Non-contact physical health monitoring in mental health seclusion

2021 ◽  
Author(s):  
Hannah Clark ◽  
Allison Edwards ◽  
Rebecca Davies ◽  
Adenike Bolade ◽  
Rachael Leaton ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Health Monitoring ◽  
Clinical Care ◽  
Fold Increase ◽  
Monitoring Device ◽  
Time Period ◽  
Health Assessments ◽  
Technological Intervention

Background: Patients in mental health services’ seclusion require regular physical health assessments to identify, prevent and manage clinical deterioration. Sometimes it may be unsafe or counter-therapeutic for clinical staff to enter the seclusion room, making it challenging to meet local seclusion standards for physical assessments. Alternatives to standard clinical assessment models are required in such circumstances to assure high quality and safe care.Aim: The primary aim was to improve the quality of physical health monitoring by making accurate vital sign measurements more frequently available. Secondary aims were to explore the clinical experience of integrating a technological innovation with routine clinical care.Method: A non-contact monitoring device was installed in the mental health seclusion room and was used in addition to existing clinical care. Over six months, adherence to local clinical guidelines was compared against a time-period prior to installation. Feedback was sought from staff and patients throughquestionnaires and focus groups. A quality improvement framework was used to continually improve the process using plan, do, study, act (PDSA) cycles.Results: The non-contact monitoring device enabled a 12.3-fold increase overall in the monitoring of physical health observations when compared to a real-world baseline rate of checks. Enhancement to standard clinical care varied accordingto patient movement levels. Patients, carers and staff expressed positive views towards the integration of the technological intervention.Conclusion: The non-contact monitoring device improved the quality and safety of care by increasing availability of physical health monitoring. It was positively received by patients, carers and staff.

scholarly journals Antipsychotic monitoring in dementia: quality of completion of antipsychotic monitoring forms in an older adult mental health service

2021 ◽  
pp. 1-7
Author(s):  
Helen Anderson ◽  
Anna Kolliakou ◽  
Daniel Harwood ◽  
Nicola Funnell ◽  
Robert Stewart ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Health Monitoring ◽  
Psychological Symptoms ◽  
Antipsychotic Treatment ◽  
Pharmacological Interventions ◽  
Health Records ◽  
People With Dementia ◽  
Adult Mental Health Service

Aims and method To support safe prescribing of antipsychotics in dementia, antipsychotic monitoring forms were embedded into our electronic health records. We present a review of the data collected on these forms to assess prescribing and identify areas for improvement in our practice and processes. Data were extracted from the structured fields of antipsychotic initiation and review forms completed between 1 January 2018 and 31 January 2020. Results We identified gaps in practice where improvements could be made, mainly with regard to physical health monitoring (and particularly electrocardiograms, performed in only 50% of patients) and the low (less than 50%) recorded use of non-pharmacological interventions for behavioural and psychological symptoms of dementia. In addition, antipsychotic treatment was continued despite lack of benefit in almost 10% of reviews. Clinical implications We advocate for recommendations on physical health monitoring of people with dementia taking antipsychotics to be added to the National Institute for Health and Care Excellence guidance on dementia and the Prescribing Observatory for Mental Health (POMH-UK) national audit.

Health-Related Quality of Life (HRQL) Among Hospitalized Adults with Sickle Cell Disease (SCD): Incorporating Patient-Reported Outcome (PRO) Measures in Clinical Care

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5962-5962 ◽  
Author(s):  
Kimberly S Esham ◽  
Angie Mae Rodday ◽  
Ruth Ann Weidner ◽  
Rachel J. Buchsbaum ◽  
Hedy P Smith ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Sickle Cell ◽  
Global Mental Health ◽  
Clinical Care ◽  
Emotional Impact ◽  
Post Discharge ◽  
Patient Reported ◽  
Domain Scores

