scholarly journals A web-based, peer-supported self-management intervention to reduce distress in relatives of people with psychosis or bipolar disorder: the REACT RCT

2020 ◽  
Vol 24 (32) ◽  
pp. 1-142 ◽  
Author(s):  
Fiona Lobban ◽  
Nadia Akers ◽  
Duncan Appelbe ◽  
Rossella Iraci Capuccinello ◽  
Lesley Chapman ◽  
...  
Keyword(s):  
Mental Health ◽  
Confidence Interval ◽  
General Health ◽  
Mental Health Problems ◽  
General Health Questionnaire ◽  
Health Technology ◽  
Self Management ◽  
Health Questionnaire ◽  
Treatment As Usual ◽  
Significant Difference

Background Relatives caring for people with severe mental health problems find information and emotional support hard to access. Online support for self-management offers a potential solution. Objective The objective was to determine the clinical effectiveness and cost-effectiveness of an online supported self-management tool for relatives: the Relatives’ Education And Coping Toolkit (REACT). Design and setting This was a primarily online (UK), single-blind, randomised controlled trial, comparing REACT plus a resource directory and treatment as usual with the resource directory and treatment as usual only, by measuring user distress and other well-being measures at baseline and at 12 and 24 weeks. Participants A total of 800 relatives of people with severe mental health problems across the UK took part; relatives who were aged ≥ 16 years, were experiencing high levels of distress, had access to the internet and were actively seeking help were recruited. Intervention REACT comprised 12 psychoeducation modules, peer support through a group forum, confidential messaging and a comprehensive resource directory of national support. Trained relatives moderated the forum and responded to messages. Main outcome measure The main outcome was the level of participants’ distress, as measured by the General Health Questionnaire-28 items. Results Various online and offline strategies, including social media, directed potential participants to the website. Participants were randomised to one of two arms: REACT plus the resource directory (n = 399) or the resource directory only (n = 401). Retention at 24 weeks was 75% (REACT arm, n = 292; resource directory-only arm, n = 307). The mean scores for the General Health Questionnaire-28 items reduced substantially across both arms over 24 weeks, from 40.2 (standard deviation 14.3) to 30.5 (standard deviation 15.6), with no significant difference between arms (mean difference –1.39, 95% confidence interval –3.60 to 0.83; p = 0.22). At 12 weeks, the General Health Questionnaire-28 items scores were lower in the REACT arm than in the resource directory-only arm (–2.08, 95% confidence interval –4.14 to –0.03; p = 0.027), but this finding is likely to be of limited clinical significance. Accounting for missing data, which were associated with higher distress in the REACT arm (0.33, 95% confidence interval –0.27 to 0.93; p = 0.279), in a longitudinal model, there was no significant difference between arms over 24 weeks (–0.56, 95% confidence interval –2.34 to 1.22; p = 0.51). REACT cost £142.95 per participant to design and deliver (£62.27 for delivery only), compared with £0.84 for the resource directory only. A health economic analysis of NHS, health and Personal Social Services outcomes found that REACT has higher costs (£286.77), slightly better General Health Questionnaire-28 items scores (incremental General Health Questionnaire-28 items score adjusted for baseline, age and gender: –1.152, 95% confidence interval –3.370 to 1.065) and slightly lower quality-adjusted life-year gains than the resource directory only; none of these differences was statistically significant. The median time spent online was 50.8 minutes (interquartile range 12.4–172.1 minutes) for REACT, with no significant association with outcome. Participants reported finding REACT a safe, confidential environment (96%) and reported feeling supported by the forum (89%) and the REACT supporters (86%). No serious adverse events were reported. Limitations The sample comprised predominantly white British females, 25% of participants were lost to follow-up and dropout in the REACT arm was not random. Conclusions An online self-management support toolkit with a moderated group forum is acceptable to relatives and, compared with face-to-face programmes, offers inexpensive, safe delivery of National Institute for Health and Care Excellence-recommended support to engage relatives as peers in care delivery. However, currently, REACT plus the resource directory is no more effective at reducing relatives’ distress than the resource directory only. Future work Further research in improving the effectiveness of online carer support interventions is required. Trial registration Current Controlled Trials ISRCTN72019945. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 32. See the NIHR Journals Library website for further project information.

scholarly journals Resiliencia asociada a factores de salud mental y sociodemográficos en enfermeros mexicanos durante COVID-19

2021 ◽  
Vol 20 (3) ◽  
pp. 1-32
Author(s):  
Reyna Jazmín Martínez Arriaga ◽  
Leivy Patricia González Ramírez ◽  
Nancy Evelyn Navarro Ruiz ◽  
José María De la Roca -Chiapas ◽  
Oscar Ulises Reynoso González
Keyword(s):  
Mental Health ◽  
General Health ◽  
Mental Health Problems ◽  
General Health Questionnaire ◽  
Risk Groups ◽  
Sociodemographic Factors ◽  
Health Questionnaire ◽  
Cross Sectional ◽  
Salud Mental ◽  
Low Levels

