scholarly journals Duration of psychiatric appointments for patients with Psychosis spectrum disorders in Serbia: Is it significantly prolonged by DIALOG+ psychosocial intervention?

2020 ◽  
Vol 52 (1-2) ◽  
pp. 13-24
Author(s):  
Ivan Ristić ◽  
Sanja Andrić-Petrović ◽  
Stefan Jerotić ◽  
Mirjana Zebić ◽  
Nikolina Jovanović ◽  
...  

Despite national and international guidelines recommending inclusion of psychotherapy and psychosocial interventions as regular part of treatment for patients with psychosis spectrum disorders (PSD), outpatient psychiatric care in Southeastern Europe (SEE) is mostly limited to medication prescription. DIALOG+ is a recently developed technology-based, patient centered psychosocial intervention that provides an economically viable intervention for treatment and comprehensive evaluation of multiple life domains. Its effectiveness in a range of psychiatric disorders has been shown in several studies conducted in high-income countries. Before an ongoing study evaluating DIALOG+ implementation and effectiveness in developing SEE countries is completed, we aimed to explore general impressions of mental health clinicians towards such an intervention and to compare the duration of treatment as usual (TAU) with DIALOG+ enriched appointments of PSD outpatients. The attendees of the national professional educational symposium were presented with DIALOG+, after which they completed a short survey on their general impressions towards the intervention. To obtain the information regarding duration of psychiatric appointments for patients with PSD in Serbia, we used data from a currently ongoing randomized clinical trial where DIALOG+ is being tested for effectiveness. The impressions of the survey (n=110) from mostly psychiatrists and psychiatry residents towards the concept of this intervention were overwhelmingly positive. However, the question arose if TAU is being prolonged by DIALOG+ to the extent that might limit its implementation. Although significant difference in average session duration was observed between DIALOG+ and TAU (31.96±16.47 vs. 19.75±6.11 minutes, p<0.01), providing structured interventions and patient evaluation might be of additional benefit for long term care and quality of life of PSD patients. To the best of our knowledge, this was the first evaluation of the duration of psychiatric appointments for outpatients with PSD in Serbia. Present information could be useful for different stakeholders in education of MH workers and implementation of DIALOG+ in the local settings.

2017 ◽  
Vol 47 (12) ◽  
pp. 2081-2096 ◽  
Author(s):  
W. T. Chien ◽  
D. Bressington ◽  
A. Yip ◽  
T. Karatzias

BackgroundWe aimed to test a mindfulness-based psychoeducation group (MBPEG), v. a conventional psychoeducation group (CPEG) v. treatment as usual (TAU), in patients with schizophrenia-spectrum disorders over a 24-month follow-up.MethodThis single-blind, multi-site, pragmatic randomized controlled trial was conducted in six community treatment facilities across three countries (Hong Kong, mainland China and Taiwan). Patients were randomly allocated to one of the treatment conditions, and underwent 6 months of treatment. The primary outcomes were changes in duration of re-hospitalizations and mental state (Positive and Negative Syndrome Scale; PANSS) between baseline and 1 week, and 6, 12 and 18 months post-treatment.ResultsA total of 300 patients in each country were assessed for eligibility between October 2013 and 30 April 2014, 38 patients per country (n = 342) were assigned to each treatment group and included in the intention-to-treat analysis. There was a significant difference in the length of re-hospitalizations between the three groups over 24 months (F2,330 = 5.23, p = 0.005), with MBPEG participants having a shorter mean duration of re-hospitalizations than those in the other groups. The MBPEG and CPEG participants had significant differential changes in proportional odds ratios of complete remission (all individual PANSS items <3) over the 24-month follow-up (37 and 26%, respectively), as opposed to only 7.2% of the TAU group (χ2 = 8.9 and 8.0, p = 0.001 and 0.003, relative risk = 3.5 and 3.1, 95% confidence interval 2.0–7.2 and 1.6–6.3).ConclusionsCompared with TAU and CPEG, MBPEG improves remission and hospitalization rates of people with schizophrenia spectrum disorders over 24 months.


