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1.
Rev. enferm. UFSM ; 9: [21], jul. 15, 2019.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1024204

RESUMEN

Objetivo: analisar a trajetória percorrida pelos adolescentes usuários de crack até o início do tratamento no Centro de Atenção Psicossocial Álcool e Drogas (CAPS AD). Método: trata-se de um estudo exploratório descritivo com abordagem qualitativa. Participaram usuários, familiares e profissionais atuantes no CAPS AD. Os dados foram coletados por meio de entrevistas semiestruturadas, organizados e tratados pelo software Nvivo 11 e, posteriormente, submetidos a Análise Temática. Resultado: a partir da análise dos dados emergiram as seguintes categorias: a forma como o adolescente usuário de crack chega ao CAPS AD; Motivos que levam o adolescente usuário de crack para tratamento no CAPS AD e Serviços utilizados pelos adolescentes usuários de crack até chegar ao CAPS AD. Considerações finais: mostra-se importante o investimento nos serviços e ações desenvolvidas pela Rede de Atenção Piscossocial (RAPS), dando-lhes maior visibilidade e acesso aos jovens.


Aim: to analyze the trajectory experienced by adolescent crack users until the beginning of their treatment in the Psychosocial Care Center for Alcohol and Drugs (CAPS AD). Method: This is a descriptive exploratory study, with a qualitative approach. Users, their relatives and workers from CAPS AD participated in the study. Data were collected through semi-structured interviews, organized and treated by Nvivo 11 software and, subsequently, submitted to Thematic Analysis. Result: From data analysis, the following categories emerged: The way the adolescent crack user arrives at CAPS AD; Reasons that lead the adolescent crack user to seek treatment at CAPS AD and Services used by adolescent crack users until they arrive at CAPS AD. Final considerations: it is important to invest in services and actions developed by the Psychosocial Care Network (RAPS), giving them greater visibility and access to young people.


Objetivo: analizar la trayectoria de los adolescentes usuarios de crack hasta empezar el tratamiento en el Centro de Atención Psicosocial Alcohol y Drogas (CAPS AD). Método: se trata de un estudio exploratorio, descriptivo, de base cualitativo. Participaron del estudio usuarios, familiares y profesionales actuantes en el CAPS AD. Los datos fueron recolectados por medio de entrevistas semiestructuradas y ordenados y tratados por el software Nvivo 11 y, posteriormente, sometidos al Análisis Temático. Resultado: a partir del análisis de los datos surgieron las siguientes categorías: la forma que el adolescente, usuario de crack, llega al CAPS AD; los motivos que llevan el adolescente, usuario de crack, a tratarse en el CAPS AD; y los servicios utilizados por los adolescentes, usuarios de crack, hasta llegar al CAPS AD. Consideraciones finales: se reveló importante la inversión en los servicios y acciones desarrolladas por la Red de Atención Psicosocial (RAPS), dando a esos mayor visibilidad y acceso a los jóvenes.


Asunto(s)
Humanos , Adolescente , Enfermería , Cocaína Crack , Centros de Tratamiento de Abuso de Sustancias , Rehabilitación Psiquiátrica
2.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud, LIS-bvsms | ID: lis-LISBR1.1-46617

RESUMEN

O Programa De Volta Para Casa (PVC) garante o auxílio-reabilitação psicossocial para a atenção e o acompanhamento de pessoas em sofrimento mental, egressas de internação em hospitais psiquiátricos, inclusive em hospitais de custódia e tratamento psiquiátrico, cuja duração tenha sido por um período igual ou superior a dois anos. O PVC busca a restituição do direito de morar e conviver em liberdade nos territórios e também a promoção de autonomia e protagonismo dos usuários.


