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1.
Rev Med Suisse ; 16(681): 307-309, 2020 Feb 12.
Artigo em Francês | MEDLINE | ID: mdl-32049451

RESUMO

Switzerland has a high rate of legal measures of constraint by international standard. Beside the incorporation of legal, medical and economic elements, the physician may be asked on what it means to be a care giver and to be free, because his decision could private his patient of a fundamental human right. The deprivation of freedom for purposes of assistance is helpful in some clinical situations but remains a controversial issue. We have to do our due diligence when assessing the patient, notably his capacity of discernment, and discuss with him and his relatives other treatments without legal constraint. The advance directives and the joint plan of crisis should be tools to increase patients' autonomy and to decrease the coercive measures.


Assuntos
Coerção , Tomada de Decisões , Hospitais Psiquiátricos , Direitos do Paciente/legislação & jurisprudência , Diretivas Antecipadas , Humanos , Transferência de Pacientes/legislação & jurisprudência , Médicos/psicologia , Suíça
2.
Lancet Psychiatry ; 6(12): 1039-1053, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31777340

RESUMO

BACKGROUND: Use of involuntary psychiatric hospitalisation varies widely within and between countries. The factors that place individuals and populations at increased risk of involuntary hospitalisation are unclear, and evidence is needed to understand these disparities and inform development of interventions to reduce involuntary hospitalisation. We did a systematic review, meta-analysis, and narrative synthesis to investigate risk factors at the patient, service, and area level associated with involuntary psychiatric hospitalisation of adults. METHODS: We searched MEDLINE, PsycINFO, Embase, and the Cochrane Controlled Clinical Register of Trials from Jan 1, 1983, to Aug 14, 2019, for studies comparing the characteristics of voluntary and involuntary psychiatric inpatients, and studies investigating the characteristics of involuntarily hospitalised individuals in general population samples. We synthesised results using random effects meta-analysis and narrative synthesis. Our review follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and is registered on PROSPERO, CRD42018095103. FINDINGS: 77 studies were included from 22 countries. Involuntary rather than voluntary hospitalisation was associated with male gender (odds ratio 1·23, 95% CI 1·14-1·32; p<0·0001), single marital status (1·47, 1·18-1·83; p<0·0001), unemployment (1·43, 1·07-1·90; p=0·020), receiving welfare benefits (1·71, 1·28-2·27; p<0·0001), being diagnosed with a psychotic disorder (2·18, 1·95-2·44; p<0·0001) or bipolar disorder (1·48, 1·24-1·76; p<0·0001), and previous involuntary hospitalisation (2·17, 1·62-2·91; p<0·0001). Using narrative synthesis, we found associations between involuntary psychiatric hospitalisation and perceived risk to others, positive symptoms of psychosis, reduced insight into illness, reduced adherence to treatment before hospitalisation, and police involvement in admission. On a population level, some evidence was noted of a positive dose-response relation between area deprivation and involuntary hospitalisation. INTERPRETATION: Previous involuntary hospitalisation and diagnosis of a psychotic disorder were factors associated with the greatest risk of involuntary psychiatric hospitalisation. People with these risk factors represent an important target group for preventive interventions, such as crisis planning. Economic deprivation on an individual level and at the population level was associated with increased risk for involuntary hospitalisation. Mechanisms underpinning the risk factors could not be identified using the available evidence. Further research is therefore needed with an integrative approach, which examines clinical, social, and structural factors, alongside qualitative research into clinical decision-making processes and patients' experiences of the detention process. FUNDING: Commissioned by the Department of Health and funded by the National Institute of Health Research (NIHR) via the NIHR Mental Health Policy Research Unit.


Assuntos
Hospitais Psiquiátricos/estatística & dados numéricos , Tratamento Involuntário/estatística & dados numéricos , Narração , Transtornos Psicóticos/diagnóstico , Humanos , Internacionalidade , Fatores de Risco , Fatores Sexuais
3.
Fortschr Neurol Psychiatr ; 87(10): 564-570, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31627238

