1
|
Woods MA, Hampton D, Okoli CTC, Heath J, Moreland G. Pilot Study Focused on Knowledge, Attitudes, and Health Access Behaviors of Psychiatric-Mental Health Nurses Regarding Suicide Prevention. J Am Psychiatr Nurses Assoc 2024:10783903241247216. [PMID: 38653730 DOI: 10.1177/10783903241247216] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE: The purpose of this pilot study was to evaluate the effect of a web-based education module on the knowledge, attitudes, and ratings of willingness to access help related to suicide prevention in psychiatric-mental health nurses. METHODS: A quasi-experimental pretest-posttest design was employed. Registered nurses from two academic health center units and a 239-bed Psychiatric Hospital were invited to participate. Scores on knowledge of suicide risk and prevention, attitudes, subjective norms, perceived behavioral control, and intent to seek help upon experiencing suicidal ideations were obtained before and after administering a 25-min web-based training. RESULTS: Twenty-nine participants completed the pre-survey, web-based education module, and post-survey. Significant increases from baseline in the scores on knowledge, attitudes, subjective norms, and intentions related to help-seeking behaviors for nurse suicide prevention were noted. Perceived behavioral control median scores increased but were not statistically significant. More than 40% of the participants reported having experienced suicidal thoughts. CONCLUSIONS: Further study is needed to determine contributors to this higher rate. Understanding the effectiveness of strategies to reduce nurse suicide can provide insights into building better nurse suicide prevention programs.
Collapse
Affiliation(s)
- Marc A Woods
- Marc A. Woods, DNP, MSN, RN, NEA-BC, UK Healthcare, Lexington, KY, USA
| | - Debra Hampton
- Debra Hampton, PhD, MSN, RN, NEA-BC, CENP, FACHE, FAONL, University of Kentucky, Lexington, KY, USA
| | - Chizimuzo T C Okoli
- Chizimuzo T. C. Okoli, PhD, MPH, MSN, PMHNP-BC, APRN, NCTTP, FAAN, Eastern State Hospital and University of Kentucky, Lexington, KY, USA
| | - Janie Heath
- Janie Heath, PhD, APRN-BC, FAAN, FNAP, FAANP, University of Kentucky, Lexington, KY, USA
| | - Gwen Moreland
- Gwen Moreland, DNP, RN, NEA-BC, UK Health care, Lexington, KY, USA
| |
Collapse
|
2
|
Matsubara C, Yamaguchi K, Imada R, Yoshizawa A, Bando Y, Kusaka T, Furuya J, Tohara H. Factors associated with the oral health status of patients with schizophrenia: A cross-sectional study. J Oral Rehabil 2024; 51:695-702. [PMID: 38044570 DOI: 10.1111/joor.13632] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 11/07/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Oral function deterioration attributed to ageing and medications is one of the main contributory factors of dysphagia. Therefore, oral health management is essential in older patients with schizophrenia. However, no previous studies have evaluated the oral function in patients with schizophrenia. OBJECTIVE We surveyed patients with schizophrenia to identify factors associated with ageing-related variations in oral function. METHODS This cross-sectional study included 34 male patients diagnosed with schizophrenia who were hospitalised at a psychiatric hospital between July and September 2021 and underwent a screening examination during dental care. The survey items included basic information, oral hygiene information, oral (oral diadochokinesis [ODK] and tongue pressure), physical function, and nutritional status. Thirty-six male community-dwelling older individuals were included as controls, and their outcomes were compared with those of patients with schizophrenia. RESULTS Compared with healthy older adults, patients with schizophrenia demonstrated significantly lower teeth numbers, ODK, and calf circumference (CC) (p < .05). Multiple regression analysis revealed that ODK was associated with age and schizophrenia (p < .05). Conversely, tongue pressure was associated with CC (p < .05), suggesting different factors' association with the parameters indicating decreased oral function. CONCLUSIONS Our study findings suggest that older patients with schizophrenia have decreased tongue pressure and generalised muscle mass, highlighting the need to manage oral function. Interventions for tongue pressure were more strongly associated with muscle mass and could be easier to manage than those with disease-dependent changes in ODK. TRIAL REGISTRATION Retrospectively registered.
Collapse
Affiliation(s)
- Chiaki Matsubara
- Department of Dental Hygiene, University of Shizuoka, Junior College, Shizuoka, Japan
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryoko Imada
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Medical Corporation Takanawakai, Tokyo, Japan
| | - Akira Yoshizawa
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Dental Oral Surgery, Nasu Chuo Hospital, Tochigi, Japan
| | | | - Teruo Kusaka
- Takatsuki Hospital, Tokyo, Japan
- Welfare Planning Office Minister's Secretariat Ministry of Economy, Trade and Industry, Tokyo, Japan
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Junichi Furuya
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Division of Oral Function Management, Department of Oral Health Management, Showa University School of Dentistry, Tokyo, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
3
|
Rodríguez-Labajos L, Kinloch J, Grant S, O'Brien G. The Role of the Built Environment as a Therapeutic Intervention in Mental Health Facilities: A Systematic Literature Review. HERD 2024:19375867231219031. [PMID: 38385552 DOI: 10.1177/19375867231219031] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
OBJECTIVES This systematic literature review synthesizes and assesses empirical research concerning the use of the built environment as a therapeutic intervention in adult mental health inpatient facilities. The review explores the impact of facility design on patient outcomes. BACKGROUND There is a growing recognition that the built environment in mental health facilities must strike a balance between ensuring safety and providing a therapeutic atmosphere. A review addressing how facility design contributes to this therapeutic environment is warranted. METHODS Database searches were conducted in CINAHL, Embase, PsychInfo, PubMed, and Web of Science from inception up to March 10, 2022. The Scottish Intercollegiate Guidelines Network (SIGN50) critical appraisal checklists were used to assess the quality of included studies. RESULTS Of the 44 peer-reviewed studies identified from nine countries, several factors emerged as vital for the therapeutic environment in mental health inpatient facilities. These included personal spaces prioritizing privacy and control of the environment, daylight-optimized spaces, versatile communal areas promoting activities and interaction, designated areas for visits and spiritual/contemplative reflection, homelike environments, the inclusion of artwork in units, open nursing stations, and dedicated female-only areas. Yet, there is a need for research yielding stronger evidence-based designs harmonizing with therapeutic needs. CONCLUSION This review offers initial guidance on designing mental health facilities that foster a therapeutic environment, while highlighting that the influence of facility design on mental health inpatients is considerably under-researched.
Collapse
Affiliation(s)
| | - Joanne Kinloch
- Research Service, NHSScotland Assure, NHS National Services Scotland, Glasgow, Scotland
| | - Susan Grant
- Procurement, Commissioning and Facilities, NHSScotland Assure, NHS National Services Scotland, Glasgow, Scotland
| | - Geraldine O'Brien
- Research Service, NHSScotland Assure, NHS National Services Scotland, Glasgow, Scotland
| |
Collapse
|
4
|
Hollander MAG, Patton A, Shields MC. Changes in institution for mental diseases (IMD) ownership status and insurance acceptance over time. Health Aff Sch 2024; 2:qxad089. [PMID: 38234578 PMCID: PMC10790904 DOI: 10.1093/haschl/qxad089] [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: 09/27/2023] [Revised: 12/11/2023] [Accepted: 01/02/2024] [Indexed: 01/19/2024]
Abstract
State Medicaid programs are prohibited from using federal dollars to pay institutions for mental diseases (IMDs)-freestanding psychiatric facilities with more than 16 beds. Increasingly, regulatory mechanisms have made payment of treatment in these settings substantially more feasible. This study evaluates if changing financial incentives are associated with increases in for-profit ownership among IMD facilities relative to non-IMD facilities, as well as greater increases in Medicaid acceptance among for-profit IMD facilities relative to for-profit non-IMD facilities. We used data from the 2014-2020 National Mental Health Services Surveys and examined 11 945 facility-years. Relative to non-IMDs, the increase in for-profit ownership among IMDs was 6.6 percentage points greater. The largest proportional change in Medicaid acceptance occurred among for-profit IMD facilities relative to for-profit non-IMDs (18.5 percentage points). Existing research is mixed on the quality of inpatient and residential psychiatric care provided in for-profit vs nonprofit and public facilities, as well as in IMD relative to non-IMD facilities. As payment policy increasingly incentivizes for-profit facilities to enter the psychiatric care space, we should be mindful of the impact of these decisions on patient safety.
Collapse
Affiliation(s)
- Mara A G Hollander
- Department of Public Health Sciences, University of North Carolina at Charlotte,Charlotte, NC 28223, United States
| | - Alexandra Patton
- Department of Public Health Sciences, University of North Carolina at Charlotte,Charlotte, NC 28223, United States
| | - Morgan C Shields
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63130, United States
| |
Collapse
|
5
|
Abufarsakh B, Okoli CTC. Nursing Staff Attitude, Subjective Norms, Perceived Behavior Control, and Intention to Provide Tobacco Treatment in a Psychiatric Hospital. J Am Psychiatr Nurses Assoc 2024; 30:30-36. [PMID: 34538112 DOI: 10.1177/10783903211045737] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although the nursing staff is fundamental in assisting individuals with mental illnesses (MI) to stop tobacco use, they often have mixed feelings about providing tobacco treatment (TT) services to people with MI in inpatient psychiatric settings. AIMS Therefore, this study aimed to understand factors associated with nursing staff's intentions to provide TT interventions for individuals diagnosed with MI in a psychiatric facility using the constructs of the theory of planned behavior (TPB). METHOD Secondary data analysis was performed using cross-sectional data collected from 98 nursing staff who worked in a state inpatient psychiatric facility. A 15-item questionnaire was used to assess nursing staff intentions to provide TT services based on TPB constructs, including attitudes (four items), subjective norms (four items), perceived behavioral controls (four items), and intentions (three items) toward providing TT. The mean scores of each subscale ranged from 1 to 7. A logistic regression analysis was used to examine the relationship between TBP constructs and nursing staff intentions to provide TT for people with MI. RESULTS Nursing staff had an acceptable mean score in the intentions subscale (4.34 ± 2.01). Only two constructs of TPB explained nursing staff intentions to provide TT: subjective norms (OR = 2.14, 95% CI [1.46, 3.13]) and perceived behavioral control (OR = 2.33, 95% CI [1.32, 4.12]). CONCLUSIONS The constructs of the TPB, the subjective norms, and the perceived behavior control were able to predict nurses' intentions to provide TT for inpatients in a psychiatric setting. Accordingly, we suggest implementing policies that make TT a normative practice while supporting the confidence and competence of nurses to deliver TT in psychiatric facilities.
