Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 40.597
Filtrar
1.
CMAJ Open ; 11(1): E1-E12, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36627127

RESUMEN

BACKGROUND: Financial incentives may improve primary care access for adults with schizophrenia or bipolar disorder (serious mental illness [SMI]). We studied the association between receipt of the SMI financial premium paid to primary care physicians and rostering of adults with SMI in different patient enrolment models (PEMs), including enhanced fee-for-service and capitation-based models with and without interdisciplinary team-based care. METHODS: We conducted a retrospective cohort study involving Ontario adults (≥18 yr) with SMI in PEM practices, in fiscal years 2016/17 and 2017/18. Using negative binomial models, we examined relations between rostering and the primary care model and the contribution of the incentive. Similar models were developed for adults with type 1 or 2 diabetes mellitus and the general population. RESULTS: Among 9730 physicians in PEM practices, 4866 (50.0%) received a premium and 448 319 (88.4%) people with SMI in PEMs were rostered. Compared with enhanced fee for service, the likelihood of rostering people with SMI was 3.0% higher for patients in capitation with team-based care (adjusted relative risk [RR] 1.03, 95% confidence interval [CI] 1.02-1.04), with similar results for capitation without team-based care (adjusted RR 1.00 95% CI 0.99-1.01). Rostering for people with diabetes was similar in team-based care (adjusted RR 1.02, 95% CI 1.02-1.03) but higher in capitation without team-based care (adjusted RR 1.03, 95% CI 1.02-1.03) and slightly higher for the Ontario population (team-based care 1.04, 95% CI 1.04-1.05, capitation without team-based care 1.03, 95% CI 1.03-1.04). INTERPRETATION: Rostering of people with SMI was lower than for the general population. Additional policy measures are needed to address persisting inequities and to promote rostering of this underserved population with complex needs.


Asunto(s)
Trastornos Mentales , Médicos , Humanos , Adulto , Estudios Retrospectivos , Motivación , Atención Primaria de Salud , Ontario/epidemiología , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia
3.
BMC Health Serv Res ; 23(1): 76, 2023 Jan 24.
Artículo en Inglés | MEDLINE | ID: mdl-36694198

RESUMEN

BACKGROUND: Alcohol use disorders (AUD) are among the most highly stigmatized medical conditions. Only a minority of individuals with AUD seek treatment, and stigma is one of the most prominent barriers to treatment-seeking. However, there is a lack of knowledge about the associations between stigma and preferences for help-seeking, and the associations between stigma and preferences for treatment seeking. AIM: to investigate the associations between stigma and preferences for where to seek help and treatment for AUD. As sub-analyses, associations between stigma, level of alcohol use and preferences for help-seeking and treatment preferences will be analyzed. METHOD: Cross-sectional design, including n = 3037 participants aged 30 - 65 years, living in Denmark. DATA: In 2020, an online questionnaire was administered by a market research company. The questionnaire covered demographics, preferences for help-seeking and treatment for AUD, stigma measured with the Difference, Disdain & Blame Scales for Public Stigma, and alcohol use measured with the Alcohol Use Disorder Test (AUDIT). ANALYSES: restricted cubic spline models were applied to model outcomes. Odds ratios were calculated. RESULTS: A lower level of stigma was associated with a higher probability of preferring formal and informal help-seeking for AUD. Both high and low levels of stigma were associated with a higher probability of preferring to consult general practitioners. Stigma was not associated with other preferences for treatment-seeking, nor trying to change oneself or a passive strategy. The sub-analyses, grouped by level of alcohol use, showed similar results. CONCLUSION: Stigma is associated with lower preferences for formal and informal help-seeking, however not type of treatment preferred. Future studies should address stigma in relation to other factors of the treatment-seeking process.