RESUMO

Multimorbidity in older psychiatric patients. OBJECTIVE: Multimorbidity represents a great challenge in the medical care of older people. METHODS: This exploratory study was part of the Gerontopsychiatry study Berlin (Gepsy-B), an analysis of data on all 941 older inpatients (> 65 years) admitted to a psychiatric hospital within a period of 3 years. RESULTS: Nearly all patients (94,2 %) suffered from a chronic somatic disorder. The mean number of chronic somatic disorders was 2.70 + 1.39 and showed age dependency (r = 0.257, p < .001). The most prevalent disorders were cerebrovascular disorders (56.5 %), hypertension (54.8 %), chronic ischemic heart diseases or arrhythmias (52.2 %) and diabetes mellitus type II (37.5 %). Furthermore, many of the patients suffered from disabilities such as movement disorders (26.2 %), severe hearing loss (16.5 %), incontinence (15.1 %) or severely reduced vision (7.4 %). Organic brain disorders were more often associated with chronic somatic disorders or disabilities. CONCLUSIONS: Older patients treated for psychiatric disorders very often show somatic multimorbidity that probably limit treatment outcome.


Assuntos
Transtornos Mentais/epidemiologia , Multimorbidade , Idoso , Idoso de 80 Anos ou mais , Doença Crônica/epidemiologia , Hospitais Psiquiátricos , Humanos , Transtornos Mentais/complicações
4.
Niger Postgrad Med J ; 26(4): 211-215, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31621660

RESUMO

Introduction: Recent evidence suggests that rates of drug use and abuse in Nigeria exceed the global average. There is a strong treatment demand for psychoactive drug use disorders in Nigeria; however, it is not known whether available treatment facilities are attending to the array of treatment needs. This audit compares the pattern of presentations at a tertiary facility with a community-based survey. Methods: A review of cases (n = 212) seen at a regional drug treatment facility over a 4-year period, using local data retrieved from the Nigerian Epidemiological Network of Drug Use (NENDU) and comparison with data from the recently published national drug use survey. Results: Nine out of ten clients seen were male (93.4%). About half (49.5%) of the clients used psychoactive substances for the first time between ages 10 and 19 years. Cannabis was the primary drug of use overall and also among males, while females were more likely to present with opiate abuse. Over half had a co-occurring physical or mental disorder, and a minority had received testing for hepatitis C in the past 12 months. Conclusion: Although patterns of drug abuse presentations were consistent with findings from a national community-based survey, there was an under-representation of females in treatment. Implications for policy development and practice are discussed.


Assuntos
/efeitos adversos , Transtornos Mentais/epidemiologia , Pacientes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/terapia , Adolescente , Adulto , Distribuição por Idade , Alcoolismo/epidemiologia , Alcoolismo/reabilitação , Criança , Comorbidade/tendências , Estudos Transversais , Feminino , Hospitais Psiquiátricos , Humanos , Tempo de Internação/estatística & dados numéricos , Tempo de Internação/tendências , Masculino , Abuso de Maconha/epidemiologia , Transtornos Mentais/reabilitação , Pessoa de Meia-Idade , Nigéria/epidemiologia , Pacientes/psicologia , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Adulto Jovem
5.
BMC Health Serv Res ; 19(1): 691, 2019 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-31610790

RESUMO

BACKGROUND: The Floresco integrated service model was designed to address the fragmentation of community mental health treatment and support services. Floresco was established in Queensland, Australia, by a consortium of non-government organisations that sought to partner with general practitioners (GPs), private mental health providers and public mental health services to operate a 'one-stop' mental health service hub. METHODS: We conducted an independent mixed-methods evaluation of client outcomes following engagement with Floresco (outcome evaluation) and factors influencing service integration (process evaluation). The main data sources were: (1) routinely-collected Recovery Assessment Scale - Domains and Stages (RAS-DS) scores at intake and review (n = 108); (2) RAS-DS scores, mental health inpatient admissions and emergency department (ED) presentations among clients prospectively assessed at intake and six-month follow-up (n = 37); (3) semi-structured interviews with staff from Floresco, consortium partners, private practitioners and the local public mental health service (n = 20); and (4) program documentation. RESULTS: Interviews identified staff commitment, co-location of services, flexibility in problem-solving, and anecdotal evidence of positive client outcomes as important enablers of service integration. Barriers to integration included different organisational practices, difficulties in information-sharing and in attracting and retaining GPs and private practitioners, and systemic constraints on integration with public mental health services. Of 1129 client records, 108 (9.6%) included two RAS-DS measurements, averaging 5 months apart. RAS-DS 'total recovery' scores improved significantly (M = 63.3%, SD = 15.6 vs. M = 69.2%, SD = 16.1; p < 0.001), as did scores on three of the four RAS-DS domains ('Looking forward', p < 0.001; 'Mastering my illness', p < 0.001; and 'Connecting and belonging', p = 0.001). Corresponding improvements, except in 'Connecting and belonging', were seen in the 37 follow-up study participants. Decreases in inpatient admissions (20.9% vs. 7.0%), median length of inpatient stay (8 vs. 3 days), ED presentations (34.8% vs. 6.3%) and median duration of ED visits (187 vs. 147 min) were not statistically significant. CONCLUSIONS: Despite the lack of a control group and small follow-up sample size, Floresco's integrated service model showed potential to improve client outcomes and reduce burden on the public mental health system. Horizontal integration of non-government and private services was achieved, and meaningful progress made towards integration with public mental health services.


