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Köktaş NÇ, Yiğitoğlu GT, Kenar ANİ. The effect of interpersonal relations theory-based motivational interviews on functional remission and insight levels of patients with schizophrenia: A randomized controlled trial. Arch Psychiatr Nurs 2023; 45:72-79. [PMID: 37544705 DOI: 10.1016/j.apnu.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 12/31/2022] [Accepted: 04/30/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Using therapeutic techniques and conducting motivational interviews in communication with patients with schizophrenia increases individuals' functional remission, insight, and motivation levels. AIM This single-blind, randomized controlled study examines the effect of Interpersonal Relations Theory-Based motivational interviews on functional remission and insight levels in patients with schizophrenia. METHODS The participants of this study were 40 patients with schizophrenia randomly assigned to either the experimental or control groups (20 in each group). The researchers carried out a 6-session Interpersonal Relations Theory-based motivational interview with the participants in the experimental group. Study data were collected using a demographic questionnaire, the Functional Remission of General Schizophrenia Scale (FROGS), and the Scale for Assessing the Three Components of Insight (SAI). RESULTS Social Functioning, Health and Treatment, Daily Living Skills, and SAI scores of the individuals in the intervention group were statistically higher than those in the control group (p < 0.05) in the post-intervention and follow-up measures. There was a positive and significant correlation between the post-intervention Social Functioning, Health and Treatment, Daily Life Skills, and total FROGS scores and the SAI score of the individuals in the intervention group (p < 0.05). CONCLUSIONS It was concluded that motivational interviews based on Interpersonal Relations Theory were effective in increasing the insights and functionality of patients with schizophrenia. Psychiatric nurses' practice of motivational interviews based on the therapeutic relationship is considered to increase the quality of care and satisfaction of patients with schizophrenia. It is recommended that this practice be used extensively in clinical practice.
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Affiliation(s)
- Nesrin Çunkuş Köktaş
- Department of Psychiatric Nursing, Faculty of Health Science, Pamukkale University, Denizli, Turkey.
| | - Gülay Taşdemir Yiğitoğlu
- Department of Psychiatric Nursing, Faculty of Health Science, Pamukkale University, Denizli, Turkey
| | - Ayşe Nur İnci Kenar
- Department of Psychiatric, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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van der Schyff EL, Ridout B, Amon KL, Forsyth R, Campbell AJ. Providing Self-Led Mental Health Support Through an Artificial Intelligence-Powered Chat Bot (Leora) to Meet the Demand of Mental Health Care. J Med Internet Res 2023; 25:e46448. [PMID: 37335608 DOI: 10.2196/46448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/21/2023] [Accepted: 05/17/2023] [Indexed: 06/21/2023] Open
Abstract
Digital mental health services are becoming increasingly valuable for addressing the global public health burden of mental ill-health. There is significant demand for scalable and effective web-based mental health services. Artificial intelligence (AI) has the potential to improve mental health through the deployment of chatbots. These chatbots can provide round-the-clock support and triage individuals who are reluctant to access traditional health care due to stigma. The aim of this viewpoint paper is to consider the feasibility of AI-powered platforms to support mental well-being. The Leora model is considered a model with the potential to provide mental health support. Leora is a conversational agent that uses AI to engage in conversations with users about their mental health and provide support for minimal-to-mild symptoms of anxiety and depression. The tool is designed to be accessible, personalized, and discreet, offering strategies for promoting well-being and acting as a web-based self-care coach. Across all AI-powered mental health services, there are several challenges in the ethical development and deployment of AI in mental health treatment, including trust and transparency, bias and health inequity, and the potential for negative consequences. To ensure the effective and ethical use of AI in mental health care, researchers must carefully consider these challenges and engage with key stakeholders to provide high-quality mental health support. Validation of the Leora platform through rigorous user testing will be the next step in ensuring the model is effective.
