scholarly journals Patients in General Practice in Denmark Referred to Physiotherapists: A Description of Patient Characteristics Based on General Health Status, Diagnoses, and Sociodemographic Characteristics

2001 ◽  
Vol 81 (3) ◽  
pp. 915-923 ◽  
Author(s):  
Carsten Krogh Jørgensen ◽  
Per Fink ◽  
Frede Olesen
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Physical Health ◽  
General Practitioners ◽  
Short Form ◽  
Signs And Symptoms ◽  
Patient Characteristics ◽  
Poor Mental Health ◽  
Medical Outcomes ◽  
Summary Scale

Abstract Background and Purpose. Both musculoskeletal illness and mental illness characterized by somatic symptoms are common in primary care, and it is hypothesized that many patients with musculoskeletal illness have relatively poor mental health. The purpose of this study was to describe the characteristics of patients in general practice in Denmark who are referred to physiotherapists with signs and symptoms of musculoskeletal illness. Subjects and Methods. One hundred ninety-four general practitioners, representing 124 practices, participated in a survey of 2,042 consecutive patients with musculoskeletal illness. Results. The diagnoses were generally poorly defined. Compared with the general population, patients with musculoskeletal illness had markedly poorer physical health and poorer mental health. Patients with poorly defined diagnoses did not differ from patients with well-defined diagnoses in terms of physical health, but they scored lower on the mental health component summary scale of the Danish version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Conclusion and Discussion. Of the patients referred to physiotherapists by general practitioners in Denmark, the subgroup with poorly defined diagnoses had lower mental health scores than those with well-defined diagnoses, suggesting that a biopsychosocial approach to care may be appropriate for this group of patients.

scholarly journals Socioeconomic inequality in recovery from poor physical and mental health in mid-life and early old age: prospective Whitehall II cohort study

2018 ◽  
Vol 72 (4) ◽  
pp. 309-313 ◽  
Author(s):  
Akihiro Tanaka ◽  
Martin J Shipley ◽  
Catherine A Welch ◽  
Nora E Groce ◽  
Michael G Marmot ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Serum Cholesterol ◽  
Short Form ◽  
Health Behaviours ◽  
Poor Mental Health ◽  
Lower Grade ◽  
Physical And Mental Health ◽  
Poor Physical Health ◽  
Specific Distribution

BackgroundFew studies have examined the influence of socioeconomic status on recovery from poor physical and mental health.MethodsProspective study with four consecutive periods of follow-up (1991–2011) of 7564 civil servants (2228 women) recruited while working in London. Health was measured by the Short-Form 36 questionnaire physical and mental component scores assessed at beginning and end of each of four rounds. Poor health was defined by a score in the lowest 20% of the age–sex-specific distribution. Recovery was defined as changing from a low score at the beginning to a normal score at the end of the round. The analysis took account of retirement status, health behaviours, body mass index and prevalent chronic disease.ResultsOf 24 001 person-observations in the age range 39–83, a total of 8105 identified poor physical or mental health. Lower grade of employment was strongly associated with slower recovery from poor physical health (OR 0.73 (95% CI 0.59 to 0.91); trend P=0.002) in age, sex and ethnicity-adjusted analyses. The association was halved after further adjustment for health behaviours, adiposity, systolic blood pressure (SBP) and serum cholesterol (OR 0.85 (0.68 to 1.07)). In contrast, slower recovery from poor mental health was associated robustly with low employment grade even after multiple adjustment (OR 0.74 (0.59 to 0.93); trend P=0.02).ConclusionsSocioeconomic inequalities in recovery from poor physical health were explained to a considerable extent by health behaviours, adiposity, SBP and serum cholesterol. These risk factors explained only part of the gradient in recovery for poor mental health.

