Intensive Case Management (ICM) Project in Eastern Lower Austria: A Description

2017 ◽  
Vol 41 (S1) ◽  
pp. s248-s248
Author(s):  
M. Ramirez Gaite ◽  
E. Gundendorfer-Mag. FH ◽  
W. Hrubos
Keyword(s):  
Case Management ◽  
Support Groups ◽  
Life Support ◽  
Psychiatric Treatment ◽  
Treatment Plan ◽  
Life Quality ◽  
Primary Objective ◽  
Community Treatment ◽  
Competing Interest ◽  
At Home

IntroductionOur ICM Project was implemented in 2012, with the primary objective of preventing hospitalizations and unburdening services. Here, we present a description.ObjectivesICM is a type of multi-professional assertive community treatment (ACT) and case management, although our concept has a stronger focus on social work than ACT and uses less resources. It aims at patient's stabilization at home, better life quality, less inpatient/residential treatments, and more access to crisis intervention.MethodsPresently we have 118 spots. Target groups are persons with severe psychiatric conditions at high risk for institutionalization or already institutionalized, including heavy users of mental health services. An initial eligibility assessment is required. At least 3 workers are providing a minimum of 2 h face-to-face contact per week per person. Care is offered predominantly at home environment and anchored in: careful distance-closeness ratio, structured and restructuring, autonomy enhancing, respectful, non-judgmental, confidential, regularity and commitment. Each treatment plan is individualized and based on two axes: intensive assistance and day-structure. It comprises comprehensive psychiatric treatment, counselling, assistance in everyday life, support groups, crisis management and interdisciplinary organizational meetings.ResultsThe program was evaluated in 2014 using the CANSAS and FLZ scales and its effectiveness was validated. Most significant improvements were found in day-structure, housing, social contacts and performance, nutrition, and psycho-education. Life satisfaction improvement was found mostly in areas of general health, performance, relaxation and autonomy.ConclusionsSince its implementation ICM has steadily expanded. Further research tools are currently being developed. Results will be presented in future publications.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Lack of Occupation and Depression Onset in Oncology Patient – Case Report

2016 ◽  
Vol 33 (S1) ◽  
pp. S497-S498
Author(s):  
L. Filipovic-Grcic ◽  
F. Đerke ◽  
M. Braš ◽  
V. Djordjevic
Keyword(s):  
Case Report ◽  
Support Groups ◽  
Psychiatric Treatment ◽  
Patient Case ◽  
Oncology Patient ◽  
Von Hippel Lindau ◽  
Cancer Support ◽  
Cancer Support Groups ◽  
Competing Interest ◽  
Von Hippel Lindau Syndrome

Being able to live an active and meaningful life is important for mental health of every individual. In this case report we examine the life of an oncology patient who developed depression six years ago. The patient is a fifty seven year old woman who has been suffering from Von Hippel-Lindau syndrome for the last forty years. Her father and two uncles died from the same disease. She had her first operation when she was seventeen years old and has had numerous operations since then. During this time she has undergone four neurosurgical operations, nephrectomy, spine and pancreas operation and eye enucleation. Despite the fact that by being a chronic oncology patient she was prone to depression, she did not develop depressive symptoms. It did not happen even as her husband went to war and left her to take care of their child. It did not come afterwards as they struggled financially. Only after they moved to a new apartment and as she finished decorating it, did depression finally occur. During entire life she was an active, outgoing person, who took pleasure in socialising and various hobbies. She only developed depression after she was pensioned, left with the responsibility to care for her old mother. Following the psychiatric treatment she regained interest in people and become active in different cancer support groups. This example accentuates the importance of every-day pleasurable activities as a defence mechanism against depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Comorbid depression and ulcerative colitis – is there a connection?

