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Carney R, Imran S, Law H, Carmichael-Murphy P, Charlton L, Parker S. "If you're struggling, you don't really care" - what affects the physical health of young people on child and adolescent mental health inpatient units? A qualitative study with service users and staff. BMC Psychiatry 2024; 24:498. [PMID: 38982436 PMCID: PMC11234625 DOI: 10.1186/s12888-024-05858-1] [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: 08/09/2023] [Accepted: 05/21/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Physical health inequalities of people with serious mental illness (SMI) have been labelled an international scandal; due to the 15-20-year reduction in life expectancy associated with poor physical health. This occurs at an early stage and evidence shows young people with and at risk for SMI are a particularly vulnerable group requiring intervention and support. However, most work has been conducted with adults and little is known about what affects physical health for young people, specifically those receiving inpatient care. METHODS We conducted semi-structured qualitative interviews with 7 service users and 6 staff members (85% female, age 14-42) on a generic mental health inpatient unit for children and adolescents. Interviews aimed to identify how young people viewed theirphysical health and factors affecting physical health and lifestyle and identify any support needed to improve physical health. Thematic analysis was conducted. . RESULTS Thematic analysis revealed the main factors affecting physical health and lifestyle for young people. Three main themes were individual factors (subthemes were mental health symptoms, knowledge, attitudes and beliefs), environmental factors (subthemes were opportunities in a restricted environment and food provision), and the influence of others (subthemes were peers, staff, family members). These factors often overlapped and could promote a healthy lifestyle or combine to increase the risk of poor physical health. Young people discussed their preferences for physical health initiatives and what would help them to live a healthier lifestyle. CONCLUSIONS Promoting physical health on inpatient units for young people is an important, yet neglected area of mental health research. We have identified a range of complex factors which have an impact on their physical health, and there is a pervasive need to address the barriers that young people experience to living a healthy lifestyle. There is an increasingly strong evidence base suggesting the benefits of physical health interventions to improve outcomes, and future work should identify ways to implement such interventions considering the barriers discussed in this article. Further collaborative research is needed with young people, clinical teams, caregivers, and commissioners to ensure improvements are made to clinical care provision and optimisation of the inpatient environment.
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Affiliation(s)
- Rebekah Carney
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, M25 3BL, UK.
- Division of Psychology and Mental Health, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, M13 9PL, UK.
| | - Shermin Imran
- Greater Manchester Mental Health NHS Foundation Trust, Bury New Road, Prestwich, M13 3BL, UK
| | - Heather Law
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, M25 3BL, UK
| | - Parise Carmichael-Murphy
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, M25 3BL, UK
- Division of Psychology and Mental Health, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, M13 9PL, UK
| | - Leah Charlton
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, M25 3BL, UK
- Division of Psychology and Mental Health, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, M13 9PL, UK
| | - Sophie Parker
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, M25 3BL, UK
- Division of Psychology and Mental Health, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, M13 9PL, UK
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Yang H, Zhu D, Liu Y, Xu Z, Liu Z, Zhang W, Cai J. Employing graph attention networks to decode psycho-metabolic interactions in Schizophrenia. Psychiatry Res 2024; 335:115841. [PMID: 38522150 DOI: 10.1016/j.psychres.2024.115841] [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: 08/21/2023] [Revised: 01/31/2024] [Accepted: 03/04/2024] [Indexed: 03/26/2024]
Abstract
Schizophrenia is a severe mental disorder characterized by intricate and underexplored interactions between psychological symptoms and metabolic health, presenting challenges in understanding the disease mechanisms and designing effective treatment strategies. To delve deeply into the complex interactions between mental and metabolic health in patients with schizophrenia, this study constructed a psycho-metabolic interaction network and optimized the Graph Attention Network (GAT). This approach reveals complex data patterns that traditional statistical analyses fail to capture. The results show that weight management and medication management play a central role in the interplay between psychiatric disorders and metabolic health. Furthermore, additional analysis revealed significant correlations between the history of psychiatric symptoms and physical health indicators, as well as the key roles of biochemical markers(e.g., triglycerides and low-density lipoprotein cholesterol), which have not been sufficiently emphasized in previous studies. This highlights the importance of medication management approaches, weight management, psychological treatment, and biomarker monitoring in comprehensive treatment and underscores the significance of the biopsychosocial model. This study is the first to utilize a GNN to explore the interactions between schizophrenia symptoms and metabolic features, providing new insights into understanding psychiatric disorders and guiding the development of more comprehensive treatment strategies for schizophrenia.