Asunto(s)
Impacto Psicosocial , Estrés Psicológico , Rehabilitación Psiquiátrica , Hospitales Psiquiátricos
3.
J. nurs. health ; 9(3): 199303, maio 2019.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1047297

RESUMEN

Objetivo: identificar os aspectos que dificultam o tratamento do adolescente usuário de crack na Rede de Atenção Psicossocial. Método: estudo exploratório e descritivo com abordagem qualitativa. Participaram 14 usuários, 11 familiares e 20 profissionais do Centro de Atenção Psicossocial Álcool e Drogas. Os dados foram coletados por meio de entrevista semiestruturada e, posteriormente, submetidos a Análise Temática. Resultados: emergiram as temáticas: características e comportamento do adolescente; necessidade de adesão voluntária ao tratamento; inespecíficidade das atividades terapêuticas do Centro para o tratamento de adolescentes; demora no atendimento no Centro; fissura; preconceito, rótulo e discriminação do usuário de droga; despreparo profissional para o trabalho com usuários de álcool e droga; e desestruturação familiar. Conclusões: salienta-se a importância de considerar as especificidades e instabilidades dessa faixa etária na organização do atendimento e na elaboração do plano terapêutico singular, de forma a favorecer sua adesão ao tratamento.(AU)


Objective: to identify the aspects hindering the treatment of the adolescent crack user in the Psychosocial Care Network. Method: exploratory and descriptive study with a qualitative approach. Participants were 14 users, 11 family members and 20 professionals of the Psychosocial Care Network for Alcohol and Drugs. Data were collected through semi-structured interviews, and then submitted to Thematic Analysis. Results: the following topics emerged: the adolescent's characteristics and behavior; need for voluntary treatment adherence; non-specificity of the therapeutic activities of Center for the treatment of adolescents; delay in care in Center; breach; prejudice, labeling and discrimination of the drug user; professional unpreparedness for working with alcohol and drug users; and family breakdown. Conclusions: we highlight the importance of considering the specificities and instabilities of this age group in organizing care and developing a peculiar therapeutic plan, in order to foster its treatment adherence.(AU)


Asunto(s)
Salud Mental , Adolescente , Cocaína Crack , Centros de Tratamiento de Abuso de Sustancias , Rehabilitación Psiquiátrica
5.
Asian J Psychiatr ; 42: 67-73, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30974306

RESUMEN

OBJECTIVE: The persistent disability and low Quality of Life (QoL) are the impacts of schizophrenia. Community-Based Rehabilitation (CBR) is recommended for people with schizophrenia. The objective of this study is to analyze the effectiveness of CBR to improve the quality of life of people with schizophrenia. METHODS: It was a quasi-experimental study, conducted in February-December 2017, in Yogyakarta, Indonesia. Subjectwere people with schizophrenia, 18-56 years old, with their caregiver. CBRintervention using psychoeducation module and social skill module during 12 weeks. It was conducted by local health workers, sub district social welfare workers, community health workers (called Kader in Indonesia) and supervised by a psychiatrist. The QoL was assessed using a validated measuring instrument at the baseline and at the week 16. Hypothesis test using Wilcoxon test RESULTS: There were 100 people with schizophrenia involved in the study. They were divided into intervention group and control group. Every group consists of 50 subjects. Both groups had similar characteristics at the baseline. The intervention group received CBR, whereas the control group didn't. Thirty-four people (68%) of intervention group increased their QoL, whereas in the control group there were twenty-three people (46%) increased their QoL. The QoL decrease occurred in one subject (4%) from the control group. Other subjects had constant QoL. Improvement of QoL in the intervention group is higher than the control group (p < 0.05). CONCLUSIONS: CBR is effective for improving the QoL of people with schizophrenia in the community. CBR is conducted by the health worker and sub-district social welfare worker.


Asunto(s)
Servicios de Salud Comunitaria/métodos , Educación del Paciente como Asunto/métodos , Rehabilitación Psiquiátrica/métodos , Psicoterapia/métodos , Calidad de Vida , Esquizofrenia/rehabilitación , Habilidades Sociales , Adolescente , Adulto , Femenino , Humanos , Indonesia , Masculino , Persona de Mediana Edad , Adulto Joven
6.
J Clin Psychiatry ; 80(1)2019.
Artículo en Inglés | MEDLINE | ID: mdl-30865789

RESUMEN

Despite the availability of effective treatments for MDD, many individuals have difficulty achieving remission. Residual symptoms can be difficult to differentiate from treatment side effects. Through 2 comic-based case presentations, this CME activity depicts common clinical scenarios and provides evidence-based strategies for effectively identifying and managing residual symptoms of MDD.


