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1.
Rev Peru Med Exp Salud Publica ; 36(2): 326-333, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31460648

RESUMO

This paper analyzes the implementation, initial results, and sustainability of innovations in the provision, financing, and management of mental health services in Peru, carried out during 2013-2018. By applying new financing mechanisms and public management strategies, 104 Community Mental Health Centers and eight Protected Homes were implemented, which prove to be more efficient than psychiatric hospitals. The set of 29 centers created between 2015 and 2017 produced in 2018 an equivalent number in consultations (244,000 vs. 246,000) and patients attended (46,000 vs. 48,000) than the set of three psychiatric hospitals, but with 11% of financing and 43% of psychiatrists. The way mental health care is being provided is changing in Peru by involving citizens and communities in ongoing care and creating better conditions for the exercise of mental health rights. Community mental health reform has gained broad support from political, international, and academic sectors, and from the media. We conclude that the reform of community-based mental health services in Peru is viable and sustainable. It is in a position to scale up the entire health sector throughout the country, subject to the commitment of the authorities, the progressive increase in public financing, and national and international collaborative strategies.


Assuntos
Serviços Comunitários de Saúde Mental/organização & administração , Reforma dos Serviços de Saúde , Hospitais Psiquiátricos/organização & administração , Serviços de Saúde Mental/organização & administração , Serviços Comunitários de Saúde Mental/economia , Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Eficiência Organizacional , Financiamento da Assistência à Saúde , Hospitais Psiquiátricos/economia , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Transtornos Mentais/terapia , Serviços de Saúde Mental/economia , Serviços de Saúde Mental/estatística & dados numéricos , Peru
2.
Rev Bras Enferm ; 72(4): 834-840, 2019 Aug 19.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31432935

RESUMO

OBJECTIVE: To characterize the presence of psychosocial risks related to the work of the nurse in a psychiatric hospital and the strategies for managing these risks. METHODS: Qualitative, in which 25 nurses from a psychiatric hospital participated using semi-structured interviews from November 2014 to January 2015. Data analysis was performed using the thematic method. RESULTS: The results showed psychosocial risks related to the work of psychiatric nurses, such as: insufficient academic training; lack of preparation and maintenance of equipment; poor relationship with colleagues; shortage of human resources and lack of capacity building; conflict between the demands of the home and work, as well as strategies for managing psychosocial risks such as family, cinema, music, reading, among others. FINAL CONSIDERATIONS: This study should provoke the reflection of managers and future nurses regarding the working conditions in a psychiatric hospital and possible psychosocial risks to which they are exposed.


Assuntos
Enfermeiras e Enfermeiros/psicologia , Enfermagem Psiquiátrica/métodos , Estresse Psicológico/complicações , Adulto , Atitude do Pessoal de Saúde , Brasil , Feminino , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Entrevistas como Assunto/métodos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Enfermagem Psiquiátrica/tendências , Pesquisa Qualitativa , Estresse Psicológico/psicologia
3.
Sultan Qaboos Univ Med J ; 19(1): e19-e25, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31198591

RESUMO

Objectives: Workplace violence (WPV) has become a world-wide concern. This study aimed to measure the prevalence of WPV among nurses working in psychiatric hospitals in Saudi Arabia. Methods: This cross-sectional study was conducted at three psychiatric hospitals in Saudi Arabia between March and May 2017. Participants completed a self-reported questionnaire which was used to measure the prevalence and explore the associated factors of WPV. A multivariate logistic regression analysis was also performed. Results: A total of 310 nurses (response rate: 62%) were included in this study. The prevalence of WPV against nurses was 90.3%, of which 57.7% had been exposed to both physical and verbal abuse. More nurses were exposed to WPV during the morning shift than the evening shift (58.4% versus 42.3%). Violent behaviour was exhibited mostly by the patients themselves (81.3%). Over half of the nurses (57.4%) required medical intervention in such cases. The majority of nurses felt either stressed (64.2%) or anxious (53.5%) and 34.2% felt depressed after the incident. Multivariate logistic regression analysis revealed that time of violence, source of violence, patient dissatisfaction with medical care and lack of organisational support for nurses were significantly associated with the occurrence of WPV in psychiatric units. Conclusion: WPV has reached an alarming rate among nurses in psychiatric hospitals in Saudi Arabia. It is crucial to invest in the prevention of WPV by constant training of workers and a mutual policy with the police and the civic prosecutor in Saudi Arabia on how to respond to violent psychiatric patients.


