Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.765
Filtrar
1.
Br J Clin Psychol ; 60(2): 270-289, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33651377

RESUMO

OBJECTIVES: In the UK, people of African-Caribbean background have the highest rates of psychosis and greatest inequity in mental health services of all ethnicities. National policies have highlighted the lack of evidence-based psychological interventions for this group. The aim of this study was to examine the acceptability of a novel Culturally adapted Family Intervention (CaFI) for African-Caribbean individuals diagnosed with non-affective psychosis and their relatives. DESIGN: A qualitative design. METHODS: Semi-structured interviews conducted with 22 service users and 12 family members following participation in CaFI. The interview topic guide included perceptions of the needs and benefits of CaFI; usefulness, cultural specificity and accessibility of CaFI therapy and supporting materials; content and delivering of CaFI sessions; views and experiences of working with CaFI therapists; and perceived barriers and facilitators to implementation. RESULTS: Deductive framework analysis identified three main themes for service users: perceived benefits, barriers and limitations, and delivery of the therapy. Four themes were identified for family members: perceived benefits, perceptions of therapists, delivery of therapy, and accessibility of therapy content, supporting materials, and cultural appropriateness. CONCLUSIONS: CaFI was found to be an acceptable intervention for African-Caribbean service users with psychosis and their relatives. Family interventions considering the needs of ethnic and cultural groups have the potential to improve the mental health care and experiences of service users and their families. PRACTITIONER POINTS: The Culturally adapted Family Intervention (CaFI) was viewed as acceptable to African-Caribbean service users with psychosis and their families. Through adapting interventions to be more culturally sensitive, it is possible to enhance the care of those who typically have poor engagement with mental health services. In-keeping with their ethos of individualized care delivery, mental health services should place more emphasis on being able to offer appropriate, culturally adapted interventions to their service users.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Família/psicologia , Serviços de Saúde Mental/normas , Transtornos Psicóticos/psicologia , Adolescente , Adulto , Região do Caribe , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Adulto Jovem
4.
J Med Internet Res ; 23(2): e23502, 2021 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-33565985

RESUMO

BACKGROUND: Culturally diverse populations (including Aboriginal and Torres Strait Islander people, people of diverse genders and sexualities, and culturally and linguistically diverse people) in nonurban areas face compounded barriers to accessing mental health care. Health information technologies (HITs) show promising potential to overcome these barriers. OBJECTIVE: This study aims to identify how best to improve a mental health and well-being HIT for culturally diverse Australians in nonurban areas. METHODS: We conducted 10 co-design workshops (N=105 participants) in primary youth mental health services across predominantly nonurban areas of Australia and conducted template analysis on the workshop outputs. Owing to local (including service) demographics, the workshop participants naturalistically reflected culturally diverse groups. RESULTS: We identified 4 main themes: control, usability, affirmation, and health service delivery factors. The first 3 themes overlap with the 3 basic needs postulated by self-determination theory (autonomy, competence, and relatedness) and describe participant recommendations on how to design an HIT. The final theme includes barriers to adopting HITs for mental health care and how HITs can be used to support care coordination and delivery. Hence, it describes participant recommendations on how to use an HIT. CONCLUSIONS: Although culturally diverse groups have specific concerns, their expressed needs fall broadly within the relatively universal design principles identified in this study. The findings of this study provide further support for applying self-determination theory to the design of HITs and reflect the tension in designing technologies for complex problems that overlap multiple medical, regulatory, and social domains, such as mental health care. Finally, we synthesize the identified themes into general recommendations for designing HITs for mental health and provide concrete examples of design features recommended by participants.