Introducción: El personal de enfermería es uno de los grupos más afectados por la actual pandemia por COVID-19. Se han reportado problemas de salud mental en esta población, sin embargo, también es importante estudiar la resiliencia, para identificar sus fortalezas. El objetivo de este estudio fue estudiar la resiliencia en enfermeros mexicanos y los factores sociodemográficos y de salud mental asociados a ella. Se llevó a cabo un estudio transversal.Método: Se envió vía online un cuestionario sociodemográfico y relacionado a COVID-19, así como el Inventario de Resiliencia y el Cuestionario General de Salud-28. Se incluyeron 556 enfermeros, la mayoría fueron mujeres (80%), solteras (60.8%) y con edades entre 26-35 años (38.3%).Resultados: Se encontraron niveles bajos de resiliencia en los enfermeros más jóvenes (p<0.001, ɳ2=0.05), solteros (p<0.001, ɳ2=0.02) y con menor nivel educativo (p=0.001, ɳ2=0.02). Los predictores de resiliencia fueron la búsqueda de información sobre salud mental (β =-0.152, p <0.001), nivel educativo más alto (β = 0.142, p<0.001), niveles bajos de depresión (β=-0.307, p<0.001) y bajos niveles de disfunción social (β =-0.261, p<0.001).Conclusión: Estos hallazgos permiten identificar los factores asociados a la resiliencia en los enfermeros y cómo estos juegan un rol muy importante en su salud mental. Asimismo, estos datos permiten la identificación de grupos con mayor riesgo psicosocial, con la finalidad de guiar estrategias en salud mental orientadas a aumentar la resiliencia. Introduction: Nursing personnel are one of the groups which have been most affected by the current COVID-19 pandemic. Although mental health problems have been reported in this population, it is important to study resilience, in order to identify its strengths. The purpose was to study resilience in Mexican nurses and the mental health and sociodemographic factors associated with it. A cross-sectional study was used. Method: A sociodemographic and COVID-19 related questionnaire, the Resilience Inventory and the General Health Questionnaire-28, was sent via online. 556 nurses were included, the majority were women (80%), single (60.8%), aged between 26-35 years (38.3%). Results: Lower resilience was found among nurses who were younger (p<0.001, ɳ2=0.05), single (p<0.001, ɳ2=0.02) and with lower levels of education (p=0.001, ɳ2=0.02). Predictors of resilience included the search for mental health information (β =-0.152, p <0.001), higher education (β = 0.142, p<0.001), low levels of depression (β=-0.307, p<0.001) and low levels of social dysfunction (β =-0.261, p<0.001). Conclusion: This findings allowed to identify the factors which are associated with resilience among nurses and how this plays an important role in their mental. Likewise, this data allows for the identification of high psychosocial risk groups, to better guide mental health strategies aimed at increasing resilience. Resumo:Introdução:O pessoal de enfermagem é um dos grupos mais afetados pela atual pandemia de COVID-19. Problemas de saúde mental têm sido relatados nessa população, porém também é importante estudar a resiliência, para identificar seus pontos fortes. O objetivo deste estudo foi estudar a resiliência em enfermeiras mexicanas e os fatores sociodemográficos e de saúde mental a ela associados. Foi realizado um estudo transversal.Método:Um questionário sociodemográfico relacionado ao COVID-19 foi enviado online, assim como o Resilience Inventory e o General Health Questionnaire-28. Foram incluídos 556 enfermeiros, a maioria mulheres (80%), solteiros (60,8%) e com idade entre 26-35 anos (38,3%).Resultados:Baixos níveis de resiliência foram encontrados nos enfermeiros mais jovens (p <0,001, ɳ2 = 0,05), solteiros (p <0,001, ɳ2 = 0,02) e com menor escolaridade (p = 0,001, ɳ2 = 0,02). Os preditores de resiliência foram a busca por informações sobre saúde mental (β = -0,152, p <0,001), maior escolaridade (β = 0,142, p <0,001), baixos níveis de depressão (β = -0,307, p <0,001 ) e baixos níveis de disfunção social (β = -0,261, p <0,001).Conclusão:Esses achados permitem identificar os fatores associados à resiliência em enfermeiros e como eles desempenham um papel muito importante em sua saúde mental. Da mesma forma, esses dados permitem identificar grupos de maior risco psicossocial, a fim de nortear estratégias de saúde mental que visem aumentar a resiliência.

