network, Karachi, Pakistan.
| | - Anayat Baig
- Interactive Research and Development, Karachi, Pakistan
| | - Sana Sajun
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Victoria Bird
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Aneeta Pasha
- Interactive Research and Development, Karachi, Pakistan
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16
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Norton MJ, Cuskelly K. Family Recovery Interventions with Families of Mental Health Service Users: A Systematic Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157858. [PMID: 34360150 PMCID: PMC8345647 DOI: 10.3390/ijerph18157858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/13/2021] [Accepted: 07/21/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Recovery has become a catalyst for much organisational and cultural change within mental health services. Recovery involves the service user living the best life of their choice despite the presence of mental health challenges. In contrast, recovery of families remains under-developed with minimal attention given to the unique support families may require in their own recovery journeys. This paper aims to place focus on the topic through a systematic review of the literature into family recovery interventions in mental health; Method and Analysis: A PRISMA compliant systematic review was initiated. It included how the reviewers retrieved and selected studies for the systematic review. It outlined the inclusion/exclusion criteria and how these were further developed through the PICO framework. It also outlined how the reviewers assessed issues of bias and quality, as well as the process of data synthesis; Results: Three studies were included in this review. Each focusing on family recovery interventions across the lifespan: Kidstime to family toolkits to family psychoeducation. The benefits and challenges of each intervention to the family were synthesised along with a list of four family recovery enablers that are vital for the implementation of such family recovery interventions; Discussion/Implications for Practice: The results highlight the paucity of quality literature available for family recovery interventions. All three studies scored poorly in terms of quality, with one particular study (Nagi and Davies 2015) lacking quotations from participants to back up their claims. From this study, a number of actions need to be implemented, specifically around the enablers needed to allow for family recovery interventions to be fully implemented.
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Affiliation(s)
- Michael John Norton
- National Engagement & Recovery Lead, Mental Health Engagement & Recovery, St. Loman’s Hospital, Palmerstown, 20 Dublin, Ireland
- Adult Continuing Education, The Laurels, University College Cork, College Road, T12 YN60 Cork, Ireland
- Correspondence:
| | - Kerry Cuskelly
- Principal Social Worker, Adult Mental Health Services, North Dublin, Ireland;
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Javed A, Lee C, Zakaria H, Buenaventura RD, Cetkovich-Bakmas M, Duailibi K, Ng B, Ramy H, Saha G, Arifeen S, Elorza PM, Ratnasingham P, Azeem MW. Reducing the stigma of mental health disorders with a focus on low- and middle-income countries. Asian J Psychiatr 2021; 58:102601. [PMID: 33611083 DOI: 10.1016/j.ajp.2021.102601] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/07/2021] [Indexed: 01/12/2023]
Abstract
Mental health disorders are a burgeoning global public health challenge, and disproportionately affect the poor. Low- and middle-income countries (LMICs) bear 80 % of the mental health disease burden. Stigma associated with mental health results in delayed help seeking, reduced access to health services, suboptimal treatment, poor outcomes and an increased risk of individuals' human rights violations. Moreover, widespread co-occurrence of physical comorbidities such as noncommunicable diseases with mental health disorders makes the treatment of both conditions challenging and worsens prognosis. This paper explores various aspects of stigma towards mental health with a focus on LMICs and assesses measures to increase help-seeking and access to and uptake of mental health services. Stigma impacts persons living with mental illness, their families and caregivers and healthcare professionals (mental health professionals, non-psychiatric specialists and general practitioners) imparting mental health care. Cultural, socio-economic and religious factors determine various aspects of mental health in LMICs, ranging from perceptions of health and illness, health seeking behavior, attitudes of the individuals and health practitioners and mental health systems. Addressing stigma requires comprehensive and inclusive mental health policies and legislations; sustainable and culturally-adapted awareness programs; capacity building of mental health workforce through task-shifting and interprofessional approaches; and improved access to mental health services by integration with primary healthcare and utilizing existing pathways of care. Future strategies targeting stigma reduction must consider the enormous physical comorbidity burden associated with mental health, prioritize workplace interventions and importantly, address the deterioration of population mental health from the COVID-19 pandemic.