Asunto(s)
Alcoholismo , Trastornos Mentales , Humanos , Alcoholismo/terapia , Trastornos Mentales/terapia , Estudios Transversales , Aceptación de la Atención de Salud , Estigma Social , Consumo de Bebidas Alcohólicas
5.
BMC Health Serv Res ; 23(1): 2, 2023 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-36593502

RESUMEN

BACKGROUND: Transition-age youth (TAY) with chronic health conditions frequently experience co-occurring mental health conditions. However, little is known about the perspectives of TAY with co-occurring diagnoses preparing to exit pediatric health and mental health services. Research is needed to understand the impact of a mental health condition on transition readiness and self-management in TAY with chronic health conditions. METHODS: TAY (aged 16-20 years) with co-occurring chronic health and mental health conditions were recruited in Alberta, Canada. Nine semi-structured individual interviews were completed by phone or videoconference, and transcribed verbatim. Guided by qualitative description, we analyzed the data using thematic analysis in partnership with five young adults with lived experience in the health/mental health systems. RESULTS: Participants shared their experiences living with simultaneous physical and mental health concerns and preparing for transition to adult care. Our analysis revealed three overarching themes: 1) "they're intertwined": connections between chronic health and mental health conditions in TAY, 2) impact of mental health on transition readiness and self-management, and 3) recommendations for service provision from the perspectives of TAY. CONCLUSIONS: Our findings highlighted the myriad ways in which physical and mental health are connected as TAY prepare for service transitions using specific examples and powerful metaphors. TAY endorsed the importance of providers discussing these connections in routine clinical care. Future research should involve co-designing and evaluating educational material addressing this topic with diverse TAY, caregivers, and service providers.


Asunto(s)
Trastornos Mentales , Salud Mental , Adulto Joven , Humanos , Adolescente , Niño , Trastornos Mentales/terapia , Trastornos Mentales/psicología , Investigación Cualitativa , Cuidadores/psicología , Enfermedad Crónica , Alberta
6.
J Med Internet Res ; 25: e38204, 2023 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-36602854

RESUMEN

BACKGROUND: The economic costs of mental disorders for society are huge. Internet-based interventions are often coined as cost-effective alternatives to usual care, but the evidence is mixed. OBJECTIVE: The aim was to review the literature on the cost-effectiveness of internet interventions for mental disorders compared with usual care and to provide an estimate of the monetary benefits of such interventions compared with usual care. METHODS: A systematic review and meta-analysis of randomized controlled trials was conducted, which included participants with symptoms of mental disorders; investigated a telephone- or internet-based intervention; included a control condition in the form of treatment as usual, psychological placebo, waiting list control, or bibliotherapy; reported outcomes on both quality of life and costs; and included articles published in English. Electronic databases such as PubMed (including MEDLINE), Embase, Emcare, PsycINFO, Web of Science, and the Cochrane Library were used. Data on risk of bias, quality of the economic evaluation, quality-adjusted life years, and costs were extracted from the included studies, and the incremental net benefit was calculated and pooled. RESULTS: The search yielded 6226 abstracts, and 37 studies with 14,946 participants were included. The quality of economic evaluations of the included studies was rated as moderate, and the risk of bias was high. A random-effects approach was maintained. Analyses suggested internet interventions were slightly more effective than usual care in terms of quality-adjusted life years gain (Hedges g=0.052, 95% CI 0.010-0.094; P=.02) and equally expensive (Hedges g=0.002, 95% CI -0.080 to 0.84; P=.96). The pooled incremental net benefit was US $255 (95% CI US $91 to US $419; P=.002), favoring internet interventions over usual care. The perspective of the economic evaluation and targeted mental disorder moderated the results. CONCLUSIONS: The findings indicate that the cost-effectiveness of internet interventions for mental disorders compared with a care-as-usual approach is likely, but generalizability to new studies is poor given the substantial heterogeneity. This is the first study in the field of mental health to pool cost-effectiveness outcomes in an aggregate data meta-analysis. TRIAL REGISTRATION: PROSPERO CRD42019141659; https://tinyurl.com/3cu99b34.


Asunto(s)
Intervención basada en la Internet , Trastornos Mentales , Humanos , Análisis Costo-Beneficio , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Trastornos Mentales/terapia
7.
JAMA Netw Open ; 6(1): e2249578, 2023 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-36622679

RESUMEN

This commentary discusses how pediatricians can become involved in improving the mental health system for children and adolescents.


