RESUMEN
Communimetric screening tools help clinicians identify and communicate their patient's areas of need and the corresponding level of action. However, few tools exist to identify mental health (MH) and developmental needs in young children. We aimed to implement and evaluate a new communimetric MH and developmental screening tool for children under 6 (HEADS-ED Under 6) in a community MH agency in Ontario, Canada. Using a prospective cohort design, we explored how intake workers used the HEADS-ED Under 6 screening tool from November 2019 to March 2021. 94.5% of children (n = 535/566) were screened with the HEADS-ED at intake. Total HEADS-ED scores and domains were used to inform the intensity of recommended services. Three clinical domains (Eating & sleeping, Development, speech/language/motor, and Emotions & behaviors) also independently predicted a priority recommendation. The tool showed good concordance with the InterRAI Early Years for children under 4 years old. The HEADS-ED Under 6 was a brief, easy, and valid screening tool, and can be used to identify important MH and developmental domains early, rate level of action/impairment, communicate severity of needs, and help determine intensity of service required.
Les outils de dépistage communimétrique aident les cliniciens à identifier et à communicer les besoins et le niveau d'action correspondant de leur patient. Cependant il existe peu d'outil pour identifier les besoins en Santé Mentale (SM en français) et les besoins développentaux chez les jeunes enfants. Nous nous sommes donné pour but d'appliquer et d'évaluer un nouveal outil communimétrique de SM et développemental pour les enfants de moins de 6 ans (HEADSED de moins de 6 ans) dans une agence communautaire de SM dans l'Ontario au Canada. En utilisant une conception de cohorte prospective nous avons exploré la manière dont les préposés à l'accueil ont utilisé le HEADSED de moins de six ans de novembre 219 à mars 2021. 94,5% des enfants (n = 535566) ont été dépister avec le HEADSED à l'accueil. Tous les scores et domaines HEADSED ont été utilisé pour éclairer l'intensité des services recommandés. Trois domaines cliniques (Manger et dormir, Développement/parole/langage/moteur, et les Emotions, comportements ont aussi prédit une recommandation de priorité indépendamment. L'outil a fait preuve d'une bonne concordance avec le InterRAI Early Years pour les enfants de moins de 4 ans. Le HEADSED de moins de 6 ans s'est avéré être un outil de dépistage valide, bref et facile, et peut être utiliser pour identifier des domaines de SM et des domaines du développement importants tôt, d'évaluer un niveau d'action/de dépréciation, de communiquer la sévérité de besoins, et aider à déterminer l'intensité des services requis. Kommunimetrische ScreeningInstrumente helfen klinisch Tätigen dabei, die Bedürfnisse ihrer Patienten zu erkennen, zu kommunizieren und die entsprechenden Maßnahmen zu ergreifen. Es gibt jedoch nur wenige Instrumente welche die Bedürfnisse von Kleinkindern hinsichtlich ihrer psychischen Gesundheit und Entwicklung ermitteln. Unser Ziel war es, ein neues kommunimetrisches ScreeningInstrument für die psychische Gesundheit und Entwicklung von Kindern unter 6 Jahren (HEADSED unter 6 Jahren) in einer kommunalen Einrichtung der psychischen Gesundheitsversorgung in Ontario, Kanada, einzuführen und zu evaluieren. In einer prospektiven Kohortenstudie untersuchten wir von November 2019 bis März 2021 wie die Mitarbeitenden der Einrichtung bei Aufnahmen das HEADSEDScreeningTool für Kinder unter 6 Jahren einsetzten. 