Asunto(s)
Trastorno Bipolar , Educación en Salud/métodos , Padres/educación , Educación del Paciente como Asunto/métodos , Rehabilitación Psiquiátrica/métodos , Psicotrópicos/uso terapéutico , Adulto , Trastorno Bipolar/psicología , Trastorno Bipolar/terapia , Niño , Salud de la Familia , Humanos , Padres/psicología
7.
BMC Psychiatry ; 19(1): 55, 2019 02 04.
Artículo en Inglés | MEDLINE | ID: mdl-30717713

RESUMEN

BACKGROUND: Clinically operated community-based residential rehabilitation units (Community Rehabilitation Units) are resource intensive services supporting a small proportion of the people with severe and persisting mental illness who experience difficulties living in the community. Most consumers who engage with these services will be diagnosed with schizophrenia or a related disorder. This review seeks to: generate a typology of service models, describe the characteristics of the consumers accessing these services, and synthesise available evidence about consumers' service experiences and outcomes. METHOD: A systematic review was undertaken to identify studies describing Community Rehabilitation Units in Australia, consumer characteristics, and evidence about consumer experiences and outcomes. Search strings were applied to multiple databases; additional records were identified through snowballing. Records presenting unique empirical research were subject to quality appraisal. RESULTS: The typology defined two service types, Community-Based Residential Care (C-BRC), which emerged in the context of de-institutionalisation, and the more recent Transitional Residential Rehabilitation (TRR) approach. Key differentiating features were the focus on transitional care and 'recovery' under TRR. Schizophrenia spectrum disorders were the most common primary diagnosis under both service types. TRR consumers were more likely to be male, referred from community settings, and less likely to be subject to involuntary treatment. Regarding outcomes, the limited quantitative evidence (4 records, 2 poor quality) indicated C-BRC was successful in supporting the majority of consumers transferred from long-term inpatient care to remain out of hospital. All qualitative research conducted in C-BRC settings was assessed to be of poor quality (3 records). No methodologically sound quantitative evidence on the outcomes of TRR was identified. Qualitative research undertaken in these settings was of mixed quality (9 records), and the four records exploring consumer perspectives identified them as valuing the service provided. CONCLUSIONS: While there is qualitative evidence to suggest consumers value the support provided by Community Rehabilitation Units, there is an absence of methodologically sound quantitative research about the consumer outcomes achieved by these services. Given the ongoing and increasing investment in these facilities within the Australian context, there is an urgent need for high-quality research examining their efficiency and effectiveness. TRIAL REGISTRATION: PROSPERO ( CRD42018097326 ).


Asunto(s)
Servicios Comunitarios de Salud Mental/métodos , Trastornos Mentales/terapia , Rehabilitación Psiquiátrica/métodos , Tratamiento Domiciliario/métodos , Índice de Severidad de la Enfermedad , Adulto , Australia/epidemiología , Servicios Comunitarios de Salud Mental/tendencias , Humanos , Pacientes Internos/psicología , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Rehabilitación Psiquiátrica/tendencias , Tratamiento Domiciliario/tendencias
8.
Psychiatr Rehabil J ; 42(1): 1-2, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30802112

