Perspectives of psychiatric patients in rural areas of Jordan: barriers to compliance and pharmacist role

Patients with a major mental illness usually need long-term treatment and rehabilitation. Since the adoption of the principle of de-institutionalization of psychiatric patients in South Africa in the 1970s, most treatment has been done in the community, through a system of psychiatric outpatient clinics. There is now a growing realization that more is needed than treatment with medication, but in a developing country resources, both human and financial, are limited. It is therefore important to establish which rehabilitation strategies can be implemented in the South African services, and how effective they are. In this study case management was implemented in the psychiatric service to black patients in rural areas. A sample of 41 patients formed the experimental group, who were seen by six nurses trained as case workers. The control group consisted of 15 patients in another clinic, who received additional attention to routine care. There were specific problems with the implementation of case management, especially inadequate training of nurses in these techniques, the restrictions on the functioning of the nurse by legal provisions and organizational rules, and the paucity of community resources. The case management was found to positively influence functional status, but did not achieve symptom reduction.

Download Full-text

Risk factors and impact of stigma on psychiatric patients in Sohag

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00403-3 ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Taher Abdelraheem Sayed ◽

Magda Mohamed Ali ◽

Saber Hadad

Keyword(s):

Risk Factors ◽

Mental Illness ◽

Psychiatric Disorder ◽

Psychiatric Hospital ◽

Rural Areas ◽

Hospital Admissions ◽

Psychiatric Patients ◽

Socioeconomic Level ◽

Stigma Score

Abstract Background Stigma among psychiatric patients is pervasive all over the world. Our aim in this study was to investigate risk factors for stigma related to psychiatric disorders and to demonstrate the major consequences of mental stigma for patients who experience mental illness. We conducted a cross-sectional study and applied a stigma scale to 573 patients with psychiatric disorders who attended our outpatient psychiatry clinic. Participants were divided into two groups, group I (no.262) with low stigma score and group II (no.311) with high stigma score. The two groups were compared in term of socio-demographic characteristics (age, gender, level of education, residency, marital status, employment and socioeconomic level), factors related to the psychiatric disorder (duration of illness, number of psychiatric hospital admission and diagnosis) and impact of psychiatric illness (follow-up visits, adherence to medications and suicidal thoughts or attempts). Results The mean age of patients with high stigma score (group II) was 29 ± 6 years. High stigma score was more common in females (53.7%), illiterate (11.9%), living in rural areas (58.2%), single (22.83%), unemployed (44.37%) and low socioeconomic class (59.49%). Patients with a high stigma score showed longer duration of psychiatric disorder (43 ± 8 months), more frequent number of psychiatric hospital admission (4.3 ± 0.5) and schizophrenia ((11.25%) and other psychotic disorders (6.49%) were common diagnoses. Patients with a high stigma score show poor adherence to medication (47.91%) and follow-up (44.05%) and a high frequency of suicidal ideation or attempt (47.91%). Significant risk factors predicting high mental stigma were level of education (explaining about 23% of the risk, P = 0.03), duration of mental illness (explaining about 25% of the risk, P = 0.019), number of hospital admissions (explaining about 22.7% of the risk, P = 0.032), diagnosis of mental illness (explaining about 27.7% of the risk, P = 0.01). Conclusion Mental stigma is more prevalent among young aged individuals, females, single, unemployed, living in rural areas and those with lower educational and socioeconomic level. Mental stigma has a parallel correlation with psychiatric disorder duration, number of psychiatric hospital admissions, as well as diagnosis of psychotic disorder. The stigma of mental illness from the viewpoint of the patient may lead to delaying the access to care as well as poor adherence to medications and follow-up. Anti-stigma measures can contribute to diminishing the psychiatric illness effect.

