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“Dual-experiences” of treatment for anorexia nervosa: an interpretative phenomenological analysis of experiences of treatment by service providers who are recovered service users 神经性厌食症治疗的“双重体验”:对康复服务使用者服务提供者治疗体验的解释性现象学分析
IF 1.2 Q3 Medicine Pub Date : 2023-08-21 DOI: 10.1108/mhrj-02-2022-0010
Emma Curry, Panoraia Andriopoulou
PurposeThe aim of this study is to explore the dual-experiences of AN recovered service providers. Prognoses for anorexia nervosa (AN) and anorexia nervosa-like (AN-like) presenting patients remain poor, and notably, no current treatment approach is reliably successful. Past research into AN has focused on singular experiences, those of either AN patients or those of practitioners providing treatment, but has yet to explore the experiences of recovered AN service users now working as AN service providers.Design/methodology/approachIn this study, four UK-based female participants shared their dual experiences of treatment for AN or AN-like presentations through individual semi-structured interviews. Data collection and analysis were conducted in accordance with an Interpretative Phenomenological Analysis methodology.FindingsAnalysis revealed four primary themes, including barriers to accessing services; the impact of treating professionals’ approaches; displacement of responsibility for treating AN; and the value of dual-experience of AN.Research limitations/implicationsThis study focuses on AN and AN-like presentations and does not address the other eating disorders. Additionally, only female-identifying individuals volunteered their participation. As such, this study is notably lacking the voices of individuals of other genders.Practical implicationsParticipant narratives suggest that improvements in the treatment of AN lie in improving professionals’ understanding of – and compassion towards – this patient group to optimise the power of the therapeutic relationship across all AN-treating professions.Social implicationsParticipants revealed a pervasive misunderstanding of AN among treating professionals that is hindering patients’ treatment and suggested that lived experience can be an asset in a professional context.Originality/valueIndividuals with dual experiences of AN can provide a unique and reflective insight into experiences of treatment through their combined personal and professional expertise and elucidate the experiences that both helped and hindered their own recovery.
目的探讨网络康复服务提供者的双重体验。神经性厌食症(AN)和神经性厌食症样(AN-like)患者的预后仍然很差,值得注意的是,目前没有可靠的治疗方法是成功的。过去对人工神经网络的研究主要集中在单一的经历上,即人工神经网络患者或提供治疗的从业人员的经历,但尚未探索康复后的人工神经网络服务使用者现在作为人工神经网络服务提供者的经历。设计/方法/方法在这项研究中,四位来自英国的女性参与者通过个人半结构化访谈分享了她们治疗AN或类似AN的双重经历。数据收集和分析是按照解释性现象学分析方法进行的。分析结果揭示了四个主要主题,包括获取服务的障碍;治疗专业人员方法的影响;治疗AN的责任转移;AN的双重经验价值。研究局限性/意义本研究主要关注AN和AN样表现,未涉及其他饮食失调。此外,只有女性自愿参与。因此,这项研究明显缺乏其他性别个体的声音。实际意义参与者的叙述表明,AN治疗的改进在于提高专业人员对该患者群体的理解和同情,以优化所有AN治疗专业的治疗关系的力量。社会意义:参与者揭示了专业治疗人员对急性脑梗死的普遍误解,这阻碍了患者的治疗,并表明生活经验在专业背景下可能是一种资产。原创性/价值具有双重AN经历的个体可以通过他们的个人和专业知识的结合,对治疗经历提供独特和反思的见解,并阐明帮助和阻碍他们自己康复的经历。
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引用次数: 0
The effectiveness of mental health literacy interventions in young people: a meta-analysis 青少年心理健康素养干预的有效性:一项荟萃分析
IF 1.2 Q3 Medicine Pub Date : 2023-08-11 DOI: 10.1108/mhrj-07-2022-0052
John G. Mills, Lee Cumbers, S. Williams, Henry Titley-Wall
PurposeAdolescence and young adulthood are recognised as critical time for developing mental health literacy (MHL). The purpose of this study is to analyse the effectiveness of current MHL interventions to guide the future development of MHL intervention strategies.Design/methodology/approachA meta-analysis adopting the PRISMA framework for systematically reviewing the literature was adopted. Three authors independently reviewed studies and extrapolated key data for analysis. A robust random-effects model with adjustments for small study biases was conducted to establish the effect sizes of all included MHL interventions. Moderator analysis was conducted to examine the effects of intervention length in MHL.FindingsA total of 11 intervention studies were identified and analysed, resulting in a medium to large pooled effect size of 0.62 (95% CI: 0.28; 0.96). Moderator analysis found that short interventions had an estimated standard mean difference (SMD) effect size of 0.9220 (95% CI: −1.1555; 2.9995). This was greater than the medium length interventions, with an estimated SMD effect size of 0.4967 (95% CI: 0.0452; 0.9483), and long interventions, with an estimated SMD effect size of 0.5628 (95% CI: −0.2726; 1.3983). As a result, MHL interventions are proficient in improving young adults’ MHL, with shorter interventions (45–50 min) having the largest effect size. This study highlights several inconsistencies in methodological rigour and reporting from studies in this area, which future research should look to address.Originality/valueTo date, MHL review studies have often focused their attention on a specific domain, most notably education and school-based setting. To the best of the authors’ knowledge, no reviews have conducted a meta-analysis across contexts and domains with a specific focus on MHL intervention strategies for young adults.