Abstract Background: SCD is a chronic disease characterized by painful vaso-occlusive (VOC) episodes and hemolysis which lead to poor HRQL and premature mortality. As curative treatment with hematopoietic stem cell transplant is only an option for a minority of adult patients, current treatments are palliative with focus on pain management. Clinically, pain assessment is commonly performed by Numeric Rating Scale, where patients rate the intensity of pain from 0 (no pain)-10 (worst imaginable pain). However, the incorporation of HRQL through the use of newer PROs into the assessment of pain and the care of patients with SCD is evolving. Our objective was to better inform the multidimensional impact of pain on adults hospitalized with VOC, as measured by the Patient-Reported Outcomes Measurement Information system (PROMIS) Global Health and the Adult Sickle Cell Quality of Life Measurement System (ASCQ-Me). Reported here are the preliminary results of the first 15 patients of our larger inception cohort with planned enrollment of 140 patients. Methods: In this study at an urban tertiary care hospital, 15 of 16 eligible adults with SCD completed the PROMIS short form (v1.1) Global Health and ASCQ-Me questionnaires on hospital admission for VOC. These measures yield scores in the domains of physical health, mental health, and sickle-cell related domains of pain-episode frequency, emotional impact, social functioning impact, pain impact, stiffness, and sleep. Seven days post-discharge, 12 of the 15 patients again completed the assessments. Standardized domain scores have a mean of 50 (SD=10) with higher scores indicating better functioning. We calculated means and standard errors (SE) for the domain scores at both assessment periods and mean change scores. Results: One eligible patient declined enrollment due to poor mental health, stating "I have lost all hope with this disease." Two of the initial 15 patients had hospital readmissions within 7 days and were censored from further analysis; the third did not respond to follow up and was readmitted within 30 days. Sixty percent of patients were female. The mean age was 30.1 years (range 22-36). The most frequent disease genotype was Hb SS (66%), followed by Hb SC (27%) and Hb Sβ+ thalassemia (7%). Eleven patients (73%) identified as black, non-Hispanic; 4 (27%) identified as Hispanic. At hospital admission, 66% of patients had 4 or more pain crises in the last 12 months. The mean score for the most severe pain during the last pain attack was 8.8 (SD = 1.4) on a scale from 0-10. The most recent pain crisis for 66% of patients lasted at least 1 week; 26% reported crisis lasting longer than 2 weeks. Of the 12 patients who completed all assessments, the table presents mean domain scores at each assessment period and the change scores. Of note, 83.3% scored at least 1 SD below the population mean for the PROMIS global physical health subscale on admission. This was unchanged 7 days post-discharge (83.3%). Half scored at least 1 SD below the population mean for PROMIS global mental health subscale, compared to 33% 7 days post-discharge. Conclusions: Administering disease-specific PRO measures at point of care is feasible. Patients who did not complete assessments following hospital discharge were all readmitted within 30 days, indicating a particularly high-risk group. At both admission and 7 days post-discharge, a significant number of patients had physical and mental health scores that were 1 SD below population norms, indicating substantial suffering. Compared to admission, scores for global mental health, social functioning and stiffness worsened following discharge on average. Scores in global physical health, emotional impact, pain impact and sleep impact improved. Further study of incorporating PRO measures in the clinical care and improvement in health outcomes among adults with SCD is warranted. Disclosures No relevant conflicts of interest to declare.

scholarly journals Physical health monitoring of patients prescribed depot antipsychotic medication in north west Edinburgh community mental health team

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S336-S337
Author(s):  
Douglas Murdie ◽  
Jakub Wojtowicz ◽  
Alexandra Thompson ◽  
Anne MacLeod ◽  
Adam Mallis ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Antipsychotic Medication ◽  
Health Monitoring ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
North West ◽  
Depot Antipsychotic ◽  
Major Mental Disorder

