scholarly journals Unlocking an acute psychiatric ward: The impact on unauthorised absences, assaults and seclusions

2017 ◽  
Vol 41 (2) ◽  
pp. 92-96 ◽  
Author(s):  
Ben Beaglehole ◽  
John Beveridge ◽  
Warren Campbell-Trotter ◽  
Chris Frampton
Keyword(s):  
Psychiatric Inpatient ◽  
Psychiatric Ward ◽  
Inpatient Service ◽  
Positive Effects ◽  
Adverse Event Data ◽  
Before And After ◽  
Acute Psychiatric Ward ◽  
Restrictive Environment ◽  
Open Wards ◽  
The Impact

Aims and methodThe acute psychiatric inpatient service in Christchurch, New Zealand, recently changed from two locked and two unlocked wards to four open wards. This provided the opportunity to evaluate whether shifting to an unlocked environment was associated with higher rates of adverse events, including unauthorised absences, violent incidents and seclusion. We compared long-term adverse event data before and after ward configuration change.ResultsRates of unauthorised absences increased by 58% after the change in ward configuration (P = 0.005), but seclusion hours dropped by 53% (P = 0.001). A small increase in violent incidents was recorded but this was not statistically significant.Clinical implicationsAlthough unauthorised absences increased, the absence of statistically significant changes for violent incidents and a reduction in seclusion hours suggest that the change to a less restrictive environment may have some positive effects.

Metabolic screen and intervene: improving mental health inpatient metabolic monitoring

2020 ◽  
pp. 103985622093614
Author(s):  
Luke Viglione ◽  
Brooke L Short
Keyword(s):  
Mental Health ◽  
Plasma Lipids ◽  
Health Workers ◽  
Low Cost ◽  
Psychiatric Inpatient ◽  
Inpatient Setting ◽  
Inpatient Service ◽  
Metabolic Monitoring ◽  
Before And After ◽  
The Impact

Objective: To assess rates of metabolic monitoring in patients prescribed antipsychotic medications in the psychiatric inpatient setting and the impact education can have regarding monitoring compliance. Method: Two identical audits were undertaken at a NSW mental health inpatient service before and after a campaign designed to educate mental health workers about the importance of metabolic monitoring. Results from both audits were compared for statistically significant improvements in monitoring rates. Results: Rates of monitoring plasma lipids increased from 21.7% to 78.8% ( p < 0.01) and rates for plasma glucose increased from 20.8% to 73.7% ( p < 0.01). There were no statistically significant changes in rates of monitoring body mass index (83.0% and 77.1%, respectively), waist circumference (36.8% and 43.2%, respectively) and blood pressure (99.1% and 100%, respectively). Conclusion: This study has shown that rates of metabolic monitoring in the inpatient setting can be improved with a relatively low-cost education intervention. While absolute rates remain low, outcomes suggest that it may be worthwhile trialling further modes of education and repeating this education in cycles.

Quality of life in body dysmorphic disorder

CNS Spectrums ◽  
2012 ◽  
Vol 17 (4) ◽  
pp. 167-175 ◽  
Author(s):  
Waguih William IsHak ◽  
Michael A. Bolton ◽  
Jean-Charles Bensoussan ◽  
George V. Dous ◽  
Trang T. Nguyen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Psychiatric Comorbidity ◽  
Body Dysmorphic Disorder ◽  
Clinical Work ◽  
Positive Effects ◽  
Before And After ◽  
Effect Of Treatment ◽  
The Impact

