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- Anrup, Roland, et al.
(author)
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Centrala universitetsvärden hotas av bolagiseringsidén
- 2013
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In: Dagens nyheter. - 1101-2447.
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Journal article (pop. science, debate, etc.)abstract
- Högskolestiftelser. Förslaget att driva svenska universitet i stiftelseform öppnar för bolagisering. Men det är ingen riktig utredning, utan en politisk pamflett utan eftertanke. Privatisering av universitet hotar både oberoendet, forskningskvaliteten och samhällsnyttan, skriver 36 forskare vid svenska högskolor och universitet.
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- Deville, Walter, et al.
(author)
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Health care for immigrants in Europe : Is there still consensus among country experts about principles of good practice? A Delphi study
- 2011
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 11, s. Art. no. 699-
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Journal article (peer-reviewed)abstract
- Background: European Member States are facing a challenge to provide accessible and effective health care services for immigrants. It remains unclear how best to achieve this and what characterises good practice in increasingly multicultural societies across Europe. This study assessed the views and values of professionals working in different health care contexts and in different European countries as to what constitutes good practice in health care for immigrants. Methods: A total of 134 experts in 16 EU Member States participated in a three-round Delphi process. The experts represented four different fields: academia, Non-Governmental Organisations, policy-making and health care practice. For each country, the process aimed to produce a national consensus list of the most important factors characterising good practice in health care for migrants. Results: The scoring procedures resulted in 10 to 16 factors being identified as the most important for each participating country. All 186 factors were aggregated into 9 themes: (1) easy and equal access to health care, (2) empowerment of migrants, (3) culturally sensitive health care services, (4) quality of care, (5) patient/health care provider communication, (6) respect towards migrants, (7) networking in and outside health services, (8) targeted outreach activities, and (9) availability of data about specificities in migrant health care and prevention. Although local political debate, level of immigration and the nature of local health care systems influenced the selection and rating of factors within each country, there was a broad European consensus on most factors. Yet, discordance remained both within countries, e. g. on the need for prioritising cultural differences, and between countries, e. g. on the need for more consistent governance of health care services for immigrants. Conclusions: Experts across Europe asserted the right to culturally sensitive health care for all immigrants. There is a broad consensus among experts about the major principles of good practice that need to be implemented across Europe. However, there also is some disagreement both within and between countries on specific issues that require further research and debate.
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- Fortugno, Federico, et al.
(author)
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Symptoms associated with victimization in patients with schizophrenia and related disorders
- 2013
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:3, s. e58142-
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Journal article (peer-reviewed)abstract
- Background: Patients with psychoses have an increased risk of becoming victims of violence. Previous studies have suggested that higher symptom levels are associated with a raised risk of becoming a victim of physical violence. There has been, however, no evidence on the type of symptoms that are linked with an increased risk of recent victimization.Methods: Data was taken from two studies on involuntarily admitted patients, one national study in England and an international one in six other European countries. In the week following admission, trained interviewers asked patients whether they had been victims of physical violence in the year prior to admission, and assessed symptoms on the Brief Psychiatric Rating Scale (BPRS). Only patients with a diagnosis of schizophrenia or related disorders (ICD-10 F20-29) were included in the analysis which was conducted separately for the two samples. Symptom levels assessed on the BPRS subscales were tested as predictors of victimization. Univariable and multivariable logistic regression models were fitted to estimate adjusted odds ratios.Results: Data from 383 patients in the English sample and 543 patients in the European sample was analysed. Rates of victimization were 37.8% and 28.0% respectively. In multivariable models, the BPRS manic subscale was significantly associated with victimization in both samples.Conclusions: Higher levels of manic symptoms indicate a raised risk of being a victim of violence in involuntary patients with schizophrenia and related disorders. This might be explained by higher activity levels, impaired judgement or poorer self-control in patients with manic symptoms. Such symptoms should be specifically considered in risk assessments.
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- Giacco, Domenico, et al.
(author)
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Caregivers' appraisals of patients' involuntary hospital treatment : European multicentre study
- 2012
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In: British Journal of Psychiatry. - : The Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 201:6, s. 486-491
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Journal article (peer-reviewed)abstract
- Background: Mental health policies emphasise that caregivers' views of involuntary psychiatric treatment should be taken into account. However, there is little evidence on how caregivers view such treatment.Aims: To explore caregivers' satisfaction with the involuntary hospital treatment of patients and what factors are associated with caregivers' appraisals of treatment.Method: A multicentre prospective study was carried out in eight European countries. Involuntarily admitted patients and their caregivers rated their appraisal of treatment using the Client Assessment of Treatment Scale 1 month after admission.Results: A total of 336 patients and their caregivers participated. Caregivers' appraisals of treatment were positive (mean of 8.5 on a scale from 0 to 10) and moderately correlated with patients' views. More positive caregivers' views were associated with greater patients' symptom improvement.Conclusions: Caregivers' appraisals of involuntary in-patient treatment are rather favourable. Their correlation with patients' symptom improvement may underline their relevance in clinical practice.
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- Giacco, Domenico, et al.