Download Full-text

Psychiatric Services in a Rural General Hospital

The International Journal of Psychiatry in Medicine ◽

10.2190/bv8t-7npu-n9r2-0q83 ◽

1978 ◽

Vol 8 (1) ◽

pp. 25-34 ◽

Cited By ~ 1

Author(s):

Arnold Werner ◽

Frederick A. Knarr ◽

Jack M. Stack

Keyword(s):

General Hospital ◽

Rural Areas ◽

Psychiatric Patients ◽

Rural Setting ◽

Medical Community ◽

Care Providers ◽

Illness Episode ◽

Inpatient Psychiatric Care ◽

Center Staff ◽

Number Of Patients

Rural areas face severe problems related to the inadequate distribution of psychiatrists. This paper describes a model of inpatient psychiatric care in a rural general hospital which has successfully overcome many of the constraints of the rural setting using a four member psychiatric consultation team. Using the medical community and its resources as the basis for care, a strong emphasis is also placed on continuing education for care providers. Important factors in the system include allowing all physicians to admit and care for psychiatric patients and the use of the emergency room physicians as interim admitting doctors when patients have no family physician. Other factors in the program are discussed. Problem areas have included continuity of care and treatment of certain types of patients. The results of the project have been an increase in the number of psychiatric patients admitted (140 to 268 per year) and a decrease in the number of patients sent to the state institution. Consultations requested on non-psychiatric patients, including children, have increased from thirty-five to sixty-seven per year. Most patients now remain in the care of their own physicians throughout a mental illness episode. Cooperation between community practitioners and the center staff has improved. With increased skill, center staff and community physicians have shown greater self sufficiency in working with hospitalized patients and their families.

Download Full-text

Training Aides to Screen Children for Speech and Language Problems

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.0704.236 ◽

1976 ◽

Vol 7 (4) ◽

pp. 236-241 ◽

Cited By ~ 5

Author(s):

Marisue Pickering ◽

William R. Dopheide

Keyword(s):

Rural Areas ◽

Large Scale ◽

School Personnel ◽

School Age Children ◽

Speech And Language ◽

Elementary School Age ◽

Evaluation Procedures ◽

Language Problems ◽

Competency Based ◽

Large Scale Screening

This report deals with an effort to begin the process of effectively identifying children in rural areas with speech and language problems using existing school personnel. A two-day competency-based workshop for the purpose of training aides to conduct a large-scale screening of speech and language problems in elementary-school-age children is described. Training strategies, implementation, and evaluation procedures are discussed.

Download Full-text

Hearing Loss Risk Factors and Strategies in Rural Areas

Perspectives on Aural Rehabilitation and Its Instrumentation ◽

10.1044/arii12.1.17 ◽

2004 ◽

Vol 12 (1) ◽

pp. 17-20

Author(s):

Gregory A. Flamme

Keyword(s):

Risk Factors ◽

Hearing Loss ◽

Rural Areas

Download Full-text

Crossing Boundaries: Accessibility for Children in Rural Areas

ASHA Leader ◽

10.1044/leader.ftr6.13082008.5 ◽

2008 ◽

Vol 13 (8) ◽

pp. 5-6 ◽

Cited By ~ 2

Author(s):

Susan Pavel

Keyword(s):

Rural Areas

Download Full-text

International Telesupervision: The Clinical Fellowship Experience

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp2.sig11.73 ◽

2017 ◽

Vol 2 (11) ◽

pp. 73-78

Author(s):

David W. Rule ◽

Lisa N. Kelchner

Keyword(s):

Graduate Students ◽

Clinical Supervision ◽

Rural Areas ◽

The United States ◽

Speech Language Pathology ◽

Access To Services ◽

East African ◽

The World ◽

Language Pathology ◽

National Certification

Telepractice technology allows greater access to speech-language pathology services around the world. These technologies extend beyond evaluation and treatment and are shown to be used effectively in clinical supervision including graduate students and clinical fellows. In fact, a clinical fellow from the United States completed the entire supervised clinical fellowship (CF) year internationally at a rural East African hospital, meeting all requirements for state and national certification by employing telesupervision technology. Thus, telesupervision has the potential to be successfully implemented to address a range of needs including supervisory shortages, health disparities worldwide, and access to services in rural areas where speech-language pathology services are not readily available. The telesupervision experience, potential advantages, implications, and possible limitations are discussed. A brief guide for clinical fellows pursuing telesupervision is also provided.

Download Full-text