Home treatment for acute mental healthcare in Ticino: protocol of the Financial Outputs, Risks, Efficacy, Satisfaction Index and Gatekeeping of Home Treatment (FORESIGHT) study (Preprint)

2021 ◽  
Author(s):  
Sara Levati ◽  
Zefiro Benedetto Mellacqua ◽  
Maria Caiata Zufferey ◽  
Emiliano Soldini ◽  
Emiliano Albanese ◽  
...  

BACKGROUND Crisis Resolution and Home Treatment (CRHT) teams represent a community-based mental health service offering a valid alternative to hospitalisation. CRHT teams have been widely implemented in various mental health systems worldwide and their goal is to take care of people with severe acute mental disorders that would be considered for admission to acute psychiatric wards. The evaluation of several home-treatment experiences shows promising results; however, it remains unclear which specific elements and characteristics of CRHT are more effective and acceptable. OBJECTIVE This study aims to assess the acceptability, effectiveness and cost-effectiveness of a new CRHT intervention in Ticino, Southern Switzerland. METHODS The study includes an interventional non-randomised quasi-experimental study combined with a qualitative study and an economic evaluation over a 48-month period. The quasi-experimental evaluation will involve two groups: patients in the northern area of the region will be offered with the CRHT service and be defined as the intervention group; patients in the southern area of the region will act as the control group and receive care as usual. Individual interviews with patients receiving the home treatment intervention and their family members will be conducted. CRHT members will be asked to take part in a focus group. The economic evaluation will include a cost-effectiveness analysis. RESULTS As of February 2021, data for the non-randomised quasi-experimental study have been collected and results are expected to be published by the end of the year. Data are currently being collected for the qualitative study and the economic evaluation, and the results will be disseminated through publication when the analysis is complete. CONCLUSIONS Compared to other Swiss CRHT experiences, the CRHT intervention in Ticino represents a unique case, as the introduction of the service is backed by the closing of one of its acute wards. The proposed study will address several areas where there are evidence gaps or contradictory findings relating to the home treatment of acute mental crisis. Findings from this study will allow local services to improve their effectiveness in a challenging domain of public health and contribute to improving access to more effective care for people with severe mental disorders. CLINICALTRIAL Trial registration ISRCTN38472626 (ISRCTN registry)

2021 ◽  
pp. 014303432110250
Author(s):  
Celeste Simões ◽  
Anabela C. Santos ◽  
Paula Lebre ◽  
João R. Daniel ◽  
Cátia Branquinho ◽  
...  

Resilience is an individual’s ability to adapt successfully to and persevere during and after significant challenges. Resilience programmes based on a socioemotional learning approach have been associated with an increase in protextive factors (e.g., prosocial competencies), improvements in physical and mental health, and a decrease in internalised and externalised symptoms. The present study aimed to evaluate the impact of the RESCUR curriculum implemented in Portuguese schools on students’ academic, behavioural, and socioemotional outcomes, based on child and teacher reports. Participants included 1,084 children (53.2% male) aged 3-15 ( M = 7.24, SD = 2.31). A quasi-experimental study compared outcomes for an experimental intervention group (AIG) with a waiting list control group (WG). The results showed the RESCUR programme decreased mental health difficulties while increasing both prosocial behaviours and well-being. In addition, academic performance increased for those in preschool after implementation. Both teachers and children consistently reported positive behavioural changes in resilience-related competencies after implementing RESCUR. Our findings contribute to the recent research on the potential of RESCUR to address key socioemotional competencies and improve relevant protextive factors. Study limitations and future recommendations are addressed.


2021 ◽  
pp. 1-14
Author(s):  
Uta Roentgen ◽  
Loek van der Heide ◽  
Ingrid E.H. Kremer ◽  
Huub Creemers ◽  
Merel A. Brehm ◽  
...  

