Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 9 de 9
Filtrar
3.
Psychiatr Serv ; 70(9): 793-800, 2019 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-31109264

RESUMEN

OBJECTIVE: Individuals with serious mental illness experience excess mortality related to general medical comorbidities. Reverse-integrated and reverse-colocated models of care have been proposed as a system-level solution. Such models integrate primary care services within behavioral health settings. Further understanding of consumer perspectives on these models is needed to ensure that models adequately engage consumers on the basis of their expressed needs. This qualitative study examined the perspectives of English- and Spanish-speaking individuals with serious mental illness on their current experience with the management of their medical care and on a hypothetical reverse-colocated care model. METHODS: Semistructured interviews were conducted in a purposive sample of 30 individuals with serious mental illness recruited from two outpatient mental health clinics affiliated with a comprehensive community-based program. The interview assessed the participant's current experience with the management of their health care, followed by a vignette describing a reverse--colocated care model and questions to elicit the participant's reaction to the vignette. An inductive thematic analysis was employed. RESULTS: Consumers expressed positive views of the potential for working with trusted staff, increased communication, and access to care through reverse colocation. Reflections on current health management experience were notable for an emphasis on self-efficacy and receipt of support for self-management strategies from mental health clinicians. CONCLUSIONS: Study findings add to prior literature indicating support for assistance with management of general medical health in the mental health setting among individuals with serious mental illness. Key themes similar to those in previous studies generate hypotheses for further evaluation.


Asunto(s)
Prestación Integrada de Atención de Salud , Trastornos Mentales/terapia , Servicios de Salud Mental , Prioridad del Paciente , Atención Primaria de Salud , Adulto , Anciano , Instituciones de Atención Ambulatoria , Servicios de Salud Comunitaria , Prestación Integrada de Atención de Salud/organización & administración , Femenino , Hispánicos o Latinos , Humanos , Masculino , Servicios de Salud Mental/organización & administración , Persona de Mediana Edad , Atención Primaria de Salud/organización & administración , Relaciones Profesional-Paciente , Investigación Cualitativa , Automanejo
4.
Early Interv Psychiatry ; 13(4): 767-772, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-29542863

RESUMEN

AIM: Recent research on first episode psychosis (FEP) has demonstrated the effectiveness of coordinated specialty care (CSC) models to support young adults and their families, yet few tools exist to promote engagement in care. This study aimed to develop a prototype computer-based role-playing game (RPG) designed for young people who have experienced FEP, and conduct a pilot study to determine feasibility and test whether the game improves consumers' attitudes toward treatment and recovery. METHODS: Twenty young people with FEP who were receiving services at a CSC program enrolled in the study and played the game for 1 hour. Pre- and post-quantitative assessments measured change in hope, recovery, stigma, empowerment and engagement in treatment. Qualitative interviews explored participants' experience with the game and ideas for further product development. RESULTS: Participants showed significant increase in positive attitudes toward recovery. The qualitative findings further demonstrated the game's positive impact across these domains. Of all game features, participants most highly valued video testimonials of other young adults with FEP telling their stories of hope and recovery. CONCLUSIONS: These findings provide modest support for the potential benefits of this type of computer-based RPG, if further developed for individuals experiencing psychosis.


Asunto(s)
Trastornos Psicóticos/terapia , Desempeño de Papel , Terapia Asistida por Computador/métodos , Adolescente , Adulto , Estudios de Factibilidad , Femenino , Humanos , Masculino , Aceptación de la Atención de Salud/psicología , Proyectos Piloto , Trastornos Psicóticos/psicología , Investigación Cualitativa , Adulto Joven
5.
Fam Pract ; 36(2): 125-131, 2019 03 20.
Artículo en Inglés | MEDLINE | ID: mdl-29860527

RESUMEN

BACKGROUND: Complicated grief, a syndrome of persistent grief diagnosed >6 months following the loss of someone close is expected to be included in the 11th revision of the International Classification of Diseases as a new diagnosis called prolonged grief disorder. Complicated grief is associated with impaired functioning and health comorbidity and does not respond to treatments for depression. Individuals may seek help in primary care where providers need to be familiar with the syndrome. OBJECTIVE: This study examines the acceptability, feasibility and outcome of a screening programme for complicated grief among diverse adults receiving behavioural health services in integrated primary care. METHODS: Behavioural health providers (n = 14) administered the Brief Grief Questionnaire and the Inventory of Complicated Grief during routine assessment and completed an acceptability survey. Descriptive statistics described rates of complicated grief symptoms and sample demographics, health and service use. RESULTS: Most providers (71%) reported the Brief Grief Questionnaire to be a moderate to very useful assessment instrument and the Inventory of Complicated Grief moderate to very useful for developing a treatment plan (57%). Of the 2425 patients screened, 1015 reported a loss over 6 months ago. Of these 1015, 28% (n = 282) screened positive on the Brief Grief Questionnaire and 22% (n = 228) endorsed symptoms of complicated grief (Inventory of Complicated Grief score ≥25), considered at high risk for needing clinical care. CONCLUSIONS: A screening programme for identifying complicated grief was acceptable to providers, feasible to implement and useful in identifying complicated grief in integrated primary care clinics.


