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- Björkman, Tommy, et al.
(författare)
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Outcome of case management based on the strengths model compared to standard care. A randomised controlled trial.
- 2002
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 37:4, s. 147-152
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The outcome of less intensive case management services, such as the strengths model, is still inconclusive, which suggests a need for more controlled studies. The aim of the present study was to investigate the outcome of a strengths model of case management service (SCM) compared to standard care. METHODS: Seventy-seven clients with a mental illness and a serious impairment in functioning in social contacts, housing or work situation were randomly allocated to SCM or standard care. Outcome was assessed with regard to use of psychiatric services, changes in symptomatology, psychosocial functioning, social network, needs for care, quality of life and client satisfaction with care. The follow-up period was 36 months. RESULTS: The results showed a greater reduction in needs for care in clients receiving SCM. No differences in clinical or social outcome were shown. Clients receiving SCM also used significantly less days in psychiatric inpatient services and were generally more satisfied with the psychiatric services offered. CONCLUSIONS: SCM failed to improve clinical and social outcome compared to standard care, but was more successful in reducing days spent in hospital, and the clients were also more satisfied with the service compared to standard care.
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- Caldera, Trinidad, et al.
(författare)
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Psychological impact of the hurricane Mitch in Nicaragua in a one-year perspective
- 2001
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 36:3, s. 108-114
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Whereas natural disasters more commonly occur in low-income countries, almost all studies on psychological consequences have been conducted in the Western world. In countries where resources are poor it is of importance to know which groups should be targeted for early intervention after a disaster. The study aims at assessing the prevalence of post-traumatic stress disorder PTSD and of post-traumatic symptoms among people afflicted by hurricane Mitch in Nicaragua and at identifying risk factors for PTSD symptoms 6 months following a disaster. METHOD: At four primary health care centres, 496 consecutive adult patients were interviewed 6 months after hurricane Mitch regarding PTSD symptoms (Harvard Trauma Questionnaire, HTQ), disaster experiences and post-disaster help-seeking. RESULTS: All individuals resident in the area during Mitch were judged to have experienced a trauma fulfilling A criteria for PTSD. Regarding more specific traumas, 39% reported a close relative to be dead or seriously injured and 72% had their house partly or completely destroyed. Prevalence of PTSD ranged from 9.0% in the worst afflicted area to 4.5% in a less damaged area. From a dimensional perspective, PTSD symptoms according to HTQ 6 months after the disaster were significantly associated with the death of a relative (beta-coefficient 0.257, P = 0.000), a house destroyed (beta-coefficient 0.148, P = 0.001), female sex (beta-coefficient 0.139, P = 0.001), previous mental health problems (beta-coefficient 0.109, P = 0.009) and illiteracy (beta-coefficient 0.110, P = 0.009). Those with previous mental health problems (OR = 4.84; 95% CI = 3.04-7.66) were more likely than others to seek from help, any source whereas the opposite was true for illiterate people (OR = 0.38; 95% CI = 0.21-0.69). Of all respondents, 8.5% reported that they had thought of taking their lives, and illiterates (OR 2.84; 95% CI = 1.12-4.37) and those with previous mental health problems (OR 2.84; 95% CI = 1.12-4.57) were at particular risk for suicidal problems. One year after Mitch, half of those identified as PTSD cases at 6 months still fulfilled the criteria for a PTSD diagnosis. CONCLUSION: PTSD represents a serious mental health problem after a disaster. Those with illiteracy, females and those with previous mental health problems should be targets for early post-disaster intervention.
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- Cedereke, Marie, et al.
(författare)
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Patients' needs during the year after a suicide attempt A secondary analysis of a randomised controlled intervention study.
- 2002
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 37:8, s. 357-363
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: We first studied whether changes of needs were influenced by randomly allocated telephone interventions between 1 and 12 months after a suicide attempt in addition to treatment as usual. These were aimed at improving motivation for professional treatment. As a secondary analysis we investigated the frequency and changes of needs during this period and if changes were related to other outcome measures. Method One month after a suicide attempt 216 patients were randomised to two telephone interventions or to no such interventions within 1 year. The Camberwell Assessment of Need (CAN) was used to evaluate 22 different need areas at 1 and 12 months. Other outcome measurements used were Global functioning axis V (GAF), psychological symptoms (SCL-90, GSI) and scale of suicide ideation (SSI). Results Of 178 patients who were followed up, 140 had been rated by CAN at both 1 and 12 months. Changes of needs did not differ between the randomised groups. At 1 month the patients had a mean number of 5.1 +/- 2.4 needs and 2.4 +/- 1.5 of these were considered as unmet. The most frequently reported needs concerned health aspects, basic needs and social needs. At 12 months needs concerning health aspects were significantly reduced, while basic needs and social needs were not. Changes of GAF explained 21 % and changes of GSI 4 % of the variance of the reduction of needs. Conclusions After 12 months, needs in health aspects, basic needs and social needs were still common. A structured evaluation of the patient's needs seems to be helpful when planning treatment after a suicide attempt.
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- Eklund, Mona, et al.
(författare)
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Relationships between satisfaction with occupational factors and health-related variables in schizophrenia outpatients
- 2001
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 36:2, s. 79-85
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The purpose of this study was to explore relationships between satisfaction with occupational factors, operationalized as occupational status and the total daily occupational situation, and health-related variables among people with schizophrenia. The health-related variables included quality of life, perceived control, sense of coherence, and psychopathology. Gender differences in these relationships were explored as well. METHODS: A sample of 74 individuals, aged 20-55 years, from outpatient psychiatric services were recruited to the study. A variety of interviews and self-rating scales were used in the data collection. RESULTS: When controlling for depressive symptoms, the results showed that satisfaction with employment status was of significance for health among patients with schizophrenia, but satisfaction with the total daily occupational situation seemed to be even more important to quality of life and other health-related aspects. In particular, satisfaction with daily occupations constituted an important dimension for self-rated quality of life. Some minor sex differences could be discerned in the pattern of associations. CONCLUSIONS: The strong association between satisfaction with daily occupations and self-rated quality of life adds a new dimension to the understanding of quality of life for this group of subjects, and suggests that helping to organise an individual's daily occupations ought to be a significant task in planning for psychiatric services.
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