BACKGROUND: Impaired upper extremity function due to muscle paresis or paralysis has a major impact on independent living and quality of life (QoL). Assistive technology (AT) for upper extremity function (i.e. dynamic arm supports and robotic arms) can increase a client’s independence. Previous studies revealed that clients often use AT not to their full potential, due to suboptimal provision of these devices in usual care. OBJECTIVE: To optimize the process of providing AT for impaired upper extremity function and to evaluate its (cost-) effectiveness compared with care as usual. METHODS: Development of a protocol to guide the AT provision process in an optimized way according to generic Dutch guidelines; a quasi-experimental study with non-randomized, consecutive inclusion of a control group (n= 48) receiving care as usual and of an intervention group (optimized provision process) (n= 48); and a cost-effectiveness and cost-utility analysis from societal perspective will be performed. The primary outcome is clients’ satisfaction with the AT and related services, measured with the Quebec User Evaluation of Satisfaction with AT (Dutch version; D-QUEST). Secondary outcomes comprise complaints of the upper extremity, restrictions in activities, QoL, medical consumption and societal cost. Measurements are taken at baseline and at 3, 6 and 9 months follow-up.


Author(s):  
Lorna Kwai Ping Suen ◽  
Janet Pui Lee Cheung

Early childhood is a formative period during which healthy habits are developed, including proper hand hygiene practices. The aim of this quasi-experimental study was to determine the effectiveness of a 4-week series of educational sessions that consider the cognitive developmental stage of children on increasing their knowledge and promoting hand hygiene practices. The intervention group (n = 33) observed the hand hygiene program, whereas another group served as the waitlist control (n = 20). Creative activities were planned for the illustration of hand hygiene concepts in terms of “right moments”, “right steps”, and “right duration”. Hand sanitizer coverage was evaluated using a hand scanner. After the intervention, the experimental group had higher knowledge level toward hand hygiene than the control group (p < 0.001). Significant improvements in hand hygiene performance at the left palm and dorsum (p < 0.05), right palm (p < 0.05), and overall hand coverage (p < 0.05) were observed in the experimental group. The study demonstrated that the knowledge and proper hand hygiene (HH) practice of children can be positively influenced by the use of an age-appropriate education program. The results of this study have implications for school health educators and parents for promoting HH practices among children at home and at the school level.


2016 ◽  
Vol 55 (6) ◽  
pp. 339 ◽  
Author(s):  
Hartono Gunadi ◽  
Rini Sekartini ◽  
Retno Asti Werdhani ◽  
Ardi Findyartini ◽  
Muhammad Arvianda Kevin Kurnia

Background Immunization is recognized as one of the strategiesto reduce vaccine preventable diseases. Competency related toimmunization are consequently important for medical students andthe medical school needs to assure the competence acquisition.Objective To assess competence related to immunization andits retention following lectures with simulations compared tolectures only.Methods A quasi-experimental study was conducted to the 5th yearstudents of University of Indonesia Medical School during the ChildAdolescent Health Module in 2012-2013. The intervention grouphad lectures with simulations and the control group had lecturesonly. Immunization knowledge was assessed with a 30 multiplechoice question (MCA) items performed before and after themodule. Competence retention was assessed by MCQ (knowledge)and OSCE (skills) 2-6 months afterwards.Results Sixty eight subjects for each group with similarcharacteristics were analyzed. There was significant differenceafter module MCQ score between two groups. Competenceretention in 2-6 months after module completion was betterin intervention group, both for the knowledge (median MCQscore of 70.00 (range 37-93) vs. mean score of 58.01 (SD 12.22),respectively; P<0.001) and skill (OSCE mean scores of 75.21 (SD10.74) vs. 62.62 (SD 11.89), respectively; P < 0.001). Proportionof subjects in the intervention group who passed both the MCQand OSCE were also significantly greater.Conclusion Lectures with simulations are proved to bemore effective in improving medical students’ immunizationcompetence as well as its retention compared to lectures onlyapproach.