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Affiliation(s)
- Hongyi Yang
- School of Design, Shanghai Jiao Tong University, Shanghai, PR China
| | - Dian Zhu
- School of Design, Shanghai Jiao Tong University, Shanghai, PR China
| | - YanLi Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Zhiqi Xu
- School of Design, Shanghai Jiao Tong University, Shanghai, PR China
| | - Zhao Liu
- School of Design, Shanghai Jiao Tong University, Shanghai, PR China.
| | - Weibo Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, PR China; Mental Health Branch, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, PR China.
| | - Jun Cai
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Mental Health Branch, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, PR China.
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3
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Carney R, El-Metaal H, Law H, Savage S, Small I, Hann M, Shields G, Shiers D, Carmichael-Murphy P, Jones R, Kimber E, McDonald A, Parker S. Motiv8: a study protocol for a cluster-randomised feasibility trial of a weight management intervention for adults with severe mental illness in secure forensic services. Pilot Feasibility Stud 2024; 10:48. [PMID: 38429815 PMCID: PMC10908020 DOI: 10.1186/s40814-024-01458-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 02/06/2024] [Indexed: 03/03/2024] Open
Abstract
INTRODUCTION People with severe mental illness have physical comorbidities which result in significant reductions in quality of life and premature mortality. Effective interventions are required that are suitable for people in secure forensic mental health services. We conducted pilot work of a multidisciplinary weight management intervention (Motiv8) which showed improvements in physical and mental health and high levels of satisfaction. We aim to test the feasibility of Motiv8 under cluster randomised conditions, with an aim to investigate the acceptability, feasibility and potential effectiveness of this intervention to supplement standard secure care. METHODS AND ANALYSIS A randomised waitlist-controlled feasibility trial of a lifestyle intervention (Motiv8) + TAU compared with TAU (+ Motiv8 waitlist) for adults on secure mental health units will be conducted. Thirty-two people (4 cohorts) will be recruited from secure services in Greater Manchester Mental Health NHS Foundation Trust. Participants will be randomly allocated to Motiv8 or TAU + Motiv8 waitlist. All participants will receive Motiv8 during the trial. Assessor-blinded physical/mental health and lifestyle assessments will be conducted at baseline, 10 weeks (post-intervention/waitlist), and after 12 weeks (post-waitlist intervention/follow-up). Motiv8 is a multidisciplinary intervention including exercise sessions, cooking/nutrition classes, physical health education, psychology sessions, sleep hygiene, peer support and medication review by pharmacy. A nested qualitative study will be conducted with a subsample of participants (n = 10) to explore their experiences of taking part. The analysis will focus on feasibility outcomes and tabulated success indicators of the study (e.g. Recruitment rates, retention rates, follow-up retention and response rates, attendance at sessions, the experience of involvement in the trial and delivery of the intervention, assessment of safety, development of a manualised intervention). Thematic analysis will be conducted through qualitative interviews. The analysis will aim to inform the development of a definitive trial. ETHICS AND DISSEMINATION The trial has been granted ethical approval from the NHS Health Research Authority and adopted onto the UK Clinical Research Network Portfolio. Findings will be disseminated via peer-reviewed publications, professional and public networks, conferences and clinical services. TRIAL REGISTRATION ISRCTN13539285.