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Affiliation(s)
- Emma L van der Schyff
- Cyberpsychology Research Group, Biomedical Informatics and Digital Health Theme, School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Brad Ridout
- Cyberpsychology Research Group, Biomedical Informatics and Digital Health Theme, School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Krestina L Amon
- Cyberpsychology Research Group, Biomedical Informatics and Digital Health Theme, School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Rowena Forsyth
- Cyberpsychology Research Group, Biomedical Informatics and Digital Health Theme, School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Andrew J Campbell
- Cyberpsychology Research Group, Biomedical Informatics and Digital Health Theme, School of Medical Sciences, The University of Sydney, Sydney, Australia
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Turikumana PD, Cloete LG, Fredericks JP. Personal barriers to participation in chosen instrumental activities of daily living among community-dwelling persons with schizophrenia in Rwanda. Afr J Disabil 2023. [DOI: 10.4102/ajod.v12i0.1063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
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Shimada T, Inagaki Y, Shimooka Y, Kawano K, Tanaka S, Kobayashi M. Effect of individualized occupational therapy on social functioning in patients with schizophrenia: A five-year follow-up of a randomized controlled trial. J Psychiatr Res 2022; 156:476-484. [PMID: 36347107 DOI: 10.1016/j.jpsychires.2022.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 10/18/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Abstract
This study aimed to evaluate the long-term effects of adding individualized occupational therapy (IOT) to a three-months group occupational therapy (GOT) on social functioning in inpatients with schizophrenia or schizoaffective disorder at a follow-up investigation five-years after discharge. Initially, patients were randomly assigned to GOT + IOT or GOT alone, with 102 patients, 48 in GOT + IOT and 54 in GOT alone, completing the five years follow-up. The primary outcome was change in social functioning assessed by the Social Functioning Scale (SFS) from baseline to five-year follow-up. Other outcomes included Brief Assessment of Cognition in Schizophrenia (BACS), Schizophrenia Cognition Rating Scale (SCoRS), Intrinsic Motivation Inventory (IMI), Global Assessment of Functioning (GAF), Positive and Negative Syndrome Scale (PANSS), and Client Satisfaction Questionnaire-8 (CSQ-8). There were significant improvements for the GOT + IOT group over GOT in the SFS total score, which could be explained by improvements in withdrawal/social engagement, interpersonal communication, pro-social activities, recreation, and independence-competence. Multiple regression analysis showed that the period from hospitalization to commencing occupational therapy, type of occupational therapy, BACS motor speed, BACS executive function, and IMI interest/enjoyment were significantly associated with SFS total score. Our findings suggest that adding IOT to GOT may improve the long-term outcome on social functioning in schizophrenic patients. However, the long time period between intervention and follow-up and the unavailability of treatment information during the follow-up period has to be mentioned as a limiting factor of this study.
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Affiliation(s)
- Takeshi Shimada
- Medical Corporation Seitaikai Mental Support Soyokaze Hospital, Nagano, Japan.
| | - Yusuke Inagaki
- Nagano Prefectural Mental Wellness Center Komagane, Nagano, Japan
| | - Yuko Shimooka
- Social Medical Corporation Ritsuzankai Iida Hospital, Nagano, Japan
| | - Kojiro Kawano
- Medical Corporation Yuaikai Tikumaso Mental Hospital, Nagano, Japan
| | - Sachie Tanaka
- Department of Health Sciences, Graduate School of Medicine, Shinshu University, Nagano, Japan
| | - Masayoshi Kobayashi
- Department of Health Sciences, Graduate School of Medicine, Shinshu University, Nagano, Japan
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Wang X, Kou X, Meng X, Yu J. Effects of a virtual reality serious game training program on the cognitive function of people diagnosed with schizophrenia: A randomized controlled trial. Front Psychiatry 2022; 13:952828. [PMID: 35911215 PMCID: PMC9334918 DOI: 10.3389/fpsyt.2022.952828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cognitive impairment persists through the course of schizophrenia and affects patients' activities of daily living. AIM This study aims to investigate the effects of a virtual reality (VR) serious game training program on the cognitive function of people diagnosed with schizophrenia. MATERIALS AND METHODS Sixty-four eligible people diagnosed with schizophrenia were recruited and randomly assigned to the intervention group (n = 31) and the control group (n = 33). The control group received standard psychiatric care. The intervention group was trained with an additional VR game twice a day for at least 10 days during hospitalization. Cognitive function was measured at enrollment and before discharge using the Brief Cognitive Assessment Tool for Schizophrenia. RESULTS Compared with those of the control group, the results of the working memory (t = 3.463, Cohen's d = 0.87, p = 0.001) and executive function (TMTA: Z = -2.272, Cohen's d = 0.59, p = 0.023; TMTB:Z = -2.365, Cohen's d = 0.62, p = 0.018) of the intervention group after intervention were significantly better. However, there was no significant difference in the results of social cognition (Z = -1.394, Cohen's d = 0.35, p = 0.163) between the two groups. CONCLUSION Intensive active virtual reality serious game training in addition to standard psychiatric care can significantly improve working memory and executive function in people diagnosed with schizophrenia. IMPLICATIONS FOR PRACTICE When helping improve the cognitive function of people diagnosed with schizophrenia, mental health professionals should identify cognitive domains to be enhanced and develop corresponding serious game training strategies.
