Treatment alliance and needs of care concerning religiousness and spirituality: A follow-up study among psychiatric inpatients

2021 ◽  
pp. 002076402110230
Author(s):  
Joke C van Nieuw Amerongen-Meeuse ◽  
Arjan W Braam ◽  
Christa Anbeek ◽  
Jos WR Twisk ◽  
Hanneke Schaap-Jonker
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Structural Equation ◽  
Treatment Compliance ◽  
Health Clinic ◽  
Care Needs ◽  
Service Engagement ◽  
Treatment Alliance ◽  
Over Time

Background: Patient satisfaction with religious/spiritual (R/S) care during mental health treatment has been associated with a better treatment alliance. Aims: To investigate the longitudinal relations between (un)met R/S care needs and treatment alliance/compliance over a 6-month period. Method: 201 patients in a Christian (CC) and a secular mental health clinic completed a questionnaire (T0) containing an R/S care needs questionnaire, the Working Alliance Inventory (WAI) and the Service Engagement Scale (SES). After 6 months 136 of them took part in a follow-up (T1). Associations were analysed using hybrid linear mixed models and structural equation modelling. Results: R/S care needs decreased over time, but a similar percentage remained unanswered (e.g. 67% of the needs on R/S conversations in a secular setting). Over a 6-month period, met R/S care needs were associated with a higher WAI score (β = .25; p < .001), and unmet R/S care needs with lower WAI score (β = −.36; p < .001), which were mainly between subjects effects. Patients reporting a high score of unmet R/S care at baseline, reported a decrease in SES over time (β = −.13; p < .05). Conclusions: Satisfaction with R/S care among mental health patients is related to a better treatment alliance. When unmet R/S care needs persist, they precede a decrease in treatment compliance. Mental health professionals are recommended to assess the presence of R/S care needs and consider possibilities of R/S care especially in the first weeks of treatment.

scholarly journals Global Sensory Impairment Independently Predicts Decreased Social Function Over Time

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 414-414
Author(s):  
Anna Huang ◽  
Kristen Wroblewski ◽  
Ashwin Kotwal ◽  
Linda Waite ◽  
Martha McClintock ◽  
...  
Keyword(s):  
Mental Health ◽  
Logistic Regression ◽  
Cognitive Function ◽  
Social Engagement ◽  
Social Function ◽  
Ordinal Logistic Regression ◽  
Sensory Function ◽  
Sensory Impairment ◽  
Over Time

Abstract The classical senses (vision, hearing, touch, taste, and smell) play a key role in social function by allowing interaction and communication. We assessed whether sensory impairment across all 5 modalities (global sensory impairment [GSI]) was associated with social function in older adults. Sensory function was measured in 3,005 home-dwelling older U.S. adults at baseline in the National Social Life, Health, and Aging Project and GSI, a validated measure, was calculated. Social network size and kin composition, number of close friends, and social engagement were assessed at baseline and 5- and 10-year follow-up. Ordinal logistic regression and mixed effects ordinal logistic regression analyzed cross-sectional and longitudinal relationships respectively, controlling for demographics, physical/mental health, disability, and cognitive function (at baseline). Adults with worse GSI had smaller networks (β=-0.159, p=0.021), fewer close friends (β=-0.262, p=0.003) and lower engagement (β=-0.252, p=0.006) at baseline, relationships that persisted at 5 and 10 year follow-up. Men, older people, African-Americans, and those with less education, fewer assets, poor mental health, worse cognitive function, and more disability had worse GSI. Men and those with fewer assets, worse cognitive function, and less education had smaller networks and lower engagement. African-American and Hispanic individuals had smaller networks and fewer close friends, but more engagement. Older respondents also had more engagement. In summary, GSI independently predicts smaller social networks, fewer close friends, and lower social engagement over time, suggesting that sensory decline results in decreased social function. Thus, rehabilitating multisensory impairment may be a strategy to enhance social function as people age.

