South African Journal of Psychiatry最新文献

Background: The high prevalence of HIV among psychiatric inpatients is well-documented, yet little is known about the provision of HIV services for these patients.

Aim: This qualitative study aimed to explore and understand healthcare providers' challenges with providing HIV services to psychiatric inpatients.

Setting: This study was conducted at the national psychiatric referral hospital in Botswana.

Methods: The authors conducted in-depth interviews with 25 healthcare providers serving HIV-positive psychiatric inpatients. Data analysis was performed using a thematic analysis approach.

Results: Healthcare providers reported challenges with transporting patients to access off-site HIV services, longer waiting periods for antiretroviral therapy (ART) initiation, patient confidentiality, fragmented services for treatment of comorbidities, and a lack of patient data integration between the national psychiatric referral hospital and other facilities such as the Infectious Diseases Care Clinic (IDCC) at the nearby district hospital. Providers' recommendations for addressing these challenges included the establishment of an IDCC at the national psychiatric referral hospital, connecting the psychiatric facility to the patient data management system to ensure integration of patient data, and provision of HIV-related in-service training to nurses.

Conclusion: Psychiatric healthcare providers advocated for on-site integration of care for psychiatric illness and HIV among inpatients to address the challenges of ART provision.

Contribution: The findings suggest the need to improve the provision of HIV services in the psychiatric hospitals in order to ensure better outcomes for this often-overlooked population. These findings are useful in improving clinical practice for HIV in psychiatric settings.

Background: Adolescents with attention-deficit/hyperactivity disorder (ADHD) experience aspects of their lives in diverse ways. They often have more energy and creativity which are positive traits of ADHD, while their inability to control their actions in academic or social spheres may cause feelings of inadequacy.

Aim: To explore illness-perception, including emotional experiences, in adolescent ADHD.

Setting: Using convenience sampling, 12 adolescent participants, eight boys and four girls, diagnosed with ADHD, were included. Participants followed up at Weskoppies Tertiary Psychiatric Hospital's child-and-adolescent outpatient clinic.

Methods: This qualitative study used semi-structured question guides to conduct interviews that allowed participants to actively construct their knowledge of their disorder. Maintaining a phenomenological perspective, thematical analysis of data was done.

Results: Adolescents' perceptions of their ADHD could be placed into three categories. 'Negative self-perception in ADHD' represented adolescents' descriptions of 'inability' and 'lack of control' over their cognitive processes, behaviour, emotions, and restlessness. Adolescents perceived 'feeling judged by others', amplified self-stigmatisation and discrimination. This antagonistic environment caused conflict between their self-perception and others' perception of them, further intensifying feelings of 'not being normal'. The theme 'self-empowerment strategies', included controlling external stimuli, accepting support from others, and personalised learning strategies.

Conclusion: Adolescents with ADHD struggle with cognitive, behavioural, and emotional control, and frequently experience stigmatisation and discrimination. They often learn to rely on self-taught coping strategies.

Contribution: This research grants perspective to educators and clinicians on experiences of adolescents with ADHD, and identifies the need to address stigmatisation. It recognises the value of personalisation of coping methods.

Background: Hospital readmissions increase healthcare system costs and can place additional strain on already sparse government funds and under-resourced hospitals. Few studies have investigated readmission of patients in mental health facilities in South Africa.

Aim: The study aimed to identify the factors associated with readmission of patients discharged from an acute psychiatric public hospital in South Africa.

Setting: The study was conducted at an acute psychiatric public hospital.

Method: A retrospective review of medical records was conducted for all patients admitted and readmitted between January 2018 and December 2019.

Results: From the pool of patient records analysed (n = 516), 93 (18.02%) were readmitted, of which the majority (75.27%) were male. The average age of patients readmitted was 27.24 ± 11.16 years, which was significantly younger than the total sample (p < 0.05; CI 1.095-7.105). Findings indicated that patients who completed lower levels of education, were unemployed and were diagnosed with substance (mono- or polysubstance) use disorder (n = 93; 100%), schizophrenia (n = 33; 35.48%), bipolar disorder (n = 9; 9.68%) or intellectual disability (n = 9; 9.68%) were more frequently readmitted, with the average length of stay varying widely between patients.

Conclusion: Younger patients and those living with more complex psychiatric conditions, particularly those who are substance abusers, were readmitted more frequently, indicating that these patients may require special consideration for management.

Contribution: The study revealed that patients living with complex psychiatric conditions such as schizophrenia and bipolar disorder were readmitted to hospital more frequently, indicating that management of these patients at the community level is challenging.