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Affiliation(s)
- Rebekah Carney
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK.
| | - Hany El-Metaal
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Heather Law
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Siobhan Savage
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Ingrid Small
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Mark Hann
- Division of Population Health, Health Services Research, and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Gemma Shields
- Division of Population Health, Health Services Research, and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - David Shiers
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- Psychosis Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK
- School of Medicine, University of Keele, Staffordshire, UK
| | - Parise Carmichael-Murphy
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Richard Jones
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Elizabeth Kimber
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Andrew McDonald
- Lancashire and South Cumbria, NHS Foundation Trust, Preston, UK
- School of Nursing and Midwifery, University of Bolton, Bolton, UK
| | - Sophie Parker
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Psychosis Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK
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Watkins A, Stein-Parbury J, Curtis J, Poole J, Teasdale S, Fibbins H, Rossimel E, Lederman O, Ward PB, Rosenbaum S, Denney-Wilson E. Tackling change in mental health service delivery: A qualitative evaluation of a lifestyle program targeting mental health staff - Keeping our Staff in Mind (KoSiM). Health Promot J Austr 2023; 34:237-245. [PMID: 35718992 PMCID: PMC10083901 DOI: 10.1002/hpja.633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/08/2022] [Accepted: 06/11/2022] [Indexed: 01/30/2023] Open
Abstract
ISSUES ADDRESSED People with severe mental illness have adverse health outcomes compared to the general population. Lifestyle interventions are effective in improving health outcomes in this population. Current cultural processes in mental health services do not generally incorporate physical health care practices. Innovative education is required to improve knowledge and confidence of staff in the delivery of preventative health measures. METHODS The Keeping our Staff in Mind (KoSiM) program delivered a brief lifestyle intervention to mental health staff. A qualitative analysis following the Standards for Reporting Qualitative Research was undertaken. Semi-structured interviews designed to elicit information about the acceptability of the program and the impact of the intervention on participants' personal and professional lives. The interviews were analysed using thematic analysis, with coding independently developed and reviewed by three authors. RESULTS Of the 103 eligible participants, 75 were interviewed. Responses revealed four main themes: (i) positive changes in clinician's approach to physical health care, (ii) improvements in attitudes to self-care and family wellbeing, (iii) positive changes in workplace culture associated with physical health care delivery and (iv) high levels of acceptability of the program. CONCLUSION The KoSiM model may be useful in other settings as a means of changing the culture of mental health services to better integrate physical health care as a core part of mental health service provision. SO WHAT?: A novel approach using staff focussed lifestyle interventions model may cut through the resistance that is encountered when implementing proven methods of clinical intervention where cultural barriers exist.
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Affiliation(s)
- Andrew Watkins
- Mindgardens Neuroscience Network, Sydney, NSW, Australia.,Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Jane Stein-Parbury
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Jackie Curtis
- Mindgardens Neuroscience Network, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Josephine Poole
- Keeping the Body in Mind, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Scott Teasdale
- Mindgardens Neuroscience Network, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Hamish Fibbins
- Mindgardens Neuroscience Network, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Elisa Rossimel
- Keeping the Body in Mind, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Oscar Lederman
- Keeping the Body in Mind, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia
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Evaluation of a training program to support the implementation of a community pharmacist-led support service for people living with severe and persistent mental illness. J Am Pharm Assoc (2003) 2023; 63:807-816.e2. [PMID: 36788042 DOI: 10.1016/j.japh.2023.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND With appropriate training, community pharmacists can support people living with severe and persistent mental illness (SPMI) by identifying and managing medication-related issues and physical health concerns. The Bridging the Gap between Physical and Mental Illness in Community Pharmacy (PharMIbridge) randomized controlled trial (RCT) tested the impact of an individualized, pharmacist-led support service for people living with SPMI. OBJECTIVE(S) To evaluate the impact of the PharMIbridge training program on pharmacy participants' knowledge and confidence, as well as stigma and attitudes, in relation to supporting, and providing services to, people living with SPMI; compared to Mental Health First Aid (MHFA) training alone. METHODS Pharmacy staff (n = 140) from 55 community pharmacies across four RCT regions attended face-to-face training. Both intervention group (IG) and comparator group (CG) participants received MHFA training while IG participants received additional PharMIbridge training, involving role-plays and mental health consumer educators (MHCEs). A questionnaire including validated instruments was administered at baseline, after training and after 12 months. Comparative analyses included paired t tests and mixed between/within analysis of variance (ANOVA). RESULTS Pre and post-training surveys were completed by 136 participants, most of which were pharmacists. Both IG and CG participants had significant reductions in stigma (P < 0.001) post-training. IG participants' confidence and knowledge regarding metabolic monitoring significantly improved compared to CG (P < 0.001). IG participants were significantly more confident and comfortable in providing medication counseling, compared to CG participants (P < 0.05). CONCLUSION MHFA training reduced participants' stigma toward mental health. However, the purpose-designed PharMIbridge training program provided pharmacists with additional knowledge and skills to confidently support the physical health care needs of people living with SPMI. The inclusion of role-plays and MHCEs allowed pharmacists to self-reflect and practice skills in safe, supportive environments. Future studies should continue to involve MHCEs in pharmacy training and explore whether these improvements are sustainable.