2018 ◽  
Vol 28 (2) ◽  
pp. 567-570
Author(s):  
Radost Assenova ◽  
Levena Kireva ◽  
Gergana Foreva

Introduction: The European definition of WONCA of general practice introduces the determinant elements of person-centered care regarding four important, interrelated characteristics: continuity of care, patient "empowerment", patient-centred approach, and doctor-patient relationship. The application of person-centred care in general practice refers to the GP's ability to master the patient-centered approach when working with patients and their problems in the respective context; use the general practice consultation to develop an effective doctor–patient relationship, with respect to patient’s autonomy; communicate, set priorities and establish a partnership when solving health problems; provide long-lasting care tailored to the needs of the patient and coordinate overall patient care. This means that GPs are expected to develop their knowledge and skills to use this key competence. Aim: The aim of this study is to make a preliminary assessment of the knowledge and attitudes of general practitioners regarding person-centered care. Material and methods: The opinion of 54 GPs was investigated through an original questionnaire, including closed questions, with more than one answer. The study involved each GP who has agreed to take part in organised training in person-centered care. The results were processed through the SPSS 17.0 version using descriptive statistics. Results: The distribution of respondents according to their sex is predominantly female - 34 (62.9%). It was found that GPs investigated by us highly appreciate the patient's ability to take responsibility, noting that it is important for them to communicate and establish a partnership with the patient - 37 (68.5%). One third of the respondents 34 (62.9%) stated the need to use the GP consultation to establish an effective doctor-patient relationship. The adoption of the patient-centered approach at work is important to 24 (44.4%) GPs. Provision of long-term care has been considered by 19 (35,2%). From the possible benefits of implementing person-centered care, GPs have indicated achieving more effective health outcomes in the first place - 46 (85.2%). Conclusion: Family doctors are aware of the elements of person-centered care, but in order to validate and fully implement this competence model, targeted GP training is required.


Author(s):  
Maria Ciaramella ◽  
Nadia Monacelli ◽  
Livia Concetta Eugenia Cocimano

AbstractThis systematic review aimed to contribute to a better and more focused understanding of the link between the concept of resilience and psychosocial interventions in the migrant population. The research questions concerned the type of population involved, definition of resilience, methodological choices and which intervention programmes were targeted at migrants. In the 90 articles included, an heterogeneity in defining resilience or not well specified definition resulted. Different migratory experiences were not adequately considered in the selection of participants. Few resilience interventions on migrants were resulted. A lack of procedure’s descriptions that keep in account specific migrants’ life-experiences and efficacy’s measures were highlighted.


2021 ◽  
Vol 6 (6) ◽  
pp. e005029
Author(s):  
Giulia Turrini ◽  
Federico Tedeschi ◽  
Pim Cuijpers ◽  
Cinzia Del Giovane ◽  
Ahlke Kip ◽  
...  

IntroductionRefugees and asylum seekers are vulnerable to common mental disorders, including post-traumatic stress disorder (PTSD). Using a network meta-analysis (NMA) approach, the present systematic review compared and ranked psychosocial interventions for the treatment of PTSD in adult refugees and asylum seekers.MethodsRandomised studies of psychosocial interventions for adult refugees and asylum seekers with PTSD were systematically identified. PTSD symptoms at postintervention was the primary outcome. Standardised mean differences (SMDs) and ORs were pooled using pairwise and NMA. Study quality was assessed with the Cochrane Risk of Bias (RoB) tool, and certainty of evidence was assessed through the Confidence in Network Meta-Analysis application.ResultsA total of 23 studies with 2308 participants were included. Sixteen studies were conducted in high-income countries, and seven in low-income or middle-income countries. Most studies were at low risk of bias according to the Cochrane RoB tool. NMA on PTSD symptoms showed that cognitive behavioural therapy (CBT) (SMD=−1.41; 95% CI −2.43 to −0.38) and eye movement desensitisation and reprocessing (EMDR) (SMD=−1.30; 95% CI −2.40 to −0.20) were significantly more effective than waitlist (WL). CBT was also associated with a higher decrease in PTSD symptoms than treatment as usual (TAU) (SMD −1.51; 95% CI −2.67 to −0.36). For all other interventions, the difference with WL and TAU was not significant. CBT and EMDR ranked best according to the mean surface under the cumulative ranking. Regarding acceptability, no intervention had less dropouts than inactive interventions.ConclusionCBT and EMDR appeared to have the greatest effects in reducing PTSD symptoms in asylum seekers and refugees. This evidence should be considered in guidelines and implementation packages to facilitate dissemination and uptake in refugee settings.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S383-S384
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Fatma Smaoui ◽  
Khaoula Rekik ◽  
...  