Assuntos
Enfermeiras e Enfermeiros/psicologia , Violência no Trabalho/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Prevalência , Arábia Saudita , Inquéritos e Questionários , Local de Trabalho/psicologia , Local de Trabalho/normas
4.
Nurs Leadersh (Tor Ont) ; 32(1): 74-84, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31228346

RESUMO

Feelings of empowerment in nursing staff can contribute to increased job satisfaction, improved quality of care and a higher retention rate within healthcare organizations. Nursing is critical at healthcare organizations, with direct and significant impact on the quality of care provided; yet, nurses often feel undervalued for the work they do. The strength-based approach of appreciative inquiry is one way to engage individuals in finding collective value through the identification of successes, enabling the creation of a shared vision and strategy for the future.


Assuntos
Enfermeiras e Enfermeiros/psicologia , Atitude do Pessoal de Saúde , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Satisfação no Emprego , Enfermeiras e Enfermeiros/estatística & dados numéricos , Autonomia Profissional , Enfermagem Psiquiátrica/métodos
6.
Healthc Q ; 21(4): 54-60, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30946656

RESUMO

In an effort to improve safety in psychiatric settings, health professionals need to be aware of patients at risk for aggression and violent behaviour. To do so, a risk-flagging functionality can be built into an electronic health record system to alert health professionals of potentially aggressive or violent patients. This paper describes a risk-flagging system at Canada's largest psychiatric hospital and presents initial findings and lessons learned. Risk flags embedded in an electronic health record system are one way of communicating patient risks to health professionals but should be complemented with other forms of risk communication.


Assuntos
Agressão , Registros Eletrônicos de Saúde/estatística & dados numéricos , Violência , Registros Eletrônicos de Saúde/normas , Hospitais Psiquiátricos/organização & administração , Humanos , Saúde do Trabalhador , Ontário , Segurança do Paciente , Fatores de Risco
7.
J Nurs Scholarsh ; 51(3): 271-280, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31034764

RESUMO

PURPOSE: This study aimed to describe the experiences of nurses who were employed in a psychiatric hospital in Fukushima prefecture during the Great East Japan Earthquake and to explore what sustained the nurses while they worked in the damaged hospital. DESIGN AND METHODS: The research design was a qualitative descriptive study. The setting for the study was one of the Fukushima psychiatric hospitals where functions were disrupted by the earthquake and tsunami. Data were collected through a dialogic interview and Katarai (a form of group interview). Nine psychiatric nurses from the hospital participated. The interview and Katarai were transcribed and the narratives were analyzed using a phenomenological approach. FINDINGS: Themes identified from the transcripts were: (a) the nurses' internalized perception of their duties, (b) responsibility toward their patients, (c) conflicts among nurses and dilemmas nurses faced during this period, and (d) what sustained the nurses to continue working. CONCLUSIONS: Through the earthquake experience, the nurses in this study reconsidered their own ways of living and ways of nursing that they had not thought about before the disaster. The findings also revealed that the state of hospital management and nursing care under normal conditions are reflected during the crisis situation in a disaster. CLINICAL RELEVANCE: Clearly, whether it is natural disaster or conflict caused by man, healthcare infrastructures are challenged when unexpected disruptions occur. The findings of this study are applicable not only because they provide guidance about infrastructure development for disaster preparedness, but also because they provide practical methods to support nurses who are placed in strongly stressful situations and have to protect patients.


Assuntos
Atitude do Pessoal de Saúde , Terremotos , Hospitais Psiquiátricos , Enfermeiras e Enfermeiros/psicologia , Estresse Psicológico/etiologia , Adulto , Feminino , Hospitais Psiquiátricos/organização & administração , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Tsunamis
9.
Healthc Manage Forum ; 32(2): 84-87, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30669876

RESUMO

Employee engagement is seen as an important aspect of organizational outcomes in health settings. In this article, the authors explore the importance of manager effectiveness in the creation and reinforcement of employee engagement. Using a naturalistic retrospective study approach, the relationships between manager training, managerial leadership activities, employee satisfaction, and organization outcomes are explored. Although directionality cannot be assumed, the three measures of managerial effectiveness, employee engagement, and client-based organizational outcomes all show positive results over a 4-year period after an investment in key initiatives to improve manager effectiveness.