目的青春期和青年期被认为是发展心理健康素养的关键时期。本研究的目的是分析当前MHL干预措施的有效性,以指导未来MHL干预策略的发展。设计/方法/方法采用PRISMA框架进行meta分析,对文献进行系统回顾。三位作者独立审查了研究并推断了分析的关键数据。采用一个校正了小研究偏差的稳健随机效应模型来确定所有纳入的MHL干预措施的效应大小。进行调节分析以检验干预时间对MHL的影响。共鉴定和分析了11项干预研究,得出中大型合并效应值为0.62 (95% CI: 0.28;0.96)。调节分析发现,短期干预的估计标准平均差(SMD)效应大小为0.9220 (95% CI:−1.1555;2.9995)。这大于中等长度的干预措施,估计SMD效应大小为0.4967 (95% CI: 0.0452;0.9483)和长期干预,估计SMD效应大小为0.5628 (95% CI: - 0.2726;1.3983)。因此,MHL干预在改善年轻人MHL方面效果显著,其中较短的干预(45-50分钟)效果最大。本研究强调了该领域研究在方法严谨性和报告方面的几个不一致之处,这是未来研究应该解决的问题。独创性/价值迄今为止,MHL评论研究通常将注意力集中在特定领域,最明显的是教育和学校环境。据作者所知,尚无综述跨背景和领域进行荟萃分析,特别关注年轻人的MHL干预策略。
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引用次数: 0
Seclusion in the context of recovery-oriented practice: the perspectives and experiences of psychologists in Ireland 康复导向实践背景下的隐居:爱尔兰心理学家的观点和经验
IF 1.2 Q3 Medicine Pub Date : 2023-07-25 DOI: 10.1108/mhrj-08-2022-0058
Antaine Stíobhairt, Nicole Cassidy, Niamh Clarke, S. Guerin
PurposeThis paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented practice and related professional practice issues.Design/methodology/approachA qualitative hermeneutic phenomenological study was conducted from a social constructivist perspective. Semi-structured interviews with 17 psychologists were analysed using reflexive thematic analysis.FindingsTwenty-four themes were identified, which were clustered into four overarching themes. Participants viewed themselves and psychology in Ireland more broadly as peripheral to seclusion. They believed that seclusion possessed no inherent therapeutic value but viewed it as an uncomfortable and multi-faceted reality. Participants regarded seclusion and recovery as largely inconsistent and difficult to reconcile, and they perceived systemic factors, which had a pervasive negative impact on seclusion and recovery in practice.Practical implicationsThe findings highlight the perceived complexity of seclusion and its interface with recovery, and the need to conscientiously balance conflicting priorities that cannot be easily reconciled to ensure ethical practice. The findings suggest psychologists are well-suited to participate in local and national discussions on using seclusion in recovery-oriented practice.Originality/valueThis study offers a unique insight into psychologists’ perceptions of seclusion and considers the implications of these views. Participants’ nuanced views suggest that psychologists can make valuable contributions to local and national discussions on these topics.