Asunto(s)
Trastornos Mentales , Salud Mental , Humanos , Niño , Adolescente , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Actitud del Personal de Salud , Pediatras
8.
Harv Rev Psychiatry ; 31(1): 1-13, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36608078

RESUMEN

ABSTRACT: The need for objective measurement in psychiatry has stimulated interest in alternative indicators of the presence and severity of illness. Speech may offer a source of information that bridges the subjective and objective in the assessment of mental disorders. We systematically reviewed the literature for articles exploring speech analysis for psychiatric applications. The utility of speech analysis depends on how accurately speech features represent clinical symptoms within and across disorders. We identified four domains of the application of speech analysis in the literature: diagnostic classification, assessment of illness severity, prediction of onset of illness, and prognosis and treatment outcomes. We discuss the findings in each of these domains, with a focus on how types of speech features characterize different aspects of psychopathology. Models that bring together multiple speech features can distinguish speakers with psychiatric disorders from healthy controls with high accuracy. Differentiating between types of mental disorders and symptom dimensions are more complex problems that expose the transdiagnostic nature of speech features. Convergent progress in speech research and computer sciences opens avenues for implementing speech analysis to enhance objectivity of assessment in clinical practice. Application of speech analysis will need to address issues of ethics and equity, including the potential to perpetuate discriminatory bias through models that learn from clinical assessment data. Methods that mitigate bias are available and should play a key role in the implementation of speech analysis.


Asunto(s)
Trastornos Mentales , Psiquiatría , Humanos , Habla , Trastornos Mentales/diagnóstico , Trastornos Mentales/terapia , Trastornos Mentales/psicología , Psicopatología
9.
PLoS One ; 18(1): e0278930, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36662789

RESUMEN

Social interventions are essential in supporting the health and well-being of people with disability, but there is a critical need to prioritise resources for those that provide the best value for money. Economic evaluation is a widely used tool to assist priority setting when resources are scarce. However, the scope and consistency of economic evaluation evidence for disability social services are unclear, making it hard to compare across interventions to guide funding decisions. This systematic review aims to summarise the current evidence in the economic evaluation of social services for people with disability and to critically compare the methodologies used in conducting the economic evaluations with a focus on the outcomes and costs. We searched seven databases for relevant studies published from January 2005 to October 2021. Data were extracted on study characteristics such as costs, outcomes, perspectives, time horizons and intervention types. Overall, economic evaluation evidence of social services for people with disability was scarce. Twenty-four economic evaluations were included, with the majority conducting a cost-effectiveness analysis (n = 16). Most interventions focused on employment (n = 10), followed by community support and independent living (n = 6). Around 40% of the studies addressed people with mental illnesses (n = 10). The evidence was mixed on whether the interventions were cost-effective but the methods used were highly variable, which made comparisons across studies very difficult. More economic evidence on the value of interventions is needed as well as a more standardised and transparent approach for future research.


Asunto(s)
Personas con Discapacidad , Trastornos Mentales , Humanos , Análisis Costo-Beneficio , Trastornos Mentales/terapia , Servicio Social
10.
BMC Psychiatry ; 23(1): 56, 2023 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-36670415