Body dysmorphic disorder (BDD) has a significant impact on the patients’ quality of life (QOL). This is an initial literature review of QOL in patients with BDD, examining the extent of QOL impairments, the impact of psychiatric comorbidity on QOL, and the effect of treatment on QOL in BDD. Studies were identified through PubMed, MEDLINE, and PsycINFO searches from 1960–2011 using the keywords: “quality of life,” “body dysmorphic disorder,” “dysmorphophobia,” and “body image.” Studies included in this review were selected using specific criteria by two authors reaching consensus. Most BDD research studies have used symptom severity measures mainly to study BDD and its treatments. BBD with or without comorbidities is significantly associated with poor QOL and functioning. Studies show that treatment of BDD, either by psychopharmacological treatments such as selective serotonin reuptake inhibitors (SSRIs) or cognitive behavior therapy, might have positive effects on QOL, although these results need to be replicated in larger studies. In conclusion, QOL could add significant value to the assessment of BDD if used as one of the primary measures in research and clinical work in BDD, by providing more information and clearer understanding on the impact of the illness on satisfaction with activities of daily life and overall sense of wellbeing before and after treatment.

scholarly journals Revisiting the Postulates of Etiological Models of Eating Disorders: Questioning Body Checking as a Longer-Term Maintaining Factor

2022 ◽  
Vol 12 ◽  
Author(s):  
Vanessa Opladen ◽  
Maj-Britt Vivell ◽  
Silja Vocks ◽  
Andrea S. Hartmann
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Negative Affect ◽  
Negative Emotion ◽  
Body Checking ◽  
Eating Disorder Symptoms ◽  
Positive Effects ◽  
General Pathology ◽  
Before And After ◽  
The Impact

Body checking (BC) is not only inherent to the maintenance of eating disorders but is also widespread among healthy females. According to etiological models, while BC serves as an affect-regulating behavior in the short term, in the longer term it is assumed to be disorder-maintaining and also produces more negative affect. The present study therefore aimed to empirically examine the proposed longer-term consequences of increased BC. In an online study, N = 167 women tracked their daily amount of BC over a total of 7 days: Following a 1-day baseline assessment of typical BC, participants were asked to check their bodies in an typical manner for 3 days and with a 3-fold increased frequency for 3-days. Before and after each BC episode, the impact of BC on affect, eating disorder symptoms, general pathology and endorsement of different functions of BC was assessed. Participants showed longer-term consequences of increased BC in terms of increased negative affect and general pathology, while eating disorder symptoms remained unaffected. In the case of typical BC, participants showed decreased general pathology and anxiety. Furthermore, the endorsement of a higher number of BC functions led to increased negative affect and an increased amount of typical BC. The findings support the theoretically assumed role of maladaptive BC in maintaining negative emotion in the longer term. However, though requiring replication, our finding of positive effects of typical BC calls into question the overall dysfunctionality of BC among non-clinical women who are not at risk of developing an eating disorder.

Mindfulness for Psychosis Groups; Within-Session Effects on Stress and Symptom-Related Distress in Routine Community Care

2019 ◽  
Vol 47 (4) ◽  
pp. 421-430 ◽  
Author(s):  
Pamela Jacobsen ◽  
Matthew Richardson ◽  
Emma Harding ◽  
Paul Chadwick
Keyword(s):  
Mindfulness Meditation ◽  
Community Setting ◽  
Evidence Base ◽  
Self Report ◽  
Psychotic Symptoms ◽  
Psychotic Experience ◽  
Positive Effects ◽  
General Stress ◽  
Before And After ◽  
The Impact

Background: There is an emerging evidence base that mindfulness for psychosis is a safe and effective intervention. However, empirical data on the within-session effects of mindfulness meditation was hitherto lacking. Aims: The aim of the study was to assess the impact of taking part in a mindfulness for psychosis group, using a within-session self-report measure of general stress, and symptom-related distress. Method: Users of a secondary mental health service (n = 34), who experienced enduring psychotic symptoms, took part in an 8-week mindfulness for psychosis group in a community setting. Mindfulness meditations were limited to 10 minutes and included explicit reference to psychotic experience arising during the practice. Participants self-rated general stress, and symptom-related distress, before and after each group session using a visual analogue scale. Results: Average ratings of general stress and symptom-related distress decreased from pre- to post-session for all eight sessions, although not all differences were statistically significant. There was no increase in general stress, or symptom-related distress across any session. Conclusions: There was evidence of positive effects and no evidence of any harmful effects arising from people with psychotic symptoms taking part in a mindfulness for psychosis session.