94,5 % der Kinder (n = 535/566) wurden bei Aufnahme mit dem HEADSED gescreent. Die HEADSEDGesamtergebnisse und Domänen wurden verwendet, um die Intensität der empfohlenen Gesundheitsleistungen zu bestimmen. Ebenfalls sagten drei klinische Domänen (Essen und Schlafen, Entwicklung/Sprechen/Sprache/Motorik und Emotionen/Verhaltensweisen) unabhängig voneinander eine prioritäre Empfehlung voraus. Das Instrument zeigte eine gute Übereinstimmung mit dem InterRAI Early Years für Kinder unter 4 Jahren. Das HEADSED für Kinder unter 6 Jahren erwies sich als ein kurzes, einfaches und valides ScreeningInstrument, das eingesetzt werden kann, um frühzeitig wichtige Bereiche psychischer Gesundheit und Entwicklung zu identifizieren, das Ausmaß von Interventionen/Beeinträchtigungen einzuschätzen, die Stärke dahingehender Bedürfnisse mitzuteilen und die notwendige Intensität von Gesundheitsleistungen zu bestimmen. ã³ãã¥ãã¡ããªãã¯ã¹ã¯ãªã¼ãã³ã°ãã¼ã«ã¯ãè¨åºå»ãæ£è ã®å¿ è¦ãªé åã¨ããã«å¯¾å¿ããè¡åã¬ãã«ãç¹å®ããä¼ããã®ã«å½¹ç«ã¤ãããããå¹¼å ã®ã¡ã³ã¿ã«ãã«ã¹(MH)ã¨çºéã®ãã¼ãºãç¹å®ãããã¼ã«ã¯ã»ã¨ãã©åå¨ããªããæ¬ç 究ã¯ãã«ããã»ãªã³ã¿ãªãªå·ã®å°åMHæ©é¢ã«ããã¦ã6æ³æªæºå ã対象ã¨ããæ°ããã³ãã¥ãã¡ããªãã¯MHããã³çºéã¹ã¯ãªã¼ãã³ã°ãã¼ã«(HEADSED under 6)ã®å°å ¥ããã³è©ä¾¡ãç®çã¨ãããååãã³ãã¼ããã¶ã¤ã³ãç¨ãã¦ã2019å¹´11æãã2021å¹´3æã«ãã¤ã³ãã¤ã¯æ å½è ã6æ³æªæºå ã¹ã¯ãªã¼ãã³ã°ãã¼ã«HEADSEDãã©ã®ããã«ä½¿ç¨ãããã調æ»ããã94.5ï¼ ã®åã©ã(n = 535/566)ãã¤ã³ãã¼ã¯æã«HEADSEDã§ã¹ã¯ãªã¼ãã³ã°ãåãããHEADSEDã®ç·ã¹ã³ã¢ã¨é åã¯ãæ¨å¥¨ããããµã¼ãã¹ã®ç¨åº¦ãç¥ãããã«ä½¿ç¨ããããã¾ãã3ã¤ã®è¨åºé å(é£æ¬²ã¨ç¡ç ãçºéã»çºèªã»è¨èªã»éåãææ /è¡å)ããåå¥ã®åªå é ä½ãäºæ¸¬ããããã®ãã¼ã«ã¯ã4æ³æªæºå ã対象ã¨ããInterRAI Early Yearsã¨è¯å¥½ãªä¸è´ã示ãããHEADSED Under 6ã¯ãç°¡æ½ã§ãç°¡åã§ãæå¹ãªã¹ã¯ãªã¼ãã³ã°ãã¼ã«ã§ãããæ©æã«éè¦ãªç²¾ç¥ä¿å¥ããã³çºéé åãç¹å®ããæ´»å/é害ã®ã¬ãã«ãè©ä¾¡ãããã¼ãºã®éç度ãä¼ããå¿ è¦ãªãµã¼ãã¹ã®å¼·åº¦ã決å®ããããã«ä½¿ç¨ãããã¨ãã§ããã.
RESUMEN
BACKGROUND: Generalized anxiety disorder (GAD) is a prevalent anxiety disorder characterized by uncontrollable worry, trouble sleeping, muscle tension, and irritability. Cognitive behavioural therapy (CBT) is one of the first-line treatments that has demonstrated high efficacy in reducing symptoms of anxiety. Electronically delivered CBT (e-CBT) has been a promising adaptation of in-person treatment, showing comparable efficacy with increased accessibility and scalability. Finding further scalable interventions that can offer benefits to patients requiring less intensive interventions can allow for better resource allocation. Some studies have indicated that weekly check-ins can also lead to improvements in GAD symptoms. However, there is a lack of research exploring the potential benefits of online check-ins for patients with GAD. OBJECTIVE: This study aims to investigate the effects of weekly online asynchronous check-ins on patients diagnosed with GAD and compare it with a group receiving e-CBT. METHODS: Participants (n e-CBT = 45; n check-in = 51) with GAD were randomized into either an e-CBT or a mental health check-in program for 12 weeks. Participants in the e-CBT program completed pre-designed modules and homework assignments through a secure online delivery platform where they received personalized feedback from a trained care provider. Participants in the mental health check-in condition had weekly asynchronous messaging communication with a care provider where they were asked structured questions with a different weekly theme to encourage conversation. RESULTS: Both treatments demonstrated statistically significant reductions in GAD-7-item questionnaire (GAD-7) scores over time, but when comparing the groups there was no significant difference between the treatments. The number of participants who dropped out and baseline scores on all questionnaires were comparable for both groups. CONCLUSIONS: The findings support the effectiveness of e-CBT and mental health check-ins for the treatment of GAD. PLAIN LANGUAGE SUMMARY TITLE: Comparing the Effectiveness of Electronically Delivered Therapy (e-CBT) to Weekly Online Mental Health Check-ins for Generalized Anxiety Disorder-A Randomized Controlled Trial.
