scholarly journals A service evaluation of outcomes in two in-patient recovery units

2017 ◽  
Vol 41 (6) ◽  
pp. 330-336 ◽  
Author(s):  
Rob Macpherson ◽  
Claudia Calciu ◽  
Chris Foy ◽  
Kim Humby ◽  
Dave Lozynskyj ◽  
...  
Keyword(s):  
Social Functioning ◽  
Service Use ◽  
Unmet Needs ◽  
Treatment Approach ◽  
Service Evaluation ◽  
First Year ◽  
Clinical Implications ◽  
Complex Needs ◽  
Supported Accommodation ◽  
Met Needs

Aims and methodTo evaluate outcomes for patients during their admission or in the first year of treatment in two in-patient recovery units. Changes in health and social functioning, service use and need (rated by patients and staff) were evaluated.ResultsIn 43 patients treated, there was a large (30%) increase in patients discharged to their own tenancies, rather than supported accommodation. There was minimal change in Health of the Nation Outcome Scales (HoNOS) scores in the course of the admission but staff- and patient-rated unmet needs reduced and met needs increased. Needs changed mainly in domains relating to social functioning. Reductions in risk to self and others were rated by staff but not patients. There were no cases of patients being readmitted to acute hospital during the study period.Clinical implicationsAlthough these results offer some support to the treatment approach described in these in-patient recovery units, further research in larger samples is needed to identify how these services can best be deployed to help individuals with severe mental illness and complex needs.

scholarly journals Evaluation of three assertive outreach teams

2013 ◽  
Vol 37 (7) ◽  
pp. 228-231 ◽  
Author(s):  
Rob Macpherson ◽  
Praveen Thyarappa ◽  
Genevieve Riley ◽  
Hannah Steer ◽  
Mike Blackburn ◽  
...  
Keyword(s):  
Social Functioning ◽  
Service Use ◽  
Unmet Needs ◽  
First Year ◽  
Clinical Implications ◽  
Service Users ◽  
Assertive Outreach ◽  
Individual Health ◽  
Met Needs ◽  
Engagement With Services

Aims and methodTo evaluate outcomes for service users during their first year of treatment in three English assertive outreach teams. Changes in health and social functioning, engagement with services, service use and need (rated by staff and service users) were evaluated.ResultsIn 49 service users we found a significant increase in mean staff-rated met needs up to 6 months of treatment. There were no significant changes in ratings of engagement or Health of the Nation Outcome Scales (HoNOS) scores at 6 and 12 months. Unmet needs rated by service users and staff showed a non-significant trend for improvement across a range of individual health and social domains. Duration of hospital admission reduced significantly between the 12 months before the evaluation and the 12 months of the evaluation. Formal and informal admission and levels of contact with crisis teams reduced over the study period.Clinical implicationsAlthough these results offer some support to the assertive outreach approach, further research in larger samples is needed to identify which changes in health and social functioning are associated with transfer to assertive outreach teams.

scholarly journals Awareness of the cost of psychotropic medication among doctors: a service evaluation

2010 ◽  
Vol 34 (9) ◽  
pp. 364-366 ◽  
Author(s):  
Dhananjay Kumar Singh ◽  
Shakil Khawaja ◽  
Ishaq Pala ◽  
Jaleel Khaja ◽  
Ray Krishnanu ◽  
...  
Keyword(s):  
Cost Effective ◽  
Service Evaluation ◽  
Financial Resources ◽  
Clinical Implications ◽  
North East ◽  
The North ◽  
Old Age Psychiatry ◽  
Level Of Knowledge ◽  
The Cost ◽  
Structured Questionnaire

Aims and methodCost-effective prescribing is an increasingly important aspect of our practice. A service evaluation was carried out to assess the level of awareness and knowledge of different aspects of cost-effective prescribing among doctors working in the North East London Foundation Trust. A semi-structured questionnaire was used to benchmark knowledge against six standards.ResultsThe survey was completed by 71% of doctors working in adult or old age psychiatry. A total of 2% of doctors stated that they should always take into consideration the price of the drug when prescribing and only 5% of doctors claimed to know the price of medications they prescribe most frequently.Clinical implicationsStrategies to improve the poor level of knowledge and awareness in this area of clinical practice would be of benefit in making the best use of limited financial resources without any detriment to patient care.

scholarly journals Ethnic Differences in Mental Health Status and Service Utilization: A Population-Based Study in Ontario, Canada

2018 ◽  
Vol 63 (7) ◽  
pp. 481-491 ◽  
Author(s):  
Maria Chiu ◽  
Abigail Amartey ◽  
Xuesong Wang ◽  
Paul Kurdyak
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
South Asian ◽  
Service Use ◽  
Unmet Needs ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Health Factors ◽  
Mental Health Factors

Background: The purpose of this study was to compare the prevalence of self-reported mental health factors, mental health service use, and unmet needs across the 4 largest ethnic groups in Ontario, Canada: white, South Asian, Chinese, and black groups. Methods: The study population was derived from the Canadian Community Health Survey, using a cross-sectional sample of 254,951 white, South Asian, Chinese, and black residents living in Ontario, Canada, between 2001 and 2014. Age- and sex-standardized prevalence estimates for mental health factors, mental health service use, and unmet needs were calculated for each of the 4 ethnic groups overall and by sociodemographic characteristics. Results: We found that self-reported physician-diagnosed mood and anxiety disorders and mental health service use were generally lower among South Asian, Chinese, and black respondents compared to white respondents. Chinese individuals reported the weakest sense of belonging to their local community and the poorest self-rated mental health and were nearly as likely to report suicidal thoughts in the past year as white respondents. Among those self-reporting fair or poor mental health, less than half sought help from a mental health professional, ranging from only 19.8% in the Chinese group to 50.8% in the white group. Conclusions: The prevalence of mental health factors and mental health service use varied widely across ethnic groups. Efforts are needed to better understand and address cultural and system-level barriers surrounding high unmet needs and to identify ethnically tailored and culturally appropriate clinical supports and practices to ensure equitable and timely mental health care.

scholarly journals Psychiatric comorbidity and medication use in autism: a community survey

2003 ◽  
Vol 27 (10) ◽  
pp. 378-381 ◽  
Author(s):  
Caryl N. Morgan ◽  
Meera Roy ◽  
Patrick Chance
Keyword(s):  
Autistic Spectrum Disorder ◽  
Psychiatric Comorbidity ◽  
Learning Disabled ◽  
Clinical Implications ◽  
Close Monitoring ◽  
Complex Needs ◽  
Medical Diagnoses ◽  
Psychiatric Illnesses ◽  
Psychiatric Conditions ◽  
High Comorbidity

Aims and Method Individuals with autism often have complex needs. In this paper, we attempt to establish the prevalence rates of other major psychiatric illnesses in learning disabled adults diagnosed with autism and analyse the use of medication in these individuals. A total of 571 clients with learning disability were screened for autistic spectrum disorder, identifying 164 individuals for study. Psychiatric and medical diagnoses were also reviewed. Results Of the individuals with autism, 35% had another comorbid psychiatric disorder. An overall prevalence rate of 10% for hypothyroidism was also identified and 35% of people with autism and no other psychiatric diagnosis were on neuroleptics. Clinical Implications Planning of services for autism will have to take into account the high comorbidity of autism and other psychiatric conditions. Individuals with autism will also benefit from close monitoring of mental state and the development of hypothyroidism.

scholarly journals A retrospective study comparing the length of admission of medium secure unit patients admitted in the three decades since 1985

2018 ◽  
Vol 43 (4) ◽  
pp. 154-157 ◽  
Author(s):  
Charles H. Earnshaw ◽  
Lucy Shaw ◽  
Deepu Thomas ◽  
Owen Haeney
Keyword(s):  
Clinical Implications ◽  
Discharge Destination ◽  
Median Length ◽  
Delivery Of Care ◽  
Factors Associated ◽  
Supported Accommodation ◽  
Admission Data ◽  
Time Period ◽  
Secure Unit ◽  
Single Medium