2017 ◽  
Vol 41 (S1) ◽  
pp. S534-S534
Author(s):  
A. Melada ◽  
I. Krišto-Mađura ◽  
A. Vidović
Keyword(s):  
Ulcerative Colitis ◽  
Psychiatric Treatment ◽  
Psychiatric Symptoms ◽  
Specific Treatment ◽  
Unknown Etiology ◽  
Suicidal Thoughts ◽  
Symptoms Of Depression ◽  
Bidirectional Communication ◽  
History Of ◽  
Competing Interest

Ulcerative colitis (UC) is a subset disorder of inflammatory bowel disease (IBD) with chronic course and symptoms such as fatigue, gastrointestinal pain, fever, etc. IBD is associated with psychological manifestations including depression and anxiety. There is an increased number of studies trying to link these comorbidities. The gut-brain axis is regulated by intestinal microbiota and this bidirectional communication including immune, neural, endocrine and metabolic mechanisms may bring us closer to the answer. The following case concerns a 56-year-old patient with history of major depressive disorder who was in continuous psychiatric care and treated with antidepressants. Several years after the beginning of psychiatric treatment, he was hospitalized for diagnostic examination due to subfebrility of unknown etiology, but with no final somatic diagnosis. After two years he was referred to our department and at administration the patient showed symptoms of depression, anxiety, lack of motivation and suicidal thoughts and tendencies. Subfebrility was still present at that time. His psychopharmacotherapy was revised and there was a slight improvement in mood and behaviour. During outpatient follow-ups the symptoms of depression were still prominent and remission was not achieved even with modulation of antidepressant pharmacotherapy. The following year the patient was diagnosed with UC and started specific treatment after he presented with diarrhea in addition to subfebrility. Subsequently his mood improved, suicidal thoughts were diminished and ultimately remission was achieved. This case suggests that only after UC was being treated the psychiatric symptoms also withdrew which implicates that inflammatory mediators were involved in pathogenesis of depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Suffering of the Spouses of Narcissistic Perverts: About Two Cases

2017 ◽  
Vol 41 (S1) ◽  
pp. S711-S711
Author(s):  
S. Ben Saadi ◽  
O. Moula ◽  
O. Zerriaa ◽  
S. Chebli ◽  
R. Ghachem
Keyword(s):  
Life Experience ◽  
Real Life ◽  
Clinical Validity ◽  
Personality Problem ◽  
Common Life ◽  
Her Family ◽  
Competing Interest ◽  
Good Agreement ◽  
Clinical Cases ◽  
At Home

IntroductionThe narcissistic perversion is a psychoanalytical term resulting from the association of 2 Freudian notions: perversion and narcissism. The concept of narcissistic pervert has no clinical validity. The companions of the narcissistic perverts undergo moral suffering, often unknown by their entourage.ObjectivesWe suggest studying the trajectory of life of two wives of narcissistic perverts.AimsEmphasize the peculiarities of the narcissistic perverse personality.MethodsWe are going to postpone 2 clinical cases of spouses of narcissistic perverts.ResultsCase 1: Mrs. A., 60-year-old, divorced once. Mother of a girl. She met her current husband during the marriage of her daughter. At the beginning of their common life, Mr. M. was loving and in the small care with his wife. After three months of the marriage, Mrs. A. reported the change of character of her husband who became aggressive, decreasing her and taking her away from her family. He seized all her goods. She is actually getting a divorce.Case 2: Mrs. R., 27-year-old, married Mr. C. after 9 months of knowledge. At the beginning of their marriage, they had a good agreement. Forced to stay at home to take care only of domestic spots, she reported a real-life experience of neglect and emotional carelessness, she felt belittled and isolated. At present engaged in a divorce procedure after been physically assaulted threatened with death.Both women consulted for depression.ConclusionThe narcissistic perversion is a personality problem which affects as well the person involved but especially his entourage. When you are in connection with a narcissistic pervert, even after leaving him, you never recover from it.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Compulsory Psychiatric Treatment in the Community

1991 ◽  
Vol 158 (6) ◽  
pp. 792-799 ◽  
Author(s):  
Tom Sensky ◽  
Timothy Hughes ◽  
Steven Hirsch
Keyword(s):  
Psychiatric Treatment ◽  
Treatment Compliance ◽  
Community Treatment ◽  
Control Group ◽  
The Past ◽  
History Of ◽  
Treatment Use ◽  
Reduced Time ◽  
Treatment Order ◽  
Community Treatment Order