Generalized anxiety disorder (GAD) is a prevalent psychiatric condition that leads to symptoms like uncontrollable worry, trouble sleeping, muscle tension, and irritability. Cognitive behavioural therapy (CBT) is a common psychotherapy used for GAD since it has been shown to reduce symptoms. However, traditional CBT that is in person can have barriers such as being inaccessible and costly, and therefore electronically delivered CBT (e-CBT) is a viable alternative since previous studies have shown its efficacy in reducing symptoms and being similar compared to face-to-face CBT. Previous studies have also shown reductions in GAD symptomology through the use of checking in on people and their mental health. Therefore, this study aimed to compare e-CBT to a check-in condition and had a total of 45 individuals in e-CBT and 51 participants in the check-in condition. Participants in the e-CBT condition completed 12 weeks of predesigned e-CBT modules, homework and received personalized feedback from a care provider. In contrast, individuals in the check-in condition completed 12 weeks of unstructured asynchronous messaging with a care provider. Results from the study showed that both the e-CBT and check-in condition demonstrated statistically significant improvements in GAD-7 across time, but when comparing the groups there was no significant difference. The results show the efficacy of e-CBT and checking in on people's mental health to reduce GAD and future research should examine the 2 conditions combined.
Asunto(s)
Trastornos de Ansiedad , Terapia Cognitivo-Conductual , Intervención basada en la Internet , Humanos , Trastornos de Ansiedad/terapia , Terapia Cognitivo-Conductual/métodos , Adulto , Femenino , Masculino , Persona de Mediana Edad , Telemedicina , Evaluación de Resultado en la Atención de Salud , Adulto JovenRESUMEN
The concept of peer support is now firmly established in the psychiatric landscape. While taking into account the benefits that this approach brings to patients and teams, it is essential to consider the need to define a framework for the practice of peer support. This framework, which is essential for the development of the practice, will help to avoid overly fragile exposure, which is synonymous with difficulties for peer helpers and their teams.
Asunto(s)
Trastornos Mentales , Grupo Paritario , Enfermería Psiquiátrica , Apoyo Social , Humanos , Trastornos Mentales/enfermería , Trastornos Mentales/psicología , FranciaRESUMEN
Over the last fifteen years or so in France, the deployment of peer professionals in mental health seems to have accelerated. The benefits of peer support have been widely demonstrated. It is based on the experiential knowledge acquired by certain patients who have recovered during their course of treatment, which can be passed on by positive identification, stimulating hope and motivation. These unique skills are then complemented by more theoretical knowledge sanctioned by a diploma that legitimises the future professionals and gives them access to undisputed recognition to work alongside pre-existing systems. However, it is not always easy to integrate them into health and social teams.
Asunto(s)
Trastornos Mentales , Grupo Paritario , Humanos , Francia , Trastornos Mentales/enfermería , Trastornos Mentales/psicología , Apoyo Social , Enfermería PsiquiátricaRESUMEN
In the world of top-level sport, optimising athletic performance does not rely solely on physical training. Taking into account the intestine-brain axis offers new ways of optimising sports preparation, partly thanks to the role of the intestinal microbiota on performance and well-being.
Asunto(s)
Atletas , Salud Mental , Humanos , Atletas/psicología , Microbioma Gastrointestinal/fisiología , Deportes/fisiología , Estado Nutricional , Rendimiento Atlético/fisiología , Fenómenos Fisiológicos en la Nutrición DeportivaRESUMEN
Suicide prevention is a major public health issue, both nationally and internationally. The management of suicidal patients leaving emergency departments is crucial to preventing the risk of suicidal recurrence. Advanced practice nurses in psychiatry and mental health can provide real added value thanks to their specialist training, their ability to carry out a comprehensive and detailed clinical assessment, their mastery of medicinal and non-medicinal therapeutic interventions, their skills in coordinating the various players involved in the care pathway, their commitment to prevention and their skills in supporting the development of the skills of care and research teams.
Asunto(s)
Enfermería de Práctica Avanzada , Enfermería Psiquiátrica , Prevención del Suicidio , Humanos , Francia , Comunicación Interdisciplinaria , Curriculum , Colaboración IntersectorialRESUMEN
The purpose of this literature review is to evaluate the extant research addressing food insecurity and mental health among street-involved 2S/LGBTQI+ youth in Canada. Searches were undertaken in academic databases, Google, and Google Scholar for relevant research articles, reports, and grey literature. Our team found nil research specifically addressing food insecurity and the mental health of street-involved 2S/LGBTQI+ youth in Canada. Given that, contextual and contributory factors affecting the mental health and food security of this population are discussed. The available research demonstrates a significant misalignment between the existing support mechanisms and the requirements of this specific population. This underscores the urgent necessity for the establishment of structurally competent, safe, and easily accessible resources. Moreover, there is a clear imperative for additional research endeavors aimed at addressing knowledge deficiencies. These efforts are crucial in empowering dietitians to facilitate enhanced interdisciplinary collaboration, thereby fostering the creation of sustainable, accessible, and appropriate food systems tailored to the needs of this vulnerable demographic.