Collapse
Affiliation(s)
- Bassema Abufarsakh
- Bassema Abufarsakh, MSN, BS, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Chizimuzo T C Okoli
- Chizimuzo T.C. Okoli, PhD, MPH, MSN, PMHNP-BC, APRN, NCTTP, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
6
|
Kamalzadeh L, de Filippis R, El Hayek S, Heidari Mokarar M, Jatchavala C, Koh EBY, Larnaout A, Noor IM, Ojeahere MI, Orsolini L, Pinto da Costa M, Ransing R, Sattari MA, Shalbafan M. Impact of stigma on the placement of mental health facilities: insights from early career psychiatrists worldwide. Front Psychiatry 2023; 14:1307277. [PMID: 38193134 PMCID: PMC10773878 DOI: 10.3389/fpsyt.2023.1307277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/08/2023] [Indexed: 01/10/2024] Open
Affiliation(s)
- Leila Kamalzadeh
- Geriatric Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Samer El Hayek
- Medical Department, Erada Center for Treatment and Rehabilitation in Dubai, Dubai, United Arab Emirates
| | - Mohsen Heidari Mokarar
- Department of Psychiatry, Imam Hossein Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Chonnakarn Jatchavala
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Eugene Boon Yau Koh
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Amine Larnaout
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
- Department of Psychiatry D, Razi Hospital, Tunis, Tunisia
| | - Isa Multazam Noor
- Department of Psychiatry, Faculty of Medicine, YARSI University, Jakarta, Indonesia
- Child and Adolescent Mental Health Unit, Dr Soeharto Heerdjan Teaching Mental Hospital, Jakarta, Indonesia
| | | | - Laura Orsolini
- Unit of Clinical Psychiatry, Department of Neurosciences/Department of Experimental and Clinical Neurosciences (DIMSC), Polytechnic University of Marche, Ancona, Italy
| | - Mariana Pinto da Costa
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Ramdas Ransing
- Department of Psychiatry, Addiction Medicine, and Clinical Neurosciences, All India Institute of Medical Sciences, Guwahati, Assam, India
| | - Mohammad Amin Sattari
- Department of Psychiatry, Imam Hossein Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammadreza Shalbafan
- Mental Health Research Center, Psychosocial Health Research Institute (PHRI), Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
7
|
Eichstadt SA, Chetty S, Magagula TG, Swart X. Factors affecting readmission of adolescent mental healthcare users to a psychiatric hospital. S Afr J Psychiatr 2023; 29:2110. [PMID: 38059197 PMCID: PMC10696544 DOI: 10.4102/sajpsychiatry.v29i0.2110] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/26/2023] [Indexed: 12/08/2023] Open
Abstract
Background Adolescent mental illness is increasing worldwide, leading to more admissions to psychiatric institutions. Many adolescents may require multiple readmissions, which is disruptive to their holistic well-being and costly for the healthcare sector. Identifying especially modifiable risk factors for readmission remains an important step in providing potential areas for improving patient care. Aim This study investigated the risk factors associated with the readmission of adolescent mental healthcare users to a specialist psychiatric unit. Setting The specialist adolescent unit at Weskoppies Psychiatric Hospital. Methods In this retrospective study, the clinical files of 345 adolescents admitted between 2015 and 2019 were reviewed. The primary outcome variable was readmission, that is, whether a patient was readmitted to Weskoppies Hospital (n = 98) compared to those with no recorded readmission (n = 247). Results Readmitted adolescents were significantly younger on first admission compared to the non-readmitted group (13.46 vs 14.26, p = 0.016). Bivariate analysis showed that the readmitted group had a much higher rate of non-adherence to treatment (38.1% vs 10.5%, p = < 0.001). Patients with a family history of mental illness had a significantly higher risk of readmission (52.2% vs 37.5%, p = 0.015). Conclusions Adolescents were more likely to be readmitted if they had first admission at a younger age, a family history of mental illness or non-adherence to treatment. Contribution Identifying especially modifiable risk factors for readmission of adolescents to improve patient care, particularly in the South African context where there is a paucity of research on this topic.
Collapse
Affiliation(s)
- Stephanie A Eichstadt
- Department of Psychiatry, Faculty of Psychiatry, University of Pretoria, Pretoria, South Africa
| | - Shren Chetty
- Department of Psychiatry, Faculty of Psychiatry, University of Pretoria, Pretoria, South Africa
| | - Thulisile G Magagula
- Department of Psychiatry, Faculty of Psychiatry, University of Pretoria, Pretoria, South Africa
| | - Xan Swart
- Private Practice, Pretoria, South Africa
| |
Collapse
|
8
|
Rahajeng B, Sari BC, Maziyyah N. Patient safety: adverse effects of Clozapine and their management at the Psychiatric Hospital Ghrasia in Yogyakarta, Indonesia. J Med Life 2023; 16:1652-1657. [PMID: 38406784 PMCID: PMC10893573 DOI: 10.25122/jml-2023-0145] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/13/2023] [Indexed: 02/27/2024] Open
Abstract
Clozapine is an atypical antipsychotic indicated for treating patients resistant to antipsychotic therapy when other medications in this class have no therapeutic effect. Clozapine has greater efficacy but more side effects than other atypical antipsychotics (e.g., agranulocytosis, seizures, sedation, and weight gain). Side effects can cause discomfort to patients and can affect patient compliance, interfering with therapeutical outcomes. This study aims to identify the side effects of clozapine use in patients at the Psychiatric Hospital Grhasia, in Yogyakarta, Indonesia. Using a cross-sectional design, this research provides a retrospective descriptive analysis using medical records of patients at the Psychiatric Hospital Ghrasia Yogyakarta. Inpatient and outpatient medical records of patients who had received a clozapine prescription from January to December 2019 were analyzed. In the 336 patients that met the inclusion criteria, the incidence of side effects from clozapine use was 16.07% (95%, CI:2.2-4.1), with the most frequent being dizziness, vomiting, diarrhea, and hypersalivation. There was no effect of age, gender, profession, or patient's disease on their incidence. The management of side effects is classified into three aspects: the drug is stopped, the patient is given additional therapy, and the patient is not given therapy. The results showed that the use of clozapine at the Psychiatric Hospital Ghrasia Yogyakarta was relatively safe. Identification of side effects is necessary to determine the follow-up treatment.
Collapse
Affiliation(s)
- Bangunawati Rahajeng
- Department of Pharmacology & Clinical Pharmacy, School of Pharmacy, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Indonesia
| | - Betha Candra Sari
- School of Pharmacy, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Indonesia
| | - Nurul Maziyyah
- Department of Pharmacology & Clinical Pharmacy, School of Pharmacy, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Indonesia
| |
Collapse
|
9
|
Norouzi N, Martinez A, Rico Z. Architectural Design Qualities of an Adolescent Psychiatric Hospital to Benefit Patients and Staff. HERD 2023; 16:103-117. [PMID: 37365801 PMCID: PMC10621023 DOI: 10.1177/19375867231180907] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVES This study is focused on how architectural design of adolescent psychiatric hospitals could positively affect not only patients but also staff members working at the hospitals. BACKGROUND Adolescents between the ages of 12 and 18 are among the young population with the highest percentage of mental illness. However, there are limited number of intentionally designed psychiatric hospitals for adolescents. Staff who work in adolescent psychiatric hospitals may face workplace violence. Studies on environmental impacts suggest that the built environment affects patients' well-being and safety as well as staff's satisfaction, working condition, safety, and health. However, there are very few studies that focus on adolescent psychiatric hospitals and the impact of the built environment on both staff and patients. METHODS Data were collected through literature analysis and semi-structured interviews with staff of three psychiatric state hospitals with adolescent patient units. The triangulation of multiple data sources informed a set of environmental design conditions that captures the complexity and connectedness of architectural design and the occupants of an adolescent psychiatric hospital. RESULTS The results present architectural composition, atmosphere, lighting, natural environment, safety, and security as indispensable design conditions to create an enclosed and city-like campus that provides a serene, secure, and structured environment that benefit staff and adolescent patients. CONCLUSION The specific design strategies that need to be incorporated in the architectural design of a safe and secure adolescent psychiatric hospital include an open floor plan that respects patients' autonomy and offers privacy while always providing staff with full visibility of patients.
Collapse
Affiliation(s)
- Neda Norouzi
- Department of Architecture, University of Texas at San Antonio, TX, USA
| | - Antonio Martinez
- Department of Architecture, University of Texas at San Antonio, TX, USA
| | - Zayra Rico
- Department of Architecture, University of Texas at San Antonio, TX, USA
| |
Collapse
|
10
|
Lequin P, Suter C, Mazallon R, Brodard R, Abrahamyan Empson L, Robalo B, Conus P, Nguyen A, Favrod J. Integration of a peer practitioner in a hospital unit for patients with psychotic disorders: an exploratory qualitative study. Front Psychiatry 2023; 14:1244433. [PMID: 37822792 PMCID: PMC10562537 DOI: 10.3389/fpsyt.2023.1244433] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/04/2023] [Indexed: 10/13/2023] Open
Abstract
Introduction Studies on the integration of peer mental health practitioners (PMHP) in hospitals are sparse, despite significant benefits being reported for patients and professionals. The integration of PMHP requires the consideration of several parameters and a change in the culture of care. This study aims to understand the impact of the integration of a PMHP in a hospital unit caring for patients with psychiatric disorders. Methods A qualitative content analysis of three focus groups with the interdisciplinarity team were conducted. A consulting PMHP was integrated into the entire research process. Results Data analysis revealed five main themes: the importance of integration, benefits for patients linked to the identification process, benefits for the team and institution, potentials risks, and perspectives. Discussion The study was conducted in a hospital setting with patients suffering from severe psychiatric disorders associated with behavioral disturbances. The benefits reported in the results outline the feasibility of PMHP integration in an acute psychiatric care setting. Nevertheless, further formalization of the PMHP role is required to minimize possible areas of tension between respective fields of activity of each professional.
Collapse
Affiliation(s)
- Pierre Lequin
- School of Nursing La Source, University of Applied Sciences and Arts of Western Switzerland (HES-SO), Delémont, Switzerland
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Caroline Suter
- School of Nursing La Source, University of Applied Sciences and Arts of Western Switzerland (HES-SO), Delémont, Switzerland
| | - Roxane Mazallon
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Rachèle Brodard
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Lilith Abrahamyan Empson
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Bruno Robalo
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Philippe Conus
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Alexandra Nguyen
- School of Nursing La Source, University of Applied Sciences and Arts of Western Switzerland (HES-SO), Delémont, Switzerland
| | - Jérôme Favrod
- School of Nursing La Source, University of Applied Sciences and Arts of Western Switzerland (HES-SO), Delémont, Switzerland
| |
Collapse
|
11
|
Sun H, Liu H, Ma C, Chen Z, Wei Y, Tang X, Xu L, Hu Y, Xie Y, Chen T, Lu Z, Wang J, Zhang T. Psychiatric emergency department visits during the coronavirus disease-2019 pandemic. Front Psychiatry 2023; 14:1236584. [PMID: 37701092 PMCID: PMC10493317 DOI: 10.3389/fpsyt.2023.1236584] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/07/2023] [Indexed: 09/14/2023] Open
Abstract
Background Previous research has demonstrated the negative impact of the coronavirus disease-2019 (COVID-19) pandemic on mental health. Aims To examine changes in the Chinese psychiatric emergency department (PED) visits for mental health crises that occurred during the pandemic. Methods Before and during the COVID-19 pandemic, PED visit counts from the largest psychiatric hospital in China between 2018 and 2020 were investigated. Electronic medical records of 2020 PED visits were extracted during the COVID-19 pandemic period and compared for the same period of 2018 and 2019. Results Overall, PED visits per year increased from 1,767 in 2018 to 2210 (an increase of 25.1%) in 2019 and 2,648 (an increase of 49.9%) in 2020. Compared with 2 years before the epidemic, during the COVID-19 pandemic, the proportion of PED visits among patients with stress disorders, sleep disorders, and anxiety disorders increased significantly. In terms of the distribution of demographic characteristics, age shows a younger trend, while the gender difference is not significant. Conclusion These findings suggest that PED care-seeking increases during the COVID-19 pandemic, highlighting the need to integrate mental health services for patients with stress, sleep, anxiety, and obsessive-compulsive disorders during public health crises.
Collapse
Affiliation(s)
- HaiMing Sun
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai, China
| | - HaiChun Liu
- Department of Automation, Shanghai Jiao Tong University, Shanghai, China
| | - ChunYan Ma
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai, China
| | - Zheng Chen
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai, China
| | - YanYan Wei
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai, China
| | - XiaoChen Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai, China
| | - LiHua Xu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai, China
| | - YeGang Hu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai, China
| | - YuOu Xie
- The First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Tao Chen
- Big Data Research Lab, University of Waterloo, Waterloo, ON, Canada
- Labor and Worklife Program, Harvard University, Cambridge, MA, United States
| | - Zheng Lu
- Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - JiJun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai, China
- Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - TianHong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai, China
| |
Collapse
|
12
|
Jang SH, Park YJ, Lee JJ, Jung WJ. Epidemiological Characteristics of a COVID-19 Outbreak in a Psychiatric Hospital in Chung-buk. Healthcare (Basel) 2023; 11:2332. [PMID: 37628529 PMCID: PMC10454191 DOI: 10.3390/healthcare11162332] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
This study investigated the causes and risks for infection spread in three psychiatric hospitals in Chung-buk, South Korea, to strategize measures to block transmission and prevent a large-scale epidemic. From December 2020 to January 2021, 358 inpatients of Psychiatric Hospitals A, B, and C were enrolled to identify the epidemiological characteristics of confirmed patients. Epidemic curves and propagation relationships were constructed and a genotype analysis was conducted. The index case inpatient from Hospital A transmitted the infection to patients in Hospitals B and C; the infection was confirmed in 47, 193, and 118 patients in Hospitals A, B, and C, respectively. The patient characteristics hampered communication and the close identification of symptom onset. The incidence rate was 10 (2.9%) among employees and 348 (35.8%) among inpatients. The relative risk was 12.1 (95% CI: 6.6-22.5) times higher among inpatients than employees. Next-generation sequencing confirmed the probable infection source as a genotype identical to that of two different outbreaks, although the infection spread was undetermined. Direct risk factors emerged from patient characteristics, wherein cohort isolation was meaningless due to uncontrolled communication. Indirect risk factors included hospital-specific problems due to external factors (non-patient system deficiencies or employee negligence). Prior inspections, a confirmation of non-infection, and institutional emergent measures are needed.