Mental Health Research in General Practice

2005 ◽  
Vol 13 (2) ◽  
pp. 181-184 ◽  
Author(s):  
Harry Minas ◽  
Steven Klimidis ◽  
Renata Kokanovic
Keyword(s):  
Mental Health ◽  
General Practice ◽  
General Practitioners ◽  
Health Research ◽  
Mental Health Research ◽  
Practice Research ◽  
Practice Setting ◽  
Key Issues ◽  
Practice Time ◽  
Time Limitations

Objective: To explore problems in carrying out a mental health research project in the general practice setting. Method: Open-ended interviews were conducted with general practice stakeholders, focusing on impediments to the conduct of mental health research in general practice and possible means for improving the participation of general practitioners in such research. Participants in the consultations were members of ?ve divisions of general practice, senior staff within an academic department of general practice, four general practitioners and a research group engaged with general practice research. The discussions were recorded in detailed interview notes, and key issues and themes emerging from consultations were derived by the researchers. Results: Three main themes summarized most of the issues reported through the consultations, including structural issues (e.g. disruption of practice, time limitations and lack of remuneration), process issues (e.g. researcher–general practice communication, researcher-imposed issues and need for partnerships) and content issues (e.g. study design, study procedures and methods). Conclusions: The consultations revealed similar ?ndings to previously published reports concerning general practice research, with an emphasis on the need for partnerships between researchers and general practice organizations in the conduct of such research.

General Practice Recruitment for People at Risk of Schizophrenia: The Buckingham Experience

2000 ◽  
Vol 34 (1_suppl) ◽  
pp. A131-A136 ◽  
Author(s):  
Ian R. H. Falloon
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Primary Care ◽  
At Risk ◽  
General Practice ◽  
Early Detection ◽  
Psychotic Disorders ◽  
Community Sample ◽  
Signs And Symptoms ◽  
Psychotic Episode

Objective The process of detecting people at high risk of schizophrenia from a community sample is a major challenge for prevention of psychotic disorders. The aim of this paper is to describe early detection procedures that can be implemented in primary care settings. Methods A selected literature review is supplemented by experiences and data obtained during the Buckingham Integrated Mental Health Care Project. Results General medical practitioners have been favoured as the agents most likely to prove helpful in detecting the key risk factors that predict the onset of schizophrenic disorders, as well as in recognising the earliest signs and symptoms of these conditions. However, the practical problems of screening for multiple and subtle risk factors in general practice are substantial, and general practitioners (GPs) often have difficulty recognising the earliest signs of a psychotic episode. A range of strategies to assist GPs detect early signs of psychosis in their patients are considered. Conclusions It is feasible to implement primary care setting early detection procedures for people at risk of schizophrenia. Implementation is aided by the use of a brief screening questionnaire, training sessions and case supervision; and increased collaboration with mental health services and other community agencies.

scholarly journals Heard, known and safe in general practice? An interview study with patients with severe and persistent mental illness

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0201
Author(s):  
Nancy Jennifer Sturman ◽  
Ryan Williams ◽  
Marianne Wyder ◽  
Johanna Lynch
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
General Practice ◽  
Physical Health ◽  
Mental Healthcare ◽  
Health Issues ◽  
Structured Interviews ◽  
Convenience Sample ◽  
Persistent Mental Illness ◽  
Community Mental Health Clinics

BackgroundAlthough GPs provide care to many patients with severe and persistent mental illness, the role and skillset of the GP in this space are contested. Patients are less satisfied with GP care of mental health than physical health issues.AimTo explore patient expectations and experiences of GP roles in their mental health, and identify opportunities for improving mental health care in general practice.Design & settingPatient participants were recruited from community mental health clinics in Brisbane, Australia.MethodIndividual semi-structured interviews were conducted with a convenience sample of patients. Interviews were audio-recorded and transcribed professionally. The authors conducted an inductive thematic analysis, attending to participant vulnerability and reflexivity.Results16 interviews were conducted by one author (RW), average duration 29 minutes. Three overarching themes were identified: being heard; being known; and being safe. Participants greatly valued ‘good GPs’ who were able to detect early signs of relapse, and with whom they came to feel heard, known and safe over time. Experiences of perfunctory, hurried care and avoidance of mental health issues were also reported. Many participants were uncertain whether GP training in mental health was sufficient to keep them safe. Patients may suspect negative attitudes to mental illness in GPs who actively engage predominantly with their physical health.ConclusionSome GPs play central roles in patients’ mental healthcare. Barriers for others need further exploration, and may include time, confidence and/or expertise. Findings challenge GPs to engage more actively and effectively with these patients in theirgeneral practice consultations.

scholarly journals Cross-sectional analysis of coding, patient characteristics, consultation frequency and pharmacological treatment of adults with severe mental disorders in Irish general practice