Assuntos
Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Adulto , Serviço Hospitalar de Emergência/estatística & dados numéricos , Utilização de Instalações e Serviços , Seguimentos , Hospitalização/estatística & dados numéricos , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Pacientes Internados/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Organizações , Avaliação de Programas e Projetos de Saúde , Queensland
7.
East Asian Arch Psychiatry ; 29(3): 87-90, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31566184

RESUMO

OBJECTIVE: This study aimed to determine the prevalence of violence and factors associated with aggressive or violent behaviour in Thai patients with schizophrenia. METHODS: This cross-sectional study was conducted in all patients with schizophrenia aged ≥18 years admitted to Suan Prung Psychiatric Hospital, Thailand, between January and November 2014. Baseline interviews were conducted by a psychiatrist and psychiatric nurses. Accessibility to weapons and toxic chemicals was evaluated. RESULTS: Of 230 patients with schizophrenia screened, 207 (162 men and 45 women) were included. Of them, only 16 (7.7%) patients had aggressive or violent behaviour, including verbal aggression (n = 7), physical aggression (n = 5), and aggression against property (n = 4). Nonetheless, only 2 (12.5%) of them had been charged by the police. The weapon score was higher in violent than non-violent patients (p < 0.05). Binary logistic regression analysis showed that the weapon score was the only significant predictor of violence. CONCLUSIONS: Patients with schizophrenia with greater access to weapons were more likely to have aggressive or violent behaviour. Routine screening for access to weapons in clinical settings and adequate treatment of psychotic symptoms may reduce the incidence of aggressive or violent behaviour and violent offences.


Assuntos
Agressão/psicologia , Psicologia do Esquizofrênico , Violência/psicologia , Violência/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Hospitalização , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Masculino , Prevalência , Tailândia/epidemiologia , Armas/estatística & dados numéricos
9.
BMC Health Serv Res ; 19(1): 617, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477102

RESUMO

BACKGROUND: Long stay in forensic psychiatric hospitals is common in patients who are defined as "not criminally responsible on account of mental disorder". However, little is known about how these patients experience and perceive the long stay within these settings. The aim of this study is to explore the perception and needs of long-stay patients in forensic psychiatric hospitals in China. METHODS: In-depth semi-structured interviews were conducted with 21 participants who had lived in the forensic psychiatry hospital for more than 8 years. We used thematic analysis strategies to analyse the qualitative data. RESULTS: Participants' perceptions clustered seven themes: hopelessness, loneliness, worthlessness, low mood, sleep disturbances, lack of freedom, and lack of mental health intervention. CONCLUSIONS: The views and opinions expressed by long-stay patients showed that psychological distress is prevailing in forensic psychiatric hospitals. Adequate and effective care and mental health interventions are recommended to be tailored for their special needs.


Assuntos
Criminosos/psicologia , Psiquiatria Legal , Hospitais Psiquiátricos , Transtornos Mentais , Satisfação do Paciente , Adulto , China , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Autoimagem
11.
Res Nurs Health ; 42(5): 410-415, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31429481