Assuntos
Atenção à Saúde/métodos , Informática Médica/métodos , Serviços de Saúde Mental/normas , Autonomia Pessoal , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Adulto Jovem
5.
J Med Internet Res ; 23(2): e19532, 2021 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-33591283

RESUMO

BACKGROUND: The recent Australian National Agenda for Eating Disorders highlights the role technology can play in improving accessibility and service development through web-based prevention, early access pathways, self-help, and recovery assistance. However, engagement with the eating disorders community to co-design, build, and evaluate these much-needed technology solutions through participatory design processes has been lacking and, until recently, underresourced. OBJECTIVE: This study aims to customize and configure a technology solution for a nontraditional (web-based, phone, email) mental health service that provides support for eating disorders and body image issues through the use of participatory design processes. METHODS: Participants were recruited chiefly through the Butterfly National Helpline 1800 ED HOPE (Butterfly's National Helpline), an Australian-wide helpline supporting anyone concerned by an eating disorder or body image issue. Participants included individuals with lived experience of eating disorders and body image issues, their supportive others (such as family, health professionals, support workers), and staff of the Butterfly Foundation. Participants took part in participatory design workshops, running up to four hours, which were held nationally in urban and regional locations. The workshop agenda followed an established process of discovery, evaluation, and prototyping. Workshop activities included open and prompted discussion, reviewing working prototypes, creating descriptive artifacts, and developing user journeys. Workshop artifacts were used in a knowledge translation process, which identified key learnings to inform user journeys, user personas, and the customization and configuration of the InnoWell Platform for Butterfly's National Helpline. Further, key themes were identified using thematic techniques and coded in NVivo 12 software. RESULTS: Six participatory design workshops were held, of which 45 participants took part. Participants highlighted that there is a critical need to address some of the barriers to care, particularly in regional and rural areas. The workshops highlighted seven overarching qualitative themes: identified barriers to care within the current system; need for people to be able to access the right care anywhere, anytime; recommendations for the technological solution (ie, InnoWell Platform features and functionality); need for communication, coordination, and integration of a technological solution embedded in Butterfly's National Helpline; need to consider engagement and tone within the technological solution; identified challenges and areas to consider when implementing a technological solution in the Helpline; and potential outcomes of the technological solution embedded in the Helpline relating to system and service reform. Ultimately, this technology solution should ensure that the right care is provided to individuals the first time. CONCLUSIONS: Our findings highlight the value of actively engaging stakeholders in participatory design processes for the customization and configuration of new technologies. End users can highlight the critical areas of need, which can be used as a catalyst for reform through the implementation of these technologies in nontraditional services.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Serviços de Saúde Mental/normas , Análise de Dados , Humanos , Projetos de Pesquisa
6.
Ann Clin Psychiatry ; 33(1): 27-34, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33529285

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic brought many challenges to patient care delivery. The need for social distancing and relaxing of federal and state telemental health regulations paved the way for widespread adoption of direct-to-consumer (DTC) ambulatory mental health video visits. METHODS: We present cases that demonstrate the use of video visits across 6 clinical areas, each serving a unique population of patients, in a large behavioral health system. The benefits and limitations of this modality are illustrated in children, adults, and older adults with mood disorders, anxiety disorders, intellectual disability, substance use disorders, neurocognitive disorders, and schizophrenia. RESULTS: Although telephone visits were acceptable and necessary to serve some patients, there are many advantages to video visits in providing best patient care. Education and support for telemental health-delivered to both patients and clinicians-is critical to the success of the DTC model. CONCLUSIONS: DTC telemental health is a widespread clinical tool used during the COVID-19 pandemic. Because this model has many strengths and advantages compared with traditional telemental health delivered in a clinic, regulators and insurers should be open to its continued use postpandemic when clinically appropriate.


Assuntos
COVID-19 , Transtornos Mentais/terapia , Serviços de Saúde Mental , Telemedicina , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Serviços de Saúde Mental/organização & administração , Serviços de Saúde Mental/normas , Pessoa de Meia-Idade , Telemedicina/organização & administração , Telemedicina/normas , Telefone , Comunicação por Videoconferência , Adulto Jovem
8.
J Nerv Ment Dis ; 209(2): 144-146, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33502141

RESUMO

ABSTRACT: To date, there is lack of specific effective treatment or vaccine for the SARS-CoV-2, and clinical and laboratory research is still ongoing to find successful drugs. Therefore, prevention to be infected through social distancing and isolation is the most effective way. However, all the other physical and mental illnesses continue to exist, if possible even more burdened by the emergency situation and social distancing. The COVID-19 pandemic, especially in many low- and middle-income countries, has caused a deeper gap in seeking psychiatric help. In this scenario, telepsychiatry could play a decisive role in implementing clinical care for frail patients and ensuring continuous mental care. Therefore, we felt the urge to write this article to express our hope that the old health care system at this time of crisis, as we know it, can offer the chance to implement pervasive care technologies that perfectly fit current psychiatric needs.