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Affiliation(s)
- Xu Wang
- West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaomin Kou
- West China Hospital, Sichuan University, Chengdu, China
| | - Xiandong Meng
- West China Hospital, Sichuan University, Chengdu, China
| | - Jianying Yu
- West China Hospital, Sichuan University, Chengdu, China
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Nuño L, Guilera G, Rojo E, Gómez-Benito J, Barrios M. An Integrated Account of Expert Perspectives on Functioning in Schizophrenia. J Clin Med 2021; 10:jcm10184223. [PMID: 34575332 PMCID: PMC8465628 DOI: 10.3390/jcm10184223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 09/09/2021] [Indexed: 11/28/2022] Open
Abstract
An integrated and interdisciplinary care system for individuals with schizophrenia is essential, which implies the need for a tool that assesses the difficulties and contextual factors of relevance to their functioning, and facilitates coordinated working across the different professions involved in their care. The International Classification of Functioning, Disability and Health Core Sets (ICF-CS) cover these requirements. This study aimed to evaluate the content validity of the ICF-CSs for schizophrenia from the perspective of experts. Six three-round Delphi studies were conducted with expert panels from different professional backgrounds which have played a significant role in the treatment of individuals with schizophrenia (psychiatry, psychology, nursing, occupational therapy, social work and physiotherapy). In total, 790 experts from 85 different countries participated in the first round. In total, 90 ICF categories and 28 Personal factors reached expert consensus (reached consensus from four or more professional perspectives). All the categories in the brief version of the ICF-CS for schizophrenia reached consensus from all the professional perspectives considered. As for the comprehensive version, 89.7% of its categories reached expert consensus. The results support the worldwide content validity of the ICF-CSs for schizophrenia from an expert perspective and underline the importance of assessing functioning by considering all the components implied.
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Affiliation(s)
- Laura Nuño
- Clinical Institute of Neuroscience (ICN), Hospital Clinic, 08036 Barcelona, Spain
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08007 Barcelona, Spain; (G.G.); (J.G.-B.); (M.B.)
- Correspondence:
| | - Georgina Guilera
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08007 Barcelona, Spain; (G.G.); (J.G.-B.); (M.B.)
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, 08007 Barcelona, Spain
| | - Emilio Rojo
- Hospital Benito Menni CASM, Sisters Hospitallers, 08830 Sant Boi de Llobregat, Spain;
- Department of Psychiatry, International University of Catalonia, 08007 Barcelona, Spain
| | - Juana Gómez-Benito
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08007 Barcelona, Spain; (G.G.); (J.G.-B.); (M.B.)
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, 08007 Barcelona, Spain
| | - Maite Barrios
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08007 Barcelona, Spain; (G.G.); (J.G.-B.); (M.B.)
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, 08007 Barcelona, Spain
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Ercan Doğu S, Kayıhan H, Kokurcan A, Örsel S. The effectiveness of a combination of Occupational Therapy and Social Skills Training in people with schizophrenia: A rater-blinded randomized controlled trial. Br J Occup Ther 2021. [DOI: 10.1177/03080226211022953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction This study aimed to assess the impact of a holistic combination of Occupational Therapy and Social Skills Training on occupational performance, social participation, and clinical symptoms in people with schizophrenia. Method 60 people with schizophrenia were randomly assigned to two groups. One group received standardized Social Skills Training once a week for a total of 10 sessions, while the other group received a combination of Occupational Therapy and Social Skills Training once a week for a total of 16 sessions. Results A greater increase was determined in the scores of COPM total performance/satisfaction and the Community Integration Questionnaire in the Occupational Therapy and Social Skills Training group. Furthermore, these achievements were sustained in the Occupational Therapy and Social Skills Training group compared to the Social Skills Training group at the 6-month follow-up. Conclusion The clients received the combination of Occupational Therapy and Social Skills Training showed a better improvement compared to the Social Skills Training group in terms of occupational performance, social participation, and severity of clinical symptoms. The use of Occupational Therapy in a holistic approach in psychosocial rehabilitation of people with schizophrenia can increase their functionality and social participation. Further studies are needed to assess long-term effects of Occupational Therapy in schizophrenia.