AimsTo monitor the quality of physical health monitoring of patients prescribed depot antipsychotic medication in the North West Edinburgh Community Mental Health Team (CMHT). We also evaluated the completeness of prescriptions and Mental Health Act (Scotland) (Act) 2003 paperwork where relevant.BackgroundAntipsychotic medications are medicines for treating conditions such as Schizophrenia, but some may be associated with an increased risk of Metabolic Syndrome. Moreover, evidence indicates that patients with major mental disorder have a reduced life expectancy in comparison to those without such diagnoses. These two factors illustrate the importance of the physical health of this patient cohort being monitored on a regular basis. This project will evaluate how a local CMHT is performing, with the possibility of enacting service improvements if required.MethodThe records of the 60 patients prescribed depot antipsychotic medication administered by this CMHT were reviewed. A check-list was created consisting of 14 categories analysing the quality of physical health monitoring, as well as compliance with prescription standards and, where relevant, Mental Health Act (Scotland) (Act) 2003 paperwork. We compared patient records against our checklist for the calendar year of 2019. The Scottish Intercollegiate Guidelines Network (SIGN) 131 (Management of Schizophrenia) section 5.2 was used as the gold standard for physical health monitoring against which the data we collected was compared.ResultWe identified a wide range of flaws with the current system and implementation of monitoring, and difficulty in locating the required information. There was no consistent monitoring of physical observations on electronic record, nor an accepted alternative way in which this was documented. Furthermore, blood tests were not consistently obtained either by the service or GP practices in a reproducible manner. This led to discussions within the CMHT regarding creation of a new pathway for the monitoring of this patient cohort using a Quality Improvement model, with the ultimate goal to establish a regular physical health clinic.ConclusionThere is significant evidence that patients with major mental disorder do not access healthcare as consistently as those without, leading to a disparity in life expectancy. In light of the fact that antipsychotic medications can be associated with Metabolic Syndrome, we have an even greater responsibility to tackle this marked health inequality by appropriately monitoring our patients. This was not done well in this particular CMHT, but this project will lead to improvements in the service and ultimately patient care.

scholarly journals Improving cardiometabolic health assessments and interventions at St Charles Hospital, London

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S214-S214
Author(s):  
Mehtab Rahman ◽  
Vernanda Julien
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Health Monitoring ◽  
Cardiometabolic Risk ◽  
Health Centre ◽  
Cardiometabolic Health ◽  
List Type ◽  
Risk Monitoring ◽  
Health Assessments ◽  
Mental Health Centre

AimsSt Charles is one of the largest inpatient mental health units in London with 8 wards and covers the boroughs of Kensington & Chelsea and Westminster. This project aimed was set up so that 95% of patients in St Charles Mental Health Centre would have a complete cardiometabolic health assessment by December 2020. This would include Weight, Smoking, Alcohol, Substance Use, Hypertension, Cholesterol and Diabetes assessments with necessary interventions recorded. The outcome of the intervention would improve overall physical health and life expectancy.MethodPeople with serious mental illness experience significantly worse physical health and shorter life expectancy of up to 10 to 15 years than the general population. CNWL is making Physical Health of patients in Mental Health Services a priority. Performance in this area has been challenging across the Trust because of: –Buy in from clinicians.–Staff did not feel empowered to discuss interventions with patients.–High sickness and absence as a result of COVID was found to directly correlate with reduced physical health monitoring/recording.–Lack of training in completing the SystmOne physical health templateThe following cardiometabolic risk monitoring interventions were recorded on SystemOne (electronic documentation platform) and performance reviewed using Tableau : Weight, Smoking, Alcohol, Substance Use, Hypertension, Cholesterol and Diabetes assessments with necessary interventions recorded.ResultPrior to the commencement of this project, the wards in St Charles Mental Health Centre completed physical health assessments on roughly 8% of the patients in February 2020. The QI project was implemented in June 2020. By September 2020, physical health recording across 8 wards across St Charles had increased to 89% following successful implementation of the interventions.ConclusionThe following interventions resulted in a significant improvement in physical health cardiometabolic risk monitoring at a busy inpatient mental health setting: –Monthly physical heath meetings to enable shared learning with ward doctors, nurses and healthcare assistants.–Ongoing one-to-one and group support to train staff with completing and recording physical health assessments.–Tableau Physical Health Report regularly reviewed with MDT during ward round meetings.–Physical health leads given supernumerary days to run physical health clinics on the wards.–Fortnightly Physical health monitoring meetings with the Director of Nursing and Head of Governance.