Following in-patient psychiatric treatment under Section 3 of the Mental Health Act, some patients have in the past remained on Section after discharge, and subsequently the Section has been renewed while the patient remained ‘on leave’. People treated thus with ‘extended leave’ probably resemble closely those who would be placed on a community treatment order if this were available. A group of these extended-leave patients was compared with a control group, matched for age, sex and diagnosis, selected by consultant psychiatrists as not requiring treatment using a community treatment order. The two groups showed very few differences, but the extended-leave patients more commonly had a history of recent dangerousness and non-compliance with psychiatric treatment. Use of extended leave improved treatment compliance, reduced time spent in hospital, and reduced levels of dangerousness.

scholarly journals Clozapine initiation in the community

2002 ◽  
Vol 26 (9) ◽  
pp. 339-341 ◽  
Author(s):  
Aileen O'Brien ◽  
Mike Firn
Keyword(s):  
Adverse Events ◽  
Assertive Community Treatment ◽  
Community Treatment ◽  
Clinical Implications ◽  
Treatment Team ◽  
Serious Adverse Events ◽  
Assertive Community Treatment Team ◽  
To Come ◽  
At Home

Aims and MethodThe study aims to describe the experience of an assertive community treatment team when commencing clozapine at home rather than in hospital, following a locally-devised policy. Any failed attempts and problems experienced are described.ResultsThere have been no serious adverse events with 13 patients who have been started on clozapine at home.Clinical ImplicationsFor an assertive community treatment team, home-initiation of clozapine is a practical option, particularly when patients refuse to come in to hospital.

scholarly journals THERAPY OF ENDOCRINE DISEASE: Novel protection and treatment strategies for chemotherapy-associated ovarian damage

2021 ◽  
Vol 184 (5) ◽  
pp. R177-R192
Author(s):  
Jiaqiang Xiong ◽  
Liru Xue ◽  
Ya Li ◽  
Weicheng Tang ◽  
Dan Chen ◽  
...  
Keyword(s):  
Treatment Plan ◽  
Ovarian Tissue ◽  
Life Quality ◽  
Treatment Strategies ◽  
Reproductive Function ◽  
Ovarian Tissue Cryopreservation ◽  
Ovarian Protection ◽  
Protection Method ◽  
Fertility Protection ◽  
Ovarian Damage

Fertility and ovarian protection against chemotherapy-associated ovarian damage has formed a new field called oncofertility, which is driven by the pursuit of fertility protection as well as good life quality for numerous female cancer survivors. However, the choice of fertility and ovarian protection method is a difficult problem during chemotherapy and there is no uniform guideline at present. To alleviate ovarian toxicity caused by anticancer drugs, effective methods combined with an individualized treatment plan that integrates an optimal strategy for preserving and restoring reproductive function should be offered from well-established to experimental stages before, during, and after chemotherapy. Although embryo, oocyte, and ovarian tissue cryopreservation are the major methods that have been proven effective and feasible for fertility protection, they are also subject to many limitations. Therefore, this paper mainly discusses the future potential methods and corresponding mechanisms for fertility protection in chemotherapy-associated ovarian damage.

Look of Life

2020 ◽  
pp. 364-375
Author(s):  
Vittoria Sichi ◽  
Giacomo Ercolani ◽  
Luca Franchini ◽  
Luca Golfari ◽  
Silvia Varani ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cancer Patients ◽  
Primary Objective ◽  
Control Group ◽  
Emotional Wellbeing ◽  
Structured Interviews ◽  
Beneficial Effects ◽  
Pain Symptoms ◽  
Anxiety Depression ◽  
At Home

The use of virtual reality (VR) shows promising results in improving the emotional wellbeing of cancer patients, reducing anxiety, depression, and pain symptoms. No data exist concerning the use of VR in cancer patients assisted at home. The ANT Foundation decided to conduct a pilot study to test the use of VR in cancer patients assisted at home. Fifty-eight ANT patients were randomized and assigned to a control group that didn't use VR devices and to an experimental group that used them. The primary objective of the pilot study was to determine whether VR device could be a viable instrument in homecare patients. Furthermore, the aim of the study was to discover if VR could have beneficial effects on patients' quality of life as well as discover which kind of videos were more effective. The innovative aspect of this study was to test the use of VR directly at home of patients, proposing a use of VR that is compatible with the needs and the daily rhythms of families, and investigating its effectiveness through appropriate validated psychometric questionnaires and semi-structured interviews.