Assertive Community Treatment of the Mentally Ill: Service Model and Effectiveness

2005 ◽  
Vol 13 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Adaobi Udechuku ◽  
James Olver ◽  
Karen Hallam ◽  
Frances Blyth ◽  
Melissa Leslie ◽  
...  
Keyword(s):  
Assertive Community Treatment ◽  
Mentally Ill ◽  
Psychiatric Inpatient ◽  
Community Treatment ◽  
Inpatient Service ◽  
Clinical Environment ◽  
Global Assessment Of Functioning ◽  
Severely Mentally Ill ◽  
Before And After

Objective: To provide a description of the service delivery model of an assertive community treatment (ACT) team in the management of a group of severely mentally ill patients and examine the effectiveness of this team in reducing readmissions to a psychiatric inpatient service. Method: A clinical case audit was performed on a single day in September 2001. Admission episodes and duration were collected for patients registered with the team in the 12 month period prior to ACT and for a period of 12 months ending on the day of the audit. Forty-three patients were registered with the team at the time of data collection. The majority (79%) were diagnosed with schizophrenia and there were high rates of comorbidity (76%) and disability (mean Global Assessment of Functioning score 45.9). The main outcome measures were the number of readmissions and readmission days before and after the institution of ACT. Results: The mean number of readmission days reduced from 70.9 to 10.2 (p < 0.05) following the institution of ACT. Conclusion: Assertive community treatment conducted in a naturalistic clinical environment is effective in signi?cantly reducing the number of readmission days in a group of patients suffering from long-term and persistent severe mental illness.

The Small-Group System and Training on an Acute Psychiatric Ward

1973 ◽  
Vol 4 (2) ◽  
pp. 173-181 ◽  
Author(s):  
Daniel A. Goldberg ◽  
Berney Goodman
Keyword(s):  
Small Group ◽  
Group Process ◽  
Psychiatric Inpatient ◽  
Resident Training ◽  
Psychiatric Ward ◽  
Patient Evaluation ◽  
Group System ◽  
Individual Interviews ◽  
Assessment And Treatment ◽  
Acute Psychiatric Ward

The functions of an acute, general hospital psychiatric inpatient teaching unit include patient evaluation and treatment, resident training and the staff communication necessary to both. On our ward, this work is complicated by heterogeneity of patient population, a large and diverse staff, and a pivotal role for inexperienced first-year residents. This paper describes a model using a small group system to integrate the multiple ward functions in light of the complicating factors. The ward is divided into two teams, and the staff and patients of each meet together four times weekly; a post-group staff meeting follows. The patient meeting is oriented around the realities of daily living. The post-group flexibly covers four areas: diagnosis and management; group process and techniques; intra-staff conflict; and ward issues. Converging on the system are multiple and overlapping observations which can be used to integrate ward functions. The simultaneous presence of all the staff increases the efficiency and accuracy of patient evaluation. Data complementing or contradicting individual interviews are supplied, enriching both assessment and teaching. Better staff communication and conflict resolution reflect the intimacy and constancy of the small group. Adjustment to the shifting and blurring of traditional roles has been progressive and there has been an impressive acceptance of more assessment and treatment responsibility by the non-medical staff. Residents' adaptation is consistently an unpredictable factor.