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6
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Watkins A, Stein-Parbury J, Denney-Wilson E, Ward PB, Rosenbaum S. Upskilling Mental Health Nurses to Address the Burden of Poor Metabolic Health: A Mixed Method Evaluation. Issues Ment Health Nurs 2020; 41:925-931. [PMID: 32552212 DOI: 10.1080/01612840.2020.1744204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
People living with a severe mental illness experience a life expectancy gap compared to the rest of the population that is largely driven by preventable cardiovascular diseases stemming from lifestyle factors, and the side effects of psychotropic medications. Mental health nurses are well positioned to help address the gap using lifestyle interventions. However, many nurses don't prioritise delivering such care, or lack the skills and confidence to implement these strategies. This study used a mixed method approach to determine the effectiveness of 2-day metabolic workshops that aimed to provide nurses with the skills to provide lifestyle interventions. The quantitative component compares pre and post measures of attitudes, confidence, knowledge and perceived barriers of providing metabolic care using a validated tool (M-BACK) and the qualitative component to elicit more details of the needs, expectations and plans of participants. Fifty-six nurse participants demonstrated statistically significant improvements in M-BACK post scores (p < 0.001), with 53 of the 56 participants (95%) achieving improved M-BACK scores. Participants identified three primary barriers to delivering metabolic care, related to individual staff members, consumers, and system issues. Prior to the course participants stated they hoped to improve their knowledge, enhance their practical skills and provide education for others. Following completion of the course participants planned to implement lifestyle education and interventions for consumers, provide education and support to other staff and integrate metabolic health care into clinical reviews and planning. This study demonstrates that education on metabolic health care can be effective in improving the attitudes, confidence, and knowledge of mental health nursing in providing metabolic health care and a decrease in the perceived barriers to delivering that care.
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Affiliation(s)
- Andrew Watkins
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of Sunshine Coast, Birtinya, Queensland, Australia.,Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Jane Stein-Parbury
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | | | - Philip B Ward
- School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia.,Liverpool Hospital, Schizophrenia Research Unit, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Simon Rosenbaum
- School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
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7
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Wheeler AJ, O'Reilly CL, El-Den S, Byrnes J, Ware RS, McMillan SS. Bridging the gap between physical and mental illness in community pharmacy ( PharMIbridge): protocol for an Australian cluster randomised controlled trial. BMJ Open 2020; 10:e039983. [PMID: 32709657 PMCID: PMC7380878 DOI: 10.1136/bmjopen-2020-039983] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION There is a significant life expectancy gap attributable to physical comorbidities for people living with severe and persistent mental illness (SPMI) compared with the general population. Medications are a major treatment for SPMI management and physical illnesses, hence pharmacists are well positioned to support mental healthcare and comorbidities. The randomised controlled trial (RCT) aim is to evaluate effectiveness of an individualised, pharmacist led, support service for people experiencing SPMI focusing on medication adherence and physical comorbidity management, compared with standard care (a medication-management service; MedsCheck). METHODS AND ANALYSIS: PharMIbridge is a cluster RCT, whereby community pharmacies in four Australian regions will be randomised (1:1 ratio), to