目的探讨爱尔兰成人心理健康服务中隔离心理学家的角色,他们对隔离的看法及其在康复导向实践中的应用以及相关的专业实践问题。设计/方法/途径从社会建构主义的视角进行定性解释学现象学研究。对17位心理学家的半结构化访谈进行了自反性主题分析。研究结果确定了24个主题,并将其归纳为四个总体主题。在爱尔兰,参与者更广泛地将自己和心理视为与世隔绝的边缘。他们认为隐居没有内在的治疗价值,但把它看作是一种不舒服的、多方面的现实。与会者认为隐居和康复在很大程度上是不一致的,难以调和的,他们认为系统因素在实践中对隐居和康复产生了普遍的负面影响。实际意义研究结果强调了隔离的复杂性及其与康复的关系,以及认真平衡不容易调和的冲突优先事项以确保道德实践的必要性。研究结果表明,心理学家非常适合参与地方和国家关于在康复实践中使用隔离的讨论。原创性/价值本研究对心理学家对隐居的看法提供了独特的见解,并考虑了这些观点的含义。参与者的细微差别表明,心理学家可以对当地和全国关于这些话题的讨论做出有价值的贡献。
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引用次数: 0
Personality disorder: no longer a diagnosis? 人格障碍:不再是诊断?
IF 1.2 Q3 Medicine Pub Date : 2023-07-20 DOI: 10.1108/mhrj-03-2023-0014
Peta Temple
PurposeThe purpose of this paper is to explore the historic policy context and social implications of the diagnosis of personality disorder and also consider formulation-based and trauma-informed understandings of distress.Design/methodology/approachOngoing changes to (and splits between) medical understandings of what is being labelled as personality disorder have eroded the label’s cultural capital, adding weight to lived-experience-led calls to Drop the Disorder (Watson, 2019). This paper explores the impact and implications of the historic policy and practice context through a lived experience lens.FindingsSuch diversity of views in the lived experience and medical communities on personality disorder has allowed alternatives to diagnostically informed understandings of distress (such as formulation-based and trauma-informed approaches) to gain traction with practitioners (Bloom and Farragher, 2013; Johnstone and Boyle, 2020). The broader assimilation of these alternative perspectives into dominant medical ideology is evidenced by the fact that the Royal College of Psychiatrists (RCP) is now also exploring alternatives to diagnosis (2023). This suggests even more change ahead for how we understand people and their relationships with trauma and distress.Research limitations/implicationsThis paper discusses UK policy and does not include broader global policies.Practical implicationsThis paper would be helpful for any student interested in where the ideas that underpin personality disorder diagnosis stemmed from and why so many lived experience practitioners and experts by profession question the diagnosis' legitimacy.Social implicationsAs the RCP is now considering alternatives to diagnosis, it is even more critical that practitioners are aware of the competing narratives surrounding this contested diagnosis – as the author believes this will promote more compassionate, trauma-informed working practices.Originality/valueThis is the author’s own work and includes not only the RCP position change but also directly quotes Professor Tyrer (who wrote the International Classification of Diseases 11), giving his views on the changed RCP position, as he recently presented at a conference here in Cornwall. The author is a part of Lighthouse peer support group and wrote this paper as preparation for a Participatory Action Research project they are planning, where they will evaluate the Sanctuary Approach with their membership to create a lived experience-designed trauma-informed charter. Before starting that work, the author wanted to better understand the historic policy context and created this paper to fill that need.