Mental health recovery narratives: their impact on service users and other stakeholder groups

2019 ◽  
Vol 23 (4) ◽  
pp. 173-184 ◽  
Author(s):  
Myra Piat ◽  
Jessica Spagnolo ◽  
Suzanne Thibodeau-Gervais ◽  
Catherine Deschamps ◽  
Yves Gosselin
Keyword(s):  
Mental Health ◽  
Mental Health Recovery ◽  
Service Users ◽  
Cross Sectional ◽  
Content Type ◽  
Positive Effects ◽  
Stakeholder Groups ◽  
Before And After ◽  
Recovery Narratives ◽  
The Impact

Purpose The purpose of this paper is twofold: first, assess the effects of the peers’ recovery narratives on service users’ perceived mental health recovery; and second, explore various stakeholders’ perspectives on the program, specifically its facilitators and barriers. Design/methodology/approach The study used a convergent mixed-method design. First, a pre-test post-test design was used with service users to evaluate the peer recovery narrative program. They completed the Recovery Assessment Scale (RAS) and participated in qualitative interviews that explored perspectives on their mental health recovery before and after the program. Second, a cross-sectional design was used to explore stakeholder groups’ perspectives on the recovery narrative program immediately after listening to the narratives. Findings While findings show that there was no statistical difference between scores on the RAS before and after the peer narratives, thematic analysis revealed a change in service users’ understanding of recovery post-narratives. Other stakeholder groups confirmed this change. However, some healthcare professionals questioned the universal positive effects of the peer recovery narrative program on service users. Stakeholders agreed that beyond effects of the peer recovery narrative program on service users, there were also positive effects among the peers themselves. Originality/value To the authors’ knowledge, this is the first Canadian study, and one of the first studies to rely on mixed-methods and various stakeholder groups to evaluate the impact of peer recovery narratives on service users. The research, thus, fills a knowledge gap on peer recovery narratives.

scholarly journals Evaluation of tobacco use and willingness to accept nicotine replacement therapy during stay in an acute inpatient psychiatric ward

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S186-S187
Author(s):  
Isabel Ganhao ◽  
Miguel Trigo ◽  
Afonso Paixao
Keyword(s):  
Smoking Cessation ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Tobacco Smoking ◽  
Psychiatric Inpatient ◽  
Willingness To Accept ◽  
Psychiatric Ward ◽  
Inpatient Stay ◽  
Nicotine Replacement ◽  
The Impact

AimsTo evaluate tobacco smoking and willingness to try and to accept prescription of nicotine replacement therapy during psychiatric acute inpatient stay. When free to choose and use as desired (without imposing smoking cessation) patients may be open to nicotine replacement therapy.BackgroundTobacco smoking interventions are increasingly in demand especially for difficult to treat patient populations, as are those with severe mental illness. Implementing totally smoke-free psychiatric inpatient units is challenging. Imposing smoking cessation and use of nicotine substitutes may or not be the best of strategies for smoking reduction and cessation in the mid and long term. Allowing the patient free choice as to trying and learning to use nicotine replacement therapy with supervision may constitute a more acceptable approach.MethodFrom 1/1/2020 to 28/1/2020 (four weeks), 40 of the 44 patients in a general adult psychiatric inpatient unit (4 patients were too sedated or too agitated to be evaluated), with smoking restricted to a designated area and only during the day, were briefly evaluated as to their tobacco smoking habits (cigarettes/day) and willingness to accept nicotine lozenges and patches and were invited to participate in a smoking cessation programme during or after discharge.ResultOf the 40 patients evaluated, 26 were male and 14 were female, average age was 34 years (age range from 19 to 79 years). Diagnostic hypotheses for patients at admission were: schizophrenic disorder/schizoaffective disorder 9, bipolar disorder 7, psychosis not otherwise specified 19, depressive disorder 1 and other 4. 20(50%) were current smokers and 20 (50%) were non or ex-smokers. The smokers reported smoking an average of 14 cigarettes/day. Only one patient refused to try nicotine lozenges and all other smokers accepted regular prescription of nicotine lozenges during inpatient stay. 5 patients (25% of smokers) asked for or accepted suggestion to try nicotine patches in combination therapy with nicotine lozenges with the goal of smoking cessation.ConclusionPatients were open to a brief informal intervention targeting smoking behaviours and readily accepted trying nicotine lozenges and prescription during their inpatient stay. The regular use of nicotine replacement therapy by some patients encouraged other patients to try and accept therapy. In addition to the habitual tobacco sharing among patients, nicotine lozenges were also shared especially with newly admitted patients. The evaluation of the impact of this intervention will require a much longer period of time of implementation.