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Affiliation(s)
- Selma Ercan Doğu
- Psychiatry Department, Health Sciences University Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Hülya Kayıhan
- Faculty of Health Sciences, Occupational Therapy Department, Biruni University, İstanbul, Turkey
| | - Ahmet Kokurcan
- Psychiatry Department, Health Sciences University Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Sibel Örsel
- Psychiatry Department, Health Sciences University Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Nuño L, Guilera G, Bell M, Rojo E, Gómez-Benito J, Calderón C, Barrios M. Occupational Therapists’ Perspective on the International Classification of Functioning, Disability and Health Core Sets (ICF–CS) for Schizophrenia. Am J Occup Ther 2021; 75:7502205060p1-7502205060p10. [PMID: 33657348 DOI: 10.5014/ajot.2021.041509] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Importance: The International Classification of Functioning, Disability and Health (ICF) Core Sets (CSs) for schizophrenia are sets of ICF categories that are relevant specifically to the functioning and disability of people with schizophrenia.
Objective: To identify the problems occupational therapists commonly encounter when treating people with schizophrenia and to validate the ICF–CSs for schizophrenia from their perspective.
Design: Three-round Delphi study using online surveys distributed to occupational therapists worldwide. Participants were asked which problems with functioning they considered most relevant when treating people with schizophrenia.
Participants: Occupational therapists experienced in the treatment of people with schizophrenia.
Measures: Responses were linked to the ICF categories by two trained health professionals, and a statistical measure of agreement and κ coefficient were calculated.
Results: Ninety-two occupational therapists from 29 countries in all six World Health Organization regions named 2,527 meaningful concepts. After the linking process, 121 ICF categories and 31 Personal Factors were presented to the expert panel, who reached consensus (agreement of ≥75%) on 97 ICF categories and 27 Personal Factors. Consensus was reached on the 25 categories in the Brief ICF–CS for schizophrenia and 89 of the 97 categories in the Comprehensive ICF–CS for schizophrenia.
Conclusions and Relevance: The ICF Core Sets for schizophrenia were validated from the perspective of occupational therapists and are potentially useful tools for clinical practice because they cover a wide variety of problems that occupational therapists deal with in interventions with people with schizophrenia.
What This Article Adds: The ICF–CSs for schizophrenia are useful guides for describing and classifying functioning, disability, and health to aid occupational therapy intervention with people with schizophrenia. Occupational therapists are essential in the rehabilitation of this client population, and their perspective has contributed to the development and enrichment of the ICF–CSs for schizophrenia.
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Affiliation(s)
- Laura Nuño
- Laura Nuño, PhD, is Clinical Psychologist, Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain;
| | - Georgina Guilera
- Georgina Guilera, PhD, is Professor, Institute of Neurosciences and Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Morris Bell
- Morris Bell, PhD, is Professor, Connecticut Mental Health Center, Yale School of Medicine, New Haven, CT
| | - Emilio Rojo
- Emilio Rojo, MD, is Medical Director, Hospital Benito Menni Complex Assistencial en Salut Mental, Sisters Hospitallers, Sant Boi de Llobregat, Spain, and Professor, Department of Psychiatry, International University of Catalonia, Barcelona, Spain
| | - Juana Gómez-Benito
- Juana Gómez-Benito, PhD, is Professor, Institute of Neurosciences and Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Caterina Calderón
- Caterina Calderón, PhD, is Associate Professor, Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Maite Barrios
- Maite Barrios, PhD, is Associate Professor, Institute of Neurosciences and Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
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Lestari R, Yusuf A, Hargono R, Setyawan FEB, Hidayah R, Ahsan A. Adapting to People With Schizophrenia: A Phenomenological Study on a Rural Society in Indonesia. Indian J Psychol Med 2021; 43:31-37. [PMID: 34349304 PMCID: PMC8295571 DOI: 10.1177/0253717620926847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The growing prevalence of schizophrenia in Indonesia requires the consideration of the families, caregivers, health care professionals, and the entire society, to serve as a support and coping resource for the patients. The process of recovery is rather difficult, especially in the absence of a decent place to live. Hence, there is the need to provide a supportive environment that facilitates recuperation from psychotic symptoms, enhances interaction with others, promotes self-expression of thoughts and feelings, and helps deal with daily stress and challenges. There are currently no studies on the framework of societal adaptation for people with schizophrenia (PWS). The aim of this research, therefore, was to explore the experiences of rural society inhabitants in adapting to PWS in Indonesia. METHODS The study uses a qualitative research design and implements an interpretive phenomenological approach. A total of ten society members were recruited from the community by purposive sampling, and the in-depth interviews conducted were audio-recorded and transcribed. In addition, thematic analysis was carried out using the interpretive phenomenological analysis method. RESULTS The majority of the participants assumed that PWS prompt the feeling of alertness over fear. In addition, the participants revealed a feeling of indecisiveness in related situations and emphasized the value of keeping up traditional beliefs and practices and the effectiveness of a demonstration of indifference. They explained the need to combine traditional and modern health practices as recommended by the spiritual leaders. CONCLUSION Societal adaptation to PWS entails the understanding of how to deal with the disease's uncertainty and complexity. It is important to create a supportive environment to promote mental health and wellbeing.
