Australasian Psychiatry最新文献

Objectives: This review examines the literature to determine whether physical design features of psychiatric facilities can help reduce aggressive behaviours in an adult patient population.

Methods: Using PRISMA's methodology, we conducted a narrative review of peer-reviewed primary studies on the physical design features and aggressive behaviours in psychiatric facilities. The Joanna Briggs Institute's (JBI) critical appraisal tool was used to assess the quality of included studies.

Results: A total of eight studies were identified. The findings revealed underlying themes in physical design efforts to reduce the incidences of aggressive behaviours, which included changes in structural design (e.g. single rooms; visiting/living/recreational areas; views of outdoors/nature; and uncrowded spaces) and changes in interior design (e.g. art and home-like/comforting environment). There were varying measures of patient aggression.

Conclusions: There was mixed evidence that superficial or structural design changes to psychiatric wards reduced patient aggression. Some studies found reduced aggression; others found no changes, while one study found increased aggression following the implementation of physical design changes. The methodological limitations of the available studies made it difficult to draw causative links and further research on the topic is needed.

Objective: Women face considerable barriers in pursuing careers in academic psychiatry.

Methods: A group of Australian and New Zealand academic women psychiatrists convened in September 2022 to identify and propose solutions to increase opportunities for women in academic psychiatry.

Results: Limiting factors were identified in pathways to academia including financial support, engagement and coordination between academia and clinical services, and flexible working conditions. Gender biases and the risk of burnout were additional and fundamental barriers. Potential solutions include offering advanced training certificates to enable trainees to commence a PhD and Fellowship contemporaneously; improved financial support; expanding opportunities for research involvement; establishing mentoring opportunities and communities of practice; and strategies to enhance safety at work and redress gender bias and imbalance in academia.

Conclusions: Support for women in research careers will decrease gender disparity in academic psychiatry and may decrease problematic gender bias in research. Fellows and trainees, the RANZCP, universities, research institutes, governments, industry and health services should collaborate to develop and implement policies supporting changes in working conditions and training. Facilitating the entry and retention of women to careers in academic psychiatry requires mentoring and development of a community of practice to provide and enable support, role modelling, and inspiration.

Background: Government mandated quarantine outside the home was implemented to mitigate COVID-19 in some countries. Individual studies report that this can result in psychological distress. Investigating levels of distress and associated risk factors across different settings would inform public health models of care during future pandemics. However, no previous systematic reviews have been conducted on the topic. Therefore, we systematically reviewed international research on the prevalence and risk factors of psychological distress within supervised quarantine facilities during the COVID-19 pandemic.

Methods: A systematic review of the literature was conducted using Medline, Psychological and Behavioural Sciences, Psych Info, Cochrane databases and Google Scholar from January 2020 until June 2023. Relevant quantitative studies published in English were included.

Results: 13 studies (pooled participants n = 4366) were included in this review. The prevalence of psychological distress varied widely across the included studies (depression 4%-63%; anxiety 4%-100%; stress 1%-68%). Associated risk factors identified were also heterogeneous between studies and facilities.

Conclusion: In future pandemics, the benefits of infection mitigation need to be weighed against the risk of psychological distress. Models of care utilising specifically designed facilities, with greater freedoms, increased comfort and ease of access to mental health services may limit psychological distress.

Objectives: This 'Realist Review' aimed to investigate the factors associated with length of stay and outcomes of medium secure care to help inform the development of a local secure care pathway.

Method: The searches generated a total of 1570 entries across multiple search engines. Following removal of duplicates, application of inclusion/exclusion criteria and selection of articles, a total of 18 were reviewed in detail, including a further five articles obtained from references and the explored grey literature.

Results: Several issues influenced not only admission to medium secure units, but also the outcomes. Many articles were retrospective studies relying on administrative data. The realist synthesis provides contextual data to inform program development.

Conclusions: The existing literature, though variable in quality, was limited by the varied jurisdictions and contexts. However it may be useful to inform care pathways for the optimal use of medium secure beds.