RESUMEN

In 1991, as a recent college graduate, I fell into my first job in psychiatric rehabilitation. In a new city, with a vague sense of getting a few years of experience before applying to graduate schools in clinical psychology, I landed a position on an assertive case management team in East Rogers Park, Chicago, Illinois. Armed with a Chicago Transit Authority card, I helped clients navigate medical appointments and laundry and visited bakeries and bookstores, but mostly I built relationships. I was encouraged to discover my clients' strengths and preferences and to use those as the foundation for the work. I learned that the best clinical care was not only based on evidence but based on values such as collaboration, pragmatism, accessibility, diversity, and fostering growth. I was hooked. Today, I believe that the same values of psychiatric rehabilitation that attracted me to the field as an idealistic young adult should be reflected not just in the articles we publish but in the fabric of how the journal operates. In this editorial, I briefly discuss collaboration, pragmatism and accessibility, diversity, and growth as they relate to the success of the Psychiatric Rehabilitation Journal. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Publicaciones Periódicas como Asunto , Rehabilitación Psiquiátrica , Humanos
9.
Lakartidningen ; 1162019 01 28.
Artículo en Sueco | MEDLINE | ID: mdl-30694520

RESUMEN

Schizophrenia affects about 0.7 % of the population and is characterized by hallucinations, delusions and reduced functioning affecting the ability to study, work and socialize. Life expectancy for patients with schizophrenia is approximately 15-20 years shorter mostly due to cardiovascular disease. Stigmatization is  common despite the fact that it is a treatable disorder with a combination of medication and psychosocial interventions. Case management, psycho-education and supported employment are proven strategies, but less than half of individuals with schizophrenia are adequately treated. The National Board of Health and Welfare is currently launching updated National Guidelines (2018). The aim is to provide an overview of evidence-based interventions enabling patients with schizophrenia to live a fairly normal life. An evaluation has revealed that previous guidelines for antipsychotic medications have been satisfactorily implemented, but not those for psychosocial interventions. These will now be emphasized as ¼central recommendations« and will be followed up with specific indicators based on data from national registers.


Asunto(s)
Guías de Práctica Clínica como Asunto , Esquizofrenia/terapia , Antipsicóticos/uso terapéutico , Humanos , Rol del Médico , Rehabilitación Psiquiátrica , Suecia
10.
J Psychosoc Nurs Ment Health Serv ; 57(6): 39-44, 2019 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-30602052

RESUMEN

The current study investigated the effectiveness of a state-wide Community Support Services training grounded in work-based learning to improve knowledge about psychiatric rehabilitation principles and skills. Supervisory staff and direct care staff in supported housing settings completed a 17-item, multiple choice, preand posttest after attending a 48-hour training series. Results indicated that participants gained psychiatric rehabilitation knowledge. These findings support the effectiveness of the training series grounded in work-based learning. [Journal of Psychosocial Nursing and Mental Health Services, 57(6), 39-44.].


Asunto(s)
Vivienda , Trastornos Mentales/rehabilitación , Enfermería Psiquiátrica/educación , Rehabilitación Psiquiátrica/educación , Adulto , Evaluación Educacional/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Rehabilitación Psiquiátrica/métodos
11.
Scand J Occup Ther ; 26(3): 219-225, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30421626

RESUMEN

BACKGROUND: The clubhouses are part of a growing international movement concerned with providing work-oriented psychosocial rehabilitation for people with a history of mental illness. Instruments used for measuring outcomes from clubhouse participation is in a developing phase. AIMS: This study aimed to assess psychometric properties of an outcome survey tool used at a Norwegian clubhouse, and to explore factors associated with members' perceived outcomes from participation at the clubhouse. METHODS: A cross-sectional design was used. The instrument's factor structure was examined with Principal Components Analysis (PCA), and internal consistency was assessed with Cronbach's α. Associations with the derived outcome scale score were examined with linear regression analysis. RESULTS: All scale items belonged to the same latent factor, and internal consistency of the items was α = 0.81. Members, who used the clubhouse more frequently perceived the outcomes from participating to be better, compared to their counterparts. CONCLUSION: The outcome scale was unidimensional and the items fit well together. Active members were likely to evaluate outcomes of clubhouse participation as more positive, compared to less active members. SIGNIFICANCE: The scale can be useful for exploring clubhouse members' perceptions of the outcomes they relate to their participation at the clubhouse.


