scholarly journals Blended Care in In-Patient Acute Psychiatric Care. The Example of a Group Training for Social Competences in Adults—A Pretest–Posttest Feasibility Study

2021 ◽  
Vol 18 (18) ◽  
pp. 9433
Author(s):  
Eileen Bendig ◽  
Ann-Marie Küchler ◽  
Harald Baumeister ◽  
Thomas Becker
Keyword(s):  
Social Skills ◽  
Inpatient Care ◽  
Psychiatric Care ◽  
Psychiatric Inpatient ◽  
Skills Training ◽  
Group Training ◽  
Inpatient Psychiatric Care ◽  
Blended Care ◽  
Acute Psychiatric Care ◽  
Blended Intervention

Introduction: Deficits in social skills can be an important modulating factor in the development and progress of various mental disorders. However, limited resources in inpatient care often impede effective social skills training. This study investigates the feasibility of a blended group training for social skills (SST) in an inpatient psychiatric setting. Methods and Analysis: For this one-group pretest–posttest trial, inpatients with a diagnosed mental disorder were recruited. Participation in the blended SST lasted four weeks and took place within usual inpatient psychiatric care. The blended intervention comprised four face-to-face group sessions and three complementary online modules within four weeks. Assessments took place before (t1) and after (t2) the training. Feasibility outcomes (use, acceptance, satisfaction, implementability into usual psychiatric inpatient care) and effectiveness outcomes regarding social skills were assessed. Results: N = 15 participants were recruited. Most patients completed all questionnaires (93%) and all modules of the blended SST concept (60%). All participants (100%) would recommend the blended intervention to a friend. Regarding social skills, exploratory analyses revealed a non-significant medium-sized effect (Cohen’s d = 0.5 95%CI 0.3 to 1.25, p = 0.08). Discussion: This trial shows that a blended care SST is feasible for the use in acute psychiatric inpatient care setting. Although the wards were acute, with high turnover and change of inpatients, 60% of participants were treated per protocol over four weeks. Overall, the evidence on blended care concepts in psychiatric care settings is extremely poor to date. Hence, this trial should encourage intensified blended inpatient psychiatric care research.

Limiting psychotropic medication prescription on discharge from psychiatric inpatient care: a possible suicide intervention?

2019 ◽  
Vol 37 (1) ◽  
pp. 43-47
Author(s):  
Eimear Cleary ◽  
Cecily C. Kelleher ◽  
Abbie Lane ◽  
Kevin M. Malone
Keyword(s):  
Suicide Prevention ◽  
Psychotropic Medication ◽  
Psychiatric Care ◽  
Psychiatric Inpatient ◽  
Potential Contribution ◽  
Prescription Data ◽  
Prescribing Practices ◽  
Inpatient Psychiatric Care ◽  
Increased Risk ◽  
Lethal Means

ObjectivesRestricting access to lethal means is an effective suicide prevention strategy. However, there is little discussion in the literature about the potential contribution of prescribing practices on discharge from inpatient psychiatric care (which has been established as a high-risk period for suicide) to suicide deaths by overdose of prescribed medication. This study aimed to assess the quantity, toxicity and potential lethality of psychotropic medication being prescribed on discharge from psychiatric care to those with and without indices of suicidality.MethodsPatient demographic, clinical and prescription data were collected from 50 randomly selected charts following discharge from inpatient psychiatric care. Psychotropic medications (dose × duration) on discharge were converted to their equivalent doses of neuroleptics, antidepressants and anxiolytics to rate toxicity and potential lethality, using the Maudsley Prescribing Guidelines. Mood stabilizing medications were also documented.Results39% of prescriptions analysed contained toxic and potentially fatal doses of either neuroleptic or antidepressant equivalent medication.ConclusionsPatient discharge from inpatient psychiatric care presents a golden opportunity to moderate access to potentially fatal psychotropic medication. Iatrogenic provision of lethal means for suicide during a period of increased risk and in a group at increased suicide risk may impact suicide prevention efforts and requires further in-depth research. Current prescribing practices may be a missed opportunity to intervene in this regard.

scholarly journals Intervensi Latihan Keterampilan Sosial pada Pasien Perilaku Kekerasan