Collapse
Affiliation(s)
| | | | | | - Woo-Jin Jung
- Korea Disease Control and Prevention Agency (KDCA), Heungdeok-gu, Cheongju-si 28159, Republic of Korea; (S.-H.J.); (Y.-J.P.); (J.-J.L.)
| |
Collapse
|
13
|
Wang A, Jia S, Shi Z, Sun X, Zhu Y, Shen M, Tang D, Chen X. Mental health literacy of Chinese nurses from public general and psychiatric hospitals: a cross-sectional study. Front Psychiatry 2023; 14:1148380. [PMID: 37588025 PMCID: PMC10427189 DOI: 10.3389/fpsyt.2023.1148380] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/07/2023] [Indexed: 08/18/2023] Open
Abstract
Background Mental health literacy (MHL) is crucial to address issues related to mental illness. Nurses' MHL is even more important because they are expected to deal with both the physical and psychological consequences of mental disorders. Objective This study investigated the level, discrepancy, and characteristics of MHL among Chinese nurses from both public general and psychiatric hospitals; identified influential factors; and explored the relationship between MHL and mental health status. Methods Using a stratified cluster sampling method to select participants, a cross-sectional survey was conducted to describe the MHL of 777 nurses from 13 general and 12 psychiatric hospitals using the Chinese version of the Mental Health Literacy Scale, Patient Health Questionnaire-2, Generalized Anxiety Disorder-2, and a demographic questionnaire. A multiple regression analysis was used to determine the factors influencing MHL among the nurses recruited. Results The participants' total score on the Chinese version of the Mental Health Literacy Scale was 93.25 (SD = 10.52). Multiple regression analysis revealed that nurses who worked in psychiatric or higher-level hospitals, with higher professional titles or higher education had higher levels of overall MHL and core MHL, while those working in general hospitals, with shorter work duration, or who were unmarried had higher social acceptance of patients. Nurses' MHL was closely correlated with their mental health status. Conclusion The overall and core MHL of Chinese nurses were at a moderate level, with social acceptance remaining at a relatively low level. There is an urgent need for MHL promotion programs to improve the MHL of clinical nurses. The focus must be given to overall MHL, especially core MHL, for non-psychiatric nurses to enhance their competence in mental health promotion and identification; more emphasis should be placed on the social acceptance of patients with mental illnesses for psychiatric nurses to improve their provision of professional services. Better MHL would be a formula for improving nurses' own mental health and their mental health service competence.
Collapse
Affiliation(s)
- Anni Wang
- School of Nursing, Fudan University, Shanghai, China
| | - Shoumei Jia
- School of Nursing, Fudan University, Shanghai, China
| | | | | | - Yuan Zhu
- Shanghai Chest Hospital, Shanghai, China
| | - Miaoli Shen
- Changning District Mental Health Center, Shanghai, China
| | - Dayu Tang
- School of Nursing, Fudan University, Shanghai, China
| | - Xizhu Chen
- School of Nursing, Fudan University, Shanghai, China
| |
Collapse
|
14
|
Du Z, Jiang Y, Lu R, Zhou Q, Pan Y, Shen Y, Zhu H. Practice of pharmaceutical services and prescription analysis in internet-based psychiatric hospitals during COVID-19 pandemic in Wuxi, China. Front Psychiatry 2023; 14:1195298. [PMID: 37547208 PMCID: PMC10397508 DOI: 10.3389/fpsyt.2023.1195298] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023] Open
Abstract
Objective To study the practice of pharmaceutical services in internet-based psychiatric hospitals, and to analyze the prescriptions to ensure the safety and efficacy of internet-based medication in Wuxi, China. Methods All 1,259 internet-based prescriptions from our hospital in 2022 were collected, and data on patients' age, gender, diagnosis, medications used, medication types, dosage forms, rationality of medication use, and reasons for irrationality were analyzed through descriptive statistics. Results In the electronic prescriptions of internet-based psychiatric hospitals, females accounted for the majority (64.50%), with a female-to-male ratio of 1.82:1. Middle-aged and young adults accounted for the majority of patients (57.50%). There were 47 diagnosed diseases involved, with 89 types of medications used and 1,938prescriptions issued. Among them, there were 78 types of western medicine with 1,876 prescriptions (96.80%), and 11 types of traditional Chinese medicine with 62 prescriptions (3.20%). The main medications used were anti-anxiety and antidepressant medications (44.94%) and psychiatric medications (42.21%). The dosage forms were all oral, with tablets (78.53%), capsules (17.54%), and solution preparations (2.17%) being the top three in frequency. According to the prescription review results, the initial pass rate of internet-based system review was 64.26%. After intervention by the internet-based system and manual review by pharmacist reviewers, the final pass rate of internet-based prescriptions reached 99.76%. Conclusion The practice of pharmaceutical services and prescription analysis in internet-based psychiatric hospitals could significantly improve medication rationality, which fills the research gap in this field. In addition, it promotes the transformation of pharmaceutical service models.
Collapse
|
15
|
Masemola VFJ, Thobakgale EM, Govender I. Integration of traditional medicine into the mental healthcare system in Tshwane, South Africa. S Afr Fam Pract (2004) 2023; 65:e1-e5. [PMID: 37265135 DOI: 10.4102/safp.v65i1.5636] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/21/2023] [Accepted: 01/22/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Mental healthcare providers have a negative attitude towards the integration of traditional health medicine (THM) into the mental health system. The attitude is based on their lack of trust in traditional practices, which are not supported by substantial evidence-based medical research. The study was conducted to determine mental healthcare providers views on the integration of traditional health medicine into the mental healthcare system. METHODS The study was conducted at a psychiatric hospital in the Tshwane district, Gauteng province, South Africa. A cross-sectional, descriptive research design was conducted on 85 respondents who consented to participate. Data were collected using a survey questionnaire from 23 psychiatrists and 62 psychiatric nurses. Data were analysed using descriptive statistics and presented in the form of graphs, frequencies and percentages. RESULTS Mental healthcare providers displayed a negative attitude towards integrating THM in psychiatric hospitals. The results showed no significant difference between psychiatrists and psychiatric nurses in their preference for modern mental healthcare practices (p = 0.25). CONCLUSION There is still doubt among the mental healthcare providers on whether to support integration of the THM into mental health system or not. The doubt is based on the two-health system isolated from each other especially in South Africa.Contribution: This study contributed by showing the need and importance of understanding a patients' cultural background, which supports the integration of a traditional health system into the mental healthcare system, which in turn will lead to the appropriate management of mental illnesses.
Collapse
Affiliation(s)
- Vusi F J Masemola
- Department of Nursing, Faculty of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria.
| | | | | |
Collapse
|
16
|
Băcilă C, Ștef L, Bucuță M, Anghel CE, Neamțu B, Boicean A, Mohor C, Ștețiu AA, Roman M. The Impact of the COVID-19 Pandemic on the Management of Mental Health Services for Hospitalized Patients in Sibiu County-Central Region, Romania. Healthcare (Basel) 2023; 11:healthcare11091291. [PMID: 37174833 PMCID: PMC10178149 DOI: 10.3390/healthcare11091291] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/14/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic brought a burden and represented a challenge for the Romanian medical system. This study explored the consequences that COVID epidemiological measures had on the quality of the mental health care provided to hospitalized patients in a regional psychiatric hospital in Romania. MATERIALS AND METHODS Both patient-level and hospital-level indicators were considered for this comparative retrospective study. On the one hand, we extracted patient-level indicators, such as sociodemographics, diagnosis, admission, and discharge dates for 7026 hospitalized patients (3701 women, average age = 55.14) from hospital records. On the other hand, for the hospital-level indicators, we included indicators referring to the aggregated concept of mental health services, such as case mix index, length of stay, bed occupancy rate and patients' degree of satisfaction. Data extracted covered a period of two years (1 March 2019-28 February 2021) before and during the first year of the COVID-19 pandemic. RESULTS We found that, compared to the pre-pandemic period, the pandemic period was marked by a drastic decrease in hospitalized patient admissions, coupled with an increase in emergency-based admissions. Other management indicators, such as the case mix index, the number of cases contracted/performed, and the degree of patient satisfaction, decreased. In contrast, the average length of stay and bed occupancy rate increased. CONCLUSIONS The COVID-19 pandemic, especially in the first year, raised multiple difficult issues for the management of psychiatric hospitals. It imposed an application of strict measures designed to face these new and unprecedented challenges. Our findings offer a detailed snapshot of the first year of the COVID-19 pandemic in terms of its impact on mental health services and suggest some future directions. Implications for hospital management are discussed.
Collapse
Affiliation(s)
- Ciprian Băcilă
- Dental and Nursing Medical Department, Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550169 Sibiu, Romania
- Collective of Scientific Research in Neurosciences of the Clinical Psychiatry Hospital "Dr. Gheorghe Preda", 550082 Sibiu, Romania
| | - Laura Ștef
- Dental and Nursing Medical Department, Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550169 Sibiu, Romania
| | - Mihaela Bucuță
- Department of Psychology, Faculty of Social and Human Sciences, "Lucian Blaga" University of Sibiu, 550024 Sibiu, Romania
| | - Claudia Elena Anghel
- Dental and Nursing Medical Department, Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550169 Sibiu, Romania
- Collective of Scientific Research in Neurosciences of the Clinical Psychiatry Hospital "Dr. Gheorghe Preda", 550082 Sibiu, Romania
| | - Bogdan Neamțu
- Clinical Medical Department, Faculty of Medicine, The "Lucian Blaga" University Sibiu, 550169 Sibiu, Romania
- Research and Telemedicine Center in Pediatric Neurology, Pediatric Clinical Hospital Sibiu, 550166 Sibiu, Romania
| | - Adrian Boicean
- Clinical Medical Department, Faculty of Medicine, The "Lucian Blaga" University Sibiu, 550169 Sibiu, Romania
| | - Cosmin Mohor
- Preclinical Department, Faculty of Medicine, The "Lucian Blaga" University Sibiu, 550169 Sibiu, Romania
| | - Andreea Angela Ștețiu
- Dental and Nursing Medical Department, Faculty of Medicine, "Lucian Blaga" University of Sibiu, 550169 Sibiu, Romania
| | - Mihai Roman
- Clinical Department of Surgery, Faculty of Medicine, The "Lucian Blaga" University Sibiu, 550169 Sibiu, Romania
| |
Collapse
|
17
|
Biran-Ovadia A, Strous RD, Bart O, Lipskaya-Velikovsky L. Study of recovery model implementation in psychiatric hospitals: Clients and multidisciplinary staff perspective. Int J Ment Health Nurs 2023; 32:603-614. [PMID: 36562517 DOI: 10.1111/inm.13106] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
The recovery model guides mental health services. However, the delivery of recovery-oriented services in inpatient settings is still a challenge. Factors affecting recovery model implementation can be classified into three types: the hospital environment, the inpatient and the service provider. This study aims to quantitatively evaluate the impact of environment, inpatient and service provider factors on recovery model implementation in hospitals. Forty-five service providers and 42 inpatients from three types of wards (acute locked, acute open and daycare) of two hospitals participated in this cross-sectional study. We assessed inpatient cognition, functional capacity and illness severity. In addition, we retrieved information on service providers' professional status and evaluated the recovery model knowledge and attitudes. Implementation of the recovery model was measured using the Recovery Self-Assessment, both the inpatient and service provider versions. Differences were found between the three types of wards in recovery orientation as reported by service providers ( χ 2 2 = 15.3, P < 0.001), but not by inpatients ( χ 2 2 = 2.34, P > 0.05). Providers' internalized knowledge and attitudes toward recovery, inpatients' functional capacity and age of illness onset were associated with recovery implementation (0.31 < r < 0.48, P < 0.05). The findings confirm quantitatively the multilevel nature of factors that affect the implementation of the recovery model in psychiatric hospitals. The inpatients' perspective should be incorporated into the service development process. Based on the study results, the reduction in the restrictive features of the wards' environment is recommended. Promotion of the recovery model implementation in the hospital setting requires the expansion of staff's internal positive attitudes toward recovery.