RESUMEN
This work is a descriptive cross-sectional study that aimed to assess by means of an online survey the well-being and psychological impact, mainly depression, anxiety, stress and post-traumatic stress disorder (PTSD), experienced by the general population after the end of lockdown following the COVID-19 pandemic. In this study, we used the PCL-S scales to assess PTSD and the DASS scale to assess depression, anxiety, and stress related to end of quarantine. Our study found that following the decontamination related to COVID-19, the psychological impact was not negligible with a significant prevalence of occurrence for several psychological disorders. We found depression (68.8%), anxiety (57.47%), stress (45.50%) and post-traumatic stress disorder (31.5%) in the subjects of our study. Following the decontamination related to COVID-19, the psychological impact was found to be as important or even more serious than the other situations that preceded it. The development of a database allowing us to understand the effect of the decontamination on the mental health of Moroccans could be useful in order to watch and prevent the occurrence of complications for psychological disorders such as depression, anxiety, stress or even a state of post-traumatic stress.
RESUMEN
This study examined the associations between residential environment and self-rated mental health (SRMH) among Canadians aged 65 or older (n = 16,304) and whether education and gender moderated the associations. Data came from the 2018 Canadian Housing Survey. Hierarchical multiple regressions were conducted to test the associations. Analyses revealed that increased dwelling size was associated with better SRMH among older women with high school education. Older adults with higher satisfaction with their dwelling design were more likely to report better SRMH, except for women with some college education. Feeling safer in the community was uniquely associated with better SRMH for men with high school education and women with a university degree. Results confirmed significant associations between specific home and residential environment features and SRMH for each gender-by-education group. Environmental programs designed to improve SRMH for older adult populations should consider within- and between-group diversity.
RESUMEN
OBJECTIVES: Heavy alcohol and drug use is reported by a substantial number of Canadians; yet, only a minority of those experiencing substance use difficulties access specialized services. Computer-Based Training for Cognitive Behavioural Therapy (CBT4CBT) offers a low-cost method to deliver accessible and high-quality CBT for substance use difficulties. To date, CBT4CBT has primarily been evaluated in terms of quantitative outcomes within substance use disorder (SUD) samples in the United States. A comparison between CBT4CBT versus standard care for SUDs in a Canadian sample is critical to evaluate its potential for health services in Canada. We conducted a randomized controlled trial of CBT4CBT versus standard care for SUD. METHODS: Adults seeking outpatient treatment for SUD (N = 50) were randomly assigned to receive either CBT4CBT or treatment-as-usual (TAU) for 8 weeks. Measures of substance use and associated harms and quality of life were completed before and after treatment and at 6-month follow-up. Qualitative interviews were administered after treatment and at follow-up, and healthcare utilization and costs were extracted for the entire study period. RESULTS: Participants exhibited improvements on the primary outcome as well as several secondary outcomes; however, there were no differences between groups. A cost-effectiveness analysis found lower healthcare costs in CBT4CBT versus TAU in a subsample analysis, but more days of substance use in CBT4CBT. Qualitative analyses highlighted the benefits and challenges of CBT4CBT. DISCUSSION: Findings supported an overall improvement in clinical outcomes. Further investigation is warranted to identify opportunities for implementation of CBT4CBT in tertiary care settings.Trial Registration: https://clinicaltrials.gov/ct2/show/NCT03767907.
Evaluating a digital intervention targeting substance use difficultiesPlain Language SummaryWhy was the study done?Heavy alcohol and drug use is frequent in the Canadian population, although very few people have access to treatment. The digital intervention, Computer-Based Training for Cognitive Behavioural Therapy (CBT4CBT), may provide a low-cost, high-quality, and easily accessible method of treatment for substance use difficulties. Limited research on this digital intervention has been conducted in Canadian populations, and few studies thus far have evaluated participants' subjective experience using the intervention, along with the cost on the Canadian healthcare system.What did the researchers do?The research team recruited participants and provided access to either CBT4CBT or to standard care at a mental health hospital for 8 weeks. Participants were asked questions about their substance use and related consequences, quality of life, and thoughts on the treatment they received. Information regarding healthcare use and the cost to the healthcare system was also gathered.What did the researchers find?Participants in both groups improved with regards to their substance use, some related consequences, and psychological quality of life. Participants provided insight on the benefits and challenges of both types of treatment. It was also found that the CBT4CBT intervention was less costly.What do these findings mean?These findings support that adults receiving CBT4CBT and standard care both improved to a similar degree in this sample. Participant feedback may inform future studies of how best to implement this intervention in clinical studies. Future studies with larger samples are needed to further examine whether CBT4CBT can increase access to supports and be beneficial in the Canadian healthcare system.