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Affiliation(s)
- Retno Lestari
- Doctoral Program of Public Health, Faculty of Public Health, Universitas Airlangga, Mulyorejo, Surabaya, Indonesia
- Study Program of Nursing Science, Faculty of Medicine, University of Brawijaya, Malang, Indonesia
- Retno Lestari, Faculty of Public Health, Universitas Airlangga, Jl. Mulyorejo, Surabaya, Jawa Timur 60115, Indonesia. E-mail:
| | - Ah Yusuf
- Faculty of Nursing, Universitas Airlangga, Mulyorejo, Surabaya, Indonesia
| | - Rachmat Hargono
- Doctoral Program of Public Health, Faculty of Public Health, Universitas Airlangga, Mulyorejo, Surabaya, Indonesia
| | | | - Ridhoyanti Hidayah
- Study Program of Nursing Science, Faculty of Medicine, University of Brawijaya, Malang, Indonesia
| | - Ahsan Ahsan
- Study Program of Nursing Science, Faculty of Medicine, University of Brawijaya, Malang, Indonesia
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Khadijah S, Darni D, Sulaihah S. Analysis of Occupational Therapy In Schizophrenic Patients. JURNAL NERS 2020. [DOI: 10.20473/jn.v14i3.17178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Nursing care in the rehabilitation phase is one which provides occupational therapy, which is one form of combination therapy between art and science to direct patients to selective activities, so that health can be improved and maintained, and prevent disability through work activities and training This study is to show evidence of the effectiveness of occupational therapy interventions: job training in schizophrenic patients at the Mental Hospital.Methods: The method used in this systematic review consists of 5 stages: identification of instruments in the literature (database search); identification of relevant literature based on title and abstract; inclusion and exclusion criteria; obtaining full text literature; assessment based on literature component and analysis of selected instruments. The database used in the literature search was Scopus, Proquest, Science Direct, Japan Journal, Cochrane by limiting the keywords "Occupational Therapy" and "Schizophrenia", which were published in the years between 2012-2018.Results: Fifteen studies were included in the analysis, only 10 journals met the criteria to be included in the quantitative design.Conclusion: From the results of this study it was found that occupational therapy was significant in improving cognitive, social, work, welfare, and contributing to the quality of life of patients.
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Petersen KS, Bjørkedal STB, Torsting AM, Eplov LF. Occupational therapy interventions in mental health: a scoping review of recent evidence. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2019. [DOI: 10.12968/ijtr.2016.0070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/AimsStudies investigating the effect of occupational therapy in mental health are few. This scoping review aims to identify, present and assess studies that have investigated the effect of occupation- and activity-based/focused interventions performed by occupational therapists in mental health.MethodsThe scoping review involved searching six databases, covering articles from 2003 to 2018. ‘The Matrix Method’ was used to describe and synthesise the content of the included studies. The Oxford Level of Evidence was used to rank the evidence, and The Critical Appraisal Skills Programme was used to assess the quality of the study.ResultsA total of 21 original studies and 4 systematic reviews were included in this review. Interventions, approaches, programmes, training, and activities such as cooking, artwork, crafts, pottery, sports, calligraphy, horticulture, and music, organised individually or in groups, were investigated in the included studies. Individualised occupational therapy showed clinically significant improvements in social functioning and cognition, promising results were found on supported employment and education.ConclusionsFew high-quality studies that have investigated the effect of occupation-and activity-based/focused interventions performed by occupational therapists in mental health were found. This scoping review highlights the importance of future high quality studies to support evidence-based practice within mental health occupational therapy.