Collapse
Affiliation(s)
- Ateret Biran-Ovadia
- The Maayenei Hayeshua Medical Center, Bnei-Brak, Israel.,The Jerusalem Mental Health Center, Jerusalem, Israel
| | - Rael D Strous
- The Maayenei Hayeshua Medical Center, Bnei-Brak, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Orit Bart
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | | |
Collapse
|
18
|
Masutha TC, Maluleke M, Raliphaswa NS, Thabathi TE, Rangwaneni ME, Lavhelani NR, Manyuma D, Kharivhe LM, Thandavhathu TG. Psychiatric Clinical Placement: Agony for College Nursing Students in South Africa. Int J Environ Res Public Health 2023; 20:3545. [PMID: 36834241 PMCID: PMC9961486 DOI: 10.3390/ijerph20043545] [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] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/11/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Clinical placements in psychiatric nursing science (PNS) are as important as other placements in any discipline in nursing education as they allow students to correlate theory to practice. Nursing students' absenteeism has become a grave concern in psychiatric institutions in South Africa. This study investigated the clinical factors leading to student nurses' absenteeism in the Limpopo College of Nursing during the psychiatric nursing science clinical placement. (2) Methods: A quantitative approach using a descriptive design was followed, where 206 students were purposively sampled. The study was conducted at the Limpopo College of Nursing situated in Limpopo Province, with five campuses offering a four-year nursing program. College campuses were used to access students since this was an easy way of accessing them. Data were collected through questionnaires of structured questions and analyzed using SPSS version 24. Ethical considerations were adhered to throughout. (3) Results: The correlation between clinical factors and absenteeism was determined. The main reported factors for absenteeism were student nurses being treated as a workforce in the clinical areas; shortage of staff in the clinical areas; inadequate supervision of student nurses by professional nurses; and being inconsiderate of student nurses requests for days off in the clinical area. (4) Conclusions: The findings revealed that student nurses' absenteeism is caused by different factors. The Department of Health should find a way of not overworking students due to a shortage of staff in the wards but consider them for experiential learning. A further qualitative study should be conducted to develop strategies to mitigate student nurses' absenteeism in psychiatric clinical placement.
Collapse
|
19
|
Haig S, Hallett N. Use of sensory rooms in adult psychiatric inpatient settings: A systematic review and narrative synthesis. Int J Ment Health Nurs 2023; 32:54-75. [PMID: 36082841 DOI: 10.1111/inm.13065] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/09/2022] [Indexed: 01/14/2023]
Abstract
Reducing the use of restrictive interventions within psychiatric inpatient settings is a global priority. There are many strategies which may support the prevention of violence before escalation into more severe incidences. Sensory rooms have been identified as one such intervention, aiding patients to emotionally regulate and reduce distress, with a growing body of academic literature interested in whether sensory rooms can ultimately impact incidences of patient violence and the use of restraint, seclusion, and other restrictive practices. A systematic literature review was conducted to identify how effective sensory rooms are at reducing patient violence and restrictive interventions within adult psychiatric inpatient settings. Eighteen studies met the eligibility criteria and were included in the review. There is a lack of evidence as to whether sensory rooms are effective at reducing seclusion, restraint, or violence. They are, however, likely to support a reduction in patient distress. Patient and staff experiences suggest sensory rooms support emotional regulation, promote self-management, and positively impact the overall patient admission experience and ward environment. Further research is needed to identify what works, for who and in what circumstances in relation to the design of sensory rooms.
Collapse
Affiliation(s)
| | - Nutmeg Hallett
- School of Nursing, University of Birmingham, Birmingham, UK
| |
Collapse
|
20
|
Du Z, Jiang Y, Lu R, Shen Y, Ou M, Wang Z, Cao L, Zhou Q, Zhu H. Establishment and application value of a novel prescription medication abuse monitoring model for psychiatric hospitals. Front Psychiatry 2023; 13:1082538. [PMID: 36699480 PMCID: PMC9868594 DOI: 10.3389/fpsyt.2022.1082538] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
Objective To construct a prescription medication abuse (PMA) monitoring model for psychiatric hospitals and to assess its applicability. Methods A PMA monitoring working group was established to guide the formulation of a PMA monitoring system, which included three active real-time monitoring modes and one retrospective analysis monitoring mode. The effect of the established system was analyzed. Results In 2021, 35 cases of effective PMA were reported, which was a significant increase compared to two cases identified through passive monitoring mode in the preceding year. Most of the reported cases were based on active real-time monitoring mode. Among them, 21 cases (60.00%) were identified during the diagnosis and treatment of medicine and nursing; 3 cases (8.57%) were reported based on drug concentration detection technology; and 5 cases (14.29%) were reported by the laboratory department during PMA screening. Besides, 6 cases (17.14%) were reported according to the retrospective analysis of the hospital information system. The majority of prescription medication abusers were adolescents under the age of 18 (12 cases, 34.29%). Overall, there were 27 cases of class II psychotropic prescription medications, accounting for 77.14%. Conclusion The combined PMA monitoring model can effectively improve the quality of PMA monitoring and provide a basis for the supervision of higher-level regulatory authorities.
Collapse
Affiliation(s)
- Zhiqiang Du
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Ying Jiang
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Rongrong Lu
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Yuan Shen
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Mengmeng Ou
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Zhe Wang
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Lina Cao
- Wuxi Institute of Drug Control, Wuxi, Jiangsu, China
| | - Qin Zhou
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Haohao Zhu
- The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| |
Collapse
|
21
|
Zhang T, Chen Z, Xiao X, Zhou L, Hu Y, Xu L, Wei Y, Tang X, Liu H, Chen T, Wu H, Wu X, Wang J. Increased anxiety and stress-related visits to the Shanghai psychiatric emergency department during the COVID-19 pandemic in 2020 compared to 2018-2019. Front Psychiatry 2023; 14:1146277. [PMID: 37032917 PMCID: PMC10076584 DOI: 10.3389/fpsyt.2023.1146277] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/08/2023] [Indexed: 04/11/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has had a significant and far-reaching impact on mental health. The psychiatric emergency department (PED) is pivotal in the management of acute and severe mental illnesses, especially anxiety-and stress-related disorders. Aims This study aimed to evaluate whether changes in the frequency or patients' demographics of visiting the PED occurred during the COVID-19 pandemic among individuals with anxiety and stress-related disorders. Methods This cross-sectional study used data on PED visit counts from the largest psychiatric hospital in China between 2018 and 2020 (before and during the COVID-19 pandemic). Data from 2020, representing the COVID-19 pandemic period, were extracted from electronic medical records and compared using descriptive statistics for the same periods in 2018 and 2019. Results The number of PED visits related to anxiety and stress disorders per year increased from 83 in 2018 to 136 (63.9% increase) in 2019 and 239 (188.0% increase) in 2020. Compared to that in 2018 and 2019, the proportion of PED visits in 2020 among patients with anxiety and stress disorders increased significantly. Patients with anxiety-and stress-related disorders during PED visits in 2020 were younger than those in 2018 and 2019 (three-year groups: F = 9.124, df = 2, p < 0.001). Conclusion Despite the epidemic-policy barriers against PED visits, PED care seeking has increased, thereby underscoring the need for crisis prevention services for patients with stress and anxiety disorders.
Collapse
Affiliation(s)
- TianHong Zhang
- Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
- *Correspondence: TianHong Zhang,
| | - Zheng Chen
- Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - XuDong Xiao
- Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - LinLin Zhou
- Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - YeGang Hu
- Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - LiHua Xu
- Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - YanYan Wei
- Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - XiaoChen Tang
- Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - HaiChun Liu
- Department of Automation, Shanghai Jiao Tong University, Shanghai, China
| | - Tao Chen
- Big Data Research Lab, University of Waterloo, Waterloo, ON, Canada
- Labor and Worklife Program, Harvard University, Cambridge, MA, United States
| | - HaiSu Wu
- Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
- HaiSu Wu,
| | - XuMing Wu
- Nantong Fourth People's Hospital and Nantong Brain Hospital, NanTong, Jiangsu, China
- XuMing Wu,
| | - JiJun Wang
- Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, China
- Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
- JiJun Wang,
| |
Collapse
|
22
|
Billé V, Gonsalvès C, Lamarche-Vadel A, Verdoux H. “It’s possible”: reducing the coercion in care for adults living with neurodevelopmental disorders: a mixed-methods study. Rech Soins Infirm 2023; 153:40-59. [PMID: 37709665 DOI: 10.3917/rsi.153.0040] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Introduction Adults living with a neurodevelopmental disorder may present episodes of aggression, which may lead to the use of seclusion or restraint. The aim of the study was to assess the effect of an intervention aimed at reducing the use of coercive measures in a long-term care unit for adults suffering from a neurodevelopmental disorder with or without psychiatric co-morbidities. Method The single-center study used a sequential mixed-methods explanatory design. Retrospective data on periods of seclusion, with and without physical restraint, were collected for the ten-month pre-intervention and post-intervention periods. A qualitative survey was conducted at the end of the intervention period among the health professionals working in the unit to review the implementation and the efficiency of the approach. Results A significant decrease was observed between the pre- and post-intervention period in the number of seclusion and restraint sequences, the number of patients experiencing seclusion and restraint, and the duration of seclusion and restraint sequences. The efficiency of the approach was confirmed by the health care professionals and was attributed to leadership focused on limiting coercive measures, better adherence to legal obligations, team cohesion, and the implementation of alternative tools and methods. Discussion Reducing the use of coercive measures with adults with neurodevelopmental disorders is possible. Further studies are needed to confirm the effectiveness of alternative strategies to seclusion and restraint.
Collapse
Affiliation(s)
- Vincent Billé
- Infirmier en pratique avancée en santé mentale et psychiatrie, M.Sc, centre hospitalier Charles Perrens, Bordeaux, France ; Faculté des sciences infirmières, Université de Montréal, Canada
| | - Claire Gonsalvès
- Infirmière en pratique avancée en santé mentale et psychiatrie, M.Sc, centre hospitalier Charles Perrens, Bordeaux, France
| | | | - Hélène Verdoux
- Médecin, Ph.D, professeure, Université de Bordeaux, centre de recherche INSERM 1219 Bordeaux Population Health, Bordeaux, France
| |
Collapse
|
23
|
Kalia K, Ling S, Moghabghab R, Branton S, Islam F, Saiva A, Kim J, Sliekers S, Harren D, Robins A. Increasing capacity to address the physical health needs of patients in a mental health and addictions hospital. Perspect Psychiatr Care 2022; 58:2337-2344. [PMID: 35294058 DOI: 10.1111/ppc.13065] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/19/2022] [Accepted: 02/24/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This paper describes the strategy and outcomes of a quality improvement initiative focused on building the capacity of nurses at a mental health and addictions teaching hospital to provide an improved standard of physical health care. Education was provided via a series of e-learning modules and interactive workshops. To reinforce the education and enhance practice change, improvements were made to electronic documentation templates and organizational standards. Further, the organization provided increased access to physical health equipment, a mobile application to support assessments and a reference card for lanyards. CONCLUSIONS Nurses identified increased confidence in performing physical assessments, and documentation improved with standards and automated forced functionality in the electronic health record. Ultimately, the organization successfully implemented a multifaceted strategy to improve physical healthcare services for people with mental health and substance use concerns. PRACTICE IMPLICATIONS Organizational investment can lead to sustainable changes in nursing confidence and increased physical health assessment completion.
Collapse
Affiliation(s)
- Kamini Kalia
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.,Arthur Labatt School of Nursing, Western University, London, Ontario, Canada
| | - Sara Ling
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Rola Moghabghab
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Branton
- North York General Hospital, Toronto, Ontario, Canada
| | - Faisal Islam
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Anika Saiva
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jayoung Kim
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Dan Harren
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Amanda Robins
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| |
Collapse
|
24
|
Torkaman M, Momennasab M, Yektatalab S, Eslami Shahrbabaki M. Nurses' patient safety competency, a predictor for safe care in psychiatric wards? Perspect Psychiatr Care 2022; 58:2854-2861. [PMID: 35780327 DOI: 10.1111/ppc.13133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/21/2021] [Accepted: 06/08/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study examined the relationship between patient safety competence and safe care from the viewpoints of nurses working in psychiatry wards. DESIGN AND METHODS The present descriptive correctional study was conducted in two psychiatry hospitals in Iran in 2020. All the nurses were selected as the study participants using the census sampling method (N = 209). FINDINGS Nurses' patient safety competency was at a low level (2.54 ± 0.52), but nurses' safe care was at a moderate level (242.08 ± 61.32). A strong positive relationship was found between the patients' safety competency and nurses' safe care (p = 0.001, r = 0.84). PRACTICE IMPLICATIONS Nursing managers should support nurses by providing the required resources and operational strategies to improve their competency and safe care in providing quality care.
