scholarly journals Self-Practice of Stabilizing and Guided Imagery Techniques for Traumatized Refugees via Digital Audio Files: Qualitative Study

10.2196/17906 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e17906
Author(s):  
Catharina Zehetmair ◽  
Ede Nagy ◽  
Carla Leetz ◽  
Anna Cranz ◽  
David Kindermann ◽  
...  
Keyword(s):  
Guided Imagery ◽  
Mental Health Problems ◽  
The Self ◽  
Digital Audio ◽  
Safe Place ◽  
Time Space ◽  
Increased Risk ◽  
Audio Files ◽  
Imagery Techniques

Background Refugees have an increased risk of developing mental health problems. There are insufficient psychosocial care structures to meet the resulting need for support. Stabilizing and guided imagery techniques have shown promising results in increasing traumatized refugees’ emotional stabilization. If delivered via audio files, the techniques can be practiced autonomously and independent of time, space, and human resources or stable treatment settings. Objective This study aimed to evaluate the self-practice of stabilizing and guided imagery techniques via digital audio files for traumatized refugees living in a reception and registration center in Germany. Methods From May 2018 to February 2019, 42 traumatized refugees participated in our study. At T1, patients received digital audio files in English, French, Arabic, Farsi, Turkish, or Serbian for self-practice. Nine days later, at T2, a face-to-face interview was conducted. Two months after T2, a follow-up interview took place via telephone. Results At T2, about half of the patients reported the daily practice of stabilizing and guided imagery techniques. At follow-up, the average frequency of practice was once weekly or more for those experiencing worse symptoms. No technical difficulties were reported. According to T2 and follow-up statements, the techniques helped the patients dealing with arousal, concentration, sleep, mood, thoughts, empowerment, and tension. The guided imagery technique “The Inner Safe Place” was the most popular. Self-practice was impeded by postmigratory distress factors, like overcrowded accommodations. Conclusions The results show that self-practice of stabilizing and guided imagery techniques via digital audio files was helpful to and well accepted by the assessed refugees. Even though postmigratory distress factors hampered self-practice, “The Inner Safe Place” technique was particularly well received. Overall, the self-practiced audio-based stabilizing and guided imagery techniques showed promising results among the highly vulnerable group of newly arrived traumatized refugees.

scholarly journals Self-Practice of Stabilizing and Guided Imagery Techniques for Traumatized Refugees via Digital Audio Files: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Catharina Zehetmair ◽  
Ede Nagy ◽  
Carla Leetz ◽  
Anna Cranz ◽  
David Kindermann ◽  
...  
Keyword(s):  
Guided Imagery ◽  
Mental Health Problems ◽  
The Self ◽  
Digital Audio ◽  
Safe Place ◽  
Time Space ◽  
Increased Risk ◽  
Audio Files ◽  
Imagery Techniques

BACKGROUND Refugees have an increased risk of developing mental health problems. There are insufficient psychosocial care structures to meet the resulting need for support. Stabilizing and guided imagery techniques have shown promising results in increasing traumatized refugees’ emotional stabilization. If delivered via audio files, the techniques can be practiced autonomously and independent of time, space, and human resources or stable treatment settings. OBJECTIVE This study aimed to evaluate the self-practice of stabilizing and guided imagery techniques via digital audio files for traumatized refugees living in a reception and registration center in Germany. METHODS From May 2018 to February 2019, 42 traumatized refugees participated in our study. At T1, patients received digital audio files in English, French, Arabic, Farsi, Turkish, or Serbian for self-practice. Nine days later, at T2, a face-to-face interview was conducted. Two months after T2, a follow-up interview took place via telephone. RESULTS At T2, about half of the patients reported the daily practice of stabilizing and guided imagery techniques. At follow-up, the average frequency of practice was once weekly or more for those experiencing worse symptoms. No technical difficulties were reported. According to T2 and follow-up statements, the techniques helped the patients dealing with arousal, concentration, sleep, mood, thoughts, empowerment, and tension. The guided imagery technique “The Inner Safe Place” was the most popular. Self-practice was impeded by postmigratory distress factors, like overcrowded accommodations. CONCLUSIONS The results show that self-practice of stabilizing and guided imagery techniques via digital audio files was helpful to and well accepted by the assessed refugees. Even though postmigratory distress factors hampered self-practice, “The Inner Safe Place” technique was particularly well received. Overall, the self-practiced audio-based stabilizing and guided imagery techniques showed promising results among the highly vulnerable group of newly arrived traumatized refugees.

scholarly journals Predictors of clinical deterioration in patients with suspected COVID-19 managed in a ‘virtual hospital’ setting: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045356
Author(s):  
Nick A Francis ◽  
Beth Stuart ◽  
Matthew Knight ◽  
Rama Vancheeswaran ◽  
Charles Oliver ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Hospital Setting ◽  
Health Problems ◽  
Clinical Deterioration ◽  
Care Services ◽  
Increased Risk ◽  
Remote Assessment ◽  
History Of