Assuntos
Serviços de Saúde Mental/organização & administração , Administração de Recursos Humanos , Engajamento no Trabalho , Hospitais Psiquiátricos/organização & administração , Humanos , Satisfação no Emprego , Liderança , Modelos Organizacionais , Administração de Recursos Humanos/métodos , Qualidade da Assistência à Saúde/organização & administração , Estudos Retrospectivos
10.
Int J Qual Health Care ; 31(5): 331-337, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-30476098

RESUMO

OBJECTIVE: This study aimed to examine and compare middle and senior hospital managers' perceptions of the effects of a mandatory accreditation program in Denmark, the Danish Healthcare Quality Program (Den Danske Kvalitetsmodel [DDKM]) after it was terminated in 2015. DESIGN: A cross-sectional online questionnaire survey. SETTING: All 26 somatic and psychiatric public hospitals in Denmark. PARTICIPANTS: All senior and middle managers. METHODS: A questionnaire with open and closed response (five-point Likert scale) questions. Quantitative data were analyzed descriptively and through ordered logistic regression by management level. Qualitative data were subjected to a software-assisted content analysis. RESULTS: The response rate was 49% (533/1059). In both the qualitative and quantitative data sets, participants perceived the DDKM as having: led to an increased focus on registration, documentation and additional and unnecessary procedures. While the DDKM was perceived as increasing a focus on quality, the time required for accreditation was at the expense of patient care. There were significant differences by management level, with middle managers having more negative perceptions of the DDKM related to time spent on documentation and registration. CONCLUSION: While the DDKM had some perceived benefits for quality improvement, it was ultimately considered time-consuming and outdated or having served its purpose. Including managers, particularly middle managers, in refinements to the new quality improvement model could capitalize on the benefits while redressing the problems with the terminated accreditation program.


Assuntos
Acreditação , Administradores Hospitalares/psicologia , Hospitais Públicos/normas , Atitude do Pessoal de Saúde , Estudos Transversais , Dinamarca , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/normas , Hospitais Públicos/organização & administração , Humanos , Melhoria de Qualidade/normas , Inquéritos e Questionários
12.
Soc Psychiatry Psychiatr Epidemiol ; 54(6): 737-744, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30470881

RESUMO

BACKGROUND: Since 1990, the provision of mental healthcare has changed substantially across Western Europe. There are fewer psychiatric hospital beds and more places in forensic psychiatric hospitals and residential facilities. However, little research has investigated the drivers behind these changes. This study explored qualitatively the perspectives of mental health professional experts on what has driven the changes in Western Europe. METHODS: In-depth interviews were conducted with twenty-four mental health experts in England, Germany and Italy, who as professionals had personal experiences of the changes in their country. Interviewees were asked about drivers of changes in institutionalised mental health care from 1990 to 2010. The accounts were subjected to a thematic analysis. RESULTS: Four broad themes were revealed: the overall philosophy of de-institutionalisation, with the aim to overcome old-fashioned asylum style care; finances, with a pressure to limit expenditure and an interest of provider organisations to increase income; limitations of community mental health care in which most severely ill patients may be neglected; and emphasis on risk containment so that patients posing a risk may be cared for in institutions. Whilst all themes were mentioned in all three countries, there were also differences in emphasis and detail. CONCLUSIONS: Distinct factors appear to have influenced changes in mental health care. Their precise influence may vary from country to country, and they have to be considered in the context of each country. The drivers may be influenced by professional groups to some extent, but also depend on the overall interest and attitudes in the society at large.


Assuntos
Atitude do Pessoal de Saúde , Pessoal de Saúde/psicologia , Institucionalização/organização & administração , Serviços de Saúde Mental/organização & administração , Inovação Organizacional , Adulto , Internação Compulsória de Doente Mental/tendências , Inglaterra , Europa (Continente) , Feminino , Alemanha , Gastos em Saúde , Hospitais Psiquiátricos/organização & administração , Humanos , Institucionalização/métodos , Institucionalização/tendências , Itália , Masculino , Serviços de Saúde Mental/tendências , Pesquisa Qualitativa , Instituições Residenciais/organização & administração
13.
Nervenarzt ; 90(3): 293-298, 2019 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-30143832