T3 Are Burns a Chronic Condition: Examining Physical and Mental Functioning up to 20 Years After Injury

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S2-S3
Author(s):  
Callie Abouzeid ◽  
Audrey E Wolfe ◽  
Gretchen J Carrougher ◽  
Nicole S Gibran ◽  
Radha K Holavanahalli ◽  
...  
Keyword(s):  
Mental Health ◽  
Hospital Stay ◽  
National Database ◽  
Time Points ◽  
Patient Reported ◽  
Burn Survivors ◽  
Population Demographic ◽  
The Impact ◽  
Over Time

Abstract Introduction Burn survivors often face many long-term physical and psychological symptoms associated with their injury. To date, however, few studies have examined the impact of burn injuries on quality of life beyond 2 years post-injury. The purpose of this study is to examine the physical and mental well-being of burn survivors up to 20 years after injury. Methods Data from the Burn Model System National Database (1997–2020) were analyzed. Patient-reported outcome measures were collected at discharge with a recall of preinjury status, and then at 5, 10, 15, and 20 years after injury. Outcomes examined were the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the Short Form-12. Trajectories were developed using linear mixed methods model with repeated measures of PCS and MCS scores over time and controlling for demographic and clinical variables. The model fitted score trajectory was generated with 95% confidence intervals to demonstrate score changes over time and associations with covariates. Results The study population included 420 adult burn survivors with a mean age of 42.4 years. The population was mainly male (66%) and white (76.4%) with a mean burn size of 21.5% and length of hospital stay of 31.3 days. Higher PCS scores were associated with follow-up time points closer to injury, shorter hospital stay, and younger age. Similarly, higher MCS scores were associated with earlier follow-up time points, shorter hospital stay, female gender, and non-perineal burns. MCS trajectories are demonstrated in the Figure. Conclusions Burn survivors’ physical and mental health worsened over time. Such a trend is different from previous reported results for mental health in the general population. Demographic and clinical predictors of recovery over time are identified.

scholarly journals Do Depressive Symptoms Shape Blacks’ Perceptions of Stress Over Time?

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
DeAnnah R Byrd ◽  
Roland J Thorpe ◽  
Keith E Whitfield
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Perceived Stress ◽  
Ordinary Least Squares ◽  
Community Dwelling ◽  
Stressful Events ◽  
Age Group ◽  
The Impact ◽  
Over Time

Abstract Background and Objectives Previous studies have linked stress to multiple negative mental health outcomes, including depression. This established stress–depression association is typically examined in one direction and cross-sectionally. This study examined the bidirectional relationships between depressive symptoms and changes in perceived stress over time in Blacks. Research Design and Methods The present study uses a community-dwelling sample of 450 Black adults, aged 51–96 years old, who participated in the Baltimore Study of Black Aging—Patterns of Cognitive Aging. Perceived stress—measured by the Perceived Stress Scale—and depressive symptoms—measured using the Center for Epidemiologic Studies Depression scale—were both assessed at baseline and follow-up 33 months later. Ordinary least squares regression was used to examine 2 bidirectional longitudinal relationships between (1) stress–depression and (2) depression–stress, and whether these associations are modified by age. Results Initial analyses testing the typical stress–depression relationship showed an effect in the expected direction, that is stress leading to more depressive symptoms over time, adjusting for model covariates, but the effect was not statistically significant (b = 0.014, p = .642). After accounting for baseline perceived stress level, age, sex, education, and chronic health conditions, depressive symptoms were positively associated with follow-up stress (b = 0.210, p &lt; .000). The depression–stress association further varied by age group such that the impact of baseline depression on changes in perceived stress was greatest in Blacks in their 60s versus those in their 50s (b = 0.267, p = .001), controlling for model covariates. Discussion and Implications Contrary to previous work, the results suggest that an individual’s mental health shapes his/her perception of stressful events and this relationship varies by age group. While the typical finding (stress impacting depression) was not significant, the findings reported here highlight the importance of considering the possible bidirectional nature of the relationships between psychosocial measures of stress and mental health in later life among Blacks.