Aims and methodAdmissions of patients to secure forensic hospitals are often lengthy. Previous research has examined factors associated with prolonged admission, but studies analysing admission data at a single medium secure unit (MSU) over a prolonged time period are lacking. We compared admission data for all patients admitted to a MSU in England during the years 1985, 1995, 2005 and 2012.ResultsThe median length of admission increased from 167 days in 1985 to 580 days in 2012, though not in the intervening cohorts. There have been changes in the discharge destination of patients, away from independent accommodation in the community towards further care or supported accommodation.Clinical implicationsThe results suggest a change in the delivery of care. Further studies should be performed to assess whether the same trends exist at other sites. If these trends are also found elsewhere, this should trigger a specialty-wide discussion about admission length and its effects on bed availability.Declaration of interestNone.

scholarly journals Does the public antiretroviral treatment programme meet patients’ needs? A study at four hospitals in eThekwini, KwaZulu-Natal, South Africa

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Delarise M. Mulqueeny ◽  
Myra Taylor
Keyword(s):  
Antiretroviral Treatment ◽  
Unmet Needs ◽  
Mixed Methods Design ◽  
The Public ◽  
Sequential Mixed Methods ◽  
Kwazulu Natal ◽  
Met Needs ◽  
Formed Part ◽  
The Individual ◽  
Depth Interviews

Background: Patients play a major role in the success of any antiretroviral treatment (ART) programme. Hence, their needs should be articulated on a regular basis for interventional processes to promote adherence, retention and quality care.Aim: This study investigated whether patients’ needs were being met, described which needs were met, which were not and how such needs could be met.Setting: The study took place at four ART clinics in eThekwini district public hospitals.Methods: This study formed part of a larger study that utilised a sequential mixed-methods design. However, only the qualitative component is documented herein. Twelve HIV-infected patients engaged in in-depth interviews (three patients from each of the four hospitals). A socio-ecological framework divided responses into four categories, namely, the individual, interpersonal, institutional and policy. Each category presented (1) patients’ needs that are being met, (2) needs that are not being met, (3) recommendations on how they can be met and (4) researchers’ observations.Results: All 12 patients reported that all their needs were not being met. They further shared their met needs, unmet needs and made recommendations for meeting their unmet needs. These needs varied per antiretroviral clinic because of unique processes at each institution.Conclusion: To adequately address the needs of HIV-infected patients, it is imperative for all stakeholders involved in the public ART programme to gain an understanding of what constitutes ‘patients’ needs’. The results reflect patients’ willingness to be involved in their care, treatment and interventional strategies to adequately meet their needs.

Modelling the predictors of e-service use among information systems users

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Immanuel Ovemeso Umukoro ◽  
Mutawakilu Adisa Tiamiyu
Keyword(s):  
User Satisfaction ◽  
Service Use ◽  
Research Effort ◽  
Information Service ◽  
Service Evaluation ◽  
Content Type ◽  
Demographic Profiles ◽  
System Service ◽  
Multi Stage ◽  
Services Use

PurposeThis paper sought to validate a proposed e-service use model that takes into account system's environment and user factors as plausible determinants of an information system's (IS) use that are not accounted for by previous IS use models. The aim is to establish the applicability of the model for e-services and IS design, implementation and use.Design/methodology/approachThis study adopts a quantitative approach to data collection and analysis. Using a systematic multi-stage random sampling, data were collected from 400 university e-library users and analysed using regression analysis to test the hypothesised relationships.FindingsInternal system factors (particularly service quality), user satisfaction, e-service environment factors and user factors (gender, programme of study, level of study and computer/IT self-efficacy) predicted the use of e-services. These findings are partly similar to and partly different from those of the earlier studies, suggesting that more studies are needed to test the comprehensive model of e-services’ use.Research limitations/implicationsThis is a replicated study and as such made use of a similar population. These findings, therefore, cannot be generalised to other organisations with users of different demographic profiles.Practical implicationsFirst, the use of the services provided through an IS is predicted by factors other than user satisfaction, system, service and information qualities. Second, system administrators, designers, library administrators and managers must ensure that these factors are considered during the design, implementation and use of ISs.Social implicationsThe paper argues for the need to design e-services and ISs with consideration for user attributes that may lead to social exclusion if not considered. This is because the environment where an IS is hosted can be a driver of e-services use, especially if management provides the enabling environment in terms of optimal staffing, training, user support and periodic e-service evaluation.Originality/valueThis paper extends research effort in understanding the predictors of use of ISs beyond the traditional system's attributes (information, service and system qualities) to include system environment and user factors.

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