2019 ◽  
Vol 1 (2) ◽  
pp. 120-126
Author(s):  
A. Nur Anna AS
Keyword(s):  
Social Skills ◽  
Aggressive Behavior ◽  
Social Relations ◽  
Inpatient Care ◽  
Social Skills Training ◽  
Negative Impact ◽  
Skills Training ◽  
Psychiatric Services ◽  
Case Study Methods

Background: Aggressive behavior is the biggest problem that often occurs in inpatient care at psychiatric services so it needs to be a top priority, the frequency of aggression has a negative impact on staff and other patients needs to be taken into consideration. Method: descriptive which conducts research on case study methods by conducting interviews and observations. Results: Social skills training given to clients who want to improve skills in social relations or who are unable to make social relations and creativity that are difficult in relation to others by using the principles of social learning. This social skills training consists of six sessions, where each session takes 45 minutes. Conclusions: Exercise skills can overcome problem solving problems. Recommendations: apply social skills training with intervention in patients aggressive behavior

The context of inpatient mental health care in England

2019 ◽  
pp. 41-46
Author(s):  
Rob Chaplin
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Inpatient Care ◽  
Psychiatric Care ◽  
Inpatient Psychiatric Care ◽  
Recent Trends ◽  
Uk National Health Service ◽  
The Uk

This chapter reviews the practice of inpatient care in relation to the provision of overall psychiatric care in England. The structure of mental health care in the UK National Health Service (NHS) is outlined and in particular the various subspecialties of inpatient care. Recent trends in the provision of inpatient psychiatric care in the UK are considered in comparison to those in Europe and North America. There follows a review of the role of public sector care under the NHS and a debate about the effectiveness of inpatient care and whether it should be a separate psychiatric subspecialty. Finally, local service developments are discussed as a type of case study to illustrate how services are currently undergoing rapid changes.

scholarly journals Effectiveness of Social Skills Training Groups in Persons with Severe Mental Illness: A Pre–Post Intervention Study

2021 ◽  
pp. 025371762110241
Author(s):  
Priyadarshini Aruldass ◽  
Thamarai Selvi Sekar ◽  
Srikrithika Saravanan ◽  
Reema Samuel ◽  
K. S. Jacob
Keyword(s):  
Social Skills ◽  
Training Program ◽  
Social Skills Training ◽  
Rating Scale ◽  
Skills Training ◽  
Group Training ◽  
Time Points ◽  
Social Skills Group ◽  
Skills Group

Background: The study aimed to evaluate the effectiveness of a social skills training program provided at the occupational therapy unit of a tertiary care center in India. Methods: The study used a pre–post interventional design where 101 consecutive patients with a diagnosis of schizophrenia or bipolar affective disorder, between 18 and 60 years, who provided written informed consent, were assessed on the Vellore Assessment of Social Performance (VASP) during the first week of attendance (baseline). Subsequently, they were enrolled in a six-session social skills group training program for two weeks. They were assessed on the VASP after one week (midterm assessment) and at the end (posttest) of the intervention. A follow-up assessment was done two weeks after cessation of the intervention. The participants were also scored on the Brief Psychiatric Rating Scale (BPRS) at four time points. Results: Repeated measures ANOVA revealed significant differences in the VASP scores between time points, that is, F(baseline, midterm) = −4.34 and P = 0.001; F (baseline, postgroup) = −6.92 and P = 0.001; and F (baseline, follow-up) = −8.71 and P = 0.001. The correlation between the BPRS and VASP scores was also significant at each time point. Conclusion: The social skills group training protocol seems to be effective and feasible for the Indian population. Since conducting multicenter clinical trials might not always be possible in resource-constrained settings, this study might be considered preliminary evidence for context-specific, peer-/family-supported social skills training.

scholarly journals The use of psychiatric services by young adults who came to Sweden as teenage refugees: a national cohort study

2016 ◽  
Vol 26 (5) ◽  
pp. 526-534 ◽  
Author(s):  
H. Manhica ◽  
Y. Almquist ◽  
M. Rostila ◽  
A. Hjern
Keyword(s):  
Outpatient Care ◽  
Inpatient Care ◽  
Psychiatric Care ◽  
Proportional Hazards ◽  
Psychiatric Inpatient ◽  
Cox Proportional Hazards ◽  
Compulsory Admission ◽  
Birth Cohorts ◽  
Health Seeking ◽  
Swedish Population