Geriatric psychiatry education in Canada: the pathway to subspecialty recognition

2010 ◽  
Vol 22 (6) ◽  
pp. 919-926 ◽  
Author(s):  
Melissa H. Andrew ◽  
Catherine Shea
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Professionals ◽  
Primary Care Physicians ◽  
Work Force ◽  
Building Blocks ◽  
Geriatric Psychiatry ◽  
Training Experience ◽  
Care Needs ◽  
The Past

ABSTRACTBackground: This paper outlines the evolution of the training of Canadian physicians and other professionals in the mental health care needs of older adults over the past 2 decades, which has culminated in long-awaited subspecialty recognition by the Royal College of Physicians and Surgeons of Canada (RCPSC). Despite the fact that Canada has more than 4000 psychiatrists officially recognized by RCPSC, and a national body of more than 200 members who practice primarily in geriatric psychiatry, the status of geriatric psychiatry as a subspecialty of psychiatry in Canada remained “unofficial” until 2009.Methods: Early along the pathway toward subspecialization, Canadian educational efforts focused on enhancing the capacity of primary care physicians and other mental health professionals to meet the mental health needs of older adults. Over the past decade, and with the encouragement of RCPSC, Canadian psychiatric educators have carefully and collaboratively defined the competencies necessary for general psychiatrists to practice across the life span, thereby influencing the psychiatry training programs to include dedicated time in geriatric psychiatry, and a more consistently defined training experience.Results: With these two important building blocks in place, Canadian psychiatry was truly ready to move ahead with subspecialization. Three new psychiatric subspecialties – geriatric, child and adolescent, and forensic – were approved at the RCPSC in September 2009.Conclusions: The developments of the past 20 years have paved the way for a subspecialty geriatric psychiatry curriculum that will be well-aligned with a new general psychiatry curriculum, and ready to complement the existing mental health work force with subspecialized skills aimed at caring for the most complex elderly patients.

scholarly journals A Cultural Consultation Service in East London: Experiences and Outcomes from Implementation of an Innovative Service

2021 ◽  
Author(s):  
Andrea Palinski ◽  
John Owiti ◽  
Micol Ascoli ◽  
Bertine de Jongh ◽  
Jane Archer ◽  
...  
Keyword(s):  
Mental Health ◽  
Cultural Competency ◽  
Mental Health Professionals ◽  
Service Use ◽  
Health Care Systems ◽  
Treatment Plan ◽  
Average Score ◽  
Service Users ◽  
Consultation Service

Executive Summary1. In the context of the increasing challenges facing mental health services and in line with existing equalities guidance (including the NHS Tower Hamlets Mental Health Promotion Strategy 2008-2011), the Cultural Consultation Service (CCS) was commissioned by Tower Hamlets NHS with support from the National Mental Health Development Unit to provide cultural consultation in East London. The CCS was designed to work at multiple levels of service delivery and commissioning with an additional focus to promote recovery and facilitate high quality clinical learning.2. The broad aims of the service were to: improve clinical outcomes, service user outcomes, and the experience of mentalhealthcare for patients from black and ethnic minorities. improve the cultural capability of mental health professionals. work at a strategic level with commissioners to inform the process of development and improvement of services.3. The CCS was launched in 2010. During the course of the first year to 18 months, the CCS aimed to develop and pilot the service specification whilst embedding itself within the local commissioning and health care systems. 4. Over 900 clinically related contacts were provided. The CCS received a total of 99 referrals for in-depth consultation over a period of 18 months. Qualitative findings were collected from 46 cases which had in-depth consultations. Quantitative outcome measures were available for 36 of these in-depth consultations both at baseline and follow-up at least 3 months following a clinical cultural consultation.5. Overall, service users referred to CCS had high levels of clinical needs. The Health of the Nation Outcomes Scale (HoNOS) was particularly high with an average score of 15.9.6. After the cultural consultation contact, clinicians rated service users as having significantly higher overall functioning. Although no significant changes were found in service users’ perception of their overall health, levels of depression and anxiety, objective scores did indicate some improvement.7. The level of service receipt (and by implication associated costs) significantly reduced after CCS intervention, with a significant reduction in use of A&amp;E services, psychiatrists and CPNs/case managers. Overall, GAF scores improved, indicating better functioning levels. Cost analysis indicates that savings amounted to £497 per patient, taking account of service use costs (which go down after intervention) and costs of CCS provision to this group. Therefore, CCS intervention costs NO MORE than usual care, and was shown to actually reduce spend per patient over a three month follow-up.8. Clinicians found CCS helpful as it provided a richer clinical perspective and allowed service users to share issues about life and illness experiences that were not previously known tostaff. More specifically, clinicians had felt the cultural consultation service had helped to provide: changes to treatment plan (71%); improved engagement (50%); increasedmedication compliance (21%); and earlier discharge (7%). Forty-five per cent of those clinicians who responded wanted to have a cultural consultant permanently based withintheir team and cited lack of resources as the main obstacle to implementing the recommendations of the CCS.9. Training sessions were delivered to five community mental health teams within Tower Hamlets, the Voluntary Sector Network, and there was a one day training on the BartsExplanatory Model Interview. In addition, there were monthly Cultural Consultation Club meetings where case presentations took place to a wider audience. Overall there was positive feedback, as clinicians reported that they had gained new knowledge with regards to ways of working with culture and in engaging with patients’ often complex narratives. This was objectively supported by significant improvements in cultural competency as reported from a validated self-evaluation quantitative questionnaire completed by clinicians which indicates that workforce cultural competence as an aggregate measure improved over time.10. The CCS provided six organisational consultations through a series of workshops on culturally competent commissioning focusing on increased awareness of the context of local services and identifying priorities for future direction.11. Having a tertiary service of cultural consultation may offer a privileged point of observation of teams’ cultures, functions and dysfunctions. It may clarify where the problemslie, rather than to offer simple solutions. Cultural consultation can therefore be conceptualised as both an effective and direct clinical intervention which improves functioning, met need, cultural competency, and it reduces costs per patient. It can also be used as a tool to analyse the scale of a clinical or organisational dilemma and what the solutions might be.