RESUMO

BACKGROUND: The German Law for the Development of Care and Funding for Psychiatric and Psychosomatic Services (PsychVVG) has established a new regulation for the mental healthcare system. In the future, characteristics of hospitals and catchment areas will be an elementary part of negotiations on remuneration. OBJECTIVE: The aim of this study was to identify structural and regional characteristics of psychiatric hospitals in Germany that contribute to increased average costs according to the views of clinical managers and directors. METHODS: In this study 37 guided expert interviews were conducted with business managers, financial controllers, leading medical and nursing personnel from psychiatric hospitals and the characteristics relevant for the budget and increased average costs were collated. RESULTS: Important factors with top priority were hospital infrastructure, characteristics of the catchment area and specialties of inpatient services provided. Obligatory service for a defined catchment area, increased documentation requirements and infrastructure of buildings and grounds were estimated as being associated with the highest additional financial expenditure. CONCLUSION: It is a challenge for clinics to prove increased average costs due to the respective hospital structural and regional characteristics. This study shows which characteristics should be considered as most cost-relevant from the perspective of hospital management.


Assuntos
Orçamentos , Hospitais Psiquiátricos , Custos e Análise de Custo , Alemanha , Hospitais Psiquiátricos/economia , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos
14.
Eur Psychiatry ; 56: 69-74, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30583254

RESUMO

BACKGROUND: In Europe, at discharge from a psychiatric hospital, patients with severe mental illness may be exposed to one of two main care approaches: personal continuity, where one clinician is responsible for in- and outpatient care, and specialisation, where various clinicians are. Such exposure is decided through patient-clinician agreement or at the organisational level, depending on the country's health system. Since personal continuity would be more suitable for patients with complex psychosocial needs, the aim of this study was to identify predictors of patients' exposure to care approaches in different European countries. METHODS: Data were collected on 7302 psychiatric hospitalised patients in 2015 in Germany, Poland, and Belgium (patient-level exposure); and in the UK and Italy (organisational-level exposure). At discharge, patients were exposed to one of the care approaches according to usual practice. Putative predictors of exposure at patients' discharge were assessed in both groups of countries. RESULTS: Socially disadvantaged patients were significantly more exposed to personal continuity. In all countries, the main predictor of exposure was the admission hospital, except in Germany, where having a diagnosis of psychosis and a higher education status were predictors of exposure to personal continuity. In the UK, hospitals practising personal continuity had a more socially disadvantaged patient population. CONCLUSION: Even in countries where exposure is decided through patient-clinician agreement, it was the admission hospital, not patient characteristics, that predicted exposure to care approaches. Nevertheless, organisational decisions in hospitals tend to expose socially disadvantaged patients to personal continuity.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Continuidade da Assistência ao Paciente/organização & administração , Transtornos Psicóticos/terapia , Adulto , Bélgica , Europa (Continente) , Feminino , Alemanha , Hospitalização , Hospitais Psiquiátricos/organização & administração , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Alta do Paciente/estatística & dados numéricos , Polônia , Transtornos Psicóticos/epidemiologia
15.
Asclepio ; 70(2): 0-0, jul.-dic. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-179151

RESUMO

Durante el primer tercio del siglo XX en España acontecieron cambios importantes en la asistencia a la locura. Varios factores influyeron en el desarrollo de las modificaciones en torno al discurso y práctica de una nueva disciplina psiquiátrica: una generación de médicos interesados en la locura y relacionados con la Junta de Ampliación de Estudios, organizaciones científicas como los Archivos de Neurobiología y el clima político progresista de la Segunda República, entre otros. El objetivo de este trabajo es visibilizar estrategias de cambio en el tratamiento de la locura en el psiquiátrico provincial de Málaga. Para ello, señalaré, por un lado, las diferentes reformas que el edificio necesitó y la relación de éstas con las prácticas asistenciales; y por otro, los intentos de reforma que llevaron a cabo Miguel Prados Such y Pedro Ortiz Ramos como profesionales de la neuropsiquiatría. Analizaré, finalmente, las relaciones entre el personal subalterno, los psiquiatras y la institución, mostrando las dinámicas de asimilación y/o rechazo de medidas concretas que pretendían mejorar las condiciones de los pacientes ingresados