Abstract Background Malignant otitis externa is a fatal infection of the external ear and temporal bone. Pseudomonas aeruginosa is the most common causative organism, while fungi are a rare cause of malignant otitis externa. We aimed to compare the clinical, therapeutic and evolutionary features between bacterial and fungal malignant otitis externa. Methods We conducted a retrospective study including all patients hospitalized for malignant otitis externa in the infectious diseases department between 2000 and 2018. Results Overall, we encountered 82 cases of malignant otitis externa, among which there were 54 cases (65.9%) of bacterial malignant otitis externa (BMO) and 28 cases (34.1%) of fungal malignant otitis externa (FMO). The males were predominant among BMO cases (57.4% vs 50%; p=0.5). Patients with FMO were significantly older (70±9 years vs 61±10 years; p&lt; 0.001) and had medical history of diabetes mellitus more frequently (96.4% vs 77.8%; p=0.03). The use of topical corticosteroids was significantly more reported among FMO cases (28.6% vs 5.6%; p=0.006). Otalgia (96.4% vs 81.5%), otorrhea (75% vs 66.7%) and cephalalgia (46.4% vs 42.6%) were the revealing symptoms among FMO and BMO, respectively, with no significant difference. Tenderness to palpation of the mastoid bone (64.3% vs 38.9%; p=0.02) and stenosis of the external auditory canal (92.9% vs 72.2%; p=0.02) were significantly more frequent among FMO cases. Complications were significantly more frequent among FMO cases (42.9% vs 9.3%; p&lt; 0.001). Treatment duration was significantly longer among FMO cases (70[40-90] days vs 45[34-75] days; p=0.03). Conclusion Our study showed that FMO affected more frequently the elderly and diabetic patients, when compared with BMO. Regardless of the causative agent, the clinical presentation was similar. However, the outcome was poor among FMO cases with the occurrence of complications, requiring a longer duration of treatment. Disclosures All Authors: No reported disclosures


2020 ◽  
pp. 002216782098214
Author(s):  
Tami Gavron

This article describes the significance of an art-based psychosocial intervention with a group of 9 head kindergarten teachers in Japan after the 2011 tsunami, as co-constructed by Japanese therapists and an Israeli arts therapist. Six core themes emerged from the analysis of a group case study: (1) mutual playfulness and joy, (2) rejuvenation and regaining control, (3) containment of a multiplicity of feelings, (4) encouragement of verbal sharing, (5) mutual closeness and support, and (6) the need to support cultural expression. These findings suggest that art making can enable coping with the aftermath of natural disasters. The co-construction underscores the value of integrating the local Japanese culture when implementing Western arts therapy approaches. It is suggested that art-based psychosocial interventions can elicit and nurture coping and resilience in a specific cultural context and that the arts and creativity can serve as a powerful humanistic form of posttraumatic care.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kylie M. Dingwall ◽  
Michelle Sweet ◽  
Alan Cass ◽  
Jaquelyne T. Hughes ◽  
David Kavanagh ◽  
...  

Abstract Background End stage kidney disease (ESKD) is associated with many losses, subsequently impacting mental wellbeing. Few studies have investigated the efficacy of psychosocial interventions for people with ESKD and none exist for Indigenous people, a population in which the ESKD burden is especially high. Methods This three-arm, waitlist, single-blind randomised controlled trial examined efficacy of the Stay Strong App in improving psychological distress (Kessler distress scale; K10), depressive symptoms (adapted Patient Health Questionnaire; PHQ-9), quality of life (EuroQoL; EQ. 5D) and dialysis adherence among Indigenous Australians undergoing haemodialysis in central and northern Australia (Alice Springs and Darwin), with follow up over two 3-month periods. Effects of immediate AIMhi Stay Strong App treatment were compared with those from a contact control app (The Hep B Story) and treatment as usual (TAU). Control conditions received the Stay Strong intervention after 3 months. Results Primary analyses of the full sample (N = 156) showed statistically significant decreases in K10 and PHQ-9 scores at 3 months for the Hep B Story but not for the Stay Strong app or TAU. Restricting the sample to those with moderate to severe symptoms of distress or depression (K10 > =25 or PHQ-9 > =10) showed significant decreases in K10 and PHQ-9 scores for both Stay Strong and Hep B Story. No significant differences were observed for the EQ-5D or dialysis attendance. Conclusions Findings suggest that talking to people about their wellbeing and providing information relevant to kidney health using culturally adapted, locally relevant apps improve the wellbeing of people on dialysis. Further research is required to replicate these findings and identify active intervention components. Trial registration ACTRN12617000249358; 17/02/2017.