RESUMO

The purpose of this study was to examine national trends and variation in nurse staffing on inpatient psychiatric units in US general hospitals from 2005-2017. The National Database of Nursing Quality Indicators® provided data on nurse staffing from 1,143 psychiatric units in 610 US hospitals. A weighted linear mixed model was fitted for each of two staffing measures: Registered nurse (RN) hours per patient day (HPPD) and non-RN HPPD. Monthly staffing levels were modeled as a function of study year, unit type, and hospital bed size, teaching status, government ownership, for-profit status, metropolitan location, and US census division. Very gradual upward trends in staffing were observed. Compared with adult units, child/adolescent units had lower RN staffing and higher non-RN staffing. Levels of both types of staffing were lower in for-profit facilities. The Pacific census division had higher RN staffing than every other census division by an estimated margin of 0.52-1.54 HPPD, and census divisions with the lowest levels of RN staffing had the highest levels of non-RN staffing. Despite concerns expressed over the past 15 years about patient violence, staffing levels, and use of seclusion and restraint on psychiatric units, average staffing levels have apparently increased only modestly since 2005, and increases in RN staffing on psychiatric units have not kept pace with increases in general care units. Marked regional differences in staffing merit further investigation.


Assuntos
Hospitais Psiquiátricos/estatística & dados numéricos , Hospitais Psiquiátricos/tendências , Recursos Humanos de Enfermagem no Hospital/provisão & distribução , Recursos Humanos de Enfermagem no Hospital/tendências , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Admissão e Escalonamento de Pessoal/tendências , Adulto , Feminino , Previsões , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Estados Unidos
12.
J Clin Psychopharmacol ; 39(5): 434-440, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31425461

RESUMO

BACKGROUND: Most pneumonia-related researches in people with severe mental illness were based on insurance claims data. This study aimed for a comprehensive analysis of factors potentially associated with risk of pneumonia in psychiatric inpatients. METHODS: Inpatients at a large psychiatric hospital diagnosed with pneumonia during the course of hospitalization were enrolled as cases. Controls were matched by ward and date. The diagnosis of pneumonia was confirmed by physicians based on clinical features, chest radiographs, and blood tests. A stepwise conditional logistic regression model was used to identify potential risk factors for pneumonia. RESULTS: Seventy-five pneumonia cases and 436 matched controls were enrolled. Conditional logistic regression revealed 3 variables significantly associated with an increased risk of pneumonia: a higher score on the Clinical Global Impression-Severity scale (adjusted odds ratio [aOR], 3.7; 95% confidence interval [CI]. 1.5-9.1), a higher score on the Charlson comorbidity index (aOR, 2.2; 95% CI, 1.5-3.2), and a longer duration of antipsychotic treatment (aOR, 1.0; 95% CI, 1.0-1.0). Two variables were significantly associated with a decreased risk of pneumonia: a higher score on the Global Assessment of Functioning scale (aOR, 0.9; 95% CI, 0.8-0.9) and an older age of onset (aOR, 0.9; 95% CI, 0.9-1.0). After adjusting for potential confounders, use of antipsychotic or other psychotropic medications was not found to be a significant risk factor for pneumonia. CONCLUSIONS: Physical comorbidities, long duration of antipsychotic treatment, early onset, severe psychiatric symptoms, and poor global functioning are associated with pneumonia in people with serious mental illness.


Assuntos
Antipsicóticos/administração & dosagem , Transtornos Mentais/tratamento farmacológico , Pneumonia/epidemiologia , Adulto , Antipsicóticos/efeitos adversos , Estudos de Casos e Controles , Feminino , Hospitalização , Hospitais Psiquiátricos , Humanos , Pacientes Internados , Masculino , Transtornos Mentais/fisiopatologia , Pessoa de Meia-Idade , Pneumonia/etiologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença
15.
Crim Behav Ment Health ; 29(3): 157-167, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31274230

RESUMO

BACKGROUND: Current Japanese forensic mental health legislation (Medical Treatment and Supervision Act [MTSA]) was enacted in 2003. Little is known, however, about the actual outcomes for the offender patients detained within hospitals under this provision. AIM: This study aimed to quantify reoffending and readmission following patients' discharge from forensic psychiatric hospital units across Japan and explore related risk factors. METHODS: We followed up 526 offenders with mental disorder who had been detained under the MTSA and who were subsequently discharged from any of the 28 hospitals nationwide between 2007 and 2015. RESULTS: The total cumulative reoffence rate was found to be 2.5% (1.1-3.9%) after 1 year and 7.5% (4.6-10.4%) after 3 years. The rate of serious reoffending was 0.4% (-0.18% to 0.99%) after 1 year and 2.0% (0.4-3.6%) after 3 years. The cumulative admission rate to local psychiatric hospitals following a discharge was 21.8% after 6 months and 37.6% after 1 year. Patients who had been discharged from their MTSA order but transferred to a general psychiatric hospital before open community residence-because it was necessary to build community supports-were more likely to reoffend than those discharged directly to the community. Patients who had been diagnosed with a substance use disorder (F10-F19) and had one subsequent admission were at higher risk of further readmissions. CONCLUSIONS: The low reoffending rates could be attributed to the intensive treatment and care plans required by the MTSA. The high rate of readmission to psychiatric hospitals may indicate shortcomings in community mental health services in Japan.