Asunto(s)
Empleos Subvencionados/psicología , Trastornos Mentales/psicología , Trastornos Mentales/rehabilitación , Rehabilitación Psiquiátrica/métodos , Psicometría/métodos , Reinserción al Trabajo/psicología , Grupos de Autoayuda/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Noruega , Encuestas y Cuestionarios
12.
J Ment Health ; 28(2): 206-212, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30449213

RESUMEN

BACKGROUND: The Recovery Self-Assessment (RSA) is a popular and well-validated instrument for assessing recovery-oriented service around the world. AIMS: This study aims to develop a Chinese version of the RSA, which assesses the recovery orientation of hospital-based mental health services. METHODS: We conducted forward and backward translations of the RSA and modify the translated Chinese based on comments by content experts. We recruited 350 people with mental illnesses who regularly attend hospital and community mental health services. The participants completed the Chinese Recovery Self-Assessment Service User version (CRSA-SU) and convergent measures on hope and mental well-being. RESULTS: The Rasch analysis supported five of the six factors in the instrument and suggests that the "Life Goal" factor could be further split into two factors. We identified three misfit items (items 6, 12 and 17) that could be considered for removal. Both the internal consistency and test-retest reliability are between satisfactory and very good within each subscale, with the exception of the Choice subscale. The seven subscales had low positive correlations with measures of hope and mental well-being, which supported the convergent validity of CRSA-SU. CONCLUSIONS: The results supported the factor structure, reliability and validity of the CRSA-SU.


Asunto(s)
Autoevaluación Diagnóstica , Trastornos Mentales/rehabilitación , Evaluación del Resultado de la Atención al Paciente , Escalas de Valoración Psiquiátrica/normas , Adulto , Grupo de Ascendencia Continental Asiática , Femenino , Humanos , Masculino , Persona de Mediana Edad , Rehabilitación Psiquiátrica , Psicometría , Reproducibilidad de los Resultados
13.
Neuropsychiatr ; 33(1): 8-24, 2019 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-30328582

RESUMEN

OBJECTIVE: Since previous meta-analyses of psychiatric-psychosomatic rehabilitation only rarely included studies from Austrian rehabilitation clinics a systematic review with meta-analysis of previously available evaluation results from Austrian rehabilitation clinics should be conducted. METHODS: A systematic literature search in several data bases (Psyndex, PsycInfo, MEDLINE, Pubmed) and additional manual search was conducted. Evaluation results from the most commonly used assessment instruments (SCL-90/BSI, BDI, WHOQOL-BREF, GAF) were extracted from the studies included and subsequently a meta-analysis was calculated with the extracted data (pre-post comparison). RESULTS: 12 publications with 9 studies from 6 different Austrian rehabilitation clinics could be included in the meta-analysis, with a total of 9329 patients. Results show a significant improvement from pre- to post assessment in the medium effect size range, with a Hedges' g of 0.53 (95%-confidence interval [0.45;0.60]) for improvement in global symptom severity, a Hedges' g of 0.59 (95%-confidence interval [0.54;0.63]) for improvement in subjective quality of life and a Hedges' g of 1.00 (95%-confidence interval [0.83;1.18]) for improvement in global functioning. The effects are robust and there is no evidence for distortion or publication bias. CONCLUSIONS: On average medium effect sizes have been previously achieved with psychiatric-psychosomatic rehabilitation in Austrian rehabilitation clinics. This is comparable with the previous results of rehabilitation clinics in Germany. However, since only one controlled study is available thus far it can not be ruled out that the effects in comparison to no rehabilitation might turn out smaller. Thus, in the future increasingly controlled studies should be conducted and the quality of conducted studies should be improved.