Deprivation and Social Support in Mental Health of Welfare Recipients in Japan

2016 ◽  
Vol 118 (2) ◽  
pp. 372-386
Author(s):  
Takahiro Yoshizumi ◽  
Seiko Mizutani ◽  
Soshiro Yamada
Keyword(s):  
Mental Health ◽  
Social Support ◽  
General Population ◽  
Emotional Support ◽  
General Health ◽  
General Health Questionnaire ◽  
Deprivation Index ◽  
Welfare Recipients ◽  
Health Questionnaire ◽  
Social Support Scale

Although many Western studies examining the mental health of welfare recipients exist, Japanese welfare recipients have been overlooked. This study investigated mental health among welfare recipients in Japan and relations with a sense of deprivation of life's necessities and social support. Participants ( n = 305) completed the General Health Questionnaire-12 (GHQ-12), Proportional Deprivation Index, and a social support scale. Participants' GHQ-12 scores exceeded those of the general public, as 54.9% scored above the cut-off, suggesting poorer mental health among welfare recipients than the general population. Proportional Deprivation Index and emotional support from relatives and friends were associated with GHQ-12 scores. These results suggest that while chronic deprivation is associated with poorer mental health among welfare recipients, receiving emotional support may help cope with distress and maintain mental health.

A Factor Analytic Study of the 60-Item General Health Questionnaire in Australian Community and General Practice Settings

1984 ◽  
Vol 18 (3) ◽  
pp. 256-262 ◽  
Author(s):  
P. W. Burvill ◽  
M. W. Knuiman ◽  
R. A. Finlay-Jones
Keyword(s):  
General Practice ◽  
General Health ◽  
General Health Questionnaire ◽  
Analytic Study ◽  
Physical Factors ◽  
Positive Finding ◽  
Health Questionnaire ◽  
Factor Analytic ◽  
Factor Analytic Study ◽  
Significant Difference

A factor analytic study of responses to a 60-item General Health Questionnaire of people in general practice and in the community in Perth, Western Australia, was performed. Five identified factors, accounting for 46% of the variance, were very similar to factors identified in an English general practice study but differed from two published Australian studies. The statistic of a relative GHQ profile was generated to compare these factors in various sets of data. There was no significant difference between the relative GHQ profile in the community and general practice data or between demographic factors such as sex, social class and country of birth. The major positive finding was of an excess of overtly psychological factors in ‘cases’ compared with an excess of more physical factors in ‘non-cases’.

Dimensions of neurosis

1992 ◽  
Vol 22 (4) ◽  
pp. 1011-1018 ◽  
Author(s):  
Glyn Lewis
Keyword(s):  
Mental Health ◽  
General Health ◽  
General Health Questionnaire ◽  
Empirical Support ◽  
General Factor ◽  
Health Questionnaire ◽  
Components Analysis ◽  
Positive Coefficients ◽  
Anxiety Depression

SynopsisFactor analyses of the General Health Questionnaire have attempted to interpret the factors as measuring anxiety, depression and social functioning. Data from two large community surveys were used to conduct an unrotated principal components analysis of the 30-item General Health Questionnaire. A general factor, indicating overall severity of psychiatric disorder, accounted for around 30% of the variance. The next most important factor, accounting for about 8% of the variance, was bipolar with the positive (‘less than usual’) items of the General Health Questionnaire having positive coefficients and the negative (‘more than usual’) items having negative coefficients. It is suggested that the concepts of positive and negative mental health derive empirical support from the results and may prove to be a useful classification of dimensions of mental health in the community.

scholarly journals Psychological Effects of Fasting on Patients Suffering from Diabetes Type 2

2020 ◽  
Author(s):  
Narjes Hazar ◽  
Somaye Gholami ◽  
Shima Shafiei ◽  
Mozhgan Hemmati ◽  
Masoud Rahmanian
Keyword(s):  
General Health ◽  
General Health Questionnaire ◽  
Diabetes Type 2 ◽  
Diabetes Type ◽  
Psychological Effects ◽  
Diabetic Patients ◽  
Health Questionnaire ◽  
Significant Difference ◽  
Before And After

Objective: We conducted this study to compare the psychological effects between diabetic patients taking fast and non-fasting counterparts to better investigate the effects of fasting on mental health of diabetes sufferers. Materials and Methods: This study was a prospective cohort conducted among diabetic patients. In this study, two types of fasting and non-fasting patients were invited to take part. During One week before and after the Ramadan, all patients were asked to complete 28-scale General Health Questionnaire (GHQ). Results: In this study, 116 patients who were suffering from diabetes completed the study. They were compared with each other in format of three groups (two fasting and one non-fasting). Mean changes of total and subscales' score were negative in nearly all groups but there were no significant difference between groups. In addition, total and subscale A, B and C scores significantly increased (positive change) but subscale D score didn’t change in fasting patients during this month. Conclusion: The results of present study revealed that fasting during the whole month of Ramadan can exacerbate patients' general health in comparison with non-fasting patients. However, because we can't determine whether this finding is attributed to fasting regardless of diabetes or has been resulted from the co-existence of fasting and the disease, it is recommended to design a study to compare diabetic and healthy fasting individuals.

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