Assuntos
COVID-19/prevenção & controle , Países em Desenvolvimento , Acesso aos Serviços de Saúde , Transtornos Mentais/terapia , Serviços de Saúde Mental , Telemedicina , Continuidade da Assistência ao Paciente/normas , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/normas , Humanos , Serviços de Saúde Mental/organização & administração , Serviços de Saúde Mental/normas , Aplicativos Móveis , Psiquiatria/organização & administração , Psiquiatria/normas , Telemedicina/organização & administração , Telemedicina/normas
9.
J Med Internet Res ; 23(1): e18934, 2021 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-33404506

RESUMO

BACKGROUND: Although approximately 10% of new mothers in Canada develop postpartum depression (PPD), they face many barriers when accessing care. eHealth offers a unique opportunity to provide psychosocial skills and support to new mothers; however, patient populations are not consistently engaged in eHealth development processes. Thus, the diversity of women's backgrounds and needs are often not reflected in existing tools. OBJECTIVE: This study aims to engage women from a variety of backgrounds and locations around British Columbia (BC) who have previously experienced PPD to determine the unmet psychoeducational needs of women with PPD and how a web-enabled platform used to deliver psychosocial skills and education to assist in the management of PPD could fulfill those needs. METHODS: Focus groups were conducted in 7 cities across BC with a total of 31 women (mean age 34.5 years, SD 4.9), with each group ranging from 2-7 participants. Focus groups were cofacilitated by the study coordinator and a local service provider in each community using a semistructured guide to discuss participants' needs, ideas, and opinions as they relate to the use of technology in PPD management. Transcripts were approached inductively using thematic analysis to identify themes and qualitative description to frame what was observed in the data. RESULTS: A total of 5 themes were identified: bridging gaps to meet needs; providing validation to combat stigma; nurturing capacity to cope, manage, and/or reach wellness; empowering people to take ownership over their mental health; and offering customization to ensure relevance. Each theme identified a need (eg, combatting stigma) and a way to address that need using a web-enabled intervention (eg, providing validation). At the intersection of these themes was the overarching value of promoting agency for women experiencing PPD. CONCLUSIONS: Ultimately, new mothers require accessible mental health care that promotes their agency in mental health care decision making. Our participants believed that a web-enabled intervention could help meet this need. These data will be used to guide the design of such an intervention, with the eventual implementation of this resource as a first-line management option for PPD.


Assuntos
Depressão Pós-Parto/terapia , Serviços de Saúde Mental/normas , Telemedicina/métodos , Adulto , Feminino , Grupos Focais , Humanos
13.
J Acquir Immune Defic Syndr ; 85(4): 475-482, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33136748

RESUMO

BACKGROUND: The spread of severe acute respiratory syndrome coronavirus 2, causative agent of the coronavirus disease 2019 (COVID-19), has necessitated widespread lockdown to mitigate the pandemic. This study examines the influence of resilience on the impact of COVID-related stress and enforced lockdown on mental health, drug use, and treatment adherence among people living with HIV (PLWH) in Argentina. SETTING: PLWH residing predominantly in Buenos Aires Metropolitan Area and urban regions of Argentina were identified from a private clinic electronic database. METHODS: Participants completed an anonymous online survey to evaluate the impact of COVID-19 on economic disruption, resilience, mental health outcomes (depression, anxiety, stress, and loneliness), adherence to HIV treatment, and substance use. We performed ordinary least squares and logistic regressions to test whether resilient coping buffered the impact of economic disruption on mental health and drug use during quarantine. RESULTS: A total of 1336 PLWH aged 18-82 were enrolled. The impact of economic disruption on mental health ΔF(1,1321) = 8.86, P = 0.003 and loneliness ΔF(1,1326) = 5.77, P = 0.016 was buffered by resilience. A 3-way interaction between resilient buffering, stress, and sex was significant ΔF(1,1325) = 4.76, P = 0.029. Participants reported less than excellent adherence to medication (33%), disruption to mental health services (11%), and disruption to substance abuse treatment (1.3%) during lockdown. DISCUSSION: The impact of COVID-stress and lockdown on emotional distress seemed mitigated by resilience coping strategies, and the buffering impact of resilience on perceived stress was greater among women. Results highlight PLWH's capacity to adhere to treatment in challenging circumstances and the importance of developing resilience skills for better coping with stress and adversity.