During the first third of the 20th Century in Spain, many reforms happened in the attendance to the madness. Several factors had an influence in the introduction of fundamental changes in the discourse and practice of a new psychiatric discipline: the interest in insanity of a generation of doctors with links to the Junta de Ampliación de Estudios (Board for Advanced Studies), scientific organisations like the Archivos de Neurobiología (Archives of Neurobiology) and the political climate in the Second Spanish Republic, among others. The aim of this study is to shed light on these strategies for change in the treatment of insanity in the Malaga provincial psychiatric hospital. To this end, I will discuss the necessary alterations made to the building itself and their relation with health care practices, in addition to the attempts to introduce reforms by neuropsychiatric professionals like Miguel Prados Such and Pedro Ortiz Ramos. Finally, I will analyse relations among support staff, psychiatrists and the institution, to appraise the dynamics of assimilation and/or rejection of specific measures designed to improve the conditions of patients admitted to it


Assuntos
Humanos , História do Século XX , Psiquiatria/história , Hospitais Psiquiátricos/história , Transtornos Mentais/epidemiologia , Transtornos Mentais/história , Neuropsiquiatria/história , Hospitais Psiquiátricos/organização & administração , Hospitais Especializados/história , Hospitais Especializados/organização & administração , Pessoas Mentalmente Doentes/história , Espanha/epidemiologia
16.
Rev Bras Enferm ; 71(suppl 5): 2280-2286, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30365795

RESUMO

OBJECTIVE: to analyze the sense perception of nursing students in the learning of communication in a psychiatric hospital. METHOD: qualitative, exploratory and descriptive, from representative drawings of the communication perceived by the body senses of 23 nursing students, and recorded enunciation of the remarkable experiences after the end of the practical activities. The data were analyzed according to thematic content. RESULTS: the heart captures perceptions, favoring interpersonal relationships; smelling shows care lacking in hospitalization; vision monopolizes the impressions of reality, making the movements static; hearing is exercised in the amplitude to listen; touching demarcates limitations of contact and interaction; and tasting, as social sense, seeks to overcome the obstacles to take care. CONCLUSION: the learning of communication was significant, making the psychiatric hospital a space to listen to what is inside, to find in the emotions and rationalities the sensations that can be inside and outside the tension nodes that interfere in the perceptions.


Assuntos
Comunicação Interdisciplinar , Percepção , Estudantes de Enfermagem/psicologia , Adulto , Brasil , Competência Clínica/normas , Bacharelado em Enfermagem/métodos , Bacharelado em Enfermagem/normas , Feminino , Hospitais Psiquiátricos/organização & administração , Humanos , Masculino , Pesquisa Qualitativa
17.
Rev Bras Enferm ; 71(suppl 5): 2316-2322, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30365800

RESUMO

OBJECTIVE: To evaluate the culture of patient safety in a mental health service. METHOD: Cross-sectional study conducted with health professionals in a mental hospital, by applying the Safety Attitudes Questionnaire (SAQ). Descriptive and inferential analyses were performed. RESULTS: One-hundred and three professionals participated in the study, with female predominance (64.1%) and time of performance equal to or greater than 21 years (32.4%). The nursing professionals of technical level and with statutory work regime were the most participative, 54.4% and 52% respectively. The total score was 69 points. The domain that reached the highest score was Job satisfaction (80 points) and the lowest was Working conditions (57 points). The statutory professionals and those with longer professional experience obtained better scores in the perception of safety culture. CONCLUSION: The result of safety culture was below the recommended, indicating the need for strengthening this construct in mental health hospitals.


Assuntos
Pessoal de Saúde/psicologia , Serviços de Saúde Mental/normas , Percepção , Gestão da Segurança/normas , Adulto , Atitude do Pessoal de Saúde , Brasil , Estudos Transversais , Feminino , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/normas , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Cultura Organizacional , Inquéritos e Questionários
18.
Eur J Public Health ; 28(5): 885-890, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30084999