2021 ◽  
Author(s):  
James Larkin ◽  
Ivana Pericin ◽  
Brian Osborne ◽  
Philip Dodd ◽  
Claire Collins
Keyword(s):  
General Practice ◽  
Mental Disorders ◽  
Depressive Disorder ◽  
General Practitioners ◽  
Pharmacological Treatment ◽  
Mental Health Problems ◽  
Patient Characteristics ◽  
Severe Mental Disorders ◽  
Consultation Rate ◽  
Cross Sectional

Abstract Background General practitioners are the gatekeepers of Irish healthcare and they offer continuity of care to patients. Irish general practice is therefore considered appropriate for preventing, diagnosing and managing most mental health problems. Aims This study sought to establish the coding frequency, consultation frequency, patient characteristics and pharmacological treatment of patients with severe mental disorders (SMDs) in Irish general practice. Methods A cross-sectional design was used. A finder tool embedded in the practice software assisted general practitioners (GPs) coding adult patients with SMDs. Eleven practices uploaded anonymous data on 2,203 patients. Variables analysed included disease code, consultations, prescriptions, sex, patient status and age. Results Overall, 2.9% (n = 2,337) of patients had ever been coded with a SMD, 2.4% (n = 1,964) coded with depressive disorder ever and 0.26% (n = 209) and 0.3% (n = 233) with bipolar disorder and schizophrenia, respectively. Overall, 68.0% (n = 1,336) of patients with depressive disorder were female, and 74.0% (n = 171) of patients with schizophrenia were public patients. The median consultation rate in the previous 3 years was highest for schizophrenia patients at 24.5 visits. Conclusions Coding of SMDs in Irish general practice appears incomplete. Patients with SMDs have high consultation rates. Patients with depressive disorder are more likely to be female and public patients. This research suggests that the improvement of coding in Irish general practice is the first practical step required to detecting prevalence rates.

scholarly journals How different domains of quality of life are associated with latent dimensions of mental health measured by GHQ-12

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Fatemeh Nouri ◽  
Awat Feizi ◽  
Hamidreza Roohafza ◽  
Masoumeh Sadeghi ◽  
Nizal Sarrafzadegan
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Cohort Study ◽  
Physical Health ◽  
Social Relationships ◽  
Rural Areas ◽  
Clinical Symptoms ◽  
Short Form ◽  
Environmental Condition

Abstract Background and objectives A short form of the General Health Questionnaire (GHQ-12) is a useful screening instrument for assessing mental health. Furthermore, Quality of life (QoL) is a critical treatment outcome in many clinical and health care research settings. This study aimed to reassess the dimensionality of GHQ-12 using Multidimensional Graded Response Model (MGRM) and evaluate how its extracted dimensions are associated with the QoL's domains. Methods Isfahan Cohort Study 2 (ICS2) is a population-based, ongoing prospective cohort study among adults aged 35 years and older who were free of cardiovascular diseases (CVDs) at the beginning of the study in 2013. A total of 1316 participants, all living in urban and rural areas of Isfahan and Najafabad, Iran was completed the GHQ-12 and WHO QoL-brief version at baseline. Five competing MGRMs with different latent structures were specified for GHQ-12. Factor scores derived from the best fitted model were used to associate with various domains of QoL. Results: The Three-Dimensional model for GHQ-12 was the best-fitted model explaining the Social Function (SF), Self Confidence (SC), and Anxiety/Depression (A/D) as three correlated yet different latent dimensions of mental health. Our findings in full adjusted multivariate regression models showed that a one-SD increase in dimensions of SC and SF was associated with a 38- to 48%-SD and 27- to 38%-SD increase in the domains scores of QoL, respectively. Moreover, for each one‐SD increase in score of A/D dimension, the domains scores of QoL decreased by 29- to 40%-SD. The highest to the lowest standardized coefficients for all latent dimensions of mental health were respectively related to the psychological, physical health, social relationships, and environmental condition domains of QoL. Furthermore, SC, A/D, and SF dimensions of GHQ-12 showed the highest to the lowest degree of association with all domains of QoL. Conclusions Our findings confirm that the GHQ-12 as a multidimensional rather than unitary instrument measures distinct dimensions of mental health. Furthermore, all aspects of QoL changed when the intensity of latent dimensions of mental health increased. Moreover, the psychological domain of QoL is the most affected by all latent dimensions of mental health, followed by physical health, social relationships, and environmental condition domains. It seems that in an attempt to full recovery as assessed by improved QoL outcomes, treatment of clinical symptoms may not be sufficient. Identifying and differentiating the structures of mental health in each community as well as implementing intervention programs aimed at focusing on specific dimensions may help in the prevention of further deterioration of mental health and improved QoL in the community.