RESUMEN

BACKGROUND: A considerable proportion of people attending mental health services are parents with dependent children. Parental mental illness can be challenging for all family members including the parent's children and partner. The hospitalization of the parent and subsequent separation from dependent children may be a particularly challenging time for all family members. The aim of this paper was to review qualitative studies of family members' experiences when parents, who have dependent children, were hospitalized for their mental illness. The experiences of parents themselves, their children aged 0-18 (including retrospective accounts of adults describing their childhoods), and other family members are included. METHODS: This systematic review followed Cochrane Collaboration and PRISMA guidelines. A search was performed with keywords relating to parents, mental illness, psychiatric treatment, inpatient units, family members and experiences. Databases included CINAHL Plus, PsycINFO, ProQuest, MEDLINE, PubMed and Scopus. Quality assessment was undertaken using an expanded version of the Critical Appraisal Skills Programme. Thematic synthesis was conducted on the included papers. RESULTS: Eight papers were identified. The quality assessment was rated as high in some papers, in terms of the clarity of research aims, justification of the methodology employed, recruitment strategy and consideration of ethics. In others, the study design, inclusion criteria and reporting of participant demographics were unclear. Family experiences of pressure and additional responsibilities associated with the parent receiving inpatient treatment were identified along with the family's need for psychoeducational information, and guidance when visiting the parent in hospital. Children expressed various emotions and the need to connect with others. The final theme related to adverse impacts on the parent-child bond when the parent was hospitalized. CONCLUSION: The limited research in this area indicates that the needs of families are not being met when a parent is hospitalized for their mental illness. There is a considerable need for adequate models of care, family-focused training for staff, and psychoeducational resources for families. Additional research in this area is essential to understand the experiences of different family members during this vulnerable time.


Asunto(s)
Trastornos Mentales , Padres , Adulto , Humanos , Estudios Retrospectivos , Padres/psicología , Familia/psicología , Trastornos Mentales/terapia , Trastornos Mentales/psicología , Hospitalización , Investigación Cualitativa
11.
Artículo en Inglés | MEDLINE | ID: mdl-36674060

RESUMEN

Half to three-fourths of mental disorders appear during adolescence or young adulthood, and the treatment gap is mainly due to lack of knowledge, lack of perceived need, and the stigmatization of mental illness. The aims of this study were to implement and evaluate a Mental Health First Aid (MHFA) training program among undergraduates. Participants were second-year students from two universities in the French-speaking region of Switzerland (N = 107), who were randomly assigned to an intervention group (n = 53) or control group (n = 54). The intervention group received a 12-h MHFA course. Online questionnaires were completed before the intervention (T0), and both 3 months (T1) and 12 months (T2) after the intervention in order to evaluate the participants' mental health knowledge, recognition of schizophrenia, and attitudes and behaviors towards mental illness. We used Generalized Estimating Equations (GEE) to examine the effects of intervention over time. After the MHFA course, the intervention group showed significantly increased basic knowledge and confidence helping others with mental illness and reduced stigmatization at both T1 and T2 compared to their baseline scores and compared to control groups. This suggests that the MHFA training program is effective and has significant short-term and long-term impacts, in terms of enhancing basic knowledge about mental health and improving attitudes towards mental illness among undergraduate students.


Asunto(s)
Trastornos Mentales , Salud Mental , Adolescente , Humanos , Adulto Joven , Adulto , Primeros Auxilios , Suiza , Trastornos Mentales/terapia , Trastornos Mentales/psicología , Estudiantes
12.
Artículo en Inglés | MEDLINE | ID: mdl-36674139

RESUMEN

South Africa has taken initiative to strengthen its mental health system, by improving the Mental Health Care Act 17 of 2002 which proclaims that mental healthcare users (MHCUs) can be treated in communities and homes. Due to short-term hospitalisations for acute MHCUs and advocacy for community-based care, families play a significant role in providing care to severe mental healthcare users. The objective of the study was to explore primary caregivers' perspective regarding the relapse of MHCUs following a short-term admission in acute psychiatric units. A qualitative explorative design was used. In-depth individual interviews were conducted with 18 primary caregivers whose family members were readmitted to four hospitals with units designated for acute MHCUs in Limpopo. NVivo computer software version 11 was used to analyse data. The findings are that MHCUs deny the mental health condition. Mental illness is considered a short illness that can be cured, which shows misconceptions about self-mental health conditions. Refusal of direct observed treatment support also emerged; hence, it is difficult for caregivers to identify if the patient is taking the correct doses or not taking the medication at all. Perceived wrong beliefs about mental illness can affect the patient's desire to seek proper management and it can be damaging in many ways. Drugs and alcohol abuse makes MHCUs display disruptive behaviours and contribute to treatment non-adherence resulting in caregivers becoming reluctant to be around them. In conclusion, mixing traditional and faith-based mental healthcare practices as reported by primary caregivers can mean that tailor-fabricated culture-specific mental healthcare is required.