Asunto(s)
Prestación Integrada de Atención de Salud/métodos , Pesar , Tamizaje Masivo , Evaluación de Resultado en la Atención de Salud , Atención Primaria de Salud , Adulto , Estudios de Factibilidad , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Factores de Tiempo
6.
Psychiatr Serv ; 69(9): 1029-1031, 2018 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-29962306

RESUMEN

Clinical practice is assumed to be informed and supported by evidence-based clinical research. Nonetheless, clinical practice often deviates from the research evidence base, sometimes leading and sometimes lagging. Two examples from integrated care in mental health care (care for serious mental illness and collaborative mental health care in primary care settings) illustrate the natural space and therefore tension between evidence and implementation that needs to be better understood. Using the tools and perspectives of both examples, the authors present a framework for the connected relationship between practice and research that is founded on measurement and uses iterative adaptation guided by oversight of and feedback from the stakeholders in this process.


Asunto(s)
Prestación Integrada de Atención de Salud , Práctica Clínica Basada en la Evidencia , Trastornos Mentales/terapia , Atención Primaria de Salud , Humanos , Investigación Biomédica Traslacional
7.
Arch Dis Child ; 96 Suppl 2: i10-4, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22053060

RESUMEN

AIMS: The Royal College of Paediatrics and Child Health (RCPCH) Science and Research Department was commissioned by the Department of Health to develop national care pathways for children with allergies: the asthma/rhinitis care pathway is the third such pathway. Asthma and rhinitis have been considered together. These conditions co-exist commonly, have remarkably similar immuno-pathology and an integrated management approach benefits symptom control. METHOD: The asthma/rhinitis pathway was developed by a multidisciplinary working group and was based on a comprehensive review of evidence. The pathway was reviewed by a broad group of stakeholders including the public and was approved by the Allergy Care Pathways Project Board and the RCPCH Clinical Standards Committee. RESULTS: The pathway entry points are defined by symptom type and severity at presentation. Acute severe rhinitis and life-threatening asthma are presented as distinct entry routes to the pathway, recognising that initial care of these conditions requires presentation-specific treatments. However, the pathway emphasises that ideal long term care should take account of both conditions in order to achieve maximal improvements in disease control and quality of life. CONCLUSIONS: The pathway recommends that acute presentations of asthma and/or rhinitis should be treated separately. Where both conditions exist, ongoing management should address the upper and lower airways. The authors recommend that this pathway is implemented locally by a multidisciplinary team (MDT) with a focus on creating networks. The MDT within these networks should work with patients to develop and agree on care plans that are age and culturally appropriate.


Asunto(s)
Asma/terapia , Vías Clínicas/organización & administración , Rinitis/terapia , Enfermedad Aguda , Adolescente , Niño , Preescolar , Prestación Integrada de Atención de Salud/organización & administración , Medicina Basada en la Evidencia/métodos , Humanos , Lactante , Recién Nacido , Relaciones Profesional-Paciente , Índice de Severidad de la Enfermedad , Sociedades Médicas , Reino Unido
8.
Psychiatr Serv ; 57(3): 361-5, 2006 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-16524994

RESUMEN

OBJECTIVE: The purpose of this study was to characterize the nature of religious and spiritual support received by family caregivers of persons with serious mental illness and to test hypotheses that religiosity would be associated with caregiver adjustment. METHODS: Eighty-three caregivers who participated in a study of the Family to Family Education Program of the National Alliance on Mental Illness were assessed at baseline in terms of their religiosity and receipt of spiritual support in coping. They also completed measures of depression, self-esteem, mastery, self-care, and subjective burden. Hierarchical regression was used to test hypotheses that religiosity would be associated with better adjustment, with confounding variables controlled for. RESULTS: Thirty-seven percent of participants reported that they had received spiritual support in coping with their relative's illness in the previous three months. When age, race, education, and gender were controlled for, religiosity was associated with less depression and better self-esteem and self-care. Personal religiosity was a stronger predictor of adjustment than religious service attendance. CONCLUSIONS: Family caregivers of persons with serious mental illness often turn to spirituality for support, and religiosity may be an important contributor to caregiver adjustment. Collaborative partnerships between mental health professionals and religious and spiritual communities represent a powerful and culturally sensitive resource for meeting the support needs of family members of persons with serious mental illness.


Asunto(s)
Adaptación Fisiológica , Cuidadores/psicología , Costo de Enfermedad , Trastornos Mentales/psicología , Religión , Espiritualidad , Depresión/psicología , Familia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Autoimagen , Apoyo Social
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA