A Biopsychosocial Intervention for Stroke Carers (BISC): development and description of the intervention

Background: Our team has developed a biopsychosocial intervention called DEPENAS that has shown to be effective in primary health care in improving health and quality of life of patients with medically unexplained symptoms. We also found that general practitioners participating in the clinical trial do not use the intervention systematically because of barriers related to psychological determinants among professionals themselves. Based on the Theoretical Domains Framework (TDF) of Susan Michie, our study aims (1) to identify psychological determinants among professionals who are perceived to be facilitators of or barriers to the systematic and generalized use of the intervention in the consultation room and (2) to design an implementation strategy that considers these determinants and helps us to address them with a series of predesigned and validated techniques. Method: A qualitative exploratory study has been designed based on semistructured individual interviews conducted following a script based on the 14 TDF domains and analyzed in a deductive way. Participants will be doctors and nurses previously trained in the intervention that was put into practice under real-world conditions, from different health centers. Results of the analysis of the interviews will be used as the basis for designing the implementation strategy. Discussion: The implementation of the DEPENAS intervention in primary care to achieve its sustained and widespread use among primary care professionals involves changes in the model of patient care and the model of the health system, toward models that are more in tune with the needs of modern society. Investigating psychological determinants in professionals and addressing them with validated techniques, as part of the strategy for implementing a given intervention, is a novel approach that has the potential to help change the way in which we tackle change in healthcare organizations.

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Comorbid mental illness and criminalness implications for housing and treatment

CNS Spectrums ◽

10.1017/s1092852915000231 ◽

2015 ◽

Vol 20 (3) ◽

pp. 231-240 ◽

Cited By ~ 2

Author(s):

Nicole R. Bartholomew ◽

Robert D. Morgan

Keyword(s):

Mental Illness ◽

Psychological Factors ◽

Criminal Behavior ◽

Social Processes ◽

Intervention Strategies ◽

Social Conventions ◽

Biopsychosocial Intervention ◽

Psychiatric Outcomes ◽

The Relationship ◽

Novel Model

The relationship between mental illness, violence, and criminal behavior is complex, and involves a multifaceted interaction of biological, psychological, and social processes. In this article, we review the emerging research that examines the neurobiological and psychological factors that distinguish between persons with mental illness who do and who do not engage in crime and violence. Additionally, a novel model for understanding the interaction between mental illness and criminalness is proposed. (As defined by Morgan and colleagues, criminalness is defined as behavior that breaks laws and social conventions and/or violates the rights and wellbeing of others.) Stemming from this model and outlined research, we argue that management and treatment approaches should target the co-occurring domains of mental illness and criminalness to improve criminal and psychiatric outcomes. Specifically, we discuss and propose effective housing (management) and biopsychosocial intervention strategies for improving outcomes.

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151 Biopsychosocial Intervention of High Frequency Emergency Department Utilizers

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2011.06.179 ◽

2011 ◽

Vol 58 (4) ◽

pp. S228 ◽

Cited By ~ 2

Author(s):

R.C. Waller

Keyword(s):

Emergency Department ◽

High Frequency ◽

Biopsychosocial Intervention

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Living with Difference: Experiences of Adolescents Subjected To Oral Facial Cleft Repair

International Journal of Indian Psychology ◽

10.25215/0302.167 ◽

2016 ◽

Vol 3 (2) ◽

Author(s):

Nandini. M ◽

Jayan. C

Keyword(s):

Specialty Care ◽

Developmental Task ◽

Intervention Package ◽

Adjustment Problems ◽

Psychological Issues ◽

Developmental Context ◽

Facial Cleft ◽

Facial Clefts ◽

Biopsychosocial Intervention ◽

Age Appropriate

Adolescents are best understood in a developmental context. The normal tasks of adolescent become complicated for the child with oral facial clefts. Existing multi specialty care is primarily aimed at physical rehabilitation with the psychological issues of care often being neglected. These articles address the biopsychosocial problems of adolescents with oral facial clefts who is experiencing adjustment problems. These articles also stress the need of a biopsychosocial intervention package for adolescence to assist in mastering the age appropriate developmental task.

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Efficacy of a six-month biopsychosocial intervention for treatment of children and adolescents with excess weight refractory to conventional therapy.