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Affiliation(s)
- Kirsten Schultz Petersen
- Associate Professor, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Siv Therese Bogevik Bjørkedal
- Assistant Researcher, Program for Research in Rehabilitation, Recovery and Shared Care, Mental Health Center Copenhagen, Hellerup, Denmark
| | - Anne Marie Torsting
- Head of Occupational Therapy, Mental Health Center Sct. Hans, Roskilde, Denmark
| | - Lene Falgaard Eplov
- Senior Consultant, Program for Research in Rehabilitation, Recovery and Shared Care, Mental Health Center Copenhagen, Hellerup, Denmark
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Shimada T, Ohori M, Inagaki Y, Shimooka Y, Ishihara I, Sugimura N, Tanaka S, Kobayashi M. Effect of adding individualized occupational therapy to standard care on rehospitalization of patients with schizophrenia: A 2-year prospective cohort study. Psychiatry Clin Neurosci 2019; 73:476-485. [PMID: 31077519 DOI: 10.1111/pcn.12858] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 04/25/2019] [Accepted: 04/30/2019] [Indexed: 12/11/2022]
Abstract
AIM We examined the effect of individualized occupational therapy (IOT) compared to the usual group occupational therapy (GOT) on the rehospitalization of patients with schizophrenia. METHODS A prospective cohort study included patients with schizophrenia who were discharged within 1 year from a psychiatric hospital. Time to rehospitalization by treatment group (GOT + IOT or GOT-alone) was evaluated with Kaplan-Meier survival analysis. The impact of demographics and clinical factors associated with rehospitalization was investigated using Cox proportional hazards models. RESULTS Of the 111 patients who met the criteria, 54 were in the GOT + IOT group and 57 in the GOT-alone group. Over the 2 years from discharge, the overall rehospitalization rate was 51.376% (56 patients); the GOT + IOT group demonstrated a significantly lower rehospitalization rate with 16 patients rehospitalized compared to 40 patients from the GOT-alone group. Time to rehospitalization was significantly longer for the GOT + IOT group compared to those in the GOT-alone group (P < 0.001). The multivariate Cox proportional hazards models showed that type of occupational therapy (hazard ratio [HR] = 0.543), medication adherence (HR = 0.343), access to resident support persons (HR = 0.450), and executive function at discharge (HR = 0.740) were all significantly associated with rehospitalization. CONCLUSION Our results provide support for the prolonging effects of IOT in relation to rehospitalization and the reduction of rehospitalization risk compared to patients with schizophrenia who receive GOT alone, in addition to supporting good cognition at discharge and favorable medication adherence.