either Intervention Group (IG) or Comparator Group (CG). All IG and CG pharmacy staff will receive Blended-Mental Health First Aid training. Additionally, IG pharmacists will receive further training on medication adherence, goal setting, motivational interviewing, managing physical health concerns and complex issues relating to psychotropic medication. CG pharmacists will not receive additional training, and will provide standard care (MedsCheck). The primary outcome will be change in participants medication adherence for psychotropic medication over 6-months. Using mixed-effects logistic regression model and a cluster size of 48 pharmacies, a total of 190 participants will need to be recruited to each arm to find a statistically significant difference in medication adherence. Secondary outcomes will be changes in factors associated with cardiometabolic risk and quality of life, emphasising physical and psychological well-being; medication-related problems; adherence to other prescribed medication; pharmacists knowledge, confidence and ability to support people experiencing SPMI; and effects on healthcare utilisation. A within RCT-based economic evaluation comparing the intervention with standard care will be undertaken. ETHICS AND DISSEMINATION The protocol and pharmacist training programme received Griffith University Human Research Ethics Committee approval (HREC/2019/473 and HREC/2019/493 respectively). Results will be published in peer-reviewed journals and available at the Sixth Community Pharmacy Agreement website (http://6cpa.com.au/about-6cpa/). TRIAL REGISTRATION NUMBER ANZCTR12620000577910.
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Affiliation(s)
- Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Faculty of Medical and Health Sciences, Auckland University, Auckland, New Zealand
| | - Claire L O'Reilly
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarira El-Den
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Joshua Byrnes
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Sara S McMillan
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- School of Pharmacy and Pharmacology, Griffith University, Gold Coast, Queensland, Australia
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Carraro A, Gobbi E, Solmi M, Watkins A, Ward PB, Rosenbaum S. Test-retest reliability of the Italian version of the M-BACK questionnaire to assess the barriers, attitudes, confidence, and knowledge of mental health staff regarding metabolic health of psychiatric patients. Brain Behav 2020; 10:e01491. [PMID: 31875357 PMCID: PMC7010570 DOI: 10.1002/brb3.1491] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 11/05/2019] [Accepted: 11/13/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The Metabolic-Barriers, Attitudes, Confidence, and Knowledge Questionnaire (M-BACK) was developed to determine the barriers, attitudes, confidence, and knowledge of mental health practitioners regarding the metabolic health of patients in order to determine the efficacy of targeted training interventions. This study aimed to validate the Italian version of M-BACK questionnaire (M-BACK-IT) and to determine the test-retest reliability. METHODS The M-BACK questionnaire was translated into Italian and back-translated using an established protocol. In order to determine the test-retest reliability of the instrument, mental health professionals were recruited from a private psychiatric hospital located in northeast Italy and completed the questionnaire on two separate occasions, seven days apart. Intraclass correlation coefficients (ICC) were calculated for the total score, as well as each of the four M-BACK domains. RESULTS Thirty mental health professionals (4 psychiatrists, 9 psychologists, 12 nurses, and 5 exercise specialists) completed the M-BACK-IT. ICCs ranged from 0.58 to 0.94. CONCLUSIONS The test-retest reliability of the M-BACK-IT demonstrated comparable results to the English version. The M-BACK-IT is a reliable measure to assess key elements of practitioners' perceptions of the barriers, their knowledge, attitudes, and confidence regarding metabolic monitoring and intervention in people with mental illness.