目的本文的目的是探索人格障碍诊断的历史政策背景和社会意义,并考虑基于公式和创伤知情的对痛苦的理解。设计/方法论/方法医学界对人格障碍的理解正在发生变化(以及两者之间的分歧),这侵蚀了该标签的文化资本,增加了生活经验的分量,导致人们呼吁放弃人格障碍(Watson,2019)。本文通过生活经验的视角探讨了历史政策和实践背景的影响和启示。发现生活经历和医学界对人格障碍的看法如此多样,使得对痛苦的诊断知情理解(如基于配方和创伤知情的方法)的替代方案能够吸引从业者(Bloom和Farragher,2013;Johnstone和Boyle,2020)。英国皇家精神病学院(RCP)现在也在探索诊断的替代方案,这证明了这些替代观点更广泛地融入了主流医学意识形态(2023年)。这表明,我们在理解人们及其与创伤和痛苦的关系方面还有更多的变化。研究局限性/含义本文讨论了英国的政策,不包括更广泛的全球政策。实践意义这篇论文将有助于任何对人格障碍诊断的基础思想来源感兴趣的学生,以及为什么这么多有生活经验的从业者和专业专家质疑诊断的合法性。社会含义由于RCP现在正在考虑诊断的替代方案,从业者意识到围绕这一有争议的诊断的相互竞争的叙述更为重要,因为作者认为这将促进更富有同情心、创伤知情的工作实践。原创性/价值这是作者自己的作品,不仅包括RCP立场的变化,还直接引用了Tyrer教授(他撰写了《国际疾病分类11》)对RCP立场变化的看法,正如他最近在康沃尔的一次会议上所说的那样。作者是灯塔同行支持小组的一员,写这篇论文是为了准备他们正在计划的参与性行动研究项目,在该项目中,他们将与成员一起评估庇护所方法,以创建一个生活体验设计的创伤知情宪章。在开始这项工作之前,作者希望更好地了解历史政策背景,并撰写了这篇论文来满足这一需求。
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引用次数: 0
A preliminary evaluation of Crisis Plus: a model for working with frequent users of psychiatric crisis and inpatient services Crisis Plus的初步评估:一个与精神病危机和住院服务频繁使用者合作的模型
IF 1.2 Q3 Medicine Pub Date : 2023-06-16 DOI: 10.1108/mhrj-05-2022-0031
Ketan Sonigra, Lucy McIvor, J. Payne-Gill, Tim Smith, A. Beck
PurposeThere is a proportion of psychiatric service users whose needs are not met by existing models of care. This can lead to a reliance on acute and crisis services. These service users may be considered high intensity users (HIUs). The purpose of this research is to evaluate the Crisis Plus model, an intervention designed to better support HIUs in the community and reduce dependency on acute and crisis services.Design/methodology/approachForty-seven HIUs were involved in Crisis Plus. The core intervention of Crisis Plus was an Anticipatory Management Plan (AMP), produced in collaboration with service users, their families and their care coordinators. AMPs were shared with relevant services and attached to electronic patient notes to ensure a uniform, psychologically informed approach to care.FindingsHIU service use was compared pre and post-AMP. On average, number of inpatient admissions, number of days spent on the ward, accepted psychiatric liaison referrals and accepted home treatment team (HTT) referrals decreased significantly.Practical implicationsCrisis Plus has taken a collaborative, proactive approach to engage HIUs, their families and the services that care for them. Crisis interventions that emphasise collaborative working and service user agency are key.Originality/valueThe provision of dedicated psychological support to HIUs and their professional and personal network is crucial to reduce reliance on acute and crisis care. Crisis Plus is unique in that it instigates co-production and active consultation with HIUs and services to improve clinical outcomes, in addition to reducing NHS expenditure.
