scholarly journals Long-term effects of a housing support intervention in homeless people with severe mental illness

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C Lemoine ◽  
S Loubiere ◽  
A Tinland ◽  
M Boucekine ◽  
V Girard ◽  
...  

Abstract Objectives Recent studies have suggested that the Housing First model is a promising strategy for providing effective services to homeless people with mental illness at a short-term horizon. The paper assesses the long-term effects of an independent housing with a recovery-oriented approach in homeless people with severe mental illness on social recovery, mental symptoms and quality of life among homeless adults with high support needs for mental and physical health services. Design and methods “Un Chez Soi d’Abord” was a randomized controlled trial conducted in 4 French cities: Lille, Marseille, Paris and Toulouse. From August 2011 to April 2014, homeless participants with a DSM-IV-TR diagnosis of bipolar disorder or schizophrenia (N = 703) were randomly assigned to Housing First (n = 353) or Treatment as Usual (n = 350). Mental symptoms (MCSI), social recovery (RAS), global physical and mental status (SF-36), subjective quality of life (S-QoL) and addictions (MINI) were collected every 6 months over 48 months. Mixed models using a longitudinal and cluster design were performed, and adjusted to age on the street, gender and mental disorder diagnosis and testing for time*group and site*time interactions. Results HF patients exhibited higher recovery (β = 3.6, 95%CI: 0.4 to 6.9), higher S-QoL (4.7, 1.1 to 8.3) such as the self-esteem (10.9, 5.8 to 15.6) and physical well-being (8.4, 3.1 to 13.8) sub-dimensions, and improved mental health symptoms (-3.1, -5.4 to -0.9) over the 4-year follow-up. No significant differences were observed for SF36 scores. HF and TAU participants experienced similar alcohol or substance dependence evolution between baseline and 48 months. Conclusions HF is a highly effective intervention associated with improved relational environment, enhancing recovery and quality of life in homeless people with schizophrenia or bipolar disorders. Addiction issues have been identified and should be targeted so as to further improve the Housing First approach. Key messages Housing First model is a highly effective intervention. Housing First model enhances recovery and quality of life in homeless people.

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Jeroen Deenik ◽  
Frank Kruisdijk ◽  
Diederik Tenback ◽  
Annemarie Braakman-Jansen ◽  
Erik Taal ◽  
...  

Author(s):  
Juliana Alves Sousa Caixeta ◽  
Jessica Caixeta Silva Sampaio ◽  
Vanessa Vaz Costa ◽  
Isadora Milhomem Bruno da Silveira ◽  
Carolina Ribeiro Fernandes de Oliveira ◽  
...  

Abstract Introduction Adenotonsillectomy is the first-line treatment for obstructive sleep apnea secondary to adenotonsillar hypertrophy in children. The physical benefits of this surgery are well known as well as its impact on the quality of life (QoL), mainly according to short-term evaluations. However, the long-term effects of this surgery are still unclear. Objective To evaluate the long-term impact of adenotonsillectomy on the QoL of children with sleep-disordered breathing (SDB). Method This was a prospective non-controlled study. Children between 3 and 13 years of age with symptoms of SDB for whom adenotonsillectomy had been indicated were included. Children with comorbities were excluded. Quality of life was evaluated using the obstructive sleep apnea questionnaire (OSA-18), which was completed prior to, 10 days, 6 months, 12 months and, at least, 18 months after the procedure. For statistical analysis, p-values lower than 0.05 were defined as statistically significant. Results A total of 31 patients were enrolled in the study. The average age was 5.2 years, and 16 patients were male. The OSA-18 scores improved after the procedure in all domains, and this result was maintained until the last evaluation, done 22 ± 3 months after the procedure. Improvement in each domain was not superior to achieved in other domains. No correlation was found between tonsil or adenoid size and OSA-18 scores. Conclusion This is the largest prospective study that evaluated the long-term effects of the surgery on the QoL of children with SDB using the OSA-18. Our results show adenotonsillectomy has a positive impact in children's QoL.