RESUMO

Background: In the region of Central and Eastern Europe, long-term departments at psychiatric hospitals provide a large proportion of the care for people with complex mental health needs. The System of United Psychiatric Rehabilitation (S.U.P.R.) project focussed on the implementation of a complex set of interventions of psychosocial rehabilitation to increase the quality of care. The aim of this study was to assess the effect of the S.U.P.R. psychosocial rehabilitation programme on the quality of care at the longer-term inpatient psychiatric departments. Methods: All 12 psychiatric hospitals in the Czech Republic were asked to participate in the study. A 'before and after' design was adopted to evaluate the impact of the S.U.P.R. programme. Quality of care was assessed using the internationally validated, web-based tool, QuIRC (Quality Indicator for Rehabilitative Care), which provides percentage scores (0-100%) on seven domains of care and an overall mean quality score. Results: Fourteen long-term wards of 12 psychiatric hospitals for adults in the Czech Republic participated in the S.U.P.R. project. The mean total QuIRC scores were relatively low at the start of the project (range 33% to 53%) but all domain scores increased two years after the S.U.P.R. programme was implemented (range 44% to 62%). Staff feedback was generally positive about the programme, but inadequate staffing was an impediment to its success. Conclusion: Implementing a modern concept for psychosocial rehabilitation aimed at progressing the recovery of people with complex mental health problems can improve the quality of care in longer term inpatient settings.


Assuntos
Hospitais Psiquiátricos/organização & administração , Assistência de Longa Duração/organização & administração , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , República Tcheca , Feminino , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Assistência de Longa Duração/estatística & dados numéricos , Masculino , Serviços de Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Garantia da Qualidade dos Cuidados de Saúde/estatística & dados numéricos
19.
BMJ Open ; 8(8): e024398, 2018 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-30127055

RESUMO

INTRODUCTION: Improvement of the quality and safety of care is associated with lower suicide rates among mental healthcare patients. In The Netherlands, about 40% of all people that die by suicide is in specialist mental healthcare. Unfortunately, the degree of implementation of suicide prevention policies and best practices within Dutch mental healthcare services is variable. Sharing and comparing outcome and performance data in confidential networks of professionals working in different organisations can be effective in reducing practice variability within and across organisations and improving quality of care. METHODS AND ANALYSIS: Using formats of professional networks to improve surgical care (Dutch Initiative for Clinical Auditing) and somatic intensive care (National Intensive Care Evaluation), 113 Suicide Prevention has taken the lead in the formation of a Suicide Prevention Action Network (SUPRANET Care), with at present 13 large Dutch specialist mental health institutions. Data on suicide, suicide attempts and their determinants as well as consumer care policies and practices are collected biannually, after consensus rounds in which key professionals define what data are relevant to collect, how it is operationalised, retrieved and will be analysed. To evaluate the impact of SUPRANET Care, standardised suicide rates will be calculated adjusted for confounding factors. Second, the extent to which suicide attempts are being registered will be analysed with the suicide attempt data. Finally, professionals' knowledge, attitude and adherence to suicide prevention guidelines will be measured with an extended version of the Professionals In Training to STOP suicide survey. ETHICS AND DISSEMINATION: This study has been approved by the Central Committee on Research Involving Human Subjects, The Netherlands. This study does not fall under the scope of the Medical Research Involving Human Subjects Act (WMO) or the General Data Protection Regulation as stated by the Dutch Data Protection Authority because data are collected on an aggregated level.


Assuntos
Hospitais Psiquiátricos , Suicídio/prevenção & controle , Estudos de Viabilidade , Feminino , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/normas , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Masculino , Países Baixos/epidemiologia , Melhoria de Qualidade , Qualidade da Assistência à Saúde , Projetos de Pesquisa , Suicídio/estatística & dados numéricos , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/estatística & dados numéricos
20.
Lancet Psychiatry ; 5(9): 765-768, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30026060

RESUMO

South Africa witnessed a national tragedy between October, 2015, and June, 2016, when the Department of Health in Gauteng province moved 1711 mental health-care users with severe mental illness or severe and profound intellectual disability out of facilities managed by a private company, Life Esidimeni, mainly into the care of non-governmental organisations. The plan was called the Gauteng Mental Health Marathon Project. In a rushed and flawed process, 144 people died, and the whereabouts of another 44 remain unknown. The report of an extensive arbitration process, released in March, 2018, raises important ethical, moral, political, legal, governance, accountability, and clinical issues. The events from the tragedy and findings that were made also serve as lessons for future deinstitutionalisation globally.


Assuntos
Desinstitucionalização/ética , Transtornos Mentais/terapia , Saúde Mental/ética , Transferência de Pacientes , Atitude do Pessoal de Saúde , Serviços Comunitários de Saúde Mental/organização & administração , Hospitais Psiquiátricos/organização & administração , Humanos , Mortalidade , Determinação de Necessidades de Cuidados de Saúde , Papel Profissional , África do Sul
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