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Dewa LH, Thibaut B, Pattison N, Campbell SJ, Woodcock T, Aylin P, Archer S. Treating insomnia in people who are incarcerated: a feasibility study of a multicomponent treatment pathway. Sleep Adv 2024; 5:zpae003. [PMID: 38370440 PMCID: PMC10873789 DOI: 10.1093/sleepadvances/zpae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/11/2023] [Indexed: 02/20/2024]
Abstract
Around 60% of people who are incarcerated have insomnia; 6-10 times more prevalent than the general population. Yet, there is no standardized, evidence-based approach to insomnia treatment in prison. We assessed the feasibility of a treatment pathway for insomnia in a high-secure prison to inform a future randomized controlled trial (RCT) and initial efficacy data for sleep and mental health outcomes. We used a within-participants pre-post design. The stepped-care pathway included: self-management with peer support, environmental aids, and cognitive behavioral therapy for insomnia (CBTi). Assessment measures for insomnia, well-being, mood, anxiety, suicidality, overall health, sleepiness, fatigue, and cognitive functioning were administered at baseline and pathway exit. Feasibility criteria included eligibility to participate, CBTi uptake, and assessment completion. Forty-two adult males who are incarcerated were approached of which 95.2% were eligible. Of those deemed eligible, most participated (36/40, 90.0%). Most who completed baseline completed post-assessments (28/36, 77.8%) and of these, most showed improvements in their subjective sleep (27/28, 96.4%). Large reductions were found from pre- to posttreatment in insomnia severity (d = -1.81, 95% CI: 8.3 to 12.9) and 57.0% reported no clinically significant insomnia symptoms at post-assessment. There was no overall change in actigraphy-measured sleep. Large treatment benefits were found for depression, anxiety, well-being, and cognitive functioning, with a medium benefit on suicidal ideation. The treatment pathway for insomnia in prison was feasible and may be an effective treatment for insomnia in people who are incarcerated, with additional promising benefits for mental health. A pragmatic RCT across different prison populations is warranted. This paper is part of the Sleep and Circadian Health in the Justice System Collection.
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Affiliation(s)
- Lindsay H Dewa
- Imperial College London, School of Public Health, London, UK
| | - Bethan Thibaut
- Imperial College London, School of Public Health, London, UK
| | | | | | - Thomas Woodcock
- Imperial College London, School of Public Health, London, UK
| | - Paul Aylin
- Imperial College London, School of Public Health, London, UK
| | - Stephanie Archer
- University of Cambridge, Department of Public Health and Primary Care, UK
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Abstract
OBJECTIVES Patients in inpatient mental health settings face similar risks (eg, medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (eg, self-harm), and the measures taken to address these (eg, restraint), may result in further risks to patient safety. The objective of this review is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology. DESIGN Systematic review and meta-synthesis. Embase, Cumulative Index to Nursing and Allied Health Literature, Health Management Information Consortium, MEDLINE, PsycINFO and Web of Science were systematically searched from 1999 to 2019. Search terms were related to 'mental health', 'patient safety', 'inpatient setting' and 'research'. Study quality was assessed using the Hawker checklist. Data were extracted and grouped based on study focus and outcome. Safety incidents were meta-analysed where possible using a random-effects model. RESULTS Of the 57 637 article titles and abstracts, 364 met inclusion criteria. Included publications came from 31 countries and included data from over 150 000 participants. Study quality varied and statistical heterogeneity was high. Ten research categories were identified: interpersonal violence, coercive interventions, safety culture, harm to self, safety of the physical environment, medication safety, unauthorised leave, clinical decision making, falls and infection prevention and control. CONCLUSIONS Patient safety in inpatient mental health settings is under-researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety, which require investment in research, policy development, and translation into clinical practice. PROSPERO REGISTRATION NUMBER CRD42016034057.
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Affiliation(s)
- Bethan Thibaut
- NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Lindsay Helen Dewa
- NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Sonny Christian Ramtale
- NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Danielle D'Lima
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Sheila Adam
- NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Hutan Ashrafian
- NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Ara Darzi
- NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Stephanie Archer
- NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, Cambridgeshire, UK
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Abstract
OBJECTIVE Physical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health. DESIGN Semistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements. SETTING AND PARTICIPANTS Academic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included. MAIN OUTCOME MEASURES Agreement in research priorities on a five-point scale. RESULTS Seventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important. CONCLUSIONS This is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this.