目的有一部分精神科服务使用者的需求没有得到现有护理模式的满足。这可能导致对紧急和危机服务的依赖。这些业务用户可被视为高强度用户(hiu)。本研究的目的是评估Crisis Plus模型,这是一种旨在更好地支持社区hiu并减少对急性和危机服务依赖的干预措施。设计/方法/方法47个hiu参与了Crisis Plus。“危机+”的核心干预措施是与服务使用者、其家庭及其护理协调员合作制定的一项预期管理计划。amp与相关服务共享,并附在电子病历上,以确保采用统一的、心理知情的护理方法。对比amp前后的服务使用情况。平均而言,住院人数、住院天数、接受精神科联络转介和接受家庭治疗小组(HTT)转介均显著下降。“危机+”项目采取了一种合作、积极的方式,让hiu、他们的家人和照顾他们的服务机构参与进来。强调协同工作和服务用户代理的危机干预措施是关键。独创性/价值为hiu及其专业和个人网络提供专门的心理支持对于减少对急性和危机护理的依赖至关重要。危机Plus的独特之处在于,除了减少NHS支出外,它还鼓励与hiu和服务机构合作生产和积极协商,以改善临床结果。
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引用次数: 0
A narrative review of the effect of sport and exercise on ADHD symptomatology in children and adolescents with ADHD 运动和锻炼对儿童和青少年多动症症状影响的叙述性综述
IF 1.2 Q3 Medicine Pub Date : 2023-06-06 DOI: 10.1108/mhrj-07-2022-0045
J. Meggs, S. Young, A. Mckeown
PurposeAttention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition with community prevalence globally of 2%–7% (M = 5%; Sayal et al., 2018). Clinicians are routinely encouraged to explain to children and young people the benefits of a healthy lifestyle, including exercise (NICE NG87, 2018). Exercise has been proposed as a safe and low-cost adjunctive approach for ADHD and is reported to be accompanied by positive effects on several aspects of executive functioning (EF). The purpose of this narrative review was to synthesise the contemporary randomised control trial (RCT) studies that examine the effect of sport, physical activity and movement on EF in children and adolescents with ADHD.Design/methodology/approachA narrative review approach with a systematic literature search using PRISMA guidelines for screening and selecting relevant systematic reviews was used. The final review included four peer-review systematic reviews (>2019).FindingsThe results identified four RCT meta-analyses and findings showed that children and adolescents with lower baseline cognitive performance demonstrated greater improvements in functioning after physical activity interventions, particularly for tasks with higher executive function demands, where baseline performance reaches an optimal level. Findings suggest that 10–20 min of acute moderate-high-intensity exercise interventions (cycling/running) appeared to have positive effects on indices of inhibitory control. Preliminary evidence suggests that as little as 5 min of jumping exercises improved inhibitory control. Sixty to eighty minutes of moderately intense, repeated (chronic) exercise appeared to demonstrate the greatest beneficial impact on selective attention.Originality/valueTo the best of the authors’ knowledge, this review is the first to present the extant literature on the effect of physical activity and sport on symptoms of young people with ADHD. It presents evidence to suggest that exercise with progressively increasing cognitive demands may have positive effects for children with ADHD, specifically in terms of improving cognitive flexibility. Further large-scale clinical trials are needed to confirm the positive effects of physical exercise on cognitive functioning in children with ADHD.
目的注意缺陷多动障碍(ADHD)是一种常见的神经发育疾病,全球社区患病率为2%-7% (M = 5%;Sayal et al., 2018)。临床医生经常被鼓励向儿童和年轻人解释健康生活方式的好处,包括锻炼(NICE NG87, 2018年)。运动被认为是一种安全、低成本的ADHD辅助治疗方法,据报道,运动对执行功能(EF)的几个方面都有积极的影响。本叙述性综述的目的是综合当代随机对照试验(RCT)研究,这些研究考察了运动、体育活动和运动对患有ADHD的儿童和青少年EF的影响。设计/方法学/方法采用叙述性综述法,采用PRISMA指南进行系统文献检索,筛选和选择相关的系统综述。最终评审包括四次同行评审系统评审(>2019)。结果确定了四项随机对照试验荟萃分析,结果表明,基线认知能力较低的儿童和青少年在体育活动干预后表现出更大的功能改善,特别是在执行功能要求较高的任务中,基线表现达到最佳水平。研究结果表明,10-20分钟的急性中高强度运动干预(骑车/跑步)似乎对抑制控制指标有积极影响。初步证据表明,只需5分钟的跳跃练习就能改善抑制控制。60到80分钟中等强度的、重复的(慢性)运动似乎对选择性注意力有最大的有益影响。原创性/价值据作者所知,这篇综述是第一个介绍体力活动和运动对青少年多动症症状影响的现有文献。它提供的证据表明,逐渐增加认知需求的运动可能对多动症儿童有积极影响,特别是在提高认知灵活性方面。需要进一步的大规模临床试验来证实体育锻炼对多动症儿童认知功能的积极影响。
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引用次数: 0
Alpha-Stim AID cranial electrotherapy stimulation (CES) anxiety treatment: anxiety, depression and health-related quality-of-life outcomes in primary health-care social prescribing services Alpha Stim AID颅骨电疗刺激(CES)焦虑治疗:初级保健社会处方服务中的焦虑、抑郁和健康相关生活质量结果
IF 1.2 Q3 Medicine Pub Date : 2023-05-25 DOI: 10.1108/mhrj-11-2022-0068