RESUMEN
BACKGROUND: Nowadays, video games are very popular among teenagers. This popularity generates concerns, whether in the media, among families or among the scientific community, who wonder about their potential harmful effects. The aim of this study was to assess the association between different types of use of video games (absence of use, use of violent video games, use of non-violent video games) and mental health and aggression. METHODS: Data was drawn from a French cross-sectional study entitled "Portrait d'Adolescents" which included 15,235 adolescents using anonymous self-administered questionnaires. We defined three groups of use of video games (absence of use, use of violent video games, use of non-violent video games) and explored the association with mental health indicators among boys and girls. RESULTS: The group categorized as "non-gamers" consisted of 1288 adolescents (8.5%), while the "non-violent video gamers" group comprised 8380 adolescents (55.5%) and the "violent video gamers" group included 5430 participants (36%). Among adolescent boys, there was no observed association between responses to mental health-related questions and the type of video game playing. However, in the "violent video gamers" group, a higher percentage of boys (6.8%) reported engaging in self-harm behaviors (p=0.001). In contrast, in the "non-violent video gamers" group, a lower proportion of boys (9.4%) reported participating in dangerous games (p<0.0001). For girls, the "violent video gamers" group exhibited a higher proportion of responses indicating poorer mental health across all explored items: 22.8% reported a history of suicide attempts (p<0.0001), 22.3% reported depression (p<0.0001), 17.8% reported self harm (p<0.0001), and 11.2% reported participating in dangerous game (p<0.0001). CONCLUSION: Violent video games appear to be associated with varying behaviors depending on the gender of adolescents, and notably contribute to much poorer mental health among adolescent girls.
RESUMEN
OBJECTIVES: It is known that lockdown alters the mental health of children in general and adolescents in particular. Here, we surveyed the mental health of high school students returning to in-class lessons after the pandemic. We compared an "anxious-depressed" group with a "neither anxious nor depressed" group with regard to perceived self-efficacy. METHODS: Students from a high school in the Rhône-Alpes region of France participated in a mental health survey. After the students had been given a study information sheet and had agreed to participate, they filled out three paper-based questionnaires the State-Trait Anxiety Inventory for Children (STAI-C), the Center for Epidemiological Studies-Depression (CES-D) self-questionnaire, and the Self-Efficacy Questionnaire for Children (SEQ-C) on an anonymous basis. RESULTS: A total of 709 datasets were analyzed. The participants' mean±standard deviation age was 15.89±0.93. The group comprised 438 girls, 251 boys, and 20 participants who did not state their sex. Compared with the boys, the girls had significantly higher scores in the STAI-C and CES-D questionnaires. According to the SEQ-C, the boys felt significantly more effective than the girls overall and for social efficacy and emotional efficacy. In contrast, the boys and girls did not differ regarding the academic efficacy score. Our main findings were that 53% (n=379) of the high school students were reportedly free of anxiety or depression, 28% (n=198) showed symptoms of subclinical anxiety and depression, and 19% (n=131) showed symptoms of clinical anxiety or depression. We compared the "anxious-depressed" group with the "neither anxious nor depressed" group: the former group was mainly composed of girls, whereas there were nearly as many boys as girls in the latter group. After adjustment for sex, the overall self-efficacy and the academic, social and emotional efficacy scores were found to be lower in the "anxious-depressed" group. The sex difference was null for social efficacy, small for overall efficacy and academic efficacy, and moderate for emotional efficacy. CONCLUSIONS: Overall, 47% of the study participants reported subclinical anxiety and/or a depression. It appears that anxiety and depression are linked to self-efficacy: the self-efficacy score was lower in the "anxious-depressed" group than in the "neither anxious nor depressed" group.
RESUMEN
OBJECTIVE: Existing studies, in mostly male samples such as veterans and athletes, show a strong association between traumatic brain injury (TBI) and mental illness. Yet, while an understanding of mental health before pregnancy is critical for informing preconception and perinatal supports, there are no data on the prevalence of active mental illness before pregnancy in females with TBI. We examined the prevalence of active mental illness ≤2 years before pregnancy (1) in a population with TBI, and (2) in subgroups defined by sociodemographic, health, and injury-related characteristics, all compared to those without TBI. METHOD: This population-based cross-sectional study was completed in Ontario, Canada, from 2012 to 2020. Modified Poisson regression generated adjusted prevalence ratios (aPRs) of active mental illness ≤2 years before pregnancy in 15,585 females with TBI versus 846,686 without TBI. We then used latent class analysis to identify subgroups with TBI according to sociodemographic, health, and injury-related characteristics and subsequently compared them to females without TBI on their outcome prevalence. RESULTS: Females with TBI had a higher prevalence of active mental illness ≤2 years before pregnancy than those without TBI (44.1% vs. 25.9%; aPR 1.46, 95% confidence interval, 1.43 to 1.49). There were 3 TBI subgroups, with Class 1 (low-income, past assault, recent TBI described as intentional and due to being struck by/against) having the highest outcome prevalence. CONCLUSIONS: Females with TBI, and especially those with a recent intentional TBI, have a high prevalence of mental illness before pregnancy. They may benefit from mental health screening and support in the post-injury, preconception, and perinatal periods. PLAIN LANGUAGE TITLE: Mental illness in the 2 years before pregnancy in a population with traumatic brain injury.