scholarly journals Effect of diamond microdermabrasion on oily skin: a case report

2018 ◽  
Vol 12 (3) ◽  
pp. 32-35
Author(s):  
Justyna Havemeister ◽  
Karolina Chilicka
Keyword(s):  
Case Report ◽  
Skin Condition ◽  
Ancient Egypt ◽  
Skin Changes ◽  
Positive Effects ◽  
Before And After ◽  
The Face ◽  
History Of ◽  
The Impact ◽  
Sebum Secretion

Background: The history of microdermabrasion dates back to ancient Egypt. The first treatment in Europe occurred in 1985 and has since become a popular method of exfoliation of the superficial layers of skin. Microdermabrasion is an effective method of taking care of the skin of the face and body, bringing about immediate effects in the treatment of deep scars and stretch marks. Aim of the study: To determine the effectiveness of diamond microdermabrasion on a person with hyperuricemia of the sebaceous glands. Materials and methods: Based on interviews, a case analysis, and the impact of diamond microdermabrasion on the structure of the skin’s surface, the level of hydration, oiliness and epidermal exfoliation were analyzed. Case report: The subject was a 22-year-old woman struggling with oily skin. A few acne lesions and a large number of blackheads were observed in her nasal area. An interview was conducted prior to the procedure to eliminate any contraindications. The study was conducted within a period of 4 months at 3-week intervals. The Nati Skin Analyzer was used to determine the skin parameters of the patient. Results: After applying a series of treatments using the microdermabrasion apparatus, satisfactory results were obtained in the form of reduced peeled sebum and improved skin hydration in the T and U zones. Conclusions: The study shows that diamond microdermabrasion treatment has a beneficial effect on the patient’s skin condition. Phot ographs before and after the surgery document the positive effects this series of treatments had. There was a decrease in the level of sebum secretion and the elimination of skin changes in the form of acne or open comedones.

Coping and Film Reception

2011 ◽  
Vol 23 (3) ◽  
pp. 149-160 ◽  
Author(s):  
Benedikt Till ◽  
Thomas Niederkrotenthaler ◽  
Arno Herberth ◽  
Martin Voracek ◽  
Gernot Sonneck ◽  
...  
Keyword(s):  
Life Satisfaction ◽  
Coping Strategies ◽  
Self Esteem ◽  
Cognitive State ◽  
Positive Effects ◽  
Before And After ◽  
Film Reception ◽  
Negative Impacts ◽  
Attitudes Toward Suicide ◽  
The Impact

This study investigated the impact of film dramas on the emotional and cognitive state of recipients, as well as mediating effects of different modes of film reception. Furthermore, associations between the modes of reception and individual favored coping strategies were examined. One hundred fifty nondepressive and nonsuicidal adults living in Austria watched one of three films featuring the death of the main character. Data on the viewers’ mood, inner tensions, self-esteem, life satisfaction, depression, suicidal tendencies, attitudes toward suicide, predominantly used modes of reception, and preferred coping strategies were collected with questionnaires that were handed out before and after seeing the movie. Results indicated that drama viewing was linked to both negative and positive effects: on the one hand, to a deterioration of mood as well as an increase of inner tensions and depression scores, and on the other hand, to a rise in self-esteem and life satisfaction as well as a drop in suicidal tendencies. The more a subject was involved in the film, the more pronounced were the negative impacts and the smaller were the positive reactions. The viewers’ preferred coping strategies were partly associated with the modes of reception: the more an individual preferred to seek social support when facing a problem, the more he or she identified with the drama’s protagonist and tried to find behavior patterns in the movie to improve his or her own life.

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