ObjectiveIdentify predictors of clinical deterioration in a virtual hospital (VH) setting for COVID-19.DesignReal-world prospective observational study.SettingVH remote assessment service in West Hertfordshire NHS Trust, UK.ParticipantsPatients with suspected COVID-19 illness enrolled directly from the community (postaccident and emergency (A&E) or medical intake assessment) or postinpatient admission.Main outcome measureDeath or (re-)admission to inpatient hospital care during VH follow-up and for 2 weeks post-VH discharge.Results900 patients with a clinical diagnosis of COVID-19 (455 referred from A&E or medical intake and 445 postinpatient) were included in the analysis. 76 (8.4%) of these experienced clinical deterioration (15 deaths in admitted patients, 3 deaths in patients not admitted and 58 additional inpatient admissions). Predictors of clinical deterioration were increase in age (OR 1.04 (95% CI 1.02 to 1.06) per year of age), history of cancer (OR 2.87 (95% CI 1.41 to 5.82)), history of mental health problems (OR 1.76 (95% CI 1.02 to 3.04)), severely impaired renal function (OR for eGFR <30=9.09 (95% CI 2.01 to 41.09)) and having a positive SARS-CoV-2 PCR result (OR 2.0 (95% CI 1.11 to 3.60)).ConclusionsThese predictors may help direct intensity of monitoring for patients with suspected or confirmed COVID-19 who are being remotely monitored by primary or secondary care services. Further research is needed to confirm our findings and identify the reasons for increased risk of clinical deterioration associated with cancer and mental health problems.

An Evaluation of Cognitive-Behavioural Techniques in the Management of Chronic Arthritic Pain in Men with Haemophilia

1991 ◽  
Vol 8 (2) ◽  
pp. 70-78 ◽  
Author(s):  
Peter W. Dunne ◽  
Matthew R. Sanders ◽  
John A. Rowell ◽  
William R. McWhirter
Keyword(s):  
Relaxation Training ◽  
Rating Scales ◽  
Guided Imagery ◽  
Coping Skills ◽  
Cognitive Coping ◽  
Pain Experience ◽  
Cognitive Behavioural ◽  
Antecedents And Consequences ◽  
Imagery Techniques

Three adults with haemophilia participated in a study designed to determine the effectiveness of cognitive-behavioural techniques in the alleviation of chronic arthritic pain. The intervention comprised cognitive-coping skills, primarily relaxation training and guided imagery techniques, as well as identifying and altering antecedents and consequences that may have influenced their pain experience. The dependent measures included visual analogue rating scales, the Arthritis Impact Measurements Scale, the Beck Depression Inventory and pedometer readings. All three men showed significant reductions in pain, which were largely maintained at six-month follow-up. This study supports earlier findings with this population, and highlights the importance of monitoring the implementation of independent measures.

scholarly journals Stabilizing Techniques and Guided Imagery for Traumatized Male Refugees in a German State Registration and Reception Center: A Qualitative Study on a Psychotherapeutic Group Intervention

2019 ◽  
Vol 8 (6) ◽  
pp. 894 ◽  
Author(s):  
Catharina Zehetmair ◽  
Inga Tegeler ◽  
Claudia Kaufmann ◽  
Anne Klippel ◽  
Luise Reddemann ◽  
...  
Keyword(s):  
Mental Health ◽  
Qualitative Study ◽  
Psychosocial Functioning ◽  
Group Intervention ◽  
Guided Imagery ◽  
Mental Health Problems ◽  
Structured Interviews ◽  
German State ◽  
Increased Risk ◽  
State Registration

Refugees have an increased risk of developing mental health problems. Due to the unstable setting in refugee state registration and reception centers, recommended trauma-focused treatment approaches are often not applicable. For this purpose, we devised a suitable therapeutic approach to treat traumatized refugees in a German state registration and reception center: Group therapy, focusing on stabilizing techniques and guided imagery according to Reddemann (2017). From May 2017 to April 2018, we conducted semi-structured interviews with n = 30 traumatized refugees to assess their experiences with the stabilizing techniques and guided imagery in group sessions and self-practice. Participants mainly reported that they had more pleasant feelings, felt increasingly relaxed, and could better handle recurrent thoughts. Additionally, the participants noticed that their psychosocial functioning had improved. The main difficulties that participants encountered were feeling stressed, having difficulties staying focused, or concentrating on the techniques. During self-practice, the participants found it most challenging that they did not have any verbal guidance, were often distracted by the surroundings in the accommodation, and had recurrent thoughts about post-migratory stressors, such as insecurity concerning the future or the application for asylum. Our results show that stabilizing techniques and guided imagery according to Reddemann (2017) are a suitable approach to treat traumatized refugees living in volatile conditions.