2014 ◽  
Vol 18 (12) ◽  
pp. 2231-2241 ◽  
Author(s):  
Marieke CE Battjes-Fries ◽  
Annemien Haveman-Nies ◽  
Reint-Jan Renes ◽  
Hante J Meester ◽  
Pieter van ’t Veer

AbstractObjectiveTo assess the effect of the Dutch school-based education programme ‘Taste Lessons’ on children’s behavioural determinants towards tasting unfamiliar foods and eating healthy and a variety of foods.DesignIn a quasi-experimental study design, data on behavioural determinants were collected at baseline, four weeks and six months after the intervention in both the intervention and control group. Children completed consecutively three questionnaires in which knowledge, awareness, skills, attitude, emotion, subjective norm and intention towards the two target behaviours were assessed. Teachers implemented on average a third of the programme activities. Multilevel regression analyses were conducted to compare individual changes in the determinants in the intervention group with those in the control group, corrected for children’s gender and age. Effect sizes were expressed as Cohen’s d.SettingDutch elementary schools.SubjectsForty-nine classes (1183 children, 9–12 years old) in grades 5–8 of twenty-one elementary schools.ResultsThe intervention group showed a higher increase in knowledge (d=0·26, P<0·01), which persisted after six months (d=0·23, P<0·05). After four weeks, the intervention group showed a higher increase in number of foods known (d=0·22, P<0·05) and tasted (d=0·21, P<0·05), subjective norm of the teacher (d=0·17, P<0·05) and intention (d=0·16, P<0·05) towards the target behaviours.ConclusionsPartial implementation of Taste Lessons during one school year showed small short-term effects on increasing behavioural determinants in relation to tasting unfamiliar foods and eating healthy and a variety of foods. Full and repeated implementation of Taste Lessons in subsequent years might result in larger effects.


2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Christopher Vunni Draiko ◽  
Khemika Yamarat ◽  
Alessio Panza ◽  
Judith Draleru ◽  
Martin Taban ◽  
...  

This study aimed to examine the effects of the Helping Babies Breathe (HBB) training interventions program on the knowledge, psychomotor skills, and competency of health workers in managing birth asphyxia and reducing mortality of newborns experiencing asphyxia within 24 hours. This study used pre- and post-test design (quasi experimental study). Purposive sampling was employed, and a computer-generated number was used to select the participants. Health workers from Juba Teaching Hospital comprised the intervention group. They were evaluated before and after the training from February to June 2017. A post training skill and competency evaluation was performed using a NeoNatalie newborn simulator and was repeated after three months of implementation for intervention and control group. Seventy health workers were enrolled; 40 were in the intervention group and 30 in the control group. Early newborn mortality due to asphyxia within 24 hours in intervention and control measure at pre and post implementation showed a significant reduction within the intervention than the control. Knowledge, psychomotor and competency of health care workers improved immediately after training and early newborn mortality reduced by half at the end of three months. It is recommended that training of health workers on HBB should be scaled up in most of the health facilities in South Sudan.


2020 ◽  
pp. 1357633X2093891 ◽  
Author(s):  
John A Naslund ◽  
Lauren M Mitchell ◽  
Udita Joshi ◽  
Dipal Nagda ◽  
Chunling Lu

Objective Telepsychiatry involves use of telecommunications technology to deliver psychiatric care and offers promise to reduce costs and increase access to mental health services. This systematic review examined cost reporting of telepsychiatry programmes for mental healthcare. Methods We systematically searched electronic databases for studies reporting costs, including economic evaluations such as cost-effectiveness analyses, or costs of developing telepsychiatry programmes for clinical care of mental disorders. Included studies enrolled participants with mental disorders and involved telepsychiatry for depression, anxiety disorders, serious mental illnesses including schizophrenia spectrum disorders and bipolar disorder, post-traumatic stress disorder, dementia or epilepsy. Results Twenty-six unique studies met inclusion criteria (17,967 participants), with most targeting depression ( n = 7; 27%), general mental disorders and screening ( n = 7; 27%), child mental health ( n = 4; 15%) and geriatric mental health ( n = 4; 15%). Nearly all studies ( n = 25; 96%) compared telepsychiatry programme costs with either standard in-person consultation or usual care, with 15 (60%) reporting that telepsychiatry programmes were less expensive, and 8 (32%) showing telepsychiatry programmes were more expensive. Three studies reported cost-effectiveness analyses, favouring telepsychiatry programmes, but at highly elevated cost-effectiveness thresholds. Few studies reported costs of developing or delivering telepsychiatry programmes. Conclusion Costs of telepsychiatry programmes varied widely, with substantial heterogeneity in how costs were defined and reported. Some programmes cost less than in-person services while others cost more. Therefore, rigorous cost-effectiveness studies following established standards in economic evaluation are needed to inform implementation and sustainability of these programmes in health systems.