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Affiliation(s)
- Afzal Javed
- Pakistan Psychiatric Research Centre, Lahore, Pakistan; World Psychiatric Association (WPA), UK.
| | - Cheng Lee
- Institute of Mental Health, Singapore
| | - Hazli Zakaria
- Malaysian Psychiatric Association (MPA), Kuala Lumpur, Malaysia
| | - Robert D Buenaventura
- Department of Neurosciences, Manila Theological College - College of Medicine, Manila, Philippines
| | - Marcelo Cetkovich-Bakmas
- Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Kalil Duailibi
- Department of Psychiatry, Santo Amaro University, São Paulo, Brazil
| | - Bernardo Ng
- Asociación Psiquiátrica Mexicana, Mexico; University of California, San Diego, CA, USA
| | - Hisham Ramy
- NeuroPsychiatry Department, Ain Shams University, Cairo, Egypt; Egyptian Psychiatric Association (EPA), Cairo, Egypt; Egyptian Association of Cognitive Behavioral Therapy (EACBT), Cairo, Egypt
| | - Gautam Saha
- Clinic Brain Neuropsychiatric Institute and Research Center, Kolkata, India; Indian Psychiatric Society, Kolkata, India
| | | | - Paola M Elorza
- Research, Development & Medical, Upjohn - A Pfizer Division, Buenos Aires, Argentina
| | | | - Muhammad Waqar Azeem
- Department of Psychiatry, Sidra Medicine, Weill Cornell Medical College, Doha, Qatar
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18
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Maleki N, Sadeghian E, Shamsaei F, Tapak L, Ghaleiha A. Comparative Analysis of Spouse’s Burden and Quality of Life in Major Depressive Disorder and Bipolar I Disorder. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2019. [DOI: 10.2174/1874464812666190819151039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Spouses of patients with bipolar disorder may experience a different quality
of life and burden than seen with major depressive disorder.
Objective:
This study was conducted to comparatively analyse spouse’s burden and quality of life in
major depressive and bipolar disorders.
Methods:
This cross-sectional study was conducted on 220 spouses of patients with major depressive
and bipolar disorders in the city of Hamadan in Iran, in 2018. Data collection tools included
Zarit Burden and QOL-BREF questionnaires. Data were analyzed by a t-test using SPSS -16.
Results:
The findings showed that 11.8% of spouses of patients with depression and 85.5% of
spouses of patients with bipolar disorder experienced severe burden (P < 0.001). The quality of life
of spouses of patients with bipolar disorder was lower than with depressive disorder (P < 0.05). In
both the groups, a negative correlation was found between burden and QOL.
Conclusion:
The spouses of patients with bipolar disorder experience more burden and lower quality
of life than depression. In both the groups, burden has a negative impact on the quality of life.
Professional help and supportive intervention can be provided to the spouses of patients with major
depressive and bipolar I disorders to reduce their burden, strengthen their coping skill and thus improve
their QOL.
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Affiliation(s)
- Nayereh Maleki
- Department of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Effat Sadeghian
- Chronic Diseases (Home Care) Research Centre, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Farshid Shamsaei
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Lily Tapak
- Department of Biostatistics, School of Public, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Ghaleiha
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Narashimha Rao IV. Engaging families and caregivers in mental health care – DS Raju Oration Award. ARCHIVES OF MENTAL HEALTH 2019. [DOI: 10.4103/amh.amh_26_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Rakhshan M, Ganjalivand S, Zarshenas L, Majdinasab N. The Effect of Collaborative Care Model-Based Intervention on Hope in Caregivers and Patients with Multiple Sclerosis: A Randomized Controlled Clinical Trial. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2018; 6:218-226. [PMID: 30035138 PMCID: PMC6048004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Multiple Sclerosis can affect the patients' and their families' life. In this regard, the collaborative care model could be useful. This study aimed to investigate the effect of the collaborative care model on hope in patients with Multiple Sclerosis (MS) and their family caregivers. METHODS This randomized controlled clinical trial was conducted in May to September 2015 on 60 patients with MS referring to the MS Society of Khuzestan province and 60 family caregivers. After block randomization, the intervention groups (patients and caregivers) received 8 intervention sessions based on collaborative care model over 12 weeks. The data were collected using Snyder's adult hope scale and a demographic questionnaire at baseline and 12 weeks after the beginning of the intervention. Data analysis was conducted through SPSS, version 19, using frequency, mean, Chi-square, independent, paired t-tests and Fisher's exact test (P˂0.05). RESULTS The results of independent t-test before the intervention showed no significant differences between the patients in the intervention (42.76±8.75) and control groups (43.13±7.20) (P=0.86) and caregivers in the intervention (50.26±5.79) and control groups (49.23±6.71) (P=0.52), regarding the score of hope. However, a significant difference was found in this regard 12 weeks after the beginning of the intervention, between the patients in the control (43.63±6.97) and intervention groups (47.96±8.72) (P=0.03), and caregivers in the control (50.66±5.79) and intervention groups (53.80±4.71) (P=0.02). CONCLUSION The collaborative care model promoted hope in patients with MS and their family caregivers. Hence, this model can be used by healthcare personnel for promoting hope among patients and caregivers. Trial Registration Number: IRCT2015051121474N2.
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Affiliation(s)
- Mahnaz Rakhshan
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Somayeh Ganjalivand
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ladan Zarshenas
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nastran Majdinasab
- Department of Neurology, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran
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