Asunto(s)
Cuidadores , Trastornos Mentales , Humanos , Cuidadores/psicología , Trastornos Mentales/terapia , Salud Mental , Enfermedad Crónica , Recurrencia , Hospitalización
13.
BMC Public Health ; 23(1): 69, 2023 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-36627597

RESUMEN

BACKGROUND: Only about half the people with depression seek professional health care services. To constitute the different predictors and associating variables of health care utilisation, we model the process and aim to test our hypothesised Seeking Mental Health Care Model. The model includes empirical influences on the help-seeking process to predict actual behaviour and incorporates superordinate (stigma, treatment experiences) as well as intermediate attitudinal variables (continuum and causal beliefs, depression literacy and self-efficacy). METHOD: All variables are examined in an online study (baseline, three- and six-month follow-up). The sample consisted of adults with depressive symptoms (PHQ-9 sum score ≥ 8), currently not receiving mental health care treatment. To examine the prediction of variables explaining help-seeking behaviour, a path model analysis was carried out (lavaan package, software R). RESULTS: Altogether, 1368 participants (Mage = 42.38, SDage = 15.22, 65.6% female) were included, 983 participating in at least one follow-up. Model fit was excellent (i.e., RMSEA = 0.059, CFI = 0.989), and the model confirmed most of the hypothesised predictions. Intermediary variables were significantly associated with stigma and experiences. Depression literacy (ß = .28), continuum beliefs (ß = .11) and openness to a balanced biopsychosocial causal model (ß = .21) significantly influenced self-identification (R2 = .35), which among the causal beliefs and self-efficacy influenced help-seeking intention (R2 = .10). Intention (ß = .40) prospectively predicted help-seeking behaviour (R2 = .16). CONCLUSION: The Seeking Mental Health Care Model provides an empirically validated conceptualisation of the help-seeking process of people with untreated depressive symptoms as a comprehensive approach considering internal influences. Implications and open questions are discussed, e.g., regarding differentiated assessment of self-efficacy, usefulness of continuum beliefs and causal beliefs in anti-stigma work, and replication of the model for other mental illnesses. TRIAL REGISTRATION: German Clinical Trials Register: DRKS00023557. Registered 11 December 2020. World Health Organization, Universal Trial Number: U1111-1264-9954. Registered 16 February 2021.


Asunto(s)
Conducta de Búsqueda de Ayuda , Trastornos Mentales , Adulto , Femenino , Humanos , Masculino , Depresión/terapia , Depresión/psicología , Trastornos Mentales/terapia , Trastornos Mentales/psicología , Salud Mental , Aceptación de la Atención de Salud/psicología , Estigma Social
14.
Eur Psychiatry ; 66(1): e9, 2023 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-36621009

RESUMEN

BACKGROUND: If people with episodic mental-health conditions lose their job due to an episode of their mental illness, they often experience personal negative consequences. Therefore, reintegration after sick leave is critical to avoid unfavorable courses of disease, longer inability to work, long payment of sickness benefits, and unemployment. Existing return-to-work (RTW) programs have mainly focused on "common mental disorders" and often used very elaborate and costly interventions without yielding convincing effects. It was the aim of the RETURN study to evaluate an easy-to-implement RTW intervention specifically addressing persons with mental illnesses being so severe that they require inpatient treatment. METHODS: The RETURN study was a multi-center, cluster-randomized controlled trial in acute psychiatric wards addressing inpatients suffering from a psychiatric disorder. In intervention wards, case managers (RTW experts) were introduced who supported patients in their RTW process, while in control wards treatment, as usual, was continued. RESULTS: A total of 268 patients were recruited for the trial. Patients in the intervention group had more often returned to their workplace at 6 and 12 months, which was also mirrored in more days at work. These group differences were statistically significant at 6 months. However, for the main outcome (days at work at 12 months), differences were no longer statistically significant (p = 0.14). Intervention patients returned to their workplace earlier than patients in the control group (p = 0.040). CONCLUSIONS: The RETURN intervention has shown the potential of case-management interventions when addressing RTW. Further analyses, especially the qualitative ones, may help to better understand limitations and potential areas for improvement.