Collapse
Affiliation(s)
- Mahya Torkaman
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Momennasab
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, By Namazee Hospital, Shiraz, Iran
| | - Shahrzad Yektatalab
- Department of Nursing, Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahin Eslami Shahrbabaki
- Neurology Research Center, Department of Shahid Beheshti Hospital, Afzalipour Medicine School, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
25
|
Suzuki A. Psychiatric hospital, domestic strategies and gender issues in Tokyo, c. 1920-45. Hist Psychiatry 2022; 33:308-318. [PMID: 35979868 DOI: 10.1177/0957154x221090630] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This paper explores domestic dynamics in the complex making of institutional psychiatry in Japan in c. 1920-45. It mainly examines gender issues between the relatively long-lasting system of the family care of mentally ill members and the use of freshly introduced systems of psychiatric hospitals. I shall look at the record of Ohji Brain Hospital (1901-45) in Tokyo, which has several thousands of case histories mainly in Tokyo c. 1920-45. From the analysis of the cases of male and female patients, as well as the complex situations of their households and kin groups, I shall look at the gender issues in the making of the psychiatric hospital regime.
Collapse
|
26
|
Saraceno B, Caldas de Almeida JM. An outstanding message of hope: the WHO World Mental Health Report 2022. Epidemiol Psychiatr Sci 2022; 31:e53. [PMID: 35833232 DOI: 10.1017/S2045796022000373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The new WHO World Health Report on Mental Health includes a comprehensive and updated assessment of the current mental health situation at the global level, a critical and well-documented reflexion on the progresses achieved and the failures registered in global mental health, and an indication of the paths and strategies that should be prioritised to ensure the transformations that are urgently needed. The report offers significant enrichments on different areas like social determinants, premature mortality of persons suffering from mental disability, the negative aspects of the persistence of inpatient institutions, the role of people with lived experience as important agents of change, the importance of child and adolescent mental health. The present Editorial stresses the importance of Deinstitutionalisation as a cross-cutting element of all health policy, plans, budgeting and service organisation and draws attention to the fact that the ubiquitous persistence of large psychiatric institutions is a clear indicator that reality is far from declarations despite the UN Convention on the Rights of Persons with Disability.
Collapse
|
27
|
Laurini O. [The psychiatric hospital in search of an extra soul]. Soins Psychiatr 2022; 43:41-42. [PMID: 36280313 DOI: 10.1016/j.spsy.2022.06.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The evocation of the meaning of the patients' suffering and their quest for appeasement refocuses the reflection on the missions of the psychiatric hospital around reception and accompaniment. It reminds us above all of the role of the carers in psychiatry, between availability, listening and benevolence. The maintenance of the link between the caregiver and the patient, in an atmosphere of trust, is essential to the care and quality of the accompaniment. We must not forget this.
Collapse
Affiliation(s)
- Olivier Laurini
- Établissement public de santé mentale Sud Bretagne, Centre hospitalier Charcot, Le Trescoët, BP 47, 56854 Caudan cedex, France.
| |
Collapse
|
28
|
Wettstein A, Tlali M, Joska JA, Cornell M, Skrivankova VW, Seedat S, Mouton JP, van den Heuvel LL, Maxwell N, Davies MA, Maartens G, Egger M, Haas AD. The effect of the COVID-19 lockdown on mental health care use in South Africa: an interrupted time-series analysis. Epidemiol Psychiatr Sci 2022; 31:e43. [PMID: 35703078 DOI: 10.1017/S2045796022000270] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIMS The coronavirus disease 2019 (COVID-19) pandemic and ensuing restrictions have negatively affected the mental health and well-being of the general population, and there is increasing evidence suggesting that lockdowns have led to a disruption of health services. In March 2020, South Africa introduced a lockdown in response to the COVID-19 pandemic, entailing the suspension of all non-essential activities and a complete ban of tobacco and alcohol sales. We studied the effect of the lockdown on mental health care utilisation rates in private-sector care in South Africa. METHODS We conducted an interrupted time-series analysis using insurance claims from 1 January 2017 to 1 June 2020 of beneficiaries 18 years or older from a large private sector medical insurance scheme. We calculated weekly outpatient consultation and hospital admission rates for organic mental disorders, substance use disorders, serious mental disorders, depression, anxiety, other mental disorders, any mental disorder and alcohol withdrawal syndrome. We calculated adjusted odds ratios (OR) for the effect of the lockdown on weekly outpatient consultation and hospital admission rates and the weekly change in rates during the lockdown until 1 June 2020. RESULTS 710 367 persons were followed up for a median of 153 weeks. Hospital admission rates (OR 0.38; 95% confidence interval (CI) 0.33-0.44) and outpatient consultation rates (OR 0.74; 95% CI 0.63-0.87) for any mental disorder decreased substantially after the introduction of the lockdown and did not recover to pre-lockdown levels by 1 June 2020. Health care utilisation rates for alcohol withdrawal syndrome doubled after the introduction of the lockdown, but the statistical uncertainty around the estimates was large (OR 2.24; 95% CI 0.69-7.24). CONCLUSIONS Mental health care utilisation rates for inpatient and outpatient services decreased substantially after the introduction of the lockdown. Hospital admissions and outpatient consultations for alcohol withdrawal syndrome increased after the introduction of the lockdown, but statistical uncertainty precludes strong conclusions about a potential unintended effect of the alcohol sales ban. Governments should integrate strategies for ensuring access and continuity of essential mental health services during lockdowns in pandemic preparedness planning.
Collapse
|
29
|
Mennicke A, Kaniuka AR, Pruneda P, Cramer RJ. Substance use-related suicide after release from correctional, behavioral health, and healthcare facilities using national violent death reporting system data. Suicide Life Threat Behav 2022; 52:132-146. [PMID: 34708427 DOI: 10.1111/sltb.12813] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Suicide and substance use are prevalent problems among persons discharged from facilities. This study (1) articulated rates of substance-related suicide deaths among those discharged correctional, behavioral health, and healthcare facilities, and (2) identified factors associated with substance-related suicide deaths unique to, or generalizing across, facility discharge. METHODS We used data from the National Violent Death Reporting System. Suicide deaths (N = 105,968) were aggregated from 2003 to 2017. Chi-square and independent samples t-tests were used to examine associations between drug/alcohol-related deaths and each correlate. Logistic regression was employed to identify the most robust substance-related suicide death-related factors. RESULTS Suicide deaths were commonly marked as being substance-related: 69% from correctional institutions, 54% from behavioral health facilities, 45% from those not released from a facility, and 39% from healthcare facilities. Regression models indicated housing interruptions and interpersonal stressors increased odds of the suicide death being marked as substance-related across discharge categories. Each discharge category also had unique predictors, underscoring the need for tailored prevention. CONCLUSIONS Substance-related suicide deaths are particularly common among adults discharged from correctional and behavioral health facilities. Findings are discussed with respect to community-focused, discharge planning, and clinical care suicide prevention strategies.
Collapse
Affiliation(s)
- Annelise Mennicke
- University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Andrea R Kaniuka
- University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Phoebe Pruneda
- University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Robert J Cramer
- University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| |
Collapse
|
30
|
Nielssen O, Large M. Homicides in psychiatric hospitals: Absence of evidence or evidence of absence? Crim Behav Ment Health 2022; 32:60-66. [PMID: 35034397 DOI: 10.1002/cbm.2226] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 12/19/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Highly publicised cases of homicide in a psychiatric hospital have raised concerns about the safety of such hospitals. AIMS To identify individual case reports of homicides by inpatients within psychiatric hospitals in order to update a 2011 study. METHODS A systematic search of the academic literature between 2010 and 2020, information seeking from service leaders in each state and territory of Australia and in New Zealand, and a search of public records in Australia and New Zealand. RESULTS The literature search revealed only one recent paper describing a homicide by a patient in a psychiatric ward. Contact with forensic psychiatrists across Australia and New Zealand yielded four cases of inpatient homicide that took place between 2010 and 2017 in Australia, and none in New Zealand. Public record searching did not add to this count. This compares to 11 inpatient homicides by 10 patients between 1985 and 2011. CONCLUSIONS Homicides in psychiatric hospitals seem to remain rare, however, there is no consistent central documentation of these events in Australasia so it is hard to be confident about the figures. Internationally, there is similarly little centralisation of evidence. Standardised methods of recording and reporting such deaths might assist the understanding and prevention of homicides in psychiatric hospitals.
Collapse
Affiliation(s)
- Olav Nielssen
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, New South Wales, Australia
- St Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Matthew Large
- University of New South Wales, Sydney, New South Wales, Australia
- Prince of Wales Hospital, Randwick, New South Wales, Australia
| |
Collapse
|
31
|
Oeljeklaus L, Schmid HL, Kornfeld Z, Hornberg C, Norra C, Zerbe S, McCall T. Therapeutic Landscapes and Psychiatric Care Facilities: A Qualitative Meta-Analysis. Int J Environ Res Public Health 2022; 19:ijerph19031490. [PMID: 35162518 PMCID: PMC8835684 DOI: 10.3390/ijerph19031490] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 01/27/2023]
Abstract
The environment in healthcare facilities can influence health and recovery of service users and furthermore contribute to healthy workplaces for staff. The concept of therapeutic landscapes seems to be a promising approach in this context. The aim of this qualitative meta-analysis is to review the effects of therapeutic landscapes for different stakeholders in psychiatric care facilities. A systematic literature search was conducted in the four data bases PubMed, PsycInfo, CINAHL, and Web of Science. Thirteen predominately qualitative studies were included in this qualitative meta-analysis. The methodological quality of these qualitative studies was assessed, using an adapted version of the Journal Article Reporting Standards for Qualitative Research, and a thematic analysis was conducted. The results were categorised into the three main themes of the physical (built and natural), social, and symbolic dimensions of the therapeutic landscape. Given the heterogeneity of the summarised data and an overall methodological quality of the included studies that can be rated as medium, the results should be interpreted with caution. Current findings are based almost exclusively on qualitative studies. Therefore, there is a need for quantitative study designs that investigate the relationship between specific environmental elements and mental health outcomes for different stakeholders in psychiatric facilities.
Collapse
Affiliation(s)
- Lydia Oeljeklaus
- Medical School OWL, Bielefeld University, 33615 Bielefeld, Germany; (L.O.); (H.-L.S.); (C.H.)
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Hannah-Lea Schmid
- Medical School OWL, Bielefeld University, 33615 Bielefeld, Germany; (L.O.); (H.-L.S.); (C.H.)
| | - Zachary Kornfeld
- LWL-Hospital Paderborn, Psychiatry Psychotherapy Psychosomatic, 33098 Paderborn, Germany; (Z.K.); (C.N.)
- Medical Faculty, Ruhr University Bochum, 44801 Bochum, Germany
| | - Claudia Hornberg
- Medical School OWL, Bielefeld University, 33615 Bielefeld, Germany; (L.O.); (H.-L.S.); (C.H.)
| | - Christine Norra
- LWL-Hospital Paderborn, Psychiatry Psychotherapy Psychosomatic, 33098 Paderborn, Germany; (Z.K.); (C.N.)
- Medical Faculty, Ruhr University Bochum, 44801 Bochum, Germany
| | - Stefan Zerbe
- Faculty of Science and Technology, Free University of Bozen-Bolzano, 39100 Bolzano, Italy;
| | - Timothy McCall
- Medical School OWL, Bielefeld University, 33615 Bielefeld, Germany; (L.O.); (H.-L.S.); (C.H.)
