Abstract
Date Presented 04/04/19
This presentation introduces Occupational Connections, a structured, short-term, occupation-based in-patient mental-health intervention focused on promotion of ...participation in community occupations. Findings from an OC effectiveness study investigating the impact on community participation, the experience of the hospital setting as recovery-oriented, and changes in client descriptive parameters (cognition, symptom severity, and functional capacity) will be presented and discussed.
Primary Author and Speaker: Lena Lipskaya-Velikovsky
Contributing Authors: Terry Krupa
Psychiatric hospitals are increasingly being digitalised. Digitalisation often requires changes at work for health professionals. A positive attitude from health professionals towards technology is ...crucial for a successful and sustainable digital transformation at work. Nevertheless, insufficient attention is being paid to the health professionals' sentiments towards technology.
This study aims to identify the implemented technologies in psychiatric hospitals and to describe the health professionals' sentiments towards these implemented technologies.
A text-mining analysis of semi-structured interviews with nurses, physicians and psychologists was conducted. The analysis comprised word frequencies and sentiment analyses. For the sentiment analyses, the SentimentWortschatz dataset was used. The sentiments ranged from -1 (strongly negative sentiment) to 1 (strongly positive sentiment).
In total, 20 health professionals (nurses, physicians and psychologists) participated in the study. When asked about the technologies they used, the participating health professionals mainly referred to the computer, email, phone and electronic health record. Overall, 4% of the words in the transcripts were positive or negative sentiments. Of all words that express a sentiment, 73% were positive. The discussed technologies were associated with positive and negative sentiments. However, of all sentences that described technology at the workplace, 69.4% were negative.
The participating health professionals mentioned a limited number of technologies at work. The sentiments towards technologies were mostly negative. The way in which technologies are implemented and the lack of health professionals' involvement seem to be reasons for the negative sentiments.
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Abstract
Background
Both perceived job insecurity and unemployment has been associated with an increased risk of developing mental ill health. It has, moreover, been proposed that an insecure ...employment may be as detrimental as unemployment itself.
Objective
To estimate incidence rate ratios (RRs) of (i) redeemed prescriptions for psychotropic drugs and (ii) psychiatric hospital treatment due to mood, anxiety, or stress-related disease, among fixed-term contract workers (as an operationalization of insecure job) vs. unemployed, in the general population of Denmark.
Methods
Data on baseline employment status were drawn from the Danish Labor Force Surveys in the years 2001–2013. Participants (10,265 fixed-term contract workers and 7926 unemployed) were followed for up to 5 years in national registers (2439 cases of psychotropic drug use, 71,516 person years; 311 cases of psychiatric hospital treatment, 86,790 person years). Adjusted RRs were obtained by Poisson regression. We aspired to minimize health selection effects by (i) exclusion of survey participants who received sickness benefits, social security cash benefits, psychiatric hospital treatment or a prescription for psychotropic drugs, within 1-year prior to baseline (
n
= 11,693), (ii) adjustment for age, gender, level of education, calendar year, disposable family income and maternity/paternity benefits within 1-year prior to baseline.
Results
The adjusted RR for fixed-term contract workers vs. unemployed was 0.98 (99.5% CI: 0.87—1.11) for psychotropic drugs and 0.93 (99.5% CI: 0.67—1.30) for psychiatric hospital treatment.
Conclusion
The present study did not find significant differences in the risk of developing mental ill health between fixed-term contract workers and unemployed, and thus suggests that fixed-term contracts may be as detrimental as unemployment.
Trial registration
International Registered Report Identifier (IRRID): DERR2-10.2196/24392.
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Individuals with psychiatric disorders have higher early mortality rates than the general population, and all types of mental disorders are associated with a short life expectancy. In this context, ...assessment of the mortali-ties of both natural and unnatural causes in psychiatric inpatients is of critical importance in terms of mortality epidemiology, which provides data that can help improve the quality and planning of psychiatric care. The popu-lation of this study retrospective, cross-sectional study consisted of inpatients that died in Manisa Mental Health and Diseases Hospital between May 2002 and December 2022. Of the 120 inpatients that died, 119 patients, 63.9% male, and 36.1% female, were included in the study sample. The mortality rate decreased from 3.2% to 0.22% during the period covered by the study. The difference between mortality rates before 2013, when qua-lity and accreditation processes started, and after 2013 has decreased from 74.8% to 25.2%. Of the natural deaths, 45.4% were caused by cardiac arrest, whereas 100% of the unnatural deaths occurred due to suicides. Short hospital stays and close follow-up in the first week of hospitalization are essential in reducing mortality rates in psychiatric inpatients. In addition, increasing the quality of health care in accordance with the national and international quality and accreditation criteria will further reduce the mortality rates in psychiatric inpati-ents.