Asunto(s)
Trastornos Mentales , Reinserción al Trabajo , Humanos , Reinserción al Trabajo/psicología , Empleo , Trastornos Mentales/terapia , Trastornos Mentales/psicología , Lugar de Trabajo , Ausencia por Enfermedad , Hospitalización
16.
Prax Kinderpsychol Kinderpsychiatr ; 72(1): 2-13, 2023 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-36628589

RESUMEN

The Child Oriented FamilyTherapy (COF) is a new therapeutic method aiming towards infants in the playing age group and their families. COF is - originally invented in Scandinavia - spreading over Germany since the beginning of the 21st century. The prevalence for psychiatric disorders in toddlers, preschoolers and young infants in Germany lies between 14 and 22 %. Treatment in an outpatients' clinic with partial hospitalization is indicated whenever the psychosocial resources are too low or the symptoms are too severe to be treated in an ambulant environment. The outpatients' department for pediatric psychiatry in Gelsenkirchen is the first institution in its field to use COF as one module to treat their young patients and their families. Due to the setting adjustments of the original method are necessary, for example a conceptualization of disease, the use of COF as a diagnostic method and the embedding of COF in an underlying treatment plan.


Asunto(s)
Psiquiatría Infantil , Trastornos Mentales , Humanos , Preescolar , Niño , Psicoterapia , Trastornos Mentales/diagnóstico , Trastornos Mentales/terapia , Pacientes Ambulatorios , Centros de Día , Alemania , Psiquiatría Infantil/historia
17.
BMC Public Health ; 23(1): 65, 2023 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-36627596

RESUMEN

BACKGROUND: Seeking information on mental health issues - both for oneself and on behalf of others (so-called surrogate-seeking) - is a critical early step in dealing with mental illness and known to impede stigmatizing attitudes and foster help-seeking. Yet, knowledge about mental health tends to be insufficient worldwide. Therefore, it is necessary to better understand the search for mental health information and examine the factors that are positively associated with information-seeking. METHOD: In a face-to-face survey in Germany (N = 1,522), we investigated the factors related to mental health information-seeking. The data was analyzed by means of a logistic regression model, in which we distinguished those searching information for themselves from so-called surrogate seekers, i.e., people who seek information on behalf of someone else. RESULTS: Twenty-six percent of German adults in our sample have already searched for information on mental health, with the majority already having searched for information for others (73% of all seekers). Our findings indicate that individuals' proximity to people with mental health issues, including their own mental health treatment experience (Cramer's V = .429, p < .001), education (Cramer's V = .184, p < .001), and desire for social distance from the affected people (F [1, 1516] = 73.580, p < .001, η2 = .046), play an important role in mental health information-seeking. The patterns of sociodemographic and proximity factors hereby differ between self-seekers and surrogate-seekers. CONCLUSIONS: Our study provides insights into the public's mental health information orientation. The findings may particularly guide strategies to improve mental health awareness and fill knowledge gaps in supporting informed decision-making and reducing stigma. Surrogate seekers appear to be an important and distinctive target group for mental health information provision. Depending on whether one wants to promote surrogate- or self-seeking seekers, different target groups and determinants should be addressed.


Asunto(s)
Trastornos Mentales , Servicios de Salud Mental , Adulto , Humanos , Salud Mental , Estigma Social , Alemania/epidemiología , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Trastornos Mentales/psicología , Aceptación de la Atención de Salud/psicología
18.
Hist Cienc Saude Manguinhos ; 29(suppl 1): 27-46, 2023.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-36629669

RESUMEN

The article deals with the presence of artistic manifestations of inmates of the Hospício de Pedro II, the first psychiatric institution in Latin America (1852-1902). The methodological framework chosen focused on the historicisation of the framing processes of mental illness, in order to demonstrate its consequences for the notion of the subject and the art he produces and in the process of circulation of this knowledge in Brazil. Derrida's concept of archive fever was used to analyse the reasons why such manifestations and the therapies used based on them were ignored by local narratives about the artistic manifestations of individuals in asylums.