(author)
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Friends and Symptom Dimensions in Patients with Psychosis: A Pooled Analysis
- 2012
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 7:11
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Journal article (peer-reviewed)abstract
- Background: Having friends is associated with more favourable clinical outcomes and a higher quality of life in mental disorders. Patients with schizophrenia have fewer friends than other mentally ill patients. No large scale studies have evaluated so far what symptom dimensions of schizophrenia are associated with the lack of friendships. Methods: Data from four multi-centre studies on outpatients with schizophrenia and related disorders (ICD F20-29) were included in a pooled analysis (N = 1396). We established whether patients had close friends and contact with friends by using the equivalent items on friendships of the Manchester Short Assessment of Quality of Life or of the Lancashire Quality of Life Profile. Symptoms were measured by the Brief Psychiatric Rating Scale or by the identical items included in the Positive and Negative Syndrome Scale. Results: Seven hundred and sixty-nine patients (55.1%) had seen a friend in the previous week and 917 (65.7%) had someone they regarded as a close friend. Low levels of negative symptoms and hostility were significantly associated with having a close friend and contact with a friend. Overall, almost twice as many patients with absent or mild negative symptoms had met a friend in the last week, compared with those with moderate negative symptoms. Conclusions: Higher levels of negative symptoms and hostility are specifically associated with the lack of friendships in patients with psychotic disorders. These findings suggest the importance of developing effective treatments for negative symptoms and hostility in order to improve the probability of patients with schizophrenia to have friends.
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- McCabe, Rosemarie, et al.
(author)
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The Therapeutic Relationship and Adherence to Antipsychotic Medication in Schizophrenia
- 2012
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 7:4
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Journal article (peer-reviewed)abstract
- Objective: Previous research has shown that a better therapeutic relationship (TR) predicts more positive attitudes towards antipsychotic medication, but did not address whether it is also linked with actual adherence. This study investigated whether the TR is associated with adherence to antipsychotics in patients with schizophrenia. Methods: 134 clinicians and 507 of their patients with schizophrenia or a related psychotic disorder participated in a European multi-centre study. A logistic regression model examined how the TR as rated by patients and by clinicians is associated with medication adherence, adjusting for clinician clustering and symptom severity. Results: Patient and clinician ratings of the TR were weakly inter-correlated (r(s) = 0.13, p = 0.004), but each was independently linked with better adherence. After adjusting for patient rated TR and symptom severity, each unit increase in clinician rated TR was associated with an increase of the odds ratio of good compliance by 65.9% (95% CI: 34.6% to 104.5%). After adjusting for clinician rated TR and symptom severity, for each unit increase in patient rated TR the odds ratio of good compliance was increased by 20.8% (95% CI: 4.4% to 39.8%). Conclusions: A better TR is associated with better adherence to medication among patients with schizophrenia. Patients' and clinicians' perspectives of the TR are both important, but may reflect distinct aspects.
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- McGranahan, Rose, et al.
(author)
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Psychopathological Symptoms and Satisfaction with Mental Health in Patients with Schizophrenia
- 2018
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In: Psychopathology. - : S. Karger AG. - 0254-4962 .- 1423-033X. ; 51:3, s. 192-197
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Journal article (peer-reviewed)abstract
- Background: The patient’s view of their mental health is a central aspect in research and practice. Yet, little is known about which psychopathological symptoms are linked with patients’ satisfaction with their mental health. We aimed to identify these symptoms in patients with schizophrenia. Methods: An individual patient data meta-analysis was conducted with data from 2,488 patients from 8 independent studies. Satisfaction with mental health was rated on a 7-point scale, and symptoms were observer-rated using identical items from the Brief Psychiatric Rating Scale and the Positive and Negative Symptom Scale. Mixed multilevel univariate followed by multivariate regression models were used to identify symptoms associated with satisfaction with mental health. Results: In univariate regressions, all subscales – not age and gender – were associated with mental health satisfaction. In the multivariate regression, only affective and negative symptoms were significantly associated with a lower satisfaction with mental health, explaining 22.5% of the variance. Conclusions: Observer-rated psychopathological symptoms are linked to patients’ mental health satisfaction. In addition to affective symptoms – which are commonly negatively linked with satisfaction ratings – a higher level of negative symptoms makes patients less satisfied with their mental health, whilst positive and other symptoms do not influence mental health satisfaction.
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- McGuire-Snieckus, Rebecca, et al.
(author)
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A new scale to assess the therapeutic relationship in community mental health care: STAR
- 2007
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In: Psychological Medicine. - 1469-8978. ; 37:1, s. 85-95
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Journal article (peer-reviewed)abstract
- Background. No instrument has been developed specifically for assessing the clinician-patient therapeutic relationship (TR) in community psychiatry. This study aimed to develop a measure of the TR with clinician and patient versions using psychometric principles for test construction. Method. A four-stage prospective study was undertaken, comprising qualitative semi-structured interviews about TRs with clinicians and patients and their assessment of nine established scales for their applicability to community care, administering an amalgamated scale of more than 100 items, followed by Principal Components Analysis (PCA) of these ratings for preliminary scale construction. test-retest reliability of the scale and administering the scale in a new sample to confirm its factorial structure. The sample consisted of patients with severe mental illness and a designated key worker in the care of 17 community mental health teams in England and Sweden. Results. New items not covered by established scales were identified, including clinician helpfulness in accessing services, patient aggression and family interference. The new patient (STAR-P) and clinician scales (STAR-C) each have 12 items comprising three subscales: positive collaboration and positive clinician input in both versions, non-supportive clinician input in the patient version, and emotional difficulties in the clinician version. Test-retest reliability was r = 0(.)76 for STAR-P and r = 0(.)68 for STAR-C. The factorial structure of the new scale was confirmed with a good fit. Conclusions. STAR is a specifically developed, brief scale to assess TRs in community psychiatry with good psychometric properties and is suitable for use in research and routine care.
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