Author(s):  
Mateus Henrique Gonçalves Meska ◽  
Leandro Yukio Mano ◽  
Janaina Pereira Silva ◽  
Gerson Alves Pereira Junior ◽  
Alessandra Mazzo

Objective: to compare the effect of exposure to unpleasant odors in a simulated clinical environment on the emotions of undergraduate nursing students. Method: quasi-experimental study. A total of 24 nursing students participated the study, divided into two groups, 12 in the intervention group with exposure to unpleasant odors, and 12 in the control group without exposure to unpleasant odors. To simulate the unpleasant vomiting odor in intervention group, fermented foods were used: boiled oats, curdled milk, spoiled Parmesan cheese, raw egg, pea soup, raisins and vinegar. Participants were filmed and the facial expression analysis was performed at six critical points: student approach; report of the complaint; clinical evaluation; and patient occurrence, intervention and reevaluation based on what was proposed by the Circumplex model of emotions recognition. Results: a total of 83,215 emotions related to the six critical points were verified. At the critical point of the proposed scenario with exposure to unpleasant odors, the intervention group presented the basic emotion of sadness and the Control Group, anger. Conclusion: it is inferred that the inclusion of unpleasant odors in the simulated scenarios can broaden the emotional development of health students.


2020 ◽  
Author(s):  
Roghaye Mehdipour-rabori ◽  
Behnaz Bagheryan ◽  
monirsadat nematollahi

Abstract Background:Clinical education is an essential part of nursing education. Selected clinical teaching methods influence it. Simulation-based mastery learning has been used to improve clinical skills among nursing students and may provide a novel way to enhance nursing skills.The object of this study was to assessthe effect of the simulation-based mastery learning on the clinicalskills of undergraduate nursing students from 2017 till 2019.Methods:This study was a quasi-experimental study withtwo groups (the control and intervention).After receiving written consent, one 117 studentsselected random convenience sampling. The intervention group participated in a simulation-based mastery learning intervention, and the control group received no intervention except for traditional training.The students of both groups completed the demographic information questionnaire and the checklist before and after the intervention. The results were analyzed by SPSS version 21 using descriptive and inferential statistics.Results:The results showed that there were no significant differences between the two groups before the intervention (p> o.o5). Also, that students’ performance in the intervention group and control group improved significantly at the post-test compared to baseline(p<0.05), implying that the simulation-based mastery model of the intervention group significantly more effective compared to that of the control.Conclusion: Thesefindings showed that mastery learning strategy improved the clinical skills ofundergraduatenursing students.The results suggest that other nursing and health profession’s programs can develop a successful mastery-based learning model.


2019 ◽  
pp. 105984051987164 ◽  
Author(s):  
Mohd Said Nurumal ◽  
Siti Hajar Mohd Zain ◽  
Mohamad Haniki Nik Mohamed ◽  
Shefaly Shorey

Preventing smoking among adolescents is critical. This study evaluated the effectiveness of the Smoking Prevention Education Program among nonsmoking adolescents. A quasi-experimental study design was used. Data were collected from Year 5 students ( n = 140) from four government primary schools in the Kuantan and Pahang districts of Malaysia. The participating schools were randomly assigned into the intervention and control groups. Questionnaires and exhaled carbon monoxide (CO) levels were used to collect data at the baseline and at 3 months postintervention. At 3 months postintervention, the percentage of nonsmokers remained 100% in the intervention group, while 2.9% of the participants in the control group reported to have smoked in past 7 days. Comparatively, the mean scores of attitudes, subjective norms, and nonsmoking intentions of the intervention group improved significantly. The intervention was effective in preventing smoking initiations among Malaysian adolescents; however, further evaluation of this intervention is needed among varied populations.


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