Assuntos
Criminosos , Hospitais Psiquiátricos/estatística & dados numéricos , Alta do Paciente , Readmissão do Paciente/estatística & dados numéricos , Transtornos Psicóticos/psicologia , Adulto , Serviços Comunitários de Saúde Mental , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/psicologia
16.
Epidemiol Psychiatr Sci ; 28(6): 605-612, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31284895

RESUMO

AIMS: To examine the extent and nature of coercive practices in mental healthcare and to consider the ethical, human rights challenges facing the current clinical practices in this area. We consider the epidemiology of coercion in mental health and appraise the efficacy of attempts to reduce coercion and make specific recommendations for making mental healthcare less coercive and more consensual. METHODS: We identified references through searches of MEDLINE, EMBASE, PsycINFO and CINAHL Plus. Search was limited to articles published from January 1980 to May 2018. Searches were carried out using the terms mental health (admission or detain* or detention or coercion) and treatment (forcible or involuntary or seclusion or restraint). Articles published during this period were further identified through searches in the authors' personal files and Google Scholar. Articles resulting from searches and relevant references cited in those articles were reviewed. Articles and reviews of non-psychiatric population, children under 16 years, and those pertaining exclusively to people with dementia were excluded. RESULTS: Coercion in its various guises is embedded in mental healthcare. There is very little research in this area and the absence of systematic and routinely collected data is a major barrier to research as well as understanding the nature of coercion and attempts to address this problem. Examples of good practice in this area are limited and there is hardly any evidence pertaining to the generalisability or sustainability of individual programmes. Based on the review, we make specific recommendations to reduce coercive care. Our contention is that this will require more than legislative tinkering and will necessitate a fundamental change in the culture of psychiatry. In particular, we must ensure that clinical practice never compromises people's human rights. It is ethically, clinically and legally necessary to address the problem of coercion and make mental healthcare more consensual. CONCLUSION: All forms of coercive practices are inconsistent with human rights-based mental healthcare. This is global challenge that requires urgent action.


Assuntos
Coerção , Hospitais Psiquiátricos/estatística & dados numéricos , Transtornos Mentais/terapia , Serviços de Saúde Mental/ética , Pessoas Mentalmente Doentes/psicologia , Participação do Paciente , Psiquiatria Legal , Hospitais Psiquiátricos/normas , Humanos , Pessoas Mentalmente Doentes/legislação & jurisprudência
17.
Acta Med Hist Adriat ; 17(1): 91-102, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31315410

RESUMO

In the first half of the 20th century, in most European countries, it was thought that cholinesterase and other drugs that counteract acetylcholine should reduce the manifestations of schizophrenia. In 1937, Fiamberti (1894-1970) introduced the transorbital method of lobotomy which established the use of acetylcholine shock treatment for curing the disturbances of schizophrenia. Accepting the idea that the psychic alterations of schizophrenia were caused by a pathological interruption of nerve conduction at a presumably cortical level, Fiamberti thought he could apply this to the clinical field using the properties of acetylcholine, an acetic ester of choline. Here, we examined, in detail, the contribution of Mario Fiamberti to acetylcholine therapy.