scholarly journals Perceived mental health, wellbeing and associated factors among Nepali migrant and non-migrant workers: A qualitative study

2020 ◽  
Author(s):  
Hridaya Raj Devkota ◽  
Bishnu Bhandari ◽  
Pratik Adhikary
Keyword(s):  
Mental Health ◽  
Qualitative Study ◽  
Physical Health ◽  
Working Conditions ◽  
Migrant Workers ◽  
Health Condition ◽  
Poor Mental Health ◽  
Physical Work ◽  
Health And Wellbeing ◽  
Mental And Physical Health

AbstractBackgroundPoor mental health and illness among the working population have serious socio-economic and public health consequences for both the individual and society/country. With a dramatic increase in work migration over the past decades, there is recent concern about the health and wellbeing of migrant workers and their accessibility to healthcare services in destination countries. This study aimed to explore the mental health and wellbeing experiences of Nepali returnee-migrants and non-migrant workers, and identify their perception on the risk factors for poor health and health service accessibility for them.MethodsThis qualitative study was conducted among Nepali migrant and non-migrant workers in February 2020. Four focus group discussions (n=25) and 15 in-depth interviews were conducted with male non-migrant and returnee migrant workers from Gulf countries and Malaysia. The discussions and interviews were audio-recorded, transcribed, translated into English and analysed thematically.ResultMigrant workers reported a higher risk of developing adverse mental health conditions than non-migrant workers. In addition, fever, upper respiratory infection, abdominal pain, ulcer, and occupational injuries were common health problems among both migrant and non-migrant workers. Other major illnesses reported by the migrant workers were heat burns and rashes, snake-bites, dengue, malaria, gallstone, kidney failure, and sexually transmitted diseases, while non-migrants reported hypertension, diabetes, and heart diseases. Adverse living and working conditions including exploitation and abuse by employers, lack of privacy and congested accommodation, language barriers, long hours’ hard physical work without breaks, and unhealthy lifestyles were the contributing factors to migrant workers’ poor mental and physical health. Both migrant and non-migrants reported poor compliance of job conditions and labor protection by their employers such as application of safety measures at work, provision of insurance and healthcare facilities that affected for their wellbeing negatively. Family problems compounded by constant financial burdens and unmet expectations were the most important factors linked with migrant workers’ poor mental health condition.ConclusionBoth migrant and non-migrant workers experienced poor mental and physical health condition largely affected by their adverse living and working conditions, unmet familial and financial needs and adherence to unhealthy life styles. It is needed to ensure the compliance of work agreement by employers and promotion of labor rights in relation to worker’s health and safety. In addition, policy interventions on raising awareness on occupational health risk and effective safety training to all migrant and non-migrant workers are recommended.

Psychological and Physical Problems in Elderly People with Problems of Falls

2017 ◽  
Vol 41 (S1) ◽  
pp. S659-S660
Author(s):  
M. Mentis ◽  
M. Gouva ◽  
E. Antoniadou ◽  
K. Mpourdoulis ◽  
I. Kesoudidou ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Elderly People ◽  
The Elderly ◽  
Poor Mental Health ◽  
University Hospital ◽  
Psychological State ◽  
Physical Damage ◽  
The Difference ◽  
Competing Interest

IntroductionFalls of the elderly to a degree been associated with poor mental health, poor social support and poor physical health.ObjectivesTo investigate the falls of elderly people in relation to their mental and physical healthy.AimsTo compare the effects of falls in the elderly in the areas of mental and physical health.MethodsThe current study used purposive sampling compromised from 48 people that visited the emergency department at the Patras University Hospital in 2016. The inclusion criterion for participation was age (> 65 years). Data was collected using WHO's questionnaire, the WHOQUOL-BREF. Finally, data was analyzed using the test t test for independent samples.ResultsThe sample constituted by 39.6% of male and 61.4% of female. The average age of the sample was M = 75.89 years. In relation to mental health, the average of the elderly with a history of falls found M = 57.26 (SD = ± 22.87), while the other was found M = 74.45 (SD = ± 15.81). The difference between the two groups was statistically significant (P < 0.05), while physical health although again the first group found to have a smaller average (M = 56.65, SD = ± 22.13) relative to the second group (M = 63.78, SD = ± 12.59) no statistical difference was observed.DiscussionsThese results demonstrates that falls beyond the physical damage that are immediately visible can as well create significant issues in the psychological state of the elderly exacerbating anxiety, fear and social isolation, which has been associated with depression event.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Measuring physical and mental health during pregnancy and postpartum in an Australian childbearing population - validation of the PROMIS Global Short Form