Aims.To investigate the patterns of use of different forms of psychiatric care in refugees who settled in Sweden as teenagers.Method.Cox proportional hazards models were used to estimate the use of different forms of psychiatric care from 2009 to 2012 in a population of 35 457 refugees, aged from 20 to 36, who had settled in Sweden as teenagers between 1989 and 2004. These findings were compared with 1.26 million peers from the same birth cohorts in the general Swedish population.Results.Unaccompanied and accompanied refugees were more likely to experience compulsory admission to a psychiatric hospital compared with the native Swedish population, with hazard ratios (HRs) of 2.76 (1.86–4.10) and 1.89 (1.53–2.34), respectively, as well as psychiatric inpatient care, with HRs of 1.62 (1.34–1.94) and 1.37 (1.25–1.50). Outpatient care visits by the young refugees were similar to the native Swedish population. The longer the refugees had residency in Sweden, the more they used outpatient psychiatric care. Refugees born in the Horn of Africa and Iran were most likely to undergo compulsory admission, with HRs of 3.98 (2.12–7.46) and 3.07 (1.52–6.19), respectively. They were also the groups who were most likely to receive inpatient care, with HRs of 1.55 (1.17–2.06) and 1.84 (1.37–2.47), respectively. Our results also indicated that the use of psychiatric care services increased with the level of education in the refugee population, while the opposite was true for the native Swedish population. In fact, the risks of compulsory admissions were particularly higher among refugees who had received a secondary education, compared with native Swedish residents, with HRs of 4.72 (3.06–7.29) for unaccompanied refugees and 2.04 (1.51–2.73) for accompanied refugees.Conclusions.Young refugees received more psychiatric inpatient care than the native Swedish population, with the highest rates seen in refugees who were not accompanied by their parents. The discrepancy between the use of inpatient and outpatient care by young refugees suggests that there are barriers to outpatient care, but we did note that living in Sweden longer increased the use of outpatient services. Further research is needed to clarify the role that education levels among Sweden's refugee populations have on their mental health and health-seeking behaviour.

scholarly journals Determinants of Revolving Door in an Acute Psychiatric Ward for Prison Inmates

2021 ◽  
Vol 12 ◽  
Author(s):  
Isabella D'Orta ◽  
François R. Herrmann ◽  
Panteleimon Giannakopoulos
Keyword(s):  
Personality Disorders ◽  
Suicidal Behavior ◽  
Psychotic Disorders ◽  
Psychiatric Care ◽  
Adjustment Disorder ◽  
Revolving Door ◽  
Psychiatric Ward ◽  
Inpatient Psychiatric Care ◽  
Acute Psychiatric Care ◽  
Depressive Episodes

Among the different types of heavy use of mental health services, frequent inpatient admission in acute care units of individuals unable to return to their usual environment refers to as revolving-door (RD). RD in prisoners is related to increased violence (acted and supported) and suicidal recidivism. We explored the determinants of RD in 200 inmates from the Swiss-French speaking areas who were admitted to the sole acute psychiatric care unit for all of the Swiss-French counties, located in Geneva. The Cuzick's test for trend across ordered groups, Kruskal-Wallis test and oneway ANOVA were used to compare demographic and clinical variables between single (one admission, N = 100), frequent (3–7, N = 69) and RD (more than 8, N = 31) during a 12 months period. In addition, univariate and multivariable ordered logistic regression modes were built to examine the determinants of RD. The sample included 27 women (mean age: 31.2 years) and 173 men (34.5 years) who were admitted during the period 2014–2019. The vast majority were single (65%) with low level of education (<6 years, 78%). Suicidal behavior was the more frequent reason for admission (57%). Psychiatric history was positive in 77.5% of cases and in 54.5% of cases there was at least one episode of inpatient psychiatric care. The more frequent ICD-10 psychiatric diagnosis in the last admission were psychotic disorder (38%), personality disorder (29.5%) and adjustment disorder (19.5%). In contrast, depressive episodes (7%) and bipolar disorder (4.5%) were rare. Group comparison showed that the presence of court-ordered treatments, suicidal behavior, personality and psychotic disorders was associated with significantly increased frequency of RD use. In univariate models, the same factors were positively associated with RD, the highest odds ratio being found for court-ordered treatments (5.77) and personality disorders (2.14). In contrast, the diagnosis of adjustment disorders was related to decreased RD use (OR 0.25). Court-ordered treatments and personality disorders were the only factors to predict RD in multivariable regression models. These findings suggest that acute psychiatric care in these patients did not depend of environmental stressors but rather represents the expression of a long-lasting vulnerability related to their psychological profile and criminal status.