Research has shown a strong association between traumatic brain injury (TBI) and mental illness. Most previous studies have been conducted in primarily male samples, like veterans and professional athletes. Understanding mental health before pregnancy is important for deciding what supports people need before and during pregnancy. However, there are no studies on the frequency of mental illness in females with TBI before a pregnancy. We examined the frequency of mental illness 2 years before pregnancy in a population with TBI, and in subgroups defined by different social, health, and injury-related characteristics, compared to those without TBI. We undertook a population-wide study of all females with and without TBI in Ontario, Canada, with a birth in 20122020. We used statistical models to compare these groups on the presence of mental illness in the 2 years before pregnancy, before and after accounting for social and health characteristics. We also identified subgroups with TBI according to their social (e.g., poverty), health (e.g., chronic conditions), and injury-related characteristics (e.g., cause of injury) and subsequently compared them to females without TBI on their frequency of mental illness in the 2 years before pregnancy. Forty-four percent of females with TBI had mental illness in the 2 years before pregnancy compared to 25% of those without TBI. There were 3 TBI subgroups. Females with low-income, past assault, and injuries that were described as being intentional had the highest frequency of mental illness in the 2 years before pregnancy. Females with TBI may benefit from mental health screening and support post-injury and around the time of pregnancy.
Asunto(s)
Lesiones Traumáticas del Encéfalo , Trastornos Mentales , Humanos , Femenino , Lesiones Traumáticas del Encéfalo/epidemiología , Estudios Transversales , Adulto , Trastornos Mentales/epidemiología , Ontario/epidemiología , Prevalencia , Adulto Joven , Embarazo , Adolescente , ComorbilidadRESUMEN
BACKGROUND: e-Health tools using validated questionnaires to assess outcomes may facilitate measurement-based care for psychiatric disorders. MoodFX was created as a free online symptom tracker to support patients for outcome measurement in their depression treatment. We conducted a pilot randomized evaluation to examine its usability, and clinical utility. METHODS: Patients presenting with a major depressive episode (within a major depressive or bipolar disorder) were randomly assigned to receive either MoodFX or a health information website as the intervention and control condition, respectively, with follow-up assessment surveys conducted online at baseline, 8 weeks and 6 months. The primary usability outcomes included the percentage of patients with self-reported use of MoodFX 3 or more times during follow up (indicating minimally adequate usage) and usability measures based on the System Usability Scale (SUS). Secondary clinical outcomes included the Quick Inventory of Depressive Symptomatology, Self-Rated (QIDS-SR) and Patient Health Questionnaire (PHQ-9). RESULTS: Forty-nine participants were randomized (24 to MoodFX and 25 to the control condition). Of the 23 participants randomized to MoodFX who completed the user survey, 18 (78%) used MoodFX 3 or more times over the 6 months of the study. The mean SUS score of 72.7 (65th-69th percentile) represents good usability. Compared to the control group, the MoodFX group had significantly better improvement on QIDS-SR and PHQ-9 scores, with large effect sizes and higher response rates at 6 months. There were no differences between conditions on other secondary outcomes such as functioning and quality of life. CONCLUSION: MoodFX demonstrated good usability and was associated with reduction in depressive symptoms. This pilot study supports the use of digital tools in depression treatment.
E-health tools may be useful for measuring and tracking symptoms and other outcomes during treatment for depression. This study is a randomized evaluation of MoodFX, a free web-based app that helps patients track their symptoms using validated questionnaires, and also offers depression information and self-management tips. A total of 49 participants with clinical depression were randomized to using MoodFX or a health information website, for 6 months. In a survey, the participants that used MoodFX found it easy and useful to use. In addition, the participants that used MoodFX had greater improvement in depressive symptoms after 6 months, compared to those who used the health information website. These results suggest that MoodFX may be a useful tool to monitor outcomes and support depression treatment.
Asunto(s)
Trastorno Bipolar , Trastorno Depresivo Mayor , Evaluación de Resultado en la Atención de Salud , Telemedicina , Humanos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Trastorno Depresivo Mayor/terapia , Proyectos Piloto , Trastorno Bipolar/terapiaRESUMEN
The subjective experience of contact with the deceased (VSCD), spontaneous and direct, by people most often in mourning, is neither rare nor new. It's even considered a universal and timeless phenomenon. Yet this psychological and sensory manifestation, which can manifest itself through sight, hearing, smell or touch, remains little known to the general public and health professionals alike. This article is an opportunity for many to discover this phenomenon, also known as necrophany.