Ruhsal bozukluğu olan bireylerin genel nüfusa göre daha yüksek erken ölüm oranlarına sahip olduğu ve tüm ruhsal bozukluk türlerinin kısa yaşam beklentisi ile ilişkili olduğu bilinmektedir. Bu bağlamda, psikiyatrik yatan hastalarda hem doğal hem de doğal olmayan nedenlerden kaynaklanan ölümlerin değerlendirilmesi, psikiyatrik bakımın kalitesini ve planlamasını iyileştirmeye yardımcı olabilecek veriler sağlayan mortalite epidemiyolojisi açısından kritik öneme sahiptir. Bu retrospektif, kesitsel çalışmanın evrenini Mayıs 2002-Aralık 2022 tarihleri arasında Manisa Ruh Sağlığı ve Hastalıkları Hastanesi'nde yatarak tedavi gören ve ölen hastalar oluşturmaktadır. Yatarak tedavi gören 120 hastadan %63,9'u erkek, %36,1'i kadın olmak üzere 119 hasta çalışma örneklemine dahil edilmiştir. Çalışmanın kapsadığı dönem boyunca ölüm oranı %3,2'den %0,22'ye düşmüştür. Kalite ve akre-ditasyon süreçlerinin başladığı yıl olan 2013 öncesi ölüm oranları ile 2013 sonrası fark ise %74.8’den %25.2’ye gerilemiştir. Doğal ölümlerin %45,4'ü kardiyak arrest nedeniyle gerçekleşirken, doğal olmayan ölümlerin %100'ü intihar nedeniyle meydana gelmiştir. Kısa hastanede kalış süreleri ve hastaneye yatışın ilk haftasında yakın takip, psikiyatrik yatan hastalarda ölüm oranlarını azaltmada esastır. Ayrıca, ulusal ve uluslararası kalite ve akreditasyon kriterlerine uygun olarak sağlık bakım kalitesinin artırılması, psikiyatrik yatan hastalarda ölüm oranlarını daha da azaltacaktır.
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Purpose
Psychiatric hospitals or mental asylums grew across the world in the colonial era. Despite concerns over quality of care and human rights violations, these hospitals continue to provide the ...majority of mental health care in most low- and middle-income countries (LMICs). We sought to review the evidence of reform of mental hospitals and associated patient outcomes.
Methods
We adopted an integrative review methodology by including experimental and non-experimental research. The review protocol was registered on PROSPERO (CRD42019130399). A range of databases and systematic hand searches were conducted by two independent reviewers. Research conducted between 1980 and May 2019, that focused on any aspect of reform in mental hospitals for adults (age 18 and upwards) with severe mental illness and published in English, were considered.
Results
16 studies were included in the review. 12 studies met inclusion criteria, and four additional reports emerged from the hand search. Studies covered—India, China, South Africa, Grenada, Georgia, Sri Lanka, Argentina and Brazil. Key findings emphasise the role of judicial intervention as a critical trigger of reform. Structural reform composed of optimisation of resources and renovations of colonial structures to cater to diverse patient needs. Process reforms include changes in medical management, admission processes and a move from closed to open wards. Staff engagement and capacity building have also been used as a modality of reform in mental hospital settings.
Conclusion
There is some documentation of reform in psychiatric hospitals. However, poor methodological quality and variation in approach and outcomes measured, make it challenging to extrapolate specific findings on process or outcomes of reform. Despite being integral service providers, psychiatric hospitals still do not adopt patient centric, recovery-oriented processes. Hence, there is an urgent need to generate robust evidence on psychiatric reform and its effect on patient outcomes.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Psychiatric inpatients constitute a population at considerably increased risk for suicide. Identifying those at imminent risk is still a challenging task for hospital staff. This retrospective ...case-control study focused on clinical risk factors related to the course of the hospital stay.
Inpatient suicide cases were identified by linking the Tyrol Suicide Register with the registers of three psychiatric hospitals in the state. Control subjects were patients who had also been hospitalized in the respective psychiatric unit but had not died by suicide. Matching variables included sex, age, hospital, diagnosis, and admission date. The study period comprised 7 years. Data were analyzed by the appropriate two-sample tests and by logistic regression.
A total of 30 inpatient suicide cases and 54 control patients were included. A number of factors differentiated cases from controls; after correction for multiple testing, the following retained significance: history of aborted suicide, history of attempted suicide, history of any suicidal behavior/threats, suicidal ideation continuing during hospitalization, no development of prospective plans, no improvement of mood during the hospital stay, and leaving ward without giving notice. Logistic regression identified the latter three variables and history of attempted suicide as highly significant predictors of inpatient suicide.
Preventive measures during hospitalization include thorough assessment of suicidal features, an emphasis on the development of future perspectives, and a review of hospital regulations for patients who want to leave the ward.
There is strong evidence that physical activities (PAs) are an important factor in increasing and maintaining mental health as well as in preventing relapse after mental health disorders. Physical ...activity is an important part of the treatment program in psychiatric hospitals. However, when individuals with mental health disorders (IMHD) leave the hospitals in Switzerland (CH), there are few possibilities to do physical activity in a given setting. One of them are voluntary sports groups for individuals with mental health disorders (SGPSY), which have been growing continuously in CH since 2016. Yet, little is known about these groups and their training settings. Therefore, the present study explores challenges, barriers, and enablers for participation in SGPSY from the point of view of the trainers of these groups. Additionally, as the sustainable implementation of SGPSY relies on the trainer, the study aims to identify reasons/motivations as well as the personality characteristics of the SGPSY trainers. Semi-structured interviews were conducted with 15 trainers of SGPSY in CH during spring 2022. Interviews were audiotaped, transcribed, and analyzed using thematic analysis in nVivo. Participants identified several intrapersonal (lack of motivation and fitness, mood problems, etc.), interpersonal (conflicts between participants), and structural barriers (time/location) that hinder IMHD from participating in SGPSY. The participating trainer reported that trainer might be helpful in overcoming the barriers by supporting IMHD as enablers. They rate social skills to be essential for the successful management and organization of SGPSY, as well as the ability to set boundaries to protect one's private life and sports skills expertise. The reasons for their engagement as trainers of SGPSY were the satisfaction of doing sports with IMHD and to improve the physical activities habits of IMHD. The findings of the study highlight the need to upskill the trainers of SGPSY in order to improve recruitment of the future trainers of SGPSY by focusing on the assessment of appropriate personality characteristics of trainers and their motives. Additionally, these findings should be integrated in the educational materials of Swiss disabled sports systems. Further research should validate the results from SGPSY participants' point of view.
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