Asunto(s)
Rehabilitación Psiquiátrica/normas , Austria , Humanos , Calidad de Vida
14.
Psychiatr Rehabil J ; 42(1): 9-16, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30265065

RESUMEN

OBJECTIVE: Peer specialists are frequently employed in mental health settings, with growing evidence for positive impact on subjective aspects of recovery. As more individuals within the mental health system have criminal justice involvement, peer specialists with incarceration histories are increasingly important, yet little is known about how their experiences with the criminal justice system factor into their work. This study sought to understand the experiences of peer specialists with criminal justice histories and how they incorporate these experiences into their work. METHODS: Purposive and snowball sampling was employed to recruit graduates from a peer training program. Three in-depth interviews were conducted each with 15 peer specialists who had incarceration experiences. RESULTS: Thematic analysis revealed that Having and Sharing Lived Experiences formed the basis of their work as peer specialists. On this foundation, participants expounded on their specialized contributions in their work as peer specialists: Engagement, Priority of Relationship, Instilling Hope, and Providing an Alternative Service. Participants' criminal justice histories influenced how they approached their work, especially around using disclosure, developing relationships, and instilling hope. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Peer specialists with incarceration histories may be a critical component toward recovery for consumers with criminal justice involvement. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Agentes Comunitarios de Salud/psicología , Criminales/psicología , Trastornos Mentales/rehabilitación , Enfermos Mentales/psicología , Grupo Paritario , Rehabilitación Psiquiátrica/psicología , Adulto , Agentes Comunitarios de Salud/educación , Humanos , Servicios de Salud Mental , Prisioneros/psicología , Investigación Cualitativa , Especialización
15.
Psychiatr Rehabil J ; 42(1): 79-87, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30265066

RESUMEN

OBJECTIVE: The purpose of the current study was to examine the relationship between education and recovery-oriented outcomes among adults with serious mental illnesses (SMIs). METHOD: Data from 623 adults with SMIs were combined from 6 separate studies, using baseline measures prior to any intervention. An independent samples t test was conducted on recovery scores and overall quality of life (QOL) to compare participants with more than high school education to those with less. Additionally, a multivariate analysis of variance was run on each of the individual items of the QOL index to further investigate differences in QOL by education group. RESULTS: Contrary to expectations, individuals with higher levels of educational attainment reported lower scores on recovery and several domains compared with individuals with lower levels of educational attainment. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The results of the current study indicate that people with SMIs with higher educational attainment may actually be at greater risk for experiencing poor recovery-oriented outcomes. Rehabilitation efforts should focus not only on increasing educational attainment, but managing other factors that potentially interfere with recovery, such as self-stigma and demoralization. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Escolaridad , Trastornos Mentales/rehabilitación , Medición de Resultados Informados por el Paciente , Rehabilitación Psiquiátrica , Calidad de Vida , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad
16.
Psychiatr Rehabil J ; 42(1): 88-99, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30265067

RESUMEN

OBJECTIVE: Social effectiveness continues to play a critical role in recovery of people with serious mental illness (SMI), with greater social effectiveness predicting many positive life outcomes. Despite the abundance of literature supporting the relationship between perceptions and behavior, little is known about predictors of perceived social effectiveness of individuals with SMI. METHODS: The purpose of this study is to examine the predictors of perceived social effectiveness of individuals with SMI. Cross-sectional data of 192 participants with SMI recruited from four psychiatric rehabilitation clubhouses in 2 states in the South and Midwest regions of the United States were used for this study. Self-report data on category of psychiatric disabilities, psychiatric symptoms, cognition, insight, educational attainment, empathy, interpersonal interactions and relationships, self-stigma, disability acceptance, and perceived social effectiveness were collected and analyzed using multiple regression analysis (MRA). RESULTS: MRA yielded a regression model that accounted for 56% of the variance in perceived social effectiveness, which is considered a large effect size. Controlling for all other factors, mood disorder, educational attainment, empathy, interpersonal interactions and relationships, and disability acceptance were found to be significant predictors of perceived social effectiveness of persons with SMI. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Practitioners should consider determining points of intervention and targeting specific elements that enhance perceived social effectiveness. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Escolaridad , Empatía , Relaciones Interpersonales , Trastornos Mentales/psicología , Trastornos Mentales/rehabilitación , Enfermos Mentales/psicología , Autoeficacia , Habilidades Sociales , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Rehabilitación Psiquiátrica , Adulto Joven
17.
Epidemiol Psychiatr Sci ; 28(1): 4-8, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30012237