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Affiliation(s)
- Attilio Carraro
- Faculty of Education, Free University of Bozen, Bozen, Italy.,Casa di Cura Parco dei Tigli, Villa di Teolo, Padova, Italy
| | - Erica Gobbi
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Marco Solmi
- Department of Neurosciences, University of Padova, Padova, Italy
| | - Andrew Watkins
- Keeping the Body in Mind Program, Bondi Centre, South Eastern Sydney Local Health District, Sydney, NSW, Australia.,Faculty of Health, University of Technology Sydney, NSW, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Schizophrenia Research Unit, Ingham Institute for Applied Medical Research, South Western Sydney Local Health District, Liverpool Hospital, Sydney, NSW, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Black Dog Institute, Prince of Wales Hospital, Sydney, NSW, Australia
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Rosenbaum S, Ward PB, Baldeo R, Fibbins H, Jarman R, Lederman O, Perram A, Poole J, Rossimel E, Smith G, Teasdale S, Wade T, Watkins A, White A, Pearce D, Curtis J. Changing health workforce attitudes to promote improved physical health in mental health service users: Keeping our Staff in Mind (KoSiM). Health Promot J Austr 2020; 31:447-455. [PMID: 31925974 DOI: 10.1002/hpja.320] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/26/2019] [Accepted: 01/06/2020] [Indexed: 12/26/2022] Open
Abstract
ISSUE ADDRESSED People living with mental illness die on average 15 years earlier than the general population, primarily due to preventable and premature cardiovascular disease. Lifestyle interventions can be effective in reducing cardiovascular risk, yet mental health services do not routinely provide targeted lifestyle interventions. Exposing mental health staff to lifestyle interventions prior to targeting patients may be critical to changing culture and improving patient outcomes. This study aimed to improve the physical health of mental health staff through a targeted lifestyle intervention. METHODS A pragmatic single-arm intervention study was conducted in a public mental health service, including inpatient and community settings, in Sydney, Australia. Participants in this study were n = 212 clinical and non-clinical staff. A five-session individualised lifestyle intervention (delivered over 5 weeks) incorporating physical activity and nutritional counselling was delivered by multidisciplinary teams. Participants were assessed at baseline, following the intervention, and at follow-up (mean = 16.7 weeks). The primary outcome was the barriers, attitudes, knowledge and confidence regarding screening, promoting and intervening to improve physical health outcomes of patients (M-BACK questionnaire). Secondary outcomes included anthropometric measures, cardiorespiratory fitness, sedentary time and nutritional intake. Repeated measures ANCOVAs were performed. RESULTS A total of 212 staff (79% female) participated in this study. M-BACK total score significantly increased from baseline to follow-up (P < .001). Waist circumference, sedentary time and total energy intake all significantly decreased (all P's < .001) and cardiorespiratory fitness significantly increased (P < .001). CONCLUSION A brief lifestyle intervention for staff of a public mental health service may increase the capability of the participants to improve their own physical health. SO WHAT?: Improving staff health may be an important strategy in improving the uptake and/or the effectiveness of lifestyle interventions targeting mental health service users.
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Affiliation(s)
- Simon Rosenbaum
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia.,School of Psychiatry, UNSW, Sydney, NSW, Australia
| | - Philip B Ward
- School of Psychiatry, UNSW, Sydney, NSW, Australia.,Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Rishi Baldeo
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Hamish Fibbins
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Rebecca Jarman
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Oscar Lederman
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Amy Perram
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Josephine Poole
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Elisa Rossimel
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Gabriella Smith
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Scott Teasdale
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia.,School of Psychiatry, UNSW, Sydney, NSW, Australia
| | - Tammy Wade
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Andrew Watkins
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Annette White
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - David Pearce
- District Mental Health, South Eastern Sydney Local Health District, Kogarah, NSW, Australia
| | - Jackie Curtis
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia.,School of Psychiatry, UNSW, Sydney, NSW, Australia.,District Mental Health, South Eastern Sydney Local Health District, Kogarah, NSW, Australia
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10