Chris Griffiths, Ksenija da Silva, Harmony Jiang, K. Walker, David Smart, A. Zafar, Sarah Deeks, S. Galvin, Taz Shah
PurposeThis study aims to evaluate the effect of Alpha-Stim Anxiety, Insomnia and Depression (AID) cranial electrotherapy stimulation (CES) on anxiety, depression and health-related quality of life for primary care social prescribing service patients with anxiety symptoms.Design/methodology/approachOpen-label patient cohort design with no control group. A total of 33 adult patients (average age 42 years) completed six weeks of Alpha-Stim AID use. Pre- and post-intervention assessment with participant self-report measures: Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder (GAD-7) and European Quality of Life Five Dimension (EQ-5D-5L).FindingsReliable improvement and remission rates, respectively, were 53.39% and 33.3% for GAD-7; 46.7% and 29.5% for PHQ-9. There was a significant improvement in GAD-7 and PHQ-9 with large effect sizes. EQ-5D-5L results showed significant improvements in health-related quality of life. Perceived quality of life increased by 0.17 on the health index score, with the intervention adding 1.68 quality-adjusted life years (QALYs).Practical implicationsAlpha-Stim AID can be delivered through a primary health-care social prescribing service and most patients will use as prescribed and complete treatment course. Alpha-Stim AID CES may be an effective anxiety and depression treatment for people with anxiety symptoms. The widespread roll-out of Alpha-Stim AID in health-care systems should be considered.Originality/valueTo the best of the authors’ knowledge, this is the first study to respond to the UK’s National Institute for Health and Care (NICE) request for the collection of real-world data to understand better Alpha-Stim AID in relation to people’s treatment uptake, response rates and treatment completion rates (NICE, 2021).
目的本研究旨在评估阿尔法刺激焦虑、失眠和抑郁(AID)颅骨电疗刺激(CES)对有焦虑症状的初级保健社会处方服务患者的焦虑、抑郁和健康相关生活质量的影响。设计/方法/方法无对照组的开放标签患者队列设计。共有33名成年患者(平均年龄42岁 年)完成6 使用Alpha Stim AID数周。干预前和干预后评估采用参与者自我报告措施:患者健康问卷(PHQ-9)、广泛性焦虑症(GAD-7)和欧洲生活质量五维度(EQ-5D-5L)。发现GAD-7的可靠改善率和缓解率分别为53.39%和33.3%;PHQ-9分别为46.7%和29.5%。GAD-7和PHQ-9有显著的改善,效果大小较大。EQ-5D-5L结果显示与健康相关的生活质量显著改善。健康指数得分的感知生活质量增加了0.17,干预增加了1.68个质量调整生命年(QALYs)。实际意义Alpha Stim AID可以通过初级保健社会处方服务提供,大多数患者将按照处方使用并完成疗程。对于有焦虑症状的人来说,阿尔法刺激剂CES可能是一种有效的焦虑和抑郁治疗方法。应考虑在医疗保健系统中广泛推广阿尔法刺激计划。原创性/价值据作者所知,这是第一项响应英国国家卫生与保健研究所(NICE)要求收集真实世界数据的研究,以更好地了解阿尔法刺激AID与人们的治疗接受率、反应率和治疗完成率之间的关系(NICE,2021)。
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引用次数: 0
Does media content have an impact on help-seeking behaviors for mental illness? A systematic review 媒体内容对精神疾病求助行为有影响吗?系统综述
IF 1.2 Q3 Medicine Pub Date : 2023-05-16 DOI: 10.1108/mhrj-06-2022-0038
J. Goodwin, L. Behan
PurposePeople who experience mental illness often demonstrate limited help-seeking behaviours. There is evidence to suggest that media content can influence negative attitudes towards mental illness; less is known about how media impacts help-seeking behaviours. The purpose of this study is to identify if media plays a role in people’s decisions to seek help for their mental health.Design/methodology/approachThe databases Academic Search Complete, CINAHL Plus with Full Text, MEDLINE, APA PsycArticles, APA PsycInfo, Social Sciences Full Text [H.W. Wilson] and Soc Index were systemically searched for papers in the English language that investigated the link between media and help-seeking for mental illness.FindingsSixteen studies met eligibility criteria. There was some evidence to suggest that various forms of media – including video and online resources – can positively influence help-seeking for mental health. Print media had some limited effect on help-seeking behaviours but was weaker in comparison to other forms of media. There was no evidence to suggest that media discourages people from seeking help.Originality/valueThis review identified that, given the heterogeneity of the included papers, and the limited evidence available, there is a need for more focused research to determine how media impacts mental health-related help-seeking behaviours.