Asunto(s)
Pesar , Humanos , Actitud Frente a la MuerteRESUMEN
Purpose: To examine whether Indigenous identity and food insecurity combined were associated with self-reported poor health.Methods: Data from the 2015-2016 Canadian Community Health Survey and multiple logistic regression were employed to evaluate the association between Indigenous identity, household food insecurity, and health outcomes, adjusted for individual and household covariates. The Alexander Research Committee in Alexander First Nation (Treaty 6) reviewed the manuscript and commented on the interpretation of study findings.Results: Data were from 59082 adults (3756 Indigenous). The prevalence of household food insecurity was 26.3% for Indigenous adults and 9.8% for non-Indigenous adults (weighted to the Canadian population). Food-secure Indigenous adults, food-insecure non-Indigenous adults, and food-insecure Indigenous adults had significantly (p < 0.001) greater odds of poor health outcomes than food-secure non-Indigenous adults (referent group). Food-insecure Indigenous adults had 1.96 [95% CI:1.53,2.52], 3.73 [95% CI: 2.95,4.72], 3.00 [95% CI:2.37,3.79], and 3.94 [95% CI:3.02,5.14] greater odds of a chronic health condition, a chronic mental health disorder, poor general health, and poor mental health, respectively, compared to food-secure non-Indigenous adults.Conclusions: Health policy decisions and programs should focus on food security initiatives for all Canadians, including addressing the unique challenges of Indigenous communities, irrespective of their food security status.
Asunto(s)
Composición Familiar , Inseguridad Alimentaria , Humanos , Canadá , Adulto , Femenino , Masculino , Persona de Mediana Edad , Estado de Salud , Encuestas Epidemiológicas , Adulto Joven , Indígena Canadiense , Anciano , Abastecimiento de Alimentos/estadística & datos numéricos , Pueblos Indígenas/estadística & datos numéricos , Adolescente , Modelos LogísticosRESUMEN
Contradictory results in the extant literature suggests that additional risk factors should be considered when exploring the impacts of maternal smartphone use on mother-infant relationships. This study used cluster analysis to explore whether certain risk factors were implicated in mother-infant dyads with high smartphone use and low mother-infant responsiveness. A cross-sectional survey of 450 participants in the UK measured infant social-emotional development, maternal depressive, anxiety and stress symptoms, wellbeing, social support, smartphone use, and mother-infant responsiveness. Participants were predominantly White (95.3%) and living with a partner (95.2%), with infants who were born full-term (88.9%). Cluster analysis identified three clusters characterized as; cluster (1) "infant at risk" showing high infant development concerns, high maternal smartphone use, and low mother-infant responsiveness; cluster (2) "mother at risk" showing high maternal depressive, anxiety, and stress scores, low social support, high maternal smartphone use, and low mother-infant responsiveness, and cluster (3) "low risk" showing low maternal smartphone use and high mother-infant responsiveness. Significant differences were found between all risk factors, except for maternal smartphone use and mother-infant responsiveness between clusters 1 and 2 suggesting that both clusters require early intervention, although interventions should be tailored towards the different risk factors they are presenting with.
Resultados contradictorios en la literatura existente sugieren que se deben considerar factores de riesgo adicionales cuando se explora el impacto del uso que la madre hace del teléfono inteligente en las relaciones madreinfante. Este estudio usó un análisis de grupo para explorar si ciertos factores de riesgo estaban implicados en las díadas madreinfante con uso elevado del teléfono inteligente y la baja sensibilidad madreinfante. Una encuesta transversal de 450 participantes en el Reino Unido midió el desarrollo socioemocional del infante, los síntomas maternos depresivos, de ansiedad y estrés, el bienestar, el apoyo social, el uso del teléfono inteligente, así como la sensibilidad madreinfante. Las participantes eran predominantemente blancas (95.3%) y convivían con una pareja (95.2%), con infantes nacidos en un período de gestación completo (88.9%). Los análisis de grupo identificaron tres grupos caracterizados como: grupo 1) "infante bajo riesgo," mostrando altas preocupaciones sobre el desarrollo del infante, uso elevado del teléfono inteligente por parte de la madre, así como baja sensibilidad madreinfante; grupo 2) "madre bajo riesgo," mostrando altos puntajes de depresión, ansiedad y estrés maternos, bajo apoyo social, uso elevado del teléfono inteligente por parte de la madre, así como baja sensibilidad madreinfante; y grupo 3) "bajo riesgo," mostrando bajo uso del teléfono inteligente por parte de la madre, y alta sensibilidad madreinfante. Se encontraron diferencias significativas en todos los factores de riesgo, excepto en el caso del uso del teléfono inteligente por parte de la madre y la sensibilidad madreinfante entre los grupos 1 y 2, lo cual indica que ambos grupos requieren de una temprana intervención, aunque las intervenciones se deben moldear en términos de los diferentes factores de riesgo que se le presenta a cada grupo.