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Affiliation(s)
- Takeshi Shimada
- Department of Health Sciences, Graduate School of Medicine, Shinshu University, Nagano, Japan.,Medical Corporation Seitaikai Mental Support Soyokaze Hospital, Nagano, Japan
| | - Manami Ohori
- North Alps Medical Center Azumi Hospital, Nagano, Japan
| | - Yusuke Inagaki
- Nagano Prefectural Mental Wellness Center Komagane, Nagano, Japan
| | - Yuko Shimooka
- Social Medical Corporation Ritsuzankai Iida Hospital, Nagano, Japan
| | - Ikuyo Ishihara
- Medical Corporation Aiseikai Matsuoka Hospital, Nagano, Japan
| | - Naoya Sugimura
- Medical Corporation Akitsukai Nanshin Hospital, Nagano, Japan
| | - Sachie Tanaka
- Department of Health Sciences, Graduate School of Medicine, Shinshu University, Nagano, Japan
| | - Masayoshi Kobayashi
- Department of Health Sciences, Graduate School of Medicine, Shinshu University, Nagano, Japan
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Toledano-González A, Labajos-Manzanares T, Romero-Ayuso D. Well-Being, Self-Efficacy and Independence in older adults: A Randomized Trial of Occupational Therapy. Arch Gerontol Geriatr 2019; 83:277-284. [PMID: 31132547 DOI: 10.1016/j.archger.2019.05.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/30/2019] [Accepted: 05/07/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The main objective of the research was to analyze whether there were differences in the effects of individual and group occupational therapy (OT) treatment on psychological well-being, self-efficacy and personal independence. METHOD A randomized clinical trial (N = 70; age = 85 years, SD = 4) comparing individual versus group occupational therapy treatment for 6 months was conducted. The evaluation was performed with the Barthel Index (Personal Independence), the Ryff Wellness Index (Well-being), the Global Self-Efficacy Scale (Self-efficacy) and the Geriatric Depression Scale (Affective state Scale). RESULTS Results showed a decrease in individual treatment scores in the variables autonomy, environmental mastery, personal growth and purpose in life, reflecting worse self-acceptance and negative well-being as well as a lower ability to maintain stable relationships. By contrast, group treatment users maintained more stable social relationships and exhibited a greater ability to resist social pressure, to develop their potential skills and to define their goals in life. There were statistically significant differences in overall self-efficacy (p < 0.001), emotional well-being (p < 0.001) and personal independence (p = 0.013), with better scores in group versus individual treatment. CONCLUSIONS Group occupational therapy interventions in older adults could be the treatment of choice in people with depressed state, improving their emotional well-being, sense of self-efficacy and level of personal independence in basic activities of daily living.
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Affiliation(s)
- Abel Toledano-González
- University of Castilla-La Mancha, Psychology Department, Health Science Faculty, Avda. Real Fábrica de la Seda, s/n, 45600, Talavera de la Reina, Toledo, Spain.
| | - Teresa Labajos-Manzanares
- University of Málaga, Physical Therapy Department, Health Science Faculty, Avda. Arquitecto Francisco Peñalosa, 3, 29071, Málaga, Spain
| | - Dulce Romero-Ayuso
- University of Granada, Physical Therapy Department, Health Science Faculty, Avda. De la Ilustración, 60, 18016, Granada, Spain
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Toledano-González A, Labajos-Manzanares T, Romero-Ayuso DM. Occupational Therapy, Self-Efficacy, Well-Being in Older Adults Living in Residential Care Facilities: A Randomized Clinical Trial. Front Psychol 2018; 9:1414. [PMID: 30131748 PMCID: PMC6090526 DOI: 10.3389/fpsyg.2018.01414] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/19/2018] [Indexed: 12/05/2022] Open
Abstract
Introduction: Choosing the type of treatment approach is as important as the treatment itself, also giving and important value to internal variables in the individual that can determine the evolution of the intervention. The main aim of this study is to determine whether individual and/or group occupational therapy leads to changes in generalized self-efficacy and psychological well-being, and to identify the type of therapy that has the best effects on older adults. Method: Prospective, randomized, comparing two treatment groups: individual and group therapy during 6 months. A total sample of 70 patients institutionalized in residential care homes for older adults with a mean age of 85 (SD = 4). Assessment was conducted using the General Self-Efficacy Scale and Ryff's Well-being Scale. For analyze the main dependent variables we used ANOVA for intra-subject and inter-subject factors and Pearson correlation between well-being and self-efficacy by type of treatment. Results: Groups were equivalent at baseline. The results show statistically significant differences between the two types of therapy, showing a positive correlation between well-being and self-efficacy, being greater at a group level than at and individual level. At the group level, practically all of variables measured in the participants were increased as shown in the results tables, including a better adaptation and predisposition to work four participants died while the study was being conducted. Conclusion: The clinical trial shows that older people in residential centers achieve an increase in emotional well-being and self-efficacy when they receive occupational therapy group, rather than individual treatment not being significant changes. Treatment group participants reported a positive experience and clinical benefits from training program. The clinical trial was registered in the U.S. National Institutes of Health (ClinicalTrials.gov) with NCT02906306 identifier.