Appetite ◽

10.1016/j.appet.2014.01.053 ◽

2014 ◽

Vol 76 ◽

pp. 209

Author(s):

R. LANZA SAIZ ◽

M. GARCі́A FUENTES ◽

L. GAITE PINDADO ◽

L. ALVAREZ GRANDA ◽

R. PESQUERA CABEZAS ◽

...

Keyword(s):

Children And Adolescents ◽

Conventional Therapy ◽

Excess Weight ◽

Biopsychosocial Intervention

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Effectiveness of Mind–Body Intervention for Inflammatory Conditions: Results from a 26-Week Randomized, Non-Blinded, Parallel-Group Trial

Journal of Clinical Medicine ◽

10.3390/jcm10143107 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3107

Author(s):

Thao Thi Nguyen ◽

Christian G. Jensen ◽

Lina Khoury ◽

Bent Deleuran ◽

Esther S. Blom ◽

...

Keyword(s):

Stress Reduction ◽

Repeated Measures ◽

Intervention Program ◽

Well Being ◽

Eligibility Criteria ◽

Treatment As Usual ◽

Mean Values ◽

Intention To Treat ◽

Significant Difference ◽

Biopsychosocial Intervention

Biopsychosocial intervention has been suggested as a complementary treatment strategy for patients with chronic conditions. We compared the effect of a mind–body intervention (MBI), relative to treatment-as-usual (TAU) on WHO-5 Well-being Index during an intensive period of 12 weeks and follow-up at week 26 among patients with either psoriasis (PsO) or rheumatoid arthritis (RA). The MBI was based on the ‘Relaxation Response Resiliency Program’ and the ‘Open and Calm Program’, as well as ‘Mindfulness Based Stress Reduction’ (MBSR). The trial was randomized, management-as-usual, and controlled. Statistical analyses were based on the intention-to-treat population using repeated measures and mixed effects models (NCT03888261). We screened 39 potential participants, 35 of which (PsO, n = 20; RA, n = 15) met the eligibility criteria and were randomized: 17 in the MBI group and 18 in the TAU group. Attrition from the intervention program was 19%, with 65% of MBI patients and 71% of TAU patients completing the outcome assessments. After 12 weeks, a statistically significant difference in WHO-5 was observed between the groups (p = 0.019). However, according to the protocol, during the entire trial period, the average (least squares mean values) WHO-5 score was higher although not statistically significant in the MBI group (65.3) compared with the TAU group (59.1), corresponding to a between-group difference over 26 weeks of 6.15 (95% CI: −0.26 to 12.56; p = 0.060). All things considered, adding biopsychosocial intervention to clinical practice to patients with conditions, such as PsO and RA, could potentially improve health-related quality of life.

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Las enfermedades raras: naturaleza, características e intervención biopsicosocial [Rare Diseases: Nature, Characteristics and Biopsychosocial Intervention]

Portularia ◽

10.5218/prts.2011.0002. ◽

2011 ◽

Vol 11 (1) ◽

pp. 11-23 ◽

Cited By ~ 1

Author(s):

Aníbal Puente-Ferreras ◽

Mª José Barahona-Gomariz ◽

Mª Paz Fernández-Lozano

Keyword(s):

Rare Diseases ◽

Biopsychosocial Intervention

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Biopsychosocial Intervention for Stroke Carers (BISC): protocol for a feasibility randomised controlled trial (RCT)

BMJ Open ◽

10.1136/bmjopen-2017-018309 ◽

2017 ◽

Vol 7 (10) ◽

pp. e018309 ◽

Cited By ~ 3

Author(s):

Marion F Walker ◽

Shirley A Thomas ◽

Phillip J Whitehead ◽

Laura Condon ◽

Rebecca J Fisher ◽

...

Keyword(s):

Quality Of Life ◽

Randomised Controlled Trial ◽

Usual Care ◽

Controlled Trial ◽

Anxiety And Depression ◽

Stroke Survivors ◽

Qualitative Interview Study ◽

Biopsychosocial Intervention ◽

Randomised Controlled

IntroductionReducing length of hospital stay for stroke survivors often creates a shift in the responsibility of care towards informal carers. Adjustment to the caregiving process is experienced by many carers as overwhelming, complex and demanding and can have a detrimental impact on mental and physical health and well-being. National policy guidelines recommend that carers’ needs are considered and addressed; despite this, few interventions have been developed and empirically evaluated. We developed a biopsychosocial intervention in collaboration with carers of stroke survivors. Our aim is to determine whether the intervention can be delivered in a group setting and evaluated using a randomised controlled trial (RCT).Methods and analysisFeasibility RCT and nested qualitative interview study. We aim to recruit up to 40 stroke carers within 1 year of the stroke onset. Carers are randomised to usual care or usual care plus biopsychosocial intervention. Each intervention group will consist of five stroke carers. The intervention will focus on: psychoeducation, psychological adjustment to stroke, strategies for reducing unwanted negative thoughts and emotions and problem-solving strategies. The main outcome is the feasibility of conducting an RCT. Carer outcomes at 6 months include: anxiety and depression, quality of life and carer strain. Data are also collected from stroke survivors at baseline and 6 months including: level of disability, anxiety and depression, and quality of life.Ethics and disseminationFavourable ethical opinion was provided by East Midlands – Nottingham2 Research Ethics Committee (14/EMI/1264). This study will determine whether delivery of the biopsychosocial intervention is feasible and acceptable to stroke carers within a group format. It will also determine whether it is feasible to evaluate the effects of the biopsychosocial intervention in an RCT. We will disseminate our findings through peer-reviewed publications and presentations at national and international conferences.Trial registration numberISRCTN15643456; Pre-results.

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Effectiveness of a multidisciplinary BIOPSYCHOSOCIAL intervention for non-specific SUBACUTE low back pain in a working population: a cluster randomized clinical trial

BMC Health Services Research ◽

10.1186/s12913-019-4810-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Romina Raczy Mas ◽

Tomàs López-Jiménez ◽

Enriqueta Pujol-Ribera ◽

María Isabel Fernández-San Martín ◽

Jenny Moix-Queraltó ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Care ◽

Intervention Group ◽

Control Group ◽

Low Back ◽

Working Population ◽

Multidisciplinary Intervention ◽

Biopsychosocial Intervention ◽

Cluster Randomized

Abstract Background Low back pain (LBP) is a multifactorial condition with individual and societal impact that affects populations globally. Current guidelines for the treatment of LBP recommend pharmacological and non-pharmacological strategies. The aim of this study was to compare usual clinical practice with the effectiveness of a biopsychosocial multidisciplinary intervention in reducing disability, severity of pain and improving quality of life in a working population of patients with subacute (2–12 weeks), non-specific LBP. Methods Longitudinal cluster randomized clinical trial conducted in 39 Primary Health Care Centres (PHCC) of Barcelona, with patients aged 18–65 years (n = 501; control group = 239; 26 PHCC, intervention group = 262; 13 PHCC). The control group received usual clinical care. The intervention group received usual clinical care plus a biopsychosocial multidisciplinary intervention, which consisted of physiotherapy, cognitive-behavioural therapy and medication. The main outcomes were changes in the Roland Morris Disability Questionnaire (RMDQ), and the minimal clinically important differences. Secondary outcomes were changes in the McGill Pain (MGPQ) and Quality of Life (SF-12) questionnaires. Assessment was conducted at baseline, 3 and 12 months. Analysis was by intention-to-treat and analyst-blinded. Multiple imputations were used. Results Of the 501 enrolled patients, 421 (84%) provided data at 3 months, and 387 (77.2%) at 12 months. Mean age was 46.8 years (SD: 11.5) and 64.7% were women. In the adjusted analysis of the RMDQ outcome, only the intervention group showed significant changes at 3 months (− 1.33 points, p = 0.005) and at 12 months (− 1.11 points, p = 0.027), but minimal clinically important difference were detected in both groups. In the adjusted analysis of the RMDQ outcome, the intervention group improvement more than the control group at 3 months (− 1.33 points, p = 0.005) and at 12 months (− 1.11 points, p = 0.027). The intervention group presented a significant difference. Both groups presented a minimal clinically important difference, but more difference in the intervention group. The intervention group presented significant differences in the MGPQ scales of current pain intensity and VAS scores at 3 months. No statistically significant differences were found in the physical and mental domains of the SF-12. Conclusions A multidisciplinary biopsychosocial intervention in a working population with non-specific subacute LBP has a small positive impact on disability, and on the level of pain, mainly at short-term, but no difference on quality of life. Trial registration ISRCTN21392091 (17 oct 2018) (Prospectively registred).

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