Assuntos
Acetilcolina/história , Hospitais Psiquiátricos/história , Esquizofrenia/história , Acetilcolina/uso terapêutico , História do Século XX , Humanos , Psicocirurgia/história , Esquizofrenia/tratamento farmacológico
18.
BMC Res Notes ; 12(1): 376, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31262359

RESUMO

OBJECTIVE: Drugs for managing mental disorders can cause adverse drug reactions (ADRs) that have negative impacts on patients yet, in Malawi, epidemiological data on the drug-related problems are limited. This study assessed the prevalence and severity of ADRs in out-patients at Zomba Mental Hospital. RESULTS: Twenty-six of forty patients (65.0%) were taking haloperidol and 14 (35.0%) chlorpromazine. The commonest diagnosis was schizophrenia (n = 23, 57.5%) followed by epileptic psychosis (n = 4, 10.0%) and general psychosis (n = 4, 10.0%) with one of psychotic depression and one psychosis secondary to general medical condition. Comorbidities were also found with epilepsy being the commonest (n = 4, 10.0%). All patients reported at least one ADR of varying severity (mild, moderate and severe). Polydipsia was the most prevalent (24, 60.0%) followed by weight gain (20, 50.0%), spasm (15, 37.5%) and xerostomia (15, 37.5%). Some ADRs were gender specific and these included impotence (6/27, 29.6%) for males and menstrual changes (3/14, 21.4%) for females. Severe ADRs were more common in the older aged group (> 35 years 8.3% vs 7.1%), in males (11.1% vs 0.0%) and on chlorpromazine (14.3% vs 3.8%). Patients taking chlorpromazine and haloperidol are at risk of experiencing a wide range of ADRs with varying degrees of severity.


Assuntos
Antipsicóticos/efeitos adversos , Clorpromazina/efeitos adversos , Disfunção Erétil/diagnóstico , Haloperidol/efeitos adversos , Distúrbios Menstruais/diagnóstico , Polidipsia/diagnóstico , Espasmo/diagnóstico , Xerostomia/diagnóstico , Adolescente , Adulto , Antipsicóticos/administração & dosagem , Clorpromazina/administração & dosagem , Estudos Transversais , Disfunção Erétil/etiologia , Disfunção Erétil/fisiopatologia , Feminino , Haloperidol/administração & dosagem , Hospitais Psiquiátricos , Humanos , Malaui , Masculino , Distúrbios Menstruais/etiologia , Distúrbios Menstruais/fisiopatologia , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Polidipsia/etiologia , Polidipsia/fisiopatologia , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/fisiopatologia , Esquizofrenia/tratamento farmacológico , Esquizofrenia/fisiopatologia , Convulsões/tratamento farmacológico , Convulsões/fisiopatologia , Espasmo/etiologia , Espasmo/fisiopatologia , Ganho de Peso/efeitos dos fármacos , Xerostomia/etiologia , Xerostomia/fisiopatologia
19.
J Forensic Nurs ; 15(3): 183-192, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31259816

RESUMO

BACKGROUND: Correctional health and forensic mental health (FMH) staff may experience vicarious trauma (VT) as a result of cumulative and repeated exposure to traumatic material in their professional roles. AIM: This study aimed to determine the incidence of VT in a sample of correctional health and FMH staff. METHODS: A cross-sectional survey including 135 correctional health and FMH staff participating in a VT management program was conducted. Survey respondents completed the Vicarious Trauma Scale and Impacts of Events Scale-Revised. FINDINGS: Most respondents had moderate or high VT (n = 78, 57.8%, and n = 40, 29.6%, respectively). Low psychological distress was reported, with posttraumatic stress disorder symptoms being experienced either mildly or not at all by most respondents. A significant relationship between total Vicarious Trauma Scale score and total Impacts of Events Scale-Revised score (r = 0.471, p = 0.000) was found, indicating that a higher level of VT was associated with an increased risk of posttraumatic stress disorder symptoms. A higher level of VT was also associated with increased reports of avoidance, intrusion, and hyperarousal (r = 0.382, p = 0.000; r = 0.489, p = 0.000; and r = 0.440, p = 0.000, respectively). CONCLUSION: Correctional health and FMH staff are at risk of developing VT and associated psychological distress. IMPLICATIONS FOR CLINICAL FMH NURSING PRACTICE: Correctional health and FMH organizations have the responsibility to ensure nurses are aware of the effects of VT and to provide opportunities for nurses to participate in VT education and management programs.


Assuntos
Recursos Humanos de Enfermagem/psicologia , Doenças Profissionais/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto , Estudos Transversais , Feminino , Hospitais Psiquiátricos , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales/epidemiologia , Prisões , Inquéritos e Questionários
20.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46617

RESUMO

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.


Assuntos
Impacto Psicossocial , Estresse Psicológico , Reabilitação Psiquiátrica , Hospitais Psiquiátricos
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