- Correspondence: ; Tel.: +49-521-106-67898
| |
Collapse
|
32
|
Weber C, Monero Flores V, Wheele TP, Miedema E, White EV. Patients' Health & Well-Being in Inpatient Mental Health-Care Facilities: A Systematic Review. Front Psychiatry 2022; 12:758039. [PMID: 35046849 PMCID: PMC8761847 DOI: 10.3389/fpsyt.2021.758039] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 12/06/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Previous research indicates that the physical environment of healthcare facilities plays an important role in the health, well-being, and recovery outcomes of patients. However, prior works on mental healthcare facilities have incorporated physical environment effects from general healthcare settings and patient groups, which cannot be readily transferred to mental healthcare settings or its patients. There appears to be a specific need for evidence synthesis of physical environmental effects in mental healthcare settings by psychopathology. Purpose: This review evaluates the state (in terms of extent, nature and quality) of the current empirical evidence of physical environmental on mental health, well-being, and recovery outcomes in mental healthcare inpatients by psychopathology. Method: A systematic review (PRISMA guidelines) was performed of studies published in English, German, Dutch, Swedish, and Spanish, of all available years until September 2020, searched in Cochrane, Ovid Index, PsycINFO, PubMed, and Web of Science and identified through extensive hand-picking. Inclusion criteria were: Adult patients being treated for mental ill-health (common mental health and mood disorders, Cochrane frame); inpatient mental health care facilities; specifications of the physical and socio-physical environment (e.g., design features, ambient conditions, privacy); all types of empirical study designs. Quality assessment and data synthesis were undertaken. Results: The search retrieved 1,068 titles of which 26 met the inclusion criteria. Findings suggest that there is only indicative evidence of the impact of the physical healthcare environment on patients' mental health, well-being, and recovery outcomes. There is significant lack of pathology-specific evidence. Methodological shortcomings and empirical scarcity account for the poor evidence. Conclusion: This review highlights the need for more research using advanced study designs.
Collapse
Affiliation(s)
- Clara Weber
- Institute of Facility Management, Life Sciences and Facility Management, Zurich University of Applied Sciences, Zurich, Switzerland
- Environmental Psychology Department, School of Psychology, University of Surrey, Guildford, United Kingdom
| | - Virna Monero Flores
- Institute of Facility Management, Life Sciences and Facility Management, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Theresa Poppy Wheele
- Institute of Facility Management, Life Sciences and Facility Management, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Elke Miedema
- Architectural Theory and Methods, Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Emma Victoria White
- Environmental Psychology Department, School of Psychology, University of Surrey, Guildford, United Kingdom
| |
Collapse
|
33
|
Yang M, Feng Y, Yuan L, Zhao H, Gao S, Li Z. High Concentration and Frequent Application of Disinfection Increase the Detection of Methicillin-Resistant Staphylococcus aureus Infections in Psychiatric Hospitals During the COVID-19 Pandemic. Front Med (Lausanne) 2021; 8:722219. [PMID: 34778288 PMCID: PMC8578793 DOI: 10.3389/fmed.2021.722219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/27/2021] [Indexed: 02/05/2023] Open
Abstract
The tolerance of certain multi-drug resistant bacteria to disinfectants may be promoted while the requirements of environmental disinfection have been raised in the high-risk areas of medical institutions during the COVID-19 pandemic. The current research addressed the mechanisms underlying a sharp increase in the detection of methicillin-resistant Staphylococcus aureus (MRSA) observed in a closed-management unit of elderly patients with mental disorders in 2020 as compared with the previous 4 years. We first conducted microbial detection in staff-hand and environment and a molecular epidemiology analysis, rejecting the hypothesis that the MRSA increase was due to an outbreak. Afterward, we turned to disinfectant concentration and frequency of use and analyzed the varied MRSA detection rates with different concentrations and frequencies of disinfection in 2020 and the previous 4 years. The MRSA detection rate increased with elevated concentration and frequency of disinfection, with 1,000 or 500 mg/L two times per day since January in 2020 vs. 500 mg/L 2-3 times per week in 2016-2019. When the disinfectant concentration was reduced from 1,000 to 500 mg/L, the MRSA detection decreased which indicated a modulatory role of disinfectant concentration. With a sustained frequency of disinfection in 2020, the MRSA detection rate was still higher, even after May, than that in the previous years. This suggested that the frequency of disinfection also contributed to the MRSA increase. Overall, the MRSA detection was augmented with the increase in disinfection concentration and frequency during the COVID-19 epidemic, suggesting that highly-concentrated and highly-frequent preventive long-term disinfection is not recommended without risk assessments in psychiatric hospitals.
Collapse
Affiliation(s)
- Mi Yang
- The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Yu Feng
- Center for Pathogen Research, West China Hospital, Sichuan University, Chengdu, China
| | - Lu Yuan
- The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Huachang Zhao
- The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Shan Gao
- University of Electronic Science and Technology of China, Chengdu, China
| | - Zezhi Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
34
|
Luo J, Liu H, Liu Y, Jiang F, Tang YL. Physical Activity and Mental Health Among Physicians in Tertiary Psychiatric Hospitals: A National Crosssectional Survey in China. Front Psychol 2021; 12:731525. [PMID: 34721196 PMCID: PMC8555760 DOI: 10.3389/fpsyg.2021.731525] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
This study aimed to examine the level of mental health and its correlates, particularly physical activity (PA) frequency, among physicians in tertiary psychiatric hospitals. In a national crosssectional survey, 4,520 physicians nested in 41 tertiary psychiatric hospitals from 29 provinces completed the online questionnaire. Their mean age was 38.5 ± 8.6 years, and 41.86% of physicians were men. More than one-third (35.24%) of physicians reported no PA in the past month, and only 21.88% reported happiness. Only 55.15 and 58.10% of the physicians reported normal status of depression and anxiety, respectively. In the adjusted multivariable ordinal logistic regression, higher PA frequency was associated with depression, anxiety, and happiness, except those who reported PA almost every day. Programs that aim to increase PA may promote the mental health of physicians in tertiary psychiatric hospitals.
Collapse
Affiliation(s)
- Jin Luo
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Substance Abuse Treatment Program, Atlanta VA Medical Center, Decatur, GA, United States
| |
Collapse
|
35
|
Atinga RA, Yarney L, Saa-Touh Mort K, Gariba JA, Salifu Yendork J. Measures and narratives of the nature, causes and consequences of violent assaults and risk perception of psychiatric hospitals in Ghana: Mental Health workers' perspectives. Int J Ment Health Nurs 2021; 30 Suppl 1:1342-1353. [PMID: 33998754 DOI: 10.1111/inm.12878] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/13/2021] [Accepted: 04/19/2021] [Indexed: 11/27/2022]
Abstract
Literature shows that mental healthcare workers in Ghana face incessant fear of patient violence that compromise safe care delivery. However, the nature, scale, perceived causes, and consequences of these assaults and how they shape risk perceptions have received limited empirical attention, hence the need for this study. The study employed sequential explanatory mixed methods where questionnaire administration preceded and informed the design of an interview guide used for in-depth interviews with health workers in referral psychiatric hospitals. Descriptive statistics and multivariate logistic regressions were used to analyze the quantitative data. Qualitative data were transcribed and analyzed thematically. Findings showed that physical and non-physical violent assaults and risk perceptions of the hospitals were statistically and significantly associated with females (P < 0.01), nurses (P < 0.01), other clinical cadre (P < 0.01), and those with low job tenure (P < 0.05). About 57% and 71% of the sample reported experiencing physical and non-physical assaults, respectively. Major and minor injuries and psychosocial problems were frequent sequelae following physical violent assaults. As a result, 80% of the participants perceived the hospitals environment to be unsafe to provide care. Violent assaults compromises safety and care delivery efforts suggesting the need for systematic interventions to minimize mental healthcare workers exposure to patient violence.
Collapse
Affiliation(s)
- Roger A Atinga
- Department of Public Administration and Health Services Management, University of Ghana Business School, Accra, Ghana
| | - Lily Yarney
- Department of Public Administration and Health Services Management, University of Ghana Business School, Accra, Ghana
| | | | - Joshua A Gariba
- Department of Sociology, School of Social Sciences, University of Ghana, Accra, Ghana
| | - Joana Salifu Yendork
- Department of Psychology, School of Social Sciences, University of Ghana, Accra, Ghana
| |
Collapse
|
36
|
Jiang T, Rosellini AJ, Horváth-Puhó E, Shiner B, Street AE, Lash TL, Sørensen HT, Gradus JL. Using machine learning to predict suicide in the 30 days after discharge from psychiatric hospital in Denmark. Br J Psychiatry 2021; 219:440-447. [PMID: 33653425 PMCID: PMC8457342 DOI: 10.1192/bjp.2021.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Suicide risk is high in the 30 days after discharge from psychiatric hospital, but knowledge of the profiles of high-risk patients remains limited. AIMS To examine sex-specific risk profiles for suicide in the 30 days after discharge from psychiatric hospital, using machine learning and Danish registry data. METHOD We conducted a case-cohort study capturing all suicide cases occurring in the 30 days after psychiatric hospital discharge in Denmark from 1 January 1995 to 31 December 2015 (n = 1205). The comparison subcohort was a 5% random sample of all persons born or residing in Denmark on 1 January 1995, and who had a first psychiatric hospital admission between 1995 and 2015 (n = 24 559). Predictors included diagnoses, surgeries, prescribed medications and demographic information. The outcome was suicide death recorded in the Danish Cause of Death Registry. RESULTS For men, prescriptions for anxiolytics and drugs used in addictive disorders interacted with other characteristics in the risk profiles (e.g. alcohol-related disorders, hypnotics and sedatives) that led to higher risk of postdischarge suicide. In women, there was interaction between recurrent major depression and other characteristics (e.g. poisoning, low income) that led to increased risk of suicide. Random forests identified important suicide predictors: alcohol-related disorders and nicotine dependence in men and poisoning in women. CONCLUSIONS Our findings suggest that accurate prediction of suicide during the high-risk period immediately after psychiatric hospital discharge may require a complex evaluation of multiple factors for men and women.
Collapse
Affiliation(s)
- Tammy Jiang
- Department of Epidemiology, Boston University School of Public Health, Massachusetts, USA
| | - Anthony J Rosellini
- Department of Psychological and Brain Sciences, Boston University, Massachusetts, USA
| | | | - Brian Shiner
- National Center for PTSD, White River Junction Veterans Affairs Medical Center, Vermont, USA
| | - Amy E Street
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Massachusetts, USA
| | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Georgia, USA
| | | | - Jaimie L Gradus
- Department of Epidemiology, Boston University School of Public Health, Massachusetts, USA
| |
Collapse
|
37
|
Thompson EC, Spirito A, Saarinen JS, Wolff JC. Psychosis-spectrum experiences linked to specific psychotherapy readiness domains among psychiatrically hospitalized adolescents. Early Interv Psychiatry 2021; 15:949-956. [PMID: 32954685 PMCID: PMC7981284 DOI: 10.1111/eip.13040] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 08/07/2020] [Accepted: 08/30/2020] [Indexed: 11/28/2022]
Abstract
AIM Early psychosocial treatment for psychosis-spectrum symptoms has been linked to positive outcomes, whereas delayed treatment is associated with poorer prognosis. Thus, there is a critical need to bolster psychotherapy engagement efforts, particularly among high-risk groups and during high-risk periods, in order to maximize recovery. This study explores the relation between psychosis-spectrum symptoms and psychotherapy readiness among psychiatrically hospitalized adolescents, a foundational step for developing more effective psychotherapy engagement approaches for this population. METHODS Adolescents (n = 704; 12-18 years) who were admitted to a psychiatric inpatient unit completed the Readiness for Psychotherapy Index (RPI), a psychosis-spectrum questionnaire (PRIME Screen), and a brief diagnostic interview at intake. Correlational patterns and regression analyses were used to explore associations between variables. RESULTS The PRIME Screen was negatively associated with the RPI Openness subscale and positively associated with the Distress subscale, beyond the effects of demographics (ie, age, sex, race) and psychiatric diagnoses. CONCLUSIONS Results indicate that the RPI probes multiple facets of psychotherapy readiness that have unique associations with psychosis-spectrum experiences. Adolescents with higher PRIME scores endorsed greater mental health-related distress and lower levels of openness to psychotherapy. These psychotherapy readiness factors warrant further exploration, as they may be significant barriers or facilitators to engaging adolescents with psychosis-spectrum symptoms in much needed early treatment services.