scholarly journals Cannabis and suicide: longitudinal study

2009 ◽  
Vol 195 (6) ◽  
pp. 492-497 ◽  
Author(s):  
Ceri Price ◽  
Tomas Hemmingsson ◽  
Glyn Lewis ◽  
Stanley Zammit ◽  
Peter Allebeck
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
Suicidal Ideation ◽  
Military Service ◽  
Mental Health Problems ◽  
Strong Association ◽  
Cannabis Use ◽  
Completed Suicide ◽  
Increased Risk

BackgroundSome studies suggest that cannabis use is associated with suicidal ideation, but no detailed longitudinal study has examined suicide as an outcome.AimsTo examine the association between cannabis use and completed suicide.MethodA longitudinal study investigated 50 087 men conscripted for Swedish military service, with cannabis use measured non-anonymously at conscription. Suicides during 33 years of follow-up were identified by linkage with the National Cause of Death Register.ResultsThere were 600 (1.2% of cohort) suicides or deaths from undetermined causes. Cannabis use was associated with an increased risk of suicide (crude OR for ‘ever use’ 1.62, 95% CI 1.28–2.07), but this association was eliminated after adjustment for confounding (adjusted OR = 0.88, 95% CI 0.65–1.20).ConclusionsAlthough there was a strong association between cannabis use and suicide, this was explained by markers of psychological and behavioural problems. These results suggest that cannabis use is unlikely to have a strong effect on risk of completed suicide, either directly or as a consequence of mental health problems secondary to its use.

scholarly journals Risk Factors for Anxiety and Depressive Symptoms in Doctors During the Coronavirus Disease 2019 Pandemic

2021 ◽  
Vol 12 ◽  
Author(s):  
Lanying He ◽  
Jian Wang ◽  
Lijuan Zhang ◽  
Feng Wang ◽  
Weiwei Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
Mental Health Problems ◽  
Depression Scale ◽  
Anxiety Symptoms ◽  
The Self ◽  
Female Sex ◽  
Self Rating ◽  
Increased Risk ◽  
A Minor

Background: The purpose of our study was to investigate the prevalence of anxiety and depressive symptoms and their risk factors among doctors during the coronavirus disease 2019 (COVID-19) pandemic.Methods: A hospital-based survey study was conducted. Anxiety symptoms were assessed using the Self-Rating Anxiety Scale (SAS), and depressive symptoms were assessed using the Self-Rating Depression Scale (SDS). Multivariable logistic regression was used to analyze anxiety and depressive symptoms across independent variables.Results: A total of 1,521 doctors were included; 11.11% (169/1,521) of the doctors had anxiety symptoms, and 16.90% (257/1,521) had depressive symptoms. Female sex [adjusted odds ratio (aOR), 1.69; 95% confidence interval (CI), 1.21–2.34; P = 0.002] and having a minor child (aOR, 2.31; 95% CI, 1.50–3.56; P &lt; 0.001) were associated with an increased risk of anxiety symptoms. Female sex (aOR, 1.56; 95% CI, 1.18–2.06; P = 0.002) and having a minor child (aOR, 1.48; 95% CI, 1.06–2.01; P = 0.022) were associated with an increased risk of depressive symptoms. Older age (aOR, 0.97; 95% CI, 0.98–0.99; P = 0.008) was associated with a decreased risk of depressive symptoms.Conclusions: Anxiety and depressive symptoms have been common mental health problems in doctors during the COVID-19 pandemic. We found that female sex, having a minor child, and younger age were major risk factors for the development of anxiety and depressive symptoms among doctors during the COVID-19 pandemic.

scholarly journals Predictors of adverse outcome in patients with suspected COVID-19 managed in a ‘virtual hospital’ setting: a cohort study

2020 ◽  
Author(s):  
Nick A Francis ◽  
Beth Stuart ◽  
Matthew Knight ◽  
Rama Vancheeswaran ◽  
Charles Oliver ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Adverse Outcome ◽  
Hospital Setting ◽  
Health Problems ◽  
List Type ◽  
Increased Risk ◽  
Wide Range ◽  
History Of