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Infecções por HIV/psicologia , Saúde Mental/tendências , Pneumonia Viral/psicologia , Transtornos de Estresse Traumático Agudo/psicologia , Adaptação Psicológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina , Infecções por Coronavirus/complicações , Infecções por Coronavirus/economia , Infecções por Coronavirus/prevenção & controle , Feminino , Infecções por HIV/complicações , Humanos , Violência por Parceiro Íntimo/tendências , Análise dos Mínimos Quadrados , Modelos Logísticos , Solidão , Masculino , Serviços de Saúde Mental/normas , Pessoa de Meia-Idade , Pandemias/economia , Pandemias/prevenção & controle , Pneumonia Viral/complicações , Pneumonia Viral/economia , Pneumonia Viral/prevenção & controle , Resiliência Psicológica , Fatores Sexuais , Isolamento Social/psicologia , Apoio Social , Transtornos de Estresse Traumático Agudo/etiologia , Transtornos Relacionados ao Uso de Substâncias/etiologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Inquéritos e Questionários , Cooperação e Adesão ao Tratamento , Adulto Jovem
18.
Inf. psiquiátr ; (241): 15-33, jul.-sept. 2020. mapas, graf
Artigo em Espanhol | IBECS | ID: ibc-197441

RESUMO

La atención a las personas que han desarrollado o pueden llegar a desarrollar una psicosis incipiente debe realizarse de forma precoz. Por ello, la detección es el paso fundamental, seguida del diagnóstico, tratamiento y recuperación de la persona. Todas estas intervenciones transversales son realizadas por diferentes profesionales sanitarios y no sanitarios ubicados en dispositivos diferentes y de entidades proveedoras dispares, lo cual requiere la creación de alianzas y trabajo en red bajo el paraguas de una Unidad Funcional que permita situar a la persona en el centro para que pueda recibir la atención más necesaria en cada momento siguiendo su proyecto vital. Dicha Unidad Funcional debe ser territorial, transversal y comunitaria. En este artículo mostramos el proceso que se ha seguido en la creación de las unidades funcionales del Programa de Atención Específica al Trastorno Psicótico Incipiente (PAE- TPI), así como las comisiones de seguimiento y los resultados preliminares para cada uno de los sectores de referencia de Benito Menni CASM (L'Hospitalet, Sant Boi y Vallès Oriental)


Attention to people who have developed or may develop an incipient psychosis should be done early. Therefore, detection is the fundamental step, followed by diagnosis, treatment and recovery of the person. All these cross-cutting interventions are carried out by different health and non-health professionals, who work in different services and from different providers. The creation of a Functional Unit have two main aims: to reach a professional networking as well as to offer a personalized intervention and a long term monitoring to the target patients of the program. This Functional Unit must be territorial, transversal and community based. In this article we show the process that has been followed in order to create the functional units and the monitoring work commissions of the "Program of Specific Attention to the Incipient Psychotic Disorder", as well as inform about the preliminary results of the three reference population areas assisted by Benito Menni CASM (L'Hospitalet, Sant Boi and Vallès Oriental)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Assistência Centrada no Paciente/organização & administração , Intervenção Médica Precoce/organização & administração , Transtornos Psicóticos/terapia , Serviços de Saúde Mental/normas , Estratégias de Saúde , Intervenção Médica Precoce/métodos , Transtornos Psicóticos/diagnóstico , Pessoal de Saúde/organização & administração , Nível de Saúde , Prestação Integrada de Cuidados de Saúde/organização & administração , Psicometria
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...