Author(s):  
Teresa Zetzl ◽  
Andre Pittig ◽  
Agnes Renner ◽  
Birgitt van Oorschot ◽  
Elisabeth Jentschke

Abstract Objective To examine the efficacy of reminder e-mails to continue yoga therapy on practice frequency and fatigue in cancer patients and long-term effects of yoga on fatigue, depression, and quality of life. Methodology One hundred two cancer patients who completed an 8-week yoga therapy were randomly allocated to two groups: reminder (N = 51) vs. no-reminder group (N = 51). After completing yoga therapy, the reminder group received weekly e-mails for 24 weeks, which reminded them of practicing yoga, whereas the no-reminder group did not. Primary outcomes were fatigue and practice frequency, and long-term outcomes were fatigue, depression, and quality of life. Data were assessed using questionnaires after yoga therapy (T1) and 6 months after completing yoga therapy (T2). Result A significantly stronger reduction of general (p = 0.038, d = 0.42) and emotional fatigue (p = 0.004, d = 0.59) and a higher increase of practice frequency (p = 0.015, d = 0.52) between T1 and T2 were found for the reminder group compared to the no-reminder group. In the mediation model, practice frequency as a mediator partially explained the changes in emotional fatigue (indirect effect B =  − 0.10). Long-term effects of yoga therapy regarding fatigue, depression, and quality of life were found (F > 7.46, p < 0.001, d > 0.54). Conclusion Weekly reminder e-mails after yoga therapy can positively affect general and emotional fatigue and help cancer patients with fatigue establish a regular yoga practice at home. However, higher practice frequency did not lead to higher physical or cognitive fatigue improvement, suggesting other factors that mediate efficacy on physical or cognitive fatigue, such as mindfulness or side effects of therapy.


2013 ◽  
Vol 190 (1) ◽  
pp. 187-193 ◽  
Author(s):  
Chyng-Wen Fwu ◽  
Paul W. Eggers ◽  
Steven A. Kaplan ◽  
Ziya Kirkali ◽  
Jeannette Y. Lee ◽  
...  

2006 ◽  
Vol 21 (6) ◽  
pp. 746-753 ◽  
Author(s):  
Andrew Siderowf ◽  
Jurg L. Jaggi ◽  
Sharon X. Xie ◽  
Catherine Loveland-Jones ◽  
Lewis Leng ◽  
...  

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
M. P. Rozing ◽  
A. Jønsson ◽  
R. Køster-Rasmussen ◽  
T. D. Due ◽  
J. Brodersen ◽  
...  

Abstract Background People with severe mental illness (SMI) have an increased risk of premature mortality, predominantly due to somatic health conditions. Evidence indicates that primary and tertiary prevention and improved treatment of somatic conditions in patients with SMI could reduce this excess mortality. This paper reports a protocol designed to evaluate the feasibility of a coordinated co-produced care program (SOFIA model, a Danish acronym for Severe Mental Illness and Physical Health in General Practice) in the general practice setting to reduce mortality and improve quality of life in patients with severe mental illness. Methods The SOFIA pilot trial is designed as a cluster randomized controlled trial targeting general practices in two regions in Denmark. We aim to include 12 practices, each of which is instructed to recruit up to 15 community-dwelling patients aged 18 and older with SMI. Practices will be randomized by a computer in a ratio of 2:1 to deliver a coordinated care program or usual care during a 6-month study period. A randomized algorithm is used to perform randomization. The coordinated care program includes educational training of general practitioners and their clinical staff educational training of general practitioners and their clinical staff, which covers clinical and diagnostic management and focus on patient-centered care of this patient group, after which general practitioners will provide a prolonged consultation focusing on individual needs and preferences of the patient with SMI and a follow-up plan if indicated. The outcomes will be parameters of the feasibility of the intervention and trial methods and will be assessed quantitatively and qualitatively. Assessments of the outcome parameters will be administered at baseline, throughout, and at end of the study period. Discussion If necessary the intervention will be revised based on results from this study. If delivery of the intervention, either in its current form or after revision, is considered feasible, a future, definitive trial to determine the effectiveness of the intervention in reducing mortality and improving quality of life in patients with SMI can take place. Successful implementation of the intervention would imply preliminary promise for addressing health inequities in patients with SMI. Trial registration The trial was registered in Clinical Trials as of November 5, 2020, with registration number NCT04618250. Protocol version: January 22, 2021; original version


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