ABSTRACTObjectiveIdentify predictors of adverse outcome in a Virtual Hospital (VH) setting for COVID 19.DesignReal-world prospective observational study.SettingVirtual hospital remote assessment service in West Hertfordshire NHS Trust, UK.ParticipantsPatients with suspected COVID-19 illness enrolled directly from the community (post-accident and emergency (A&E) or medical intake assessment) or post-inpatient admission.Main outcome measureDeath or (re-)admission to inpatient hospital care over 28 days.Results900 patients with a clinical diagnosis of COVID-19 (455 referred from A&E or medical intake and 445 post-inpatient) were included in the analysis. 76 (8.4%) of these experienced an adverse outcome (15 deaths in admitted patients, 3 deaths in patients not admitted, and 58 additional inpatient admissions). Predictors of adverse outcome were increase in age (OR 1.04 [95%CI: 1.02, 1.06] per year of age), history of cancer (OR 2.87 [95%CI: 1.41, 5.82]), history of mental health problems (OR 1.76 [95%CI: 1.02, 3.04]), severely impaired renal function (OR for eGFR <30 = 9.09 [95%CI: 2.01, 41.09]) and having a positive SARS-CoV-2 PCR result (OR 2.0 [95% CI: 1.11, 3.60]).ConclusionsThese predictors may help direct intensity of monitoring for patients with suspected or confirmed COVID-19 who are being remotely monitored by primary or secondary care services. Further research is needed to identify the reasons for increased risk of adverse outcome associated with cancer and mental health problems.ARTICLE SUMMARYStrengths and limitations of this studyThe study uses anonymised data from all patients registered for the virtual hospital between 17/03/20 and 17/05/20, and therefore selection bias is not an issue.At the time of this study, this was the only service providing remote follow-up for patients with suspected COVID-19 in the area, and therefore our findings are likely to be relevant to primary care patients receiving remote follow-up.We were able to collect reliable data on a wide range of clinical and demographic features, and reliably follow all patients for the primary outcome for at least two weeks following their discharge from the VH.We were not able to extract detailed symptom or clinical examination data, and there were significant amounts of missing data for some variables.Our study is likely underpowered to detect all predictors, especially in the analysis of our two sub-groups

scholarly journals 535The epidemiology of all-cause and cause-specific mortality following release from prison in 11 countries

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Rohan Borschmann ◽  
Holly Tibble ◽  
Matthew Spittal ◽  
David Preen ◽  
Jane Pirkis ◽  
...  
Keyword(s):  
Mental Health Problems ◽  
Meta Analysis ◽  
Physical And Mental Health ◽  
Relevant Evidence ◽  
Analysis Methodology ◽  
Increased Risk ◽  
Global Epidemiology ◽  
Individual Participant ◽  
Causes And Risk Factors

Abstract Background More than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance. Methods We aimed to comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from incarceration. We created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology. Results Using linked data from the 29 individual cohorts, the combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up. Preliminary analyses indicate a marked elevation in mortality risk following release from incarceration, with this risk beginning on the day of release. At the time of writing, more detailed analyses are underway regarding all-cause and cause-specific deaths – along with risk and protective factors – and findings will be presented at the WCE conference. Conclusions The MARIC consortium represents an important advancement in the field, bringing international attention to this problem. Key messages The MARIC consortium will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalised population.

Clinical Success Using the Audio-Visual Feedback Training for Cluttering

2019 ◽  
Vol 4 (6) ◽  
pp. 1589-1594
Author(s):  
Yvonne van Zaalen ◽  
Isabella Reichel
Keyword(s):  
Visual Feedback ◽  
Clinical Success ◽  
Pause Duration ◽  
Digital Audio ◽  
Male Adolescents ◽  
Feedback Training ◽  
Positive Effects ◽  
Speech Monitoring ◽  
Adolescents And Adults

Purpose Among the best strategies to address inadequate speech monitoring skills and other parameters of communication in people with cluttering (PWC) is the relatively new but very promising auditory–visual feedback (AVF) training ( van Zaalen & Reichel, 2015 ). This study examines the effects of AVF training on articulatory accuracy, pause duration, frequency, and type of disfluencies of PWC, as well as on the emotional and cognitive aspects that may be present in clients with this communication disorder ( Reichel, 2010 ; van Zaalen & Reichel, 2015 ). Methods In this study, 12 male adolescents and adults—6 with phonological and 6 with syntactic cluttering—were provided with weekly AVF training for 12 weeks, with a 3-month follow-up. Data was gathered on baseline (T0), Week 6 (T1), Week 12 (T2), and after follow-up (T3). Spontaneous speech was recorded and analyzed by using digital audio-recording and speech analysis software known as Praat ( Boersma & Weenink, 2017 ). Results The results of this study indicated that PWC demonstrated significant improvements in articulatory rate measurements and in pause duration following the AVF training. In addition, the PWC in the study reported positive effects on their ability to retell a story and to speak in more complete sentences. PWC felt better about formulating their ideas and were more satisfied with their interactions with people around them. Conclusions The AVF training was found to be an effective approach for improving monitoring skills of PWC with both quantitative and qualitative benefits in the behavioral, cognitive, emotional, and social domains of communication.

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