Collapse
Affiliation(s)
- Elizabeth C Thompson
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Division of Child and Adolescent Psychiatry, Bradley Hospital, Riverside, Rhode Island, USA.,Division of Child and Adolescent Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Jiayin Sperry Saarinen
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Jennifer C Wolff
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Division of Child and Adolescent Psychiatry, Bradley Hospital, Riverside, Rhode Island, USA.,Division of Child and Adolescent Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA
| |
Collapse
|
38
|
Jacobs R, Grobler C, Strumpher J. Identifying a probable suicide cluster in an acute care psychiatric hospital in the Eastern Cape, South Africa. S Afr J Psychiatr 2021; 27:1646. [PMID: 33936803 PMCID: PMC8063759 DOI: 10.4102/sajpsychiatry.v27i0.1646] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/08/2021] [Indexed: 11/03/2022] Open
Abstract
Background Two young male patients who were diagnosed with drug-induced psychosis committed suicide in a psychiatric hospital in South Africa within a month of each other. The psychiatric nurses working in the hospital had never before had to deal with a similar trauma of suicide cluster. Aim To assess the psychiatric nurses' experiences of suicide cluster in an inpatient psychiatric setting. Setting A psychiatric hospital in the Eastern Cape, South Africa. Method A qualitative design was used. The research population consisted of psychiatric nurses who were purposively selected. Data were gathered using in-depth interviews where the participants narrated their experiences of the incidents. The interviews were transcribed verbatim and the data was coded using descriptive and explanatory codes. Trustworthiness was ensured. Ethical principles of justice, autonomy, beneficence and non-maleficence were ensured. Results An attempt was made to compare the suicides of two patients with the characteristics of cluster suicide to determine if clustering took place. Two young males committed suicide in an institutional setting within a month of each other. Other characteristics present included using the same method, in the same venue and in the same unit. They had similar educational and social backgrounds. The second victim knew the first victim and was aware of what happened. Conclusion When the two events are analysed together it would seem as if clustering did occur. The suicide victims knew each other and victim number 2 was aware of the facts of the first suicide. They were in their early 20's, were mentally ill and committed suicide in the same site, using the same method and were both institutionalised at the time. Members of the mental healthcare team should be made aware of the characteristics of clustering so that when a suicide attempt occurs in a place where mentally-ill individuals are cared for, measures can be put in place to prevent another patient from copying such an event.
Collapse
Affiliation(s)
- Ruwayda Jacobs
- Department of Emergency Medical Care, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
| | - Christoffel Grobler
- Department of School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Johanita Strumpher
- Department of Nursing, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
| |
Collapse
|
39
|
Takamura K, Hebbard AM, Robert S. Characterization of inpatient care for patients admitted to a psychiatric hospital with a home opioid prescription. Ment Health Clin 2021; 11:55-58. [PMID: 33850683 PMCID: PMC8019545 DOI: 10.9740/mhc.2021.03.055] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction Patients with mental illness are particularly at risk for OUD, and due to this higher risk, providers may be more inclined to withhold their home opioids when they are admitted to a psychiatric hospital. Patients whose home opioids are continued or withheld during admission may be treated differently with respect to pain control, orders for nonopioid adjunctive pain agents, orders for intramuscular as-needed medications, orders for seclusion and/or restraints, and outpatient referrals for OUD treatment. The objective of this retrospective pilot study was to characterize inpatient care for these 2 patient populations. Methods Thirty-one inpatient encounters were reviewed for patients who had opioid prescriptions before admission and were discharged from the medical center's psychiatric service from June 1 through August 31, 2019. Results Orders for nonopioid adjunctive pain agents and intramuscular as-needed medications trended higher for the opioid-withheld group, suggesting greater polypharmacy and patient dissatisfaction compared with the opioid-continued group. Additionally, what became evident was the lack of consistent and clear documentation regarding the discharge plans for the patients' home opioid and OUD treatment. Discussion These findings may prompt inpatient interdisciplinary teams to develop a better process of documentation to facilitate continuity of care.
Collapse
Affiliation(s)
- Kei Takamura
- Clinical Pharmacy Coordinator - Psychiatry, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York,
| | - Amy M Hebbard
- Coordinator for Psychiatric Pharmacy Services - MUSC Health, Charleston, South Carolina; Affiliate Assistant Professor, Medical University of South Carolina College of Pharmacy, Charleston, South Carolina
| | - Sophie Robert
- Clinical Pharmacy Specialist - Psychiatry, Medical University of South Carolina Health, Charleston, South Carolina; Research Assistant Professor, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina; Adjunct Assistant Professor, Medical University of South Carolina, College of Pharmacy, Charleston, South Carolina
| |
Collapse
|
40
|
Lantta T, Varpula J, Cheung T, Wong WK, Cheng PYI, Ng T, Ng CF, Yam CP, Ip G, Bressington D, Välimäki M. Prevention and management of aggressive behaviour in patients at psychiatric hospitals: a document analysis of clinical practice guidelines in Hong Kong. Int J Ment Health Nurs 2020; 29:1079-1091. [PMID: 32602160 DOI: 10.1111/inm.12742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 01/01/2023]
Abstract
Patient aggressive behaviour remains a significant public health concern worldwide. The use of restraint and seclusion remains a last resort but not an uncommon practice in clinical psychiatry in the management of aggressive events. There seems to be a paucity of evidenced-based research examining the policy framework guiding the use of restraint and seclusion in Asia contexts. The purpose of this study was to conduct an analysis on the guidelines in psychiatric hospitals in Hong Kong, and to explore the extent to which these guidelines were aligned with the international clinical guidelines for the prevention and management of patient aggression in psychiatry. A descriptive document analysis was used to analyse the guidelines from four psychiatric hospitals in Hong Kong in comparison with the NICE (National Institute of Health and Care Excellence UK) guidelines. Data were collected from December 2017 to June 2018. A total of 91 written documents were retrieved. Preventing violence and aggression has the highest level of agreement (31%,) while the use of restrictive interventions has the lowest level of agreement (12%). The sub-recommendation with most in line with the NICE guidelines were restrictive interventions, de-escalation, and improving service users' experiences. However, for example, staff training, working with police, and reduced use of restrictive interventions seemed to have no agreement with the NICE guidelines. Variation exists between the Asian (Hong Kong) local policy framework/guidelines and the European (UK) national policy framework. There are also large discrepancies in the written guidelines on patient aggressive behaviour when comparing local policy frameworks, cluster-based documents, and departmental practices.
Collapse
Affiliation(s)
- Tella Lantta
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Jaakko Varpula
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Wai Kit Wong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Po Yee Ivy Cheng
- Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital, Hospital Authority, Hong Kong (SAR), China
| | - Tony Ng
- Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital, Hospital Authority, Hong Kong (SAR), China
| | - Chi Fai Ng
- Department of Psychiatry, Tai Po Hospital, Hospital Authority, Hong Kong (SAR), China
| | - Chun Pong Yam
- Department of Psychiatry, Kowloon Hospital, Hospital Authority, Hong Kong (SAR), China
| | - Glendy Ip
- Kwai Chung Hospital, Hospital Authority, Hong Kong (SAR), China
| | - Daniel Bressington
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland.,School of Nursing, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| |
Collapse
|
41
|
Ter-Israelyan AY. [On the issue of standards of organization of hospital psychiatric care]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2020; 28:449-453. [PMID: 32526126 DOI: 10.32687/0869-866x-2020-28-3-449-453] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 01/23/2020] [Indexed: 11/06/2022]
Abstract
In the conditions of reforming psychiatric service in the Russian Federation, the procedure of organizing psychiatric care of patients in hospital, the effectiveness of treatment of patients in psychiatric hospital during 2015-2017 were analyzed. The article presents the results of study of organization of psychiatric care of patients in specialized hospital on the basis of Psychiatric clinical hospital № 13. The analysis covered number of patients treated in hospital by nosological forms; number of patients by gender. The age categories of mental patients and the format of professional status of patients were considered. The main indicators of psychiatric hospital activity were investigated: average duration of stay of patient in hospital, annual bed using, bed turnover, number of bed days. The attention was paid to primary output of patients with disabilities, number of re-hospitalizations and compulsory hospitalization. The analysis of financing of inpatient psychiatric care of treated patients for the study period of time was implemented. The vector of providing psychiatric care to patients at the stage of out-patient and hospital-replacing cases.
Collapse
Affiliation(s)
- A Yu Ter-Israelyan
- The State Budget Institution of Health Care "The Psychiatric Hospital № 13" of the Moscow Health Care Department, 109559, Moscow, Russia,
| |
Collapse
|
42
|
Carey C, Doody E, McCafferty R, Madden M, Clendennen N, Lyons D. Psychiatry NCHD referrals to the local emergency department in the context of an in-house primary care service. Ir J Psychol Med 2020;:1-5. [PMID: 32758316 DOI: 10.1017/ipm.2020.82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES. Patients with psychiatric illness are at increased risk of developing non-psychiatric medical illnesses. There have been positive reports regarding the integration of primary care services into mental health facilities. Here, we evaluate the appropriateness of psychiatry non-consultant hospital doctors (NCHD) transfers to the local emergency department (ED) in the context of an in-house primary care service. METHODS. We reviewed the inpatient transfers from St Patrick's University Hospital (SPUH) to the local ED at St James' Hospital (SJH) from 1 January 2016 to 31 December 2017. We used inpatient admission to SJH as our primary marker of an appropriate transfer. RESULTS. 246 inpatients were transferred from SPUH to the SJH ED for medical review in the years 2016 and 2017. 27 (11%) of these were referred to the ED by the primary care service. 51% of those referred were admitted with similar rates of admission for both general practitioner (n = 27, 54% admitted) and NCHD initiated referrals (n = 219, 51% admitted). Acute neurological illness, concern regarding a cardiac illness, and deliberate self-harm were the most common reasons for referral. CONCLUSION. Our primary finding is that, of those transferred to ED by either primary care or a psychiatry NCHD, a similar proportion was judged to be in need of inpatient admission. This indicates that as a group, psychiatry NCHD assessment of acuity and need for transfer was similar to that of their colleagues in primary care.
Collapse
|
43
|
Jiang F, Liu T, Zhou H, Rakofsky JJ, Liu H, Liu Y, Tang YL. Developing medical record-based, healthcare quality indicators for psychiatric hospitals in China: a modified Delphi-Analytic Hierarchy Process study. Int J Qual Health Care 2020; 31:733-740. [PMID: 30753601 DOI: 10.1093/intqhc/mzz005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/26/2018] [Accepted: 01/16/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To develop a medical record-based, comprehensive system of healthcare quality indicators for psychiatric hospitals in China. DESIGN A modified Delphi process with analytic hierarchy process (AHP) was used. PARTICIPANTS Twenty nationally-recognized experts were invited to participate in two rounds of Delphi expert consultation and AHP. METHODS Fifty potential indicators were included based on literature review, and 20 experts were asked to rate the importance of each indicator using two rounds of email surveys. The AHP was used to determine the relative importance of the finalized quality indicators. RESULTS The average authoritative coefficient was 0.92 ± 0.07. After two rounds of Delphi consultation, 47 healthcare quality indicators were identified for Chinese psychiatric hospitals. The mean importance ratings ranged from 7.06 to 8.84 on a nine-point scale, with variation coefficients ranging from 0.04 to 0.22. The percentage of full score for potential indicators ranged from 16% to 74%. In two rounds, the Kendall's W coefficients ranged from 0.423 to 0.535. The weights of structure, process and outcome were 0.175, 0.211 and 0.614, respectively. CONCLUSION We developed the first set of healthcare quality indicators for psychiatric hospitals in mainland China, and it will provide a standardized and meaningful guide to evaluate the healthcare quality of psychiatric hospitals across the country.
Collapse
Affiliation(s)
- Feng Jiang
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management of Tsinghua University, Beijing, China
| | - Huixuan Zhou
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jeffrey J Rakofsky
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.,Atlanta VA Medical Center, Decatur, Georgia, USA
| |
Collapse
|
44
|
Conlon M, Tew J, Solai LK, Gopalan P, Azzam P, Karp JF. Care Transitions in the Psychiatric Hospital: Focus on Older Adults. Am J Geriatr Psychiatry 2020; 28:368-377. [PMID: 32029376 DOI: 10.1016/j.jagp.2019.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 10/26/2022]
Abstract
Patients undergoing a care transition are vulnerable to duplication of services, conflicting care recommendations, and errors in medication reconciliation. Older adults may be more vulnerable to care transitions given their relatively higher medical burden, cognitive impairment, and frequent polypharmacy. In this Treatment in Geriatric Mental Health: Research in Action article, we first present the results of a quality improvement study examining the frequency of care transitions to and from the medical hospital among patients admitted to a university-affiliated psychiatric hospital. Among a sample of 50 geriatric adults and 50 nongeriatric adults admitted to the psychiatric hospital, we tallied the number of care transitions to and from the medical hospital. We found that the geriatric cohort was significantly more likely to experience this type of care transition (p = 0.012, Fisher's exact test) compared to the nongeriatric cohort. In the second part of this article, we use a clinical vignette to illustrate the types of medical errors that can occur as a vulnerable and frail older adult moves between acute psychiatric and medical settings. Finally, we list provider-level and systems-level evidence-based recommendations for how care of the patient in the vignette could be improved. The quality improvement study and clinical vignette demonstrate how older adults are at greater risk for care transitions to and from the acute medical setting during psychiatric hospitalization, and that creative solutions are required to improve outcomes.