RESUMEN

This study is aimed at the importance of social care in rehabilitation. A brief overview of the social care theme is used as the methodology. There is a tension in mental health care between biological and psychological treatments that focus on deficits at the individual level (symptoms, disabilities) and social interventions that try to address local inequalities and barriers in order to improve access for service users to ordinary housing, employment and leisure opportunities. The history of mental health care tells us that social care is often underfunded and too easily dismissed as not the business of health care. But too much emphasis on a health model of individual deficits is a slippery slope to institutionalisation by way of therapeutic nihilism. Rehabilitation services follow the biopsychosocial model but with a shift in emphasis, recognising the vital role played by social interventions in improving the functional outcomes that matter to service users including access to housing, occupation, leisure facilities and the support of family and friends. In conclusion, rehabilitation is framed within a model of personal recovery in which the target of intervention is to boost hope and help the individual find a meaning to life, living well regardless of enduring symptoms.


Asunto(s)
Empleos Subvencionados , Trastornos Mentales/rehabilitación , Servicios de Salud Mental/organización & administración , Rehabilitación Psiquiátrica , Vivienda Popular , Apoyo Social , Prestación de Atención de Salud , Humanos , Trastornos Mentales/psicología , Factores Socioeconómicos
18.
Epidemiol Psychiatr Sci ; 28(4): 408-417, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29199920

RESUMEN

AIMS: Incorporating consumer perspectives into mental health services design is important in working to deliver recovery-oriented care. One of the challenges faced in mental health rehabilitation services is limited consumer engagement with the available support. Listening to consumers' expectations of mental health services, and what they hope to achieve, provides an opportunity to examine the alignment between existing services and the priorities and preferences of the people who use them. We explored consumer understandings and expectations of three recovery-oriented community-based residential mental-health rehabilitation units using semi-structured interviews; two of these units were trialling a staffing model integrating peer support with clinical care. METHODS: Twenty-four consumers completed semi-structured interviews with an independent interviewer during the first 6 weeks of their stay at the rehabilitation unit. Most participants had a primary diagnosis of schizophrenia or a related psychotic disorder (87%). A pragmatic approach to grounded theory guided the analysis, facilitating identification of content and themes, and the development of an overarching conceptual map. RESULTS: The rehabilitation units were considered to provide a transformational space and a transitional place. The most common reason given for engagement was housing insecurity or homelessness rather than the opportunity for rehabilitation engagement. Differences in expectations did not emerge between consumers entering the clinical and integrated staffing model sites. CONCLUSIONS: Consumers understand the function of the rehabilitation service they are entering. However, receiving rehabilitation support may not be the key driver of their attendance. This finding has implications for promoting consumer engagement with rehabilitation services. The absence of differences between the integrated and clinical staffing models may reflect the novelty of the rehabilitation context. The study highlights the need for staff to find better ways to increase consumer awareness of the potential relevance of evidence-based rehabilitation support to facilitating their recovery.


Asunto(s)
Servicios Comunitarios de Salud Mental/organización & administración , Trastornos Mentales/rehabilitación , Rehabilitación Psiquiátrica/organización & administración , Adulto , Actitud del Personal de Salud , Actitud Frente a la Salud , Participación de la Comunidad , Femenino , Teoría Fundamentada , Humanos , Entrevistas como Asunto , Masculino , Trastornos Mentales/psicología , Motivación , Investigación Cualitativa
19.
Disabil Rehabil ; 41(1): 19-25, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-28849674