2021 ◽  
Vol 12 (02) ◽  
pp. 290-294
Author(s):  
T.R. Kanmani ◽  
Birudu Raju ◽  
Subhas Konar ◽  
Dhaval Shukla ◽  
Raghavendra Kukkehalli

Abstract Introduction The caregiver’s psychosocial problems are unnoticed in the emergency and trauma care center. Therefore, the study objective was to understand the impact of psychoeducation and psychosocial intervention on traumatic brain injury (TBI) caregivers during hospitalization. Methodology The study adopted a descriptive research design. Sixty-three (n = 63) consented caregivers were recruited by using a cross-sectional survey method. Two separate checklists were used to collect the psychosocial problems in emergency and trauma care as well as to know the satisfaction levels of caregivers after the intervention. R free 3.0.1 software was used to calculate the frequency and percentage. Results The caregiver’s mean age was 39 years (39.46 ± 16.22). The majority of the caregivers were males (45; 71.4%) working as daily wagers (42; 66.7%). Caregivers experienced psychosocial problems, that is, depression, anxiety, stress, unable to handle crisis, grief, lack of coping skills (57; 90.5%), emotional distress (57; 90.5%), financial constraints (45; 71.1%), and need for referral services (45; 71.1%). Tailor-made psychosocial interventions were provided to the caregivers. Conclusion To conclude, there is a greater need to provide psychosocial intervention and train the caregivers to provide care for TBI survivors during hospitalization. There is a need to develop the uniform standard operating procedure for medical and psychiatric social workers in providing psychosocial care in emergency and trauma care setting.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 185-185
Author(s):  
Rachel McPherson ◽  
Barbara Resnick ◽  
Elizabeth Galik

Abstract Communication and interactions are an integral part of care in long-term care settings. Resident variables, such as race and gender, shape communication and interaction between staff and residents. The Quality of Interactions Schedule (QuIS) was developed to measure the quality of verbal and nonverbal interactions among nursing staff and older adults initially for those in acute care and later used as well in a variety of long term care settings. A quantified measurement of the quality of interactions between residents and staff was created to quantify the QuIS. The purpose of this study was to describe the gender and racial differences in scored quality of interactions. Data for the present study was based on baseline data from the Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia (EIT-4-BPSD) implementation study. A total of 535 residents from 55 settings were included in the analyses. An analysis of covariance was conducted to determine a difference in QuIS scores between males and females while controlling for age. The second model tested for differences in QuIS scores between blacks and whites while controlling for age and gender. There was not a statistically significant difference in QuIS scores between male and female residents. There was a significant difference in QuIS scores between those who were black versus white, such that those who were black received more positive interactions from staff than those who were white. Future work should focus on a deeper examination of resident factors and staff factors that may influence these interactions.


2017 ◽  
Vol 210 (5) ◽  
pp. 324-332 ◽  
Author(s):  
Danyael Lutgens ◽  
Genevieve Gariepy ◽  
Ashok Malla

BackgroundNegative symptoms observed in patients with psychotic disorders undermine quality of life and functioning. Antipsychotic medications have a limited impact. Psychological and psychosocial interventions, with medication, are recommended. However, evidence for the effectiveness of specific non-biological interventions warrants detailed examination.AimsTo conduct a meta-analytic and systematic review of the literature on the effectiveness of non-biological treatments for negative symptoms in psychotic disorders.MethodWe searched for randomised controlled studies of psychological and psychosocial interventions in psychotic disorders that reported outcome on negative symptoms. Standardised mean differences (SMDs) in values of negative symptoms at the end of treatment were calculated across study domains as the main outcome measure.ResultsA total of 95 studies met our criteria and 72 had complete quantitative data. Compared with treatment as usual cognitive–behavioural therapy (pooled SMD −0.34, 95% CI −0.55 to −0.12), skills-based training (pooled SMD −0.44, 95% CI −0.77 to −0.10), exercise (pooled SMD −0.36, 95% CI −0.71 to −0.01), and music treatments (pooled SMD −0.58, 95% CI −0.82 to −0.33) provide significant benefit. Integrated treatment models are effective for early psychosis (SMD −0.38, 95% CI −0.53 to −0.22) as long as the patients remain in treatment. Overall quality of evidence was moderate with a high level of heterogeneity.ConclusionsSpecific psychological and psychosocial interventions have utility in ameliorating negative symptoms in psychosis and should be included in the treatment of negative symptoms. However, more effective treatments for negative symptoms need to be developed.


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