目的经历精神疾病的人往往表现出有限的求助行为。有证据表明,媒体内容会影响人们对精神疾病的负面态度;人们对媒体如何影响求助行为知之甚少。这项研究的目的是确定媒体是否在人们寻求心理健康帮助的决定中发挥作用。设计/方法/方法在数据库Academic Search Complete、CINAHL Plus with Full Text、MEDLINE、APA PsycArticles、APA PsycInfo、Social Sciences Full Text[H.W.W.W.Wilson]和Soc Index中系统搜索英文论文,调查媒体与精神疾病求助之间的联系。发现16项研究符合资格标准。有证据表明,包括视频和在线资源在内的各种形式的媒体可以对寻求心理健康帮助产生积极影响。印刷媒体对求助行为的影响有限,但与其他形式的媒体相比较弱。没有证据表明媒体不鼓励人们寻求帮助。原创性/价值这篇综述发现,鉴于所收录论文的异质性和可用证据的有限性,有必要进行更集中的研究,以确定媒体如何影响心理健康求助行为。
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引用次数: 0
Evaluating referral pathways to a specialist trauma service 评估专科创伤服务的转诊途径
IF 1.2 Q3 Medicine Pub Date : 2023-05-16 DOI: 10.1108/mhrj-08-2022-0055
F. Rocca, T. Schröder, S. Regel
PurposeLengthy and complex routes to specialist care may negatively affect clinical profiles of trauma survivors accessing mental health services. The purpose of this study was to describe the characteristics and referral pathways of a cohort of clients accepted by a specialist trauma service in England; and investigate the associations between referral pathways and clients’ clinical profiles, namely, pre-treatment levels of post-traumatic stress, depression, anxiety, stress and post-traumatic growth.Design/methodology/approachData on 117 consecutive, accepted referrals were extracted from clients’ clinical records. Information on demographics, trauma histories, clinical presentations and referral pathways was synthesised through summary statistics. Correlational analyses were conducted to test associations with pre-treatment scores.FindingsClients accessing the service were highly complex and mostly experienced prolonged, interpersonal trauma. Pathways to the service varied, but 50% of the sample had at least four “steps” in their referral histories and seven previous clinical contacts. The average time between trauma and specialist referral was 16.34 years. The number of referral steps positively, significatively and moderately correlated with anxiety and stress at pre-treatment.Research limitations/implicationsLimitations include issues around collecting past referral information, the small sample size for clients with available pre-treatment data and the lack of post-treatment scores.Originality/valueThis evaluation provides an informative overview of the characteristics and referral pathways of clients accessing a specialist trauma service. It also offers preliminary insights on the relationship between clients’ routes into the service and their clinical profiles. Practice, commissioning and research implications are discussed.