RESUMEN

BACKGROUND: Preliminary evidence suggests that older people who seek medical help for subjective memory complaints (SMC) may be at risk for depression, poor quality of life (QoL), and functional limitations. This study aims to: (1) further investigate bio-psycho-social characteristics, participation in personally meaningful activities and QoL of help-seekers; and (2) examine the relationship of these characteristics to QoL, and explore the unique contribution of participation to QoL. METHODS: Cognitive, meta-cognitive, emotional, social, participation, and QoL measures were used to compare 51 help-seekers referred from geriatric clinics to 40 age-matched controls who did not seek help for memory problems. RESULTS: Help-seekers exhibited lower participation and QoL, had lower mean cognitive scores, reported more memory mistakes and negative memory-beliefs, more depression, worse self-efficacy, and less positive social interaction than non-help-seekers. Quality of life in help-seekers was significantly correlated with most variables. Participation contributed to the explained variance of QoL in help-seekers, beyond that accounted for by cognition and emotional status. DISCUSSION: Help-seekers with SMC exhibited a complex health condition that includes not only SMC, but also objective memory impairment, depression, functional restrictions, negative memory beliefs, low perception of memory abilities, reduced self-efficacy and insufficient social interactions, all associated with lower QoL. This multi-faceted condition should be considered in the treatment of help-seekers. Implications for Rehabilitation Older people who seek help for subjective memory complaints may be facing a larger problem involving bio-psycho-social factors, affecting participation in meaningful activities and quality of life. Quality of life may be improved via treatment of depression, functional restrictions, memory beliefs, self-efficacy, and positive social interactions. Participation in meaningful activities is an especially important target for improving health and quality of life in this population. Interventions for older adults seeking help for subjective memory complaints will benefit from adopting a bio-psycho-social rehabilitation perspective.


Asunto(s)
Trastornos de la Memoria , Memoria , Rehabilitación Psiquiátrica/métodos , Calidad de Vida , Anciano , Cognición , Depresión/diagnóstico , Depresión/psicología , Depresión/terapia , Femenino , Evaluación Geriátrica/métodos , Disparidades en el Estado de Salud , Conducta de Búsqueda de Ayuda , Humanos , Relaciones Interpersonales , Masculino , Trastornos de la Memoria/diagnóstico , Trastornos de la Memoria/psicología , Persona de Mediana Edad , Autoeficacia , Participación Social
20.
Dementia (London) ; 18(1): 8-35, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27380931

RESUMEN

An influential review in 2010 concluded that non-pharmacological multi-component interventions have positive effects on cognitive functioning, activities of daily living, behaviour and mood of people with dementia. Our aim here is to provide an up-to-date overview of research into psychosocial interventions and their impact on psychosocial outcomes. We focused on randomised controlled trials, controlled studies and reviews published between October 2008 and August 2015, since the earlier review. The search of PsychInfo, Medline and the Cochrane database of systematic reviews yielded 61 relevant articles, organised into four themes echoing key phases of the care pathway: Living at home with dementia (five reviews, eight studies), carer interventions (three reviews, four studies), interventions in residential care (16 reviews, 12 studies) and end-of-life care (three reviews, two studies), along with an additional group spanning community and institutional settings (six reviews, two studies). Community findings suggested that appointment of dementia specialists and attention to case management can produce positive outcomes; physical therapies, cognitive training and modified cognitive behaviour therapy also had a range of benefits. There was more limited evidence of positive benefits for people with dementia through interventions with family carers. Thirty-two articles focused on the management of 'behavioural symptoms' through a range of interventions all of which had some evidence of benefit. Also a range of multi-component and specific interventions had benefits for cognitive, emotional and behavioural well-being of people with dementia in residential settings, as well as for quality of life. Overall, interventions tended to be short term with impact only measured in the short term. We recommend further research on interventions to promote living well in the community post-diagnosis and to address end-of-life care. Development of psychosocial interventions would benefit from moving beyond the focus on control of behaviours to focus on wider aspects of life for people with dementia.


Asunto(s)
Demencia/rehabilitación , Rehabilitación Psiquiátrica/métodos , Sistemas de Apoyo Psicosocial , Cuidadores , Demencia/psicología , Servicios de Atención de Salud a Domicilio , Humanos , Servicios de Salud Mental , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Instituciones Residenciales , Cuidado Terminal , Resultado del Tratamiento
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