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Valerie Slavin ◽  
Jenny Gamble ◽  
Debra K. Creedy ◽  
Jennifer Fenwick ◽  
Julie Pallant
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Internal Consistency ◽  
Postpartum Period ◽  
Smoking Status ◽  
Short Form ◽  
Internal Consistency Reliability ◽  
Outcomes Measurement ◽  
Pregnancy And Childbirth ◽  
Pregnancy And Postpartum

Abstract Background Health related quality of life is a critical concept during the perinatal period but remains under-researched. The International Consortium for Health Outcomes Measurement have included the Patient Reported Outcomes Measurement Information System (PROMIS®) Global Short Form (GSF) in their core outcome set for pregnancy and childbirth to measure health related quality of life. The PROMIS GSF has not been fully evaluated as a valid and reliable instrument in this population. This study assessed the psychometric properties of the PROMIS GSF during pregnancy and postpartum period. Methods PROMIS GSF was administered to a sample of 309 pregnant women at four time-points during pregnancy (≤ 27 and 36-weeks) and postpartum (6- and 26-weeks). The structural validity, internal consistency reliability, construct validity, and responsiveness of the PROMIS GSF were evaluated. The internal structure of the PROMIS GSF was explored using Rasch Measurement Theory. Response format, item fit, differential item functioning (item bias), dimensionality of the scale and its targeting were assessed. Results Two revised subscales (Mental Health: four items; and Physical Health: five items) showed good fit to the Rasch model. The revised mental health subscale demonstrated good internal consistency reliability during pregnancy and postpartum period (α = .88 and .87, respectively). The internal consistency reliability of the physical health subscale was adequate (α = .76 and .75, respectively). The revised mental health subscale was sensitive to group differences according to a history of mental health disorder, income, smoking status, drug use, stress levels and planned versus unplanned pregnancy. Differences in scores on the revised physical subscale were detected for groups based on obesity, income, drug use, smoking status, stress, and history of mental health disorders. Scores on both subscales recorded significant changes across the four time-points, spanning pregnancy and postpartum period. Conclusions The revised version of the PROMIS GSF was better able to measure mental and physical health during pregnancy and postpartum period compared to the original version. Findings support the clinical and research application of the PROMIS GSF within the International Consortium for Health Outcomes Measurement Standard Set of Outcome Measures for Pregnancy and Childbirth. Ongoing psychometric analysis of the PROMIS GSF is recommended in other maternity populations.

The glass is not half empty: optimism, pessimism, and health among older adults

2019 ◽  
Vol 32 (1) ◽  
pp. 135-139 ◽  
Author(s):  
Michael D. Barnett ◽  
Ellen A. Anderson
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Physical Health ◽  
Short Form ◽  
Well Being ◽  
Community Dwelling ◽  
Physical And Mental Health ◽  
Cross Sectional Survey ◽  
Life Orientation Test ◽  
Health And Well Being

ABSTRACTObjectives:Optimism and pessimism are distinct constructs that have demonstrated independent relationships with aspects of health and well-being. The purpose of this study was to investigate whether optimism or pessimism is more closely linked with physical and mental health among older adults.Design:Cross-sectional survey.Participants:Community-dwelling older adults (N = 272) ages 59–95 in the southern United States.Measurements:The Life Orientation Test—Revised and the Short Form 8.Results:At the bivariate level, optimism was associated with higher physical health and mental health, while pessimism was associated with lower physical health and mental health. Multiple-regression analyses as well as comparison of correlation coefficients found that pessimism was more closely associated with physical health and mental health than optimism.Conclusions:These results add to the literature suggesting that, in terms of older adults’ health and well-being, avoiding pessimism may be more important than being optimistic.

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