scholarly journals Portuguese Adaptation and Input for the Validation of the Views on Inpatient Care (VOICE) Outcome Measure to Assess Service Users’ Perceptions of Inpatient Psychiatric Care

2017 ◽  
Vol 30 (11) ◽  
pp. 790
Author(s):  
João Palha ◽  
Filipa Palha ◽  
Pedro Dias ◽  
Manuel Gonçalves-Pereira
Keyword(s):  
Internal Consistency ◽  
Inpatient Care ◽  
Health Care Quality ◽  
Psychiatric Care ◽  
Outcome Measure ◽  
Care Quality ◽  
Service Users ◽  
Inpatient Psychiatric Care ◽  
Portuguese Version ◽  
The Impact

Introduction: Patient satisfaction is an important measure of health care quality. Patients’ views have seldom been considered in the construction of measures addressing satisfaction with inpatient facilities in psychiatry. The Views on Inpatient Care - VOICE - is a first service-user generated outcome measure relying solely on their perceptions of acute care, representing a valuable indicator of service users’ perceived quality of care. The present study aimed to contribute to the validation of the Portuguese version of VOICE.Material and Methods: The questionnaire was translated into Portuguese and applied to a sample of eighty-five female inpatients of a psychiatric institution. Data analysis focused on assessing reliability and exploring the impact of demographic and clinical variables on participants’ satisfaction.Results: Internal consistency of the questionnaire was high (α = 0.87). Participants’ age and marital status were associated with differences in scores, with older patients and patients who were married or involved in a close relationship presenting higher satisfaction levels.Discussion: The questionnaire demonstrated good internal consistency and acceptability, as well as construct validity. Further studies should expand the analysis of the psychometric properties of this measure e.g., test-retest reliability.Conclusion: The Portuguese version of VOICE is a promising tool to assess service users’ perceptions of inpatient psychiatric care in Portugal.

Factors associated with satisfaction of inpatient psychiatric care: a cross country comparison

2019 ◽  
Vol 50 (2) ◽  
pp. 284-292 ◽  
Author(s):  
Victoria Bird ◽  
Elisabetta Miglietta ◽  
Domenico Giacco ◽  
Michael Bauer ◽  
Lauren Greenberg ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Clinical Outcomes ◽  
Inpatient Care ◽  
Psychiatric Inpatient ◽  
Patient Characteristics ◽  
Care Quality ◽  
Severe Illness ◽  
Inpatient Psychiatric Care ◽  
Education Levels ◽  
The Uk

AbstractBackgroundPatient satisfaction is a key indicator of inpatient care quality and is associated with clinical outcomes following admission. Different patient characteristics have been inconsistently linked with satisfaction. This study aims to overcome previous limitations by assessing which patient characteristics are associated with satisfaction within a large study of psychiatric inpatients conducted across five European countries.MethodsAll patients with a diagnosis of psychotic (F2), affective (F3) or anxiety/somataform (F4) disorder admitted to 57 psychiatric inpatient units in Belgium, Germany, Italy, Poland and the UK were included. Data were collected from medical records and face-to-face interviews, with patients approached within 2 days of admission. Satisfaction with inpatient care was measured on the Client Assessment of Treatment Scale.ResultsHigher satisfaction scores were associated with being older, employed, living with others, having a close friend, less severe illness and a first admission. In contrast, higher education levels, comorbid personality disorder and involuntary admission were associated with lower levels of satisfaction. Although the same patient characteristics predicted satisfaction within the five countries, there were significant differences in overall satisfaction scores across countries. Compared to other countries, patients in the UK were significantly less satisfied with their inpatient care.ConclusionsHaving a better understanding of patient satisfaction may enable services to improve the quality of care provided as well as clinical outcomes for all patients. Across countries, the same patient characteristics predict satisfaction, suggesting that similar analytical frameworks can and should be used when assessing satisfaction both nationally and internationally.

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