Les résultats contradictoires dans les recherches existantes suggèrent que des facteurs de risque supplémentaires devraient être pris en considération en explorant les impacts de l'utilisation maternelle du smartphone sur les relations mèrebébé. Cette étude a utilisé une analyse typologique afin d'explorer si certains facteurs de risque étaient impliqués chez les dyades mèrenourrisson avec une utilisation élevée du smartphone et une réaction mèrenourrisson faible. Une étude transversale de 450 participantes au Royaume Uni a mesuré le développement socioémotionnel du bébé, les symptômes dépressives, d'anxiété et de stress maternel, le bienêtre maternel, le soutien social, l'utilisation du smartphone et la réaction mèrenourrisson. Les participantes étaient essentiellement Blanches (95,3%), vivant avec un partenaire (95,2%), avec des bébés étant nés à terme (88,9%). Une analyse typologique a identifié trois clusters (types) avec ces caractéristiques: type 1) "nourrisson à risque" avec des problèmes de développement infantile élevés, une utilisation maternelle du smartphone élevée, et une réaction mèrebébé faible; type 2) "mère à risque" faisant état de scores maternels élevés de dépression, d'anxiété et de stress, d'un soutien social faible, avec une utilisation maternelle du smartphone élevée, et une réaction mèrebébé faible, et type 3) "risque faible" montrant peu d'utilisation maternelle du smartphone et une réaction élevée mèrebébé. Des différences importantes ont été trouvées entre tous les facteurs de risque, saut pour l'utilisation maternelle du smartphone et la réaction maternelle entre les types 1 et 2, ce qui suggère que les deux types exigent une intervention précoce, bien que les interventions devraient être adaptées aux différents facteurs de risque avec lesquelles elles se présentent.
Asunto(s)
Relaciones Madre-Hijo , Madres , Teléfono Inteligente , Humanos , Femenino , Relaciones Madre-Hijo/psicología , Adulto , Análisis por Conglomerados , Estudios Transversales , Lactante , Factores de Riesgo , Madres/psicología , Masculino , Factores Protectores , Apoyo Social , Depresión , Adulto Joven , Ansiedad , Reino Unido , Desarrollo Infantil , Estrés Psicológico , Recién NacidoRESUMEN
The Litterapsy study focuses on the assessment of health literacy in patients with psychiatric disorders, a field that has been little studied in France. It is based on the observations of an advanced practice nurse specializing in psychosocial rehabilitation. Its aim is to provide objective data to better understand how these patients understand medical information and navigate the healthcare system.
Asunto(s)
Enfermería de Práctica Avanzada , Alfabetización en Salud , Trastornos Mentales , Psiquiatría , Humanos , Atención a la SaludRESUMEN
In a medical-social setting, the work of addiction care providers is somewhat unusual. Drawing on the teachings of Carl Rogers and his person-centred approach, and Hildegard Peplau and her theory of care based on the interpersonal relationship, this article explores the possibilities of welcoming a user to an addictology care, support and prevention center that is trying to rethink its operations at a time when advanced practice nurses are being deployed.
Asunto(s)
Enfermería de Práctica Avanzada , Femenino , HumanosRESUMEN
INTRODUCTION: Mindfulness meditation has gained prominence in somatic and psychiatric care in several countries including France. Studies have shown its effectiveness in various conditions, in particular the prevention of depressive relapses. However, there are criticisms and concerns about its potential links to Buddhism and spirituality, raising issues of secularism and sectarianism. This issue is particularly conflicting in France with regard its historical and political relationship with secularism. OBJECTIVES: This study aims to assess quantitative data regarding the impact of mindfulness meditation on spirituality and religiosity using quantitative validated scales. METHODS: A systematic review was conducted. PubMed was searched for relevant studies using keywords related to mindfulness and spirituality/religiosity scales. Four scales assessing spirituality were identified: FACIT-sp, INSPIRIT, DSES, and DUREL. Qualitative analysis determined if scale items pertained to spirituality or other topics considered by opponents to mindfulness as "at risk" for deviances or sectarian aberrations. Quantitative analysis assessed the effect size of changes in scale scores before and after mindfulness meditation interventions. RESULTS: Eighteen studies were analyzed, with varying scales and program durations including 1272 participants. Qualitative analysis showed that most scales contained items related to spirituality as well as "at risk" elements like religion and mysticism. Quantitative analysis revealed that a few studies reported significant increases in spirituality scores following mindfulness meditation, but the clinical relevance of these changes was questioned. In general, control groups had smaller score changes. INTERPRETATION: While some studies suggest a potential increase in spirituality due to mindfulness meditation, the clinical significance of these findings remains uncertain. Moreover, mindfulness meditation's ties to Buddhism are disputed, and its roots are intertwined with various psychotherapy traditions that incorporate spirituality. The role of secularism in psychotherapy is also debated in France, emphasizing the need for proper use and regulation policy rather than prohibition of mindfulness-based approaches. This study highlights the complexity of assessing the impact of mindfulness meditation on spirituality and religiosity. It suggests that a pragmatic approach focusing on risk and harm reduction may be more suitable than labeling the practice as "at risk". Further research is needed to clarify these issues in the specific cultural context of France.