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Affiliation(s)
- Lindsay H Dewa
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK
- School of Public Health, Imperial College London, London, UK
| | - Kevin Murray
- Forensic Mental Healthcare, West London Mental Health NHS Trust, London, UK
| | - Bethan Thibaut
- School of Public Health, Imperial College London, London, UK
| | - Sonny Christian Ramtale
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK
| | - Sheila Adam
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK
| | - Ara Darzi
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK
| | - Stephanie Archer
- NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK
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Gril J, Thibaut B. Tree mechanics and wood mechanics: relating hygrothermal recovery of green wood to the maturation process. ACTA ACUST UNITED AC 1994. [DOI: 10.1051/forest:19940311] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Fournier M, Chanson B, Thibaut B, Guitard D. Mesures des déformations résiduelles de croissance à la surface des arbres, en relation avec leur morphologie. Observations sur différentes espèces. ACTA ACUST UNITED AC 1994. [DOI: 10.1051/forest:19940305] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Frascaria N, Chanson B, Thibaut B, Lefranc M. Génotypes et résistance mécanique radiale du bois de châtaignier (Castanea sativa Mill). Analyse d'un des facteurs explicatifs de la roulure. ACTA ACUST UNITED AC 1992. [DOI: 10.1051/forest:19920105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Fournier M, Chanson B, Guitard D, Thibaut B. Mécanique de l'arbre sur pied : modélisation d'une structure en croissance soumise à des chargements permanents et évolutifs. 1. Analyse des contraintes de support. ACTA ACUST UNITED AC 1991. [DOI: 10.1051/forest:19910503] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Fournier M, Chanson B, Thibaut B, Guitard D. Mécanique de l'arbre sur pied : modélisation d'une structure en croissance soumise à des chargements permanents et évolutifs. 2. Analyse tridimensionnelle des contraintes de maturation, cas du feuillu standard. ACTA ACUST UNITED AC 1991. [DOI: 10.1051/forest:19910504] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Peyresblanques J, Saint Val C, Duvezin-Caubet P, Brunel JP, Dussarte AM, Sire J, Thibaut B. [A familial case of botulism with severe toxemia]. Bull Soc Ophtalmol Fr 1978; 78:961-3. [PMID: 755585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Fleury P, Thibaut B, Lefebvre C. [Treatment of lesions of the supra-pyramidal facial recess in some forms of chronic otitis. Technic of trans-mastoid approach using the window on the drum or posterior tympanotomy. Simplified technic]. Ann Otolaryngol Chir Cervicofac 1973; 90:475-80. [PMID: 4749255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Labayle J, Fleury P, Thibaut B. [Technic of approach to the 3d portion of the 7th nerve]. Ann Otolaryngol Chir Cervicofac 1971; 88:363-6. [PMID: 5128645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Fleury P, Thibaut B. [Account of a foreign body in the ear]. Ann Otolaryngol Chir Cervicofac 1969; 86:186-8. [PMID: 5769830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Lemoyne J, Fleury P, Thibaut B. [Discussion of some points of surgical technic in the treatment of chronic frontal sinusitis]. Ann Otolaryngol Chir Cervicofac 1968; 85:121-30. [PMID: 5651952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Lemoyne J, Fleury P, Thibaut B. [Our current conception of tympanoplasty in chronic otorrhea and its sequelae in adults]. Ann Otolaryngol Chir Cervicofac 1967; 84:801-22. [PMID: 5582137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Fleury P, Thibaut B. [Apropos of 2 voluminous vascular tumors of the O.R.L. area (cystic lymphangioma of submental development; hemangioma of low parapharyngeal development)]. Ann Otolaryngol Chir Cervicofac 1967; 84:868-70. [PMID: 5582141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Fleury P, Thibaut B. [Reflections of an embryologic order suggested by 2 cases of anomalies of cervicofacial morphogenesis. Franceschetti's disease. Congenital fistula of the 1st cleft]. Ann Otolaryngol Chir Cervicofac 1967; 84:874-7. [PMID: 5582143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Lemoyne J, Fleury P, Thibaut B, Cotin G, Gourdin J. [Attico-mastoid suppurations before tympanoplasty in adults. Procedure to follow with respect to the facial bones]. Ann Otolaryngol Chir Cervicofac 1965; 82:885-899. [PMID: 5856767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Lemoyne J, Fleury P, Thibaut B, Fombeur JP. [Apropos of a case of tuberculosis of the frontal sinus]. Ann Otolaryngol Chir Cervicofac 1965; 82:978-80. [PMID: 5856776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Lemoyne J, Fleury P, Thibaut B. [Apropos of 2 cases of epithelioma of the external auditory canal]. Ann Otolaryngol Chir Cervicofac 1965; 82:996-8. [PMID: 5856779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Lemoyne J, Fleury P, Thibaut B. [Anomaly of incudo-malleolar mobility in 3 cases of interposition]. Ann Otolaryngol Chir Cervicofac 1965; 82:994-6. [PMID: 5856778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Thibaut B. [What the physician should know about deviations of the septum]. Rev Prat 1965; 15:2775-83. [PMID: 5840344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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