scholarly journals Depression after Obstetric Fistula Repair

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Mary Stokes ◽  
Jeffrey Wilkinson ◽  
Prakash Ganesh ◽  
William Nundwe ◽  
Rachel Pope
Keyword(s):  
Mental Health ◽  
Obstetric Fistula ◽  
Age Group ◽  
Fistula Repair ◽  
Symptoms Of Depression ◽  
Persistent Depression ◽  
Continence Status ◽  
Operative Assessment ◽  
Over Time

Aims: To measure depression using the PHQ-9 over time and to identify characteristics associated with persistent depression. Methods: A database of women undergoing obstetric fistula repair was used to examine association of depression with variables such as general demographics, type of obstetric fistula, surgical outcome, and continence status at the time of discharge. Results: 797 patients completed the PHQ-9 upon initial pre-operative assessment. 365 (45.8%) had a PHQ-9 score of 5 or higher, indicating symptoms of depression. Pre-operatively, depression was associated with the 18-34 year old age group and women with no children. Post-operatively, worse incontinence was associated with depression, however, over time depression was rarely found among women returning for follow-up. Conclusions: The decrease of depression seen over time is either due to selection bias or due to improved adjustment to one’s circumstances. Either way, this study underscores the need for ongoing follow-up, perhaps especially for those not presenting. Further studies are needed to assess the mental health of women who do not present for follow-up visits.

scholarly journals Cancer Screening Belief Scale – Chinese Version (CSBS-C)

2007 ◽  
Vol 5 (2) ◽  
pp. 79-88 ◽  
Author(s):  
Su-I Hou
Keyword(s):  
Cancer Screening ◽  
Structural Equation ◽  
Chinese Women ◽  
Sem Analysis ◽  
Equation Modeling ◽  
Validity And Reliability ◽  
New Instrument ◽  
Instrument Measuring ◽  
Over Time

Objective: To develop and validate a culturally sensitive scale measuring cancer screening beliefs for Chinese; and to examine the validity and reliability of the scores of the new instrument (CSBS-C). Methods: A modified instrument measuring cancer screening beliefs in general was developed, adapting from the previous Cervical Smear Belief Inventory (CSBI) developed by Hou and Luh (2005) among Chinese women, and tested among a Chinese worksite population in Taiwan. Items consisted in the CSBS-C were carefully reworded from Hou’s previously validated CSBI to reflect statements that would apply to cancer screening beliefs in general. Participants were asked to complete the self-administered screening belief items at baseline and one month follow-up (follow-up rate = 81%). Structural equation modeling (SEM) was used to assess the stability of the scores of the three-factor scale measured over time. Confirmatory factor analysis (CFA) was then used to validate these hypothesized theoretical constructs (factors). Results: SEM analysis revealed that the standardized coefficients of the three factors measured over time ranged from .30 to .75, indicating reasonable stabilities, and all three models revealed acceptable model fits (RMSEA=.06 ~ .09; GFI=.90~.99; IFI=.92~.99; TLI=.89~.97; and CFI=.92~.99). The final version of the CSBS-C, validated by CFA, consisted of 17 items that were clustered into three subscales: pros (eight items), cons (six items), and perceived cancer risks (three items); with all items loaded consistently and significantly with their corresponding factors (p

scholarly journals A Cognitive Development Chart for School-age Children and Adolescents

2019 ◽  
Author(s):  
André R. Simioni ◽  
Daniel S. Pine ◽  
João R. Sato ◽  
Pedro M. Pan ◽  
Rochele Paz Fonseca ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Cognitive Development ◽  
High Risk ◽  
Children And Adolescents ◽  
Mental Health Professionals ◽  
Mental Health Problems ◽  
Health Problems ◽  
Predictive Utility

ABSTRACTObjectiveTo evaluate the reliability and predictive utility of a time-efficient cognitive development chart that seeks to identify children and adolescents with high-risk for multiple outcomes such as mental health problems, substance use, and educational difficulties.MethodWe analyzed data from the Brazilian High-Risk Cohort for Psychiatric Disorders (HRC), a longitudinal school-based study conducted from 2010-2011 to 2013-2014. Participants were 2,239 children and adolescents, 6 to 17 years of age, who completed the cognitive assessment at baseline. The task used to track cognitive development was the Two Choice Reaction Time task (<3 minutes of duration, computer-based), which assesses the accuracy and speed of perceptual decision-making. Mental health, substance use, and educational outcomes were assessed by validated standardized methods. Key variables were measured at baseline and 3-year follow-up. The predictive utility was assessed using static (deviations from the age-expected performance at baseline) and dynamic (deviations from the age-expected change in performance over time) indicators.ResultsThe reliability of the task parameter was high (intra-class correlation coefficient = 0.8). Static indicators of cognitive development significantly predicted concurrent mental, intellectual and educational difficulties, as well as incident and persistent educational difficulties and substance use in the 3-year follow-up. Dynamic indicators predicted persistent mental health problems.ConclusionPrimary-care and mental health professionals need a time-efficient tool for tracking deviations from age-expected cognitive development, which predicts multiple unwanted outcomes at the same time. If replicated, future results could support the generation of tools for tracking risk for mental health, substance use, and educational difficulties.

scholarly journals Obesity and Mental Health: A Longitudinal, Cross-Cultural Examination in Germany and China

2021 ◽  
Vol 12 ◽  
Author(s):  
Kristen L. Lavallee ◽  
Xiao Chi Zhang ◽  
Silvia Schneider ◽  
Jüergen Margraf
Keyword(s):  
Mental Health ◽  
Life Satisfaction ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Male Students ◽  
Health State ◽  
One Year ◽  
The Relationship ◽  
Chinese Male

The present study examines the relationship between obesity and mental health using longitudinal data. Participants with data at baseline and one-year follow-up were included from two countries: Germany (364) and China (9007). A series of structural equation models with three mediators and one moderator were conducted separately for female and male students in Germany and China. Zero-order correlations indicated that overweight/obesity was significantly related to later depression and anxiety in Chinese males. Additional effects of obesity on later mental health flowed through effects on attractiveness (Chinese and German females, and Chinese males), physical health (Chinese males), and life satisfaction (German females). Though overweight/obesity is related to mental health across many other studies, results in this study yield total effects between overweight/obesity and follow-up mental health only in Chinese males. The relationship between overweight/obesity and follow-up mental health was significantly mediated by follow-up attractiveness, or health state, or life satisfaction in German females, Chinese females, and Chinese male students, with no significant indirect effects found in German male students. This highlights the possible importance of culture in examining these effects.

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