scholarly journals Comparative analysis of postoperative sexual dysfunction and quality of life in type a aortic dissection patients of different ages

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zeng-Rong Luo ◽  
Dong-Shan Liao ◽  
Liang-Wan Chen
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Depressive Symptoms ◽  
Sexual Dysfunction ◽  
Aortic Dissection ◽  
Physical Health ◽  
The Elderly ◽  
Type A Aortic Dissection ◽  
Postoperative Sexual Dysfunction

Abstract Background To compare postoperative sexual dysfunction (SD) and quality of life (QOL) in Type A Aortic Dissection (AAD) Patients of Different Ages. Methods From January 2018 to December 2019, 204 AAD postoperative survivors in Union Hospital of Fujian Medical University were selected and were divided into young group (less than 50 years old) and elderly group (more than 50 years old). We evaluated SD according to the male International Erectile Dysfunction Index (IIEF-5) and female sexual function index (FSFI). The Short Form 12 Health Survey Questionnaire (SF-12) and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) were used to investigate the QOL, Quick Inventory Depressive Symptomatology-Self Report (QIDS-SR) and the Beck Depression Inventory-II (BDI-II) to investigate depressive symptoms. Results One hundred seventy-five patients completed all the questionnaire (85.8%). The total SD prevalence rate was 38.9% (68 cases), with 27.4% of the young (20 cases) and 47.1% of the elderly (48 cases). The age of non-SD and SD patients was 49.0 ± 11.5 and 56.9 ± 10.8 years, respectively (P = 0.03). Compared with non-SD patients, the total physical health of SD patients was significantly worse (P = 0.04), however, the mental health was not significantly worse (P = 0.77); the depressive symptoms did not expressed a significant difference between the SD and non-SD groups (QIDS-SR P = 0.15, BDI-II P = 0.06). Total physical health scores in the young SD group did not show significant better than elderly SD group (P = 0.24), however, total mental health scores showed significantly worse (P = 0.04), depressive symptoms scores were significantly higher (QIDS-SR P = 0.03, BDI-II P = 0.04). Conclusion The postoperative AAD SD prevalence of elderly is higher than that of young, and the total physical health of SD patients is poorer than those without SD patients. The young SD patients did not show a significant higher physical health scores than the elderly SD patients, instead, the young SD patients were more psychologically affected than the elderly SD patients, whose mental health was worse, and depression symptoms were more obvious, suggesting that the factors affecting the QOL of postoperative SD patients are related to physical factors, but the young postoperative SD patients mainly affected by psychological factors.

Abstract T P124: Psychometric Properties of the Chinese Version of the Stroke Specific Quality of Life Scale in Community-Dwelling Stroke Survivors

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Suzanne H Lo ◽  
Anne M Chang ◽  
Janita P Chau ◽  
Glenn E Gardner
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Physical Health ◽  
Stroke Survivors ◽  
Sf 36 ◽  
Quality Of Life Scale ◽  
Life Scale ◽  
Positive Correlations ◽  
Component Scores