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Affiliation(s)
- Abel Toledano-González
- Department of Psychology, Faculty of Occupational Therapy, Speech Therapy and Nursing, University of Castilla-La Mancha, Talavera de la Reina, Spain
| | | | - Dulce María Romero-Ayuso
- Division of Occupational Therapy, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
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Shimada T, Ohori M, Inagaki Y, Shimooka Y, Sugimura N, Ishihara I, Yoshida T, Kobayashi M. A multicenter, randomized controlled trial of individualized occupational therapy for patients with schizophrenia in Japan. PLoS One 2018; 13:e0193869. [PMID: 29621261 PMCID: PMC5886394 DOI: 10.1371/journal.pone.0193869] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 02/16/2018] [Indexed: 11/18/2022] Open
Abstract
The individualized occupational therapy (IOT) program is a psychosocial program that we developed to facilitate proactive participation in treatment and improve cognitive functioning and other outcomes for inpatients with acute schizophrenia. The program consists of motivational interviewing, self-monitoring, individualized visits, handicraft activities, individualized psychoeducation, and discharge planning. This multicenter, open-labeled, blinded-endpoint, randomized controlled trial evaluated the impact of adding IOT to a group OT (GOT) program as usual for outcomes in recently hospitalized patients with schizophrenia in Japanese psychiatric hospitals setting compared with GOT alone. Patients with schizophrenia were randomly assigned to the GOT+IOT group or the GOT alone group. Among 136 randomized patients, 129 were included in the intent-to-treat population: 66 in the GOT+IOT and 63 in the GOT alone groups. Outcomes were administered at baseline and discharge or 3 months following hospitalization including the Brief Assessment of Cognition in Schizophrenia Japanese version (BACS-J), the Schizophrenia Cognition Rating Scale Japanese version, the Social Functioning Scale Japanese version, the Global Assessment of Functioning scale, the Intrinsic Motivation Inventory Japanese version (IMI-J), the Morisky Medication Adherence Scale-8 (MMAS-8), the Positive and Negative Syndrome Scale (PANSS), and the Japanese version of Client Satisfaction Questionnaire-8 (CSQ-8J). Results of linear mixed effects models indicated that the IOT+GOT showed significant improvements in verbal memory (p <0.01), working memory (p = 0.02), verbal fluency (p < 0.01), attention (p < 0.01), and composite score (p < 0.01) on the BACS-J; interest/enjoyment (p < 0.01), value/usefulness (p < 0.01), perceived choice (p < 0.01), and IMI-J total (p < 0.01) on the IMI-J; MMAS-8 score (p < 0.01) compared with the GOT alone. Patients in the GOT+IOT demonstrated significant improvements on the CSQ-8J compared with the GOT alone (p < 0.01). The present findings provide support for the feasibility in implementing an IOT program and its effectiveness for improving cognitive impairment and other outcomes in patients with schizophrenia.
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Affiliation(s)
- Takeshi Shimada
- Department of Occupational Therapy, Medical Corporation Seitaikai, Mental Support Soyokaze Hospital, Nagano, Japan
- Department of Health Sciences, Graduate School of Medicine, Shinshu University, Nagano, Japan
| | - Manami Ohori
- Department of Occupational Therapy, North Alps Medical Center, Azumi Hospital, Nagano, Japan
| | - Yusuke Inagaki
- Department of Occupational Therapy, Nagano Prefectural Mental Wellness Center Komagane, Nagano, Japan
| | - Yuko Shimooka
- Department of Occupational Therapy, Social Medical Corporation Ritsuzankai, Iida Hospital, Nagano, Japan
| | - Naoya Sugimura
- Department of Occupational Therapy, Medical Corporation Akitsukai, Nanshin Hospital, Nagano, Japan
| | - Ikuyo Ishihara
- Department of Occupational Therapy, Medical Corporation Aiseikai, Matsuoka Hospital, Nagano, Japan
| | - Tomotaka Yoshida
- Department of Occupational Therapy, Medical Corporation Seitaikai, Mental Support Soyokaze Hospital, Nagano, Japan
| | - Masayoshi Kobayashi
- Department of Health Sciences, Graduate School of Medicine, Shinshu University, Nagano, Japan
- * E-mail:
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Gutman SA, Brown T. A Bibliometric Analysis of the Quantitative Mental Health Literature in Occupational Therapy. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/0164212x.2017.1413479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sharon A. Gutman
- Professor, Rehabilitation and Regenerative Medicine, Columbia University Medical Center, Programs in Occupational Therapy, New York, NY
| | - Ted Brown
- Associate Professor, Faculty of Medicine, Nursing, and Health Sciences, Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University – Peninsula Campus, Frankston, VIC, Australia
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