Collapse
Affiliation(s)
- Matthew Conlon
- Department of Psychiatry, University of Pittsburgh School of Medicine (MC, JT, LKS, PG, PA, and JFK), Pittsburgh, PA; University of Pittsburgh Medical Center (MC, JT, LKS, PG, PA, and JFK), Pittsburgh, PA.
| | - James Tew
- Department of Psychiatry, University of Pittsburgh School of Medicine (MC, JT, LKS, PG, PA, and JFK), Pittsburgh, PA; University of Pittsburgh Medical Center (MC, JT, LKS, PG, PA, and JFK), Pittsburgh, PA
| | - LalithKumer K Solai
- Department of Psychiatry, University of Pittsburgh School of Medicine (MC, JT, LKS, PG, PA, and JFK), Pittsburgh, PA; University of Pittsburgh Medical Center (MC, JT, LKS, PG, PA, and JFK), Pittsburgh, PA
| | - Priya Gopalan
- Department of Psychiatry, University of Pittsburgh School of Medicine (MC, JT, LKS, PG, PA, and JFK), Pittsburgh, PA; University of Pittsburgh Medical Center (MC, JT, LKS, PG, PA, and JFK), Pittsburgh, PA
| | - Pierre Azzam
- Department of Psychiatry, University of Pittsburgh School of Medicine (MC, JT, LKS, PG, PA, and JFK), Pittsburgh, PA; University of Pittsburgh Medical Center (MC, JT, LKS, PG, PA, and JFK), Pittsburgh, PA
| | - Jordan F Karp
- Department of Psychiatry, University of Pittsburgh School of Medicine (MC, JT, LKS, PG, PA, and JFK), Pittsburgh, PA; University of Pittsburgh Medical Center (MC, JT, LKS, PG, PA, and JFK), Pittsburgh, PA
| |
Collapse
|
45
|
Abstract
Purpose This study aimed to describe the experiences of nurses who were employed in a psychiatric hospital in Fukushima prefecture during the Great East Japan Earthquake and to explore what sustained the nurses while they worked in the damaged hospital. Design and Methods The research design was a qualitative descriptive study. The setting for the study was one of the Fukushima psychiatric hospitals where functions were disrupted by the earthquake and tsunami. Data were collected through a dialogic interview and Katarai (a form of group interview). Nine psychiatric nurses from the hospital participated. The interview and Katarai were transcribed and the narratives were analyzed using a phenomenological approach. Findings Themes identified from the transcripts were: (a) the nurses’ internalized perception of their duties, (b) responsibility toward their patients, (c) conflicts among nurses and dilemmas nurses faced during this period, and (d) what sustained the nurses to continue working. Conclusions Through the earthquake experience, the nurses in this study reconsidered their own ways of living and ways of nursing that they had not thought about before the disaster. The findings also revealed that the state of hospital management and nursing care under normal conditions are reflected during the crisis situation in a disaster. Clinical Relevance Clearly, whether it is natural disaster or conflict caused by man, healthcare infrastructures are challenged when unexpected disruptions occur. The findings of this study are applicable not only because they provide guidance about infrastructure development for disaster preparedness, but also because they provide practical methods to support nurses who are placed in strongly stressful situations and have to protect patients.
Collapse
Affiliation(s)
| | - Ikuko Kato
- Assistant Professor, Fukushima Medical University, Fukushima, Japan
| | - Takako Ohkawa
- Associate Professor, Fukushima Medical University, Fukushima, Japan
| |
Collapse
|
46
|
Deisenhammer EA, Behrndt-Bauer EM, Kemmler G, Haring C, Miller C. Suicide in Psychiatric Inpatients- A Case-Control Study. Front Psychiatry 2020; 11:591460. [PMID: 33408654 PMCID: PMC7779474 DOI: 10.3389/fpsyt.2020.591460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/23/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: Psychiatric inpatients constitute a population at considerably increased risk for suicide. Identifying those at imminent risk is still a challenging task for hospital staff. This retrospective case-control study focused on clinical risk factors related to the course of the hospital stay. Method: Inpatient suicide cases were identified by linking the Tyrol Suicide Register with the registers of three psychiatric hospitals in the state. Control subjects were patients who had also been hospitalized in the respective psychiatric unit but had not died by suicide. Matching variables included sex, age, hospital, diagnosis, and admission date. The study period comprised 7 years. Data were analyzed by the appropriate two-sample tests and by logistic regression. Results: A total of 30 inpatient suicide cases and 54 control patients were included. A number of factors differentiated cases from controls; after correction for multiple testing, the following retained significance: history of aborted suicide, history of attempted suicide, history of any suicidal behavior/threats, suicidal ideation continuing during hospitalization, no development of prospective plans, no improvement of mood during the hospital stay, and leaving ward without giving notice. Logistic regression identified the latter three variables and history of attempted suicide as highly significant predictors of inpatient suicide. Conclusions: Preventive measures during hospitalization include thorough assessment of suicidal features, an emphasis on the development of future perspectives, and a review of hospital regulations for patients who want to leave the ward.
Collapse
Affiliation(s)
- Eberhard A Deisenhammer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
| | - Elisa-Marie Behrndt-Bauer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria.,Department of Psychiatry and Psychotherapy, Center for Health Services Research in Medicine, Erlangen, Germany
| | - Georg Kemmler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Haring
- Department of Psychiatry and Psychotherapy B, State Hospital Hall in Tirol, Hall in Tirol, Austria
| | - Carl Miller
- Department of Psychiatry, County Hospital Kufstein, Kufstein, Austria
| |
Collapse
|
47
|
Chun JY, Jun JY, Choi J, Jo M, Kwak K, Jeong Y, Lee J, Park J, Lee KH, Nam Y, Choi YJ, Lee YM, Kim NJ. Coronavirus Disease 2019 Outbreak in a Psychiatric Closed Ward: What We Have to Learn. Front Psychiatry 2020; 11:579235. [PMID: 33551861 PMCID: PMC7862577 DOI: 10.3389/fpsyt.2020.579235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/15/2020] [Indexed: 12/25/2022] Open
Affiliation(s)
- June Young Chun
- Department of Internal Medicine, National Cancer Center, Goyang, South Korea
| | - Jin Yong Jun
- Department of Psychiatry, National Center for Mental Health, Seoul, South Korea
| | - Jiah Choi
- Department of Internal Medicine, Keimyung University, Daegu, South Korea
| | - Minho Jo
- Department of Psychiatry, National Center for Mental Health, Seoul, South Korea
| | - Kyongmin Kwak
- Department of Internal Medicine, Sangju Redcross Hospital, Sangju, South Korea
| | - Yunjin Jeong
- Public Health Center, Ministry of Health and Welfare, Seoul, South Korea
| | - Junsoo Lee
- Public Health Center, Ministry of Health and Welfare, Seoul, South Korea
| | - Junkyu Park
- Public Health Center, Ministry of Health and Welfare, Seoul, South Korea
| | - Kang Hee Lee
- Department of Planning and Public Relations, National Center for Mental Health, Seoul, South Korea
| | - Yoonyoung Nam
- Department of Psychiatry, National Center for Mental Health, Seoul, South Korea
| | - Young Ju Choi
- Department of Internal Medicine, National Cancer Center, Goyang, South Korea
| | - Young Moon Lee
- Department of Psychiatry, National Center for Mental Health, Seoul, South Korea
| | - Nam Joong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| |
Collapse
|
48
|
Ter-Israelian AI, Evdokimova TE. [The modern features of organization of hospital-substituting psychiatric care]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2020; 28:98-100. [PMID: 32119217 DOI: 10.32687/0869-866x-2020-28-1-98-100] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 09/20/2018] [Indexed: 06/10/2023]
Abstract
The article presents results of study of issues of psychiatric care organization in mental hospital in 2015-2017. The structure, age distribution and social status of patients are analyzed on the basis of data from Psychiatric Hospital № 13 of the Moscow Health Care Department.
Collapse
Affiliation(s)
- A Iu Ter-Israelian
- The State Budget Institution of Health Care "The Psychiatric Hospital № 13" of the Moscow Health Care Department, 109559, Moscow, Russia,
| | - T E Evdokimova
- The Federal State Autonomous Educational Institution of Higher Education "The Peoples' Friendship University of Russia" (RUDN University), 117198, Moscow, Russia
| |
Collapse
|
49
|
Wood L, Williams C, Billings J, Johnson S. The role of psychology in a multidisciplinary psychiatric inpatient setting: Perspective from the multidisciplinary team. Psychol Psychother 2019; 92:554-564. [PMID: 30311351 DOI: 10.1111/papt.12199] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/17/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Psychologists routinely work in psychiatric inpatient settings and it is acknowledged that they cannot work in isolation from the multidisciplinary team. The aim of this study was to examine the multidisciplinary team's perspective on the role of psychology within the acute psychiatric inpatient setting. DESIGN A qualitative approach was taken utilizing semi-structured interviews for data collection. METHODS Interviews were undertaken with 12 multidisciplinary team members (occupational therapists, psychiatric nurses, psychiatrists, and clinical managers) examining their perspectives on the role of psychology within the acute psychiatric inpatient setting. Thematic analysis was used to analyse data. RESULTS The analysis identified two key themes 'psychological treatments', which describes the perceived function of psychology on the ward, and 'integrated psychological working' outlining key issues that psychologists should consider when working in multidisciplinary teams. CONCLUSIONS Psychology is seen by multidisciplinary team members as an integral, but not first line, treatment option in the psychiatric inpatient setting. Both direct work and indirect work were valued by multidisciplinary staff participants. The multidisciplinary team do not have a clear understanding of the role of psychology. Education dialogue about the role are required. PRACTITIONER POINTS The role of psychology in the psychiatric inpatient setting is valued by the multidisciplinary team. Psychology was not viewed as a first-line treatment option in the psychiatric inpatient setting but an 'add-on' to medical treatment. Psychology was a valued source of support for skilling-up and offering reflective space to the multidisciplinary team. Psychologists need to better promote their role and their skills to the multidisciplinary team.
Collapse
Affiliation(s)
- Lisa Wood
- Division of Psychiatry, University College London, UK.,Acute and Rehabilitation Directorate, North East London Foundation Trust, Goodmayes Hospital, Ilford, UK.,School of Health and Social Care, University of Essex, Colchester, UK
| | - Claire Williams
- Acute and Rehabilitation Directorate, North East London Foundation Trust, Goodmayes Hospital, Ilford, UK
| | - Jo Billings
- Division of Psychiatry, University College London, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, UK
| |
Collapse
|
50
|
Böhmer MW, Krüger C. Therapeutic relationships and the problem of containment: Experiences of patients at a psychiatric training hospital. S Afr J Psychiatr 2019; 25:1246. [PMID: 31745442 PMCID: PMC6852003 DOI: 10.4102/sajpsychiatry.v25i0.1246] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 06/21/2019] [Indexed: 11/25/2022] Open
Abstract
Background The biopsychosocial model emphasises the role of human relationships in psychiatric care. Therapeutic relationships that improve treatment outcome and provide containment are desperately needed by patients in distress. Despite the importance of human relationships, they are neglected in an era dominated by biological psychiatry. Aim This qualitative research project explores the experiences, perceptions and subsequent needs of patients. The role of therapeutic relationships, and the factors that patients felt influenced their relationship with their therapists, were examined. Setting A psychiatric training hospital in South Africa. Method Thirty in-depth semi-structured interviews were conducted with 15 inpatients. A qualitative, explorative-descriptive, collective case study design was used. Purposive sampling ensured maximum variation and richness of information. Grounded theory methods were used to analyse transcribed recordings. Results Patients valued therapeutic relationships that provide containment and potentially obviate the need for ‘measures of control’. A model of containment was developed to demonstrate the various factors that interact in the attempt to provide containment to patients in a psychiatric training hospital system. Conclusion Training hospitals should emphasise the role of therapeutic relationships in achieving containment and positive treatment outcomes. In developing countries, severe shortcomings in mental healthcare resources hinder the building of personal therapeutic relationships.
Collapse
Affiliation(s)
- Manfred W Böhmer
- Department of Psychiatry, University of Pretoria, Pretoria, South Africa
| | - Christa Krüger
- Department of Psychiatry, University of Pretoria, Pretoria, South Africa
| |
Collapse
|