Introduction: Health-related quality of life is a significant outcome of stroke survivors’ recovery. The 49-item English version of the Stroke Specific Quality of Life Scale (SSQOL) (Williams et al., 2009) is a stroke-specific assessment of stroke survivors’ health-related quality of life in 12 domains. However there has been no Chinese version of the scale for Chinese stroke survivors in Hong Kong. Aim: To examine the reliability and validity of the Chinese version of Stroke Specific Quality of Life Scale (SSQOL-C) in stroke survivors. Methods: SSQOL was translated into Chinese and blind back-translated by independent bilingual baccalaureate nursing students. Content validity was reviewed by an expert panel which consisted of one nurse academic, one nurse manager, three advanced practice nurses, and two registered nurses. A cross-sectional study was conducted to validate the translated version. A convenience sample of 135 adult stroke survivors were recruited from three community centres and a stroke support group in Hong Kong. Internal consistency analysis was performed. Pearson’s correlation coefficients were calculated between SSQOL-C, SF-36, and Frenchay Activities Index (FAI) to determine the convergent validity. Results: Content validity index of SSQOL-C was 0.99. SSQOL-C had high internal consistency with Cronbach’s alpha of 0.94 for the total scale, and between 0.65 and 0.90 for the 12 domains. The total SSQOL-C scores showed significant positive correlations with SF-36 physical health (r=0.58, p<0.01) and mental health (r=0.54, p<0.01) component scores, and FAI score (r=0.59, p<0.01). SSQOL-C physical subtotal scores showed significant positive correlations with SF-36 physical health (r=0.55, p<0.01) and mental health (r=0.43, p<0.01) component scores, and FAI score (r=0.54, p<0.01). SSQOL-C psychosocial subtotal scores showed significant positive correlations with SF-36 physical health (r=0.52, p<0.01) and mental health (r=0.56, p<0.01) component scores, and FAI score (r=0.56, p<0.01). Conclusion: The results showed SSQOL-C had good content and convergent validity, and reliability in Chinese stroke survivors. Further evaluation of factor structure of SSQOL-C will be conducted to determine its validity.

Monitoring the physical health of individuals with serious mental illness

2008 ◽  
Vol 25 (3) ◽  
pp. 108-115
Author(s):  
Majella Cahill ◽  
Anne Jackson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Service ◽  
Physical Health ◽  
Serious Mental Illness ◽  
Health Monitoring ◽  
Service Providers ◽  
Psychiatric Service ◽  
Service Users ◽  
Effective Models

AbstractDeveloping effective models of identifying and managing physical ill health amongst mental health service users has become an increasing concern for psychiatric service providers. This article sets out the general professional and Irish statutory obligations to provide physical health monitoring services for individuals with serious mental illness. Review and summary statements are provided in relation to the currently available guidelines on physical health monitoring.

scholarly journals Positivity in Mental and Physical Health

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Urvashi Sharma ◽  
Dr. Ravindra Kumar
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Mental Health Problems ◽  
Weight Ratio ◽  
Well Being ◽  
Good Mental Health ◽  
Physical Wellbeing ◽  
Good Nutrition ◽  
Mental And Physical Health

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Mental health refers to our overall psychological well-being. It includes the way we feel about our self, the quality of our relationships, and our ability to manage our feelings and deal with difficulties. Good mental health isn’t just the absence of mental health problems. People who are emotionally or mentally healthy are in control of their emotions and their behavior. They are able to handle life’s challenges, build strong relationships, and recover from setbacks. Positive mental health is a state of well-being in which we realize our abilities, can cope with life’s normal stresses, and can work regularly and productively. Physical health means a good body health, which is healthy because of regular physical activity, good nutrition, and adequate rest. Physical health can be determined by considering someone’s height/weight ratio, their Body Mass Index. Another term for physical health is physical wellbeing. Physical wellbeing is defined as something a person can achieve by developing all health-related components of his/her lifestyle. It can be concluded that mental and physical health is fundamentally linked. There are multiple associations between mental health and chronic physical conditions that significantly impact people’s quality of life. Just as physical fitness helps our bodies to stay strong, mental fitness helps us to achieve and sustain a state of good mental health. When we are mentally healthy, we enjoy our life and environment, and the people in it.

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