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Vancampfort D, Watkins A, Ward PB, Probst M, De Hert M, Van Damme T, Mugisha J. Barriers, attitudes, confidence, and knowledge of nurses regarding metabolic health screening and intervention in people with mental illness: a pilot study from Uganda. Afr Health Sci 2019; 19:2546-2554. [PMID: 32127827 PMCID: PMC7040261 DOI: 10.4314/ahs.v19i3.30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background People with mental illness are at an increased risk for developing cardio-metabolic disorders. Routine screening following pharmacotherapy is however unacceptably low in sub-Saharan African countries with less than 1% adequately screened. It is unknown whether this is due to a lack of adequate competences. Objectives The aim of this pilot study was to assess the barriers, attitudes, confidence, and knowledge of nurses regarding metabolic health, prevention and treatment in Uganda. Methods Twenty-eight nurses (39% female, 30.9±6.9 years) completed the Metabolic — Barriers, Confidence, Attitudes and Knowledge Questionnaire and the physical activity prescription rate item of the Exercise in Mental Illness Questionnaire. Results More than 75% had a positive attitude towards metabolic screening and intervention and more than 50% were confident in providing smoking cessation advice, and physical activity and nutritional counseling. However, 57% stated that their heavy workload prevented them from doing health screening and promotion activities. There was a negative correlation (ρ=-0.54, P=0.003) between the frequency of physical activity prescription and the perception of the inability of patients to change. Conclusion The present findings suggest that nurses are generally supportive of metabolic health screening and intervention but their high workload prevents them from implementing metabolic health interventions.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven — University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
- KU Leuven — University of Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium
| | - Andrew Watkins
- Keeping the Body in Mind Program, The Bondi Centre, South Eastern Sydney Local Health District, Sydney, NSW, Australia
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Schizophrenia Research Unit, Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Michel Probst
- KU Leuven — University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Marc De Hert
- KU Leuven — University of Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium
| | - Tine Van Damme
- KU Leuven — University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - James Mugisha
- Kyambogo University, Kampala, Uganda
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda
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Fibbins H, Ward PB, Watkins A, Curtis J, Rosenbaum S. Improving the health of mental health staff through exercise interventions: a systematic review. J Ment Health 2018; 27:184-191. [PMID: 29447044 DOI: 10.1080/09638237.2018.1437614] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Exercise interventions are efficacious in reducing cardiometabolic risk and improving symptoms in people with severe mental illness, yet evidence guiding the implementation and scalability of such efforts is lacking. Given increasing efforts to address the disparity in physical health outcomes facing people with a mental illness, novel approaches to increasing adoption of effective interventions are required. Exercise interventions targeting mental health staff may improve staff health while also creating more positive attitudes towards the role of lifestyle interventions for people experiencing mental illness. AIMS We aimed to determine the feasibility, acceptability and effectiveness of exercise interventions delivered to staff working in mental health services. METHOD A systematic review was conducted from database inception, until November 2017. Studies recruiting staff participants to receive an exercise intervention were eligible for inclusion. RESULTS Five studies met the inclusion criteria. Physical health interventions for mental health staff were feasible and acceptable with low dropout rates. Reductions in anthropometric measures and work-related stress were reported. CONCLUSIONS Limited evidence suggests that exercise interventions targeting mental health staff are feasible and acceptable. Further research is required to determine the efficacy of such interventions and the impact such strategies may have on staff culture and patient outcomes.
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Affiliation(s)
- Hamish Fibbins
- a Keeping the Body in Mind Program , South Eastern Sydney Local Health District , Sydney , NSW , Australia.,b School of Psychiatry , University of New South Wales , Sydney , NSW , Australia
| | - Philip B Ward
- b School of Psychiatry , University of New South Wales , Sydney , NSW , Australia.,c Schizophrenia Research Unit , South Western Sydney Local Health District , Sydney , NSW , Australia.,d Ingham Institute for Applied Medical Research , Liverpool , NSW , Australia
| | - Andrew Watkins
- a Keeping the Body in Mind Program , South Eastern Sydney Local Health District , Sydney , NSW , Australia.,e Faculty of Health, University of Technology , Sydney , NSW , Australia , and
| | - Jackie Curtis
- a Keeping the Body in Mind Program , South Eastern Sydney Local Health District , Sydney , NSW , Australia.,b School of Psychiatry , University of New South Wales , Sydney , NSW , Australia
| | - Simon Rosenbaum
- b School of Psychiatry , University of New South Wales , Sydney , NSW , Australia.,f The Black Dog Institute , Randwick , NSW , Australia
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