Digital healthcare: Fools gold or a promised land?

2016 ◽  
Vol 33 (S1) ◽  
pp. S28-S28
Author(s):  
M. Wise
Keyword(s):  
Support Groups ◽  
Phone Call ◽  
Systematic Evaluation ◽  
Promised Land ◽  
Use Of Technology ◽  
Competing Interest ◽  
Video Calling ◽  
Health Care Application ◽  
Digital Healthcare

Digital healthcare is the use of technology to deliver healthcare. There are many facets of it. The paradigm of care at a distance e.g. a live interface is the most understood, whether it is the old fashioned analog phone call or that of todays Millenial who ‘get’ Skype or see video calling as a day to day reality.This has moved to non-live uses, asynchronous, the modern version of written communication, email, videomessage, Instagram, twitter or any one of a multitude of social media.It has progressed beyond that though to a plethora of devices, apps and cross breeds that promise to maximise your patients health, and often your practice income! Grand claims, if not ones supported by the evidence.They have broadened the range of providers from the plain vanilla (group) therapist to the Cyber support groups; from patient information sheets, to sophisticated hyperlinked, video embedded ‘hope box’, or manual on your phone. They have changed in vivo exposure from what was limited by travel time, to what is limited by the programmers imagination.Telemdecine can connect patients and providers worldwide – how can that not be an amazing promise, today's truly outstanding goal – tomorrow commonplace event.The promise of near infinite data; if only we can measure enough, we can treat better, may hold true for a physical paradigm such as mobile ECG or BP monitoring, but is it true for mental health?Science is not a door to infinite wisdom, but a rescue from unending ignorance. The evidence is that technological innovations are not a magic solution but tools widening access, they are to travel what the motorway is to the dust track. They are an equaliser in that more people can be reached than ever before–but they do not replace human skill and ability.By December 2015, 500 million smartphone users worldwide will be estimated to be using a health care application. Yet, there is no evidence of a systematic evaluation of a fraction of these apps. They may not be snake oil salesman, but has the placebo effect graduated from molecules to ones and zero's?We will explore the evidence to understand some of the promises and the realities of what was once Tomorrows World, here today.Disclosure of interestThe author has not supplied his declaration of competing interest.

At-home ethnography: a native researcher’s fieldwork reflections

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Azher Hameed Qamar
Keyword(s):  
Primary Objective ◽  
Content Type ◽  
Ethnographic Fieldwork ◽  
Fieldwork Experience ◽  
Rapport Building ◽  
Contextual Sensitivity ◽  
Native Context ◽  
Access To The Field ◽  
Building Rapport ◽  
At Home

PurposeIn last few decades, the native anthropology has been highlighted for its potential to immediately grasping cultural familiarity, contextual sensitivity, and rapport building. Nevertheless, detachment from the native context is also seen as a challenge for the native researcher. This paper aims to provide invaluable information about the fieldwork experience of the author as a native researcher in rural Punjab Pakistan. The author presents and reflects the fieldwork challenges faced and the strategies used to overcome the challenges. The primary objective of this paper is to discuss the methodological strategies to face the challenges of doing at-home ethnography.Design/methodology/approachThis paper is based on ethnographic fieldwork conducted in native context.FindingsDealing with contextual complexity and sensitivity with the author’s native learning, the author used native knowledge as a useful resource to investigate insider’s perspective on infant care belief practices. Furthermore, the author addressed the challenges related to building rapport, gaining friendly access to the families and children, and setting aside presumptions. The author discusses the strategies opted, such as selecting a research assistant, gaining access to the field, planning fieldwork and bracketing native presumptions.Practical implicationsThis paper provides important insight of at-home ethnography and technical understanding to conduct fieldwork in native contexts.Originality/valueBased on my ethnographic fieldwork, this article contributes in contemporary debates on the challenges in doing at-home ethnography.

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