O artigo trata da presença de manifestações artísticas de internos do Hospício de Pedro II, primeira instituição psiquiátrica da América Latina (1852-1902). O referencial metodológico escolhido centrou-se na historicização dos processos de enquadramento das doenças mentais, com vistas a demonstrar suas consequências para a noção de sujeito e da arte que ele produz e no processo de circulação desses saberes no Brasil. O conceito de mal de arquivo, de Derrida, foi utilizado para analisar os motivos pelos quais tais manifestações e as terapêuticas utilizadas a partir delas foram ignoradas pelas narrativas locais acerca das manifestações artísticas de indivíduos internados em asilos.


Asunto(s)
Hospitales Psiquiátricos , Trastornos Mentales , Humanos , Brasil , Trastornos Mentales/terapia , Archivos , Registros
19.
Health Lit Res Pract ; 7(1): e2-e13, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36629782

RESUMEN

BACKGROUND: Health literacy is increasingly recognized as a major determinant of health; however, our insights into the health literacy strengths and needs of adults living with serious or persistent mental illness remain limited by a notable lack of research in this area. Improving our understanding is important because people in this group are especially vulnerable to numerous negative health outcomes, many preventable. OBJECTIVE: To assess the health literacy strengths and needs of people living with serious or persistent mental illness in terms of their ability to acquire, understand, and use information about their illness and the health services they require. METHODS: A cross-sectional convergent mixed methods design guided by the Ophelia Access and Equity Framework. People diagnosed with serious or persistent mental illness were offered participation. Quantitative and qualitative data was collected using questionnaires (Health Literacy Questionnaire [HLQ], World Health Organization [WHO-5]) and semi-structured interviews. Hierarchical cluster analysis identified and grouped participants with similar health literacy scores into mutually exclusive groups, for the development of clinical vignettes. KEY RESULTS: Participants struggled most with the appraisal of health information (HLQ mean 2.72, standard deviation [SD] .63 [scale 1-4]) and navigating what they often perceived to be a confusing health care system (HLQ mean 3.29, SD .79 [scale 1-5]). On the other hand, most participants reported positive experiences with their health care providers (HLQ mean 3.19, SD .62 [scale 1-4]) and generally felt understood and supported. The cluster analysis suggests we should not assume people living with serious or persistent mental illness have homogeneous HL strengths and needs, meaning a one-size-fits-all solution for improving health literacy in this diverse group will likely not be a successful strategy. It will be important to explore solutions that embrace patient-centered care approaches. CONCLUSIONS: This study is one of only a handful assessing the health literacy strengths and needs of people living with serious or persistent mental illness. By collecting both quantitative and qualitative data, then analyzing the results using sophisticated cluster analysis methods, the authors were able to develop clinical vignettes per the Ophelia Framework that offer results in a practical way that can be readily understood and acted upon by stakeholders. We found that the HLQ is a measure of HL that is acceptable to mental health clients, and our findings provide preliminary data on the use of this instrument in the mental health population. [HLRP: Health Literacy Research and Practice. 2023;7(1):e2-e13.] Plain Language Summary: This study explored the health literacy strengths and needs of people living with serious or persistent mental illness. The results showed a mix of strengths and needs among our participants, though several consistent themes emerged. Most of our participants felt understood and supported by their health care providers, but many often struggle with judging the quality of health information and finding their way through the health care system.


Asunto(s)
Alfabetización en Salud , Trastornos Mentales , Adulto , Humanos , Estudios Transversales , Enfermedad Crónica , Encuestas y Cuestionarios , Trastornos Mentales/terapia
20.
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...