目的漫长而复杂的专科护理路线可能会对创伤幸存者获得精神卫生服务的临床表现产生负面影响。本研究的目的是描述在英国接受创伤专科服务的一组病人的特点和转诊途径;并调查转诊途径与来访者临床特征之间的关系,即治疗前创伤后应激、抑郁、焦虑、压力和创伤后成长水平。设计/方法/方法从患者的临床记录中提取117例连续接受转诊的数据。通过汇总统计综合了人口统计、创伤史、临床表现和转诊途径方面的信息。进行相关分析以检验与治疗前评分的相关性。使用该服务的客户非常复杂,大多数经历了长期的人际创伤。获得服务的途径各不相同,但50%的样本在他们的转诊历史中至少有四个“步骤”和七个以前的临床接触。从创伤到专家转诊的平均时间为16.34年。转诊步骤数与治疗前焦虑、压力呈正相关、显著相关、中度相关。研究局限性/启示局限性包括收集过去转诊信息的问题,治疗前数据可用的客户样本量小以及缺乏治疗后评分。原创性/价值这一评估提供了一个信息的特点概述和转介途径的客户访问一个专门的创伤服务。它还提供了关于客户进入服务的路线和他们的临床档案之间关系的初步见解。讨论了实践、调试和研究意义。
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引用次数: 0
Reducing anxiety and hospital readmission in the early weeks following discharge from inpatient rehabilitation: the new community enhanced rehabilitation team 减少住院康复出院后最初几周的焦虑和再次住院:新的社区强化康复小组
IF 1.2 Q3 Medicine Pub Date : 2023-05-08 DOI: 10.1108/mhrj-09-2022-0059
K. Fenton, Katherine Kidd, A. Lord
PurposeThe purpose of this study is to assess if the new community-enhanced rehabilitation team reduced anxiety and readmissions in service users discharged from an inpatient rehabilitation setting.Design/methodology/approachThe study used both qualitative and quantitative methodology. Service user’s anxiety level was measured before being discharged and at the end of the Community Enhanced Rehabilitation Team (CERT) transition intervention. Six service users were interviewed to gain further understanding of their experiences of anxiety.FindingsFindings showed the anxiety score was significantly lower (M = 1.5, 95% CI [0.051,2.99], t(20) = 2.159, p = 0.043) following the CERT intervention (M = 8.6, SD = 6.4) compared to before (M = 10.1, SD = 7.0). No service user receiving the CERT intervention was readmitted to hospital within 12 weeks of discharge from the inpatient setting, compared to three service users (15% of those discharged) who were discharged to other community services.Research limitations/implicationsCommunity rehabilitation pathways would benefit from having interventions to aid patient transitions from inpatient to the community. The National Health Service (NHS) trusts develop community rehabilitation teams as recommended by the National Institute for Health and Care Excellence (NICE), and they should consider including transitional support as part of their model.Practical implicationsIt is recommended that as NHS trusts design and implement community mental health teams, they should consider including transition support as part of their model.Social implicationsPeople with severe and enduring mental health difficulties who have been in an inpatient rehabilitation setting would benefit from community transitional support. This study suggests that such support helps reduce anxiety and readmission.Originality/valueCommunity rehabilitation teams are currently being developed across the NHS as part of the NHS long-term plan. These teams are new, and as such, there is a dearth of information regarding their effectiveness. To the best of the authors’ knowledge, this is one of the first studies to evaluate outcomes in these new teams.
目的本研究的目的是评估新的社区增强康复团队是否减少了住院康复机构出院的服务使用者的焦虑和再入院。设计/方法/方法这项研究采用了定性和定量两种方法。在出院前和社区加强康复小组(CERT)过渡干预结束时测量服务使用者的焦虑水平。六名服务用户接受了采访,以进一步了解他们的焦虑经历。结果:CERT干预后患者焦虑评分(M = 8.6, SD = 6.4)显著低于干预前(M = 10.1, SD = 7.0) (M = 1.5, 95% CI [0.051,2.99], t(20) = 2.159, p = 0.043)。接受应急响应干预的服务使用者在出院后12周内没有再次入院,相比之下,有3名服务使用者(占出院者的15%)出院到其他社区服务机构。研究局限/意义社区康复途径将受益于干预措施,以帮助患者从住院过渡到社区。国家卫生服务(NHS)信托机构按照国家卫生和护理卓越研究所(NICE)的建议发展社区康复团队,他们应该考虑将过渡性支持作为其模式的一部分。建议NHS信托机构在设计和实施社区精神卫生团队时,应考虑将过渡性支持作为其模式的一部分。社会影响在住院康复环境中患有严重和持久精神健康困难的人将受益于社区过渡支助。这项研究表明,这种支持有助于减少焦虑和再入院。作为国民保健制度长期计划的一部分,目前正在全国建立社区康复小组。这些团队都是新的,因此,缺乏有关其有效性的信息。据作者所知,这是第一批评估这些新团队结果的研究之一。
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引用次数: 0
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Mental Health Review Journal
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