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Melvin CL, Barnoux M, Alexander R, Roy A, Devapriam J, Blair R, Tromans S, Shepstone L, Langdon PE. A systematic review of in-patient psychiatric care for people with intellectual disabilities and/or autism: effectiveness, patient safety and experience. BJPsych Open 2022; 8:e187. [PMID: 36268640 PMCID: PMC9634562 DOI: 10.1192/bjo.2022.571] [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] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND An increasing number of children, adolescents and adults with intellectual disabilities and/or autism are being admitted to general psychiatric wards and cared for by general psychiatrists. AIMS The aim of this systematic review was to consider the likely effectiveness of in-patient treatment for this population, and compare and contrast differing models of in-patient care. METHOD A systematic search was completed to identify papers where authors had reported data about the effectiveness of in-patient admissions with reference to one of three domains: treatment effect (e.g. length of stay, clinical outcome, readmission), patient safety (e.g. restrictive practices) and patient experience (e.g. patient or family satisfaction). Where possible, outcomes associated with admission were considered further within the context of differing models of in-patient care (e.g. specialist in-patient services versus general mental health in-patient services). RESULTS A total of 106 studies were included and there was evidence that improvements in mental health, social functioning, behaviour and forensic risk were associated with in-patient admission. There were two main models of in-patient psychiatric care described within the literature: admission to a specialist intellectual disability or general mental health in-patient service. Patients admitted to specialist intellectual disability in-patient services had greater complexity, but there were additional benefits, including fewer out-of-area discharges and lower seclusion rates. CONCLUSIONS There was evidence that admission to in-patient services was associated with improvements in mental health for this population. There was some evidence indicating better outcomes for those admitted to specialist services.
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Affiliation(s)
| | | | - Regi Alexander
- Broadland Clinic and Community Forensic Learning Disability Team, Hertfordshire Partnership University NHS Foundation Trust, UK; and School of Life and Medical Sciences, University of Hertfordshire, UK
| | - Ashok Roy
- Centre for Educational Development, Appraisal and Research, University of Warwick, UK; Centre for Mental Health and Wellbeing Research, University of Warwick, UK; and Brooklands Hospital, Coventry and Warwickshire Partnership NHS Trust, UK
| | - John Devapriam
- Trust Headquarters, Herefordshire and Worcestershire Health and Care NHS Trust, UK
| | - Robert Blair
- School of Computing Sciences, University of East Anglia, UK
| | - Samuel Tromans
- Adult Learning Disabilities Service, Leicestershire Partnership NHS Trust, UK; and Department of Health Sciences, University of Leicester, UK
| | - Lee Shepstone
- Norwich Medical School, University of East Anglia, UK
| | - Peter E Langdon
- Centre for Educational Development, Appraisal and Research, University of Warwick, UK; Centre for Mental Health and Wellbeing Research, University of Warwick, UK; Brooklands Hospital, Coventry and Warwickshire Partnership NHS Trust, UK; and Research and Development, Herefordshire and Worcestershire Health and Care NHS Trust, UK
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Landi G, Simoni E, Landi I, Galeazzi GM, Moscara M, Pighi M, Ferri P, Di Lorenzo R. Therapeutic Factors in a Psychiatric Group Therapy: a Preliminary Validation of Therapeutic Factors Inventory-8, Italian Version. Psychiatr Q 2021; 92:523-536. [PMID: 32814985 DOI: 10.1007/s11126-020-09834-2] [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] [Indexed: 10/23/2022]
Abstract
Several studies support group therapy effectiveness due to the activation in patients of unique psychological mechanisms defined as non-specific therapeutic factors (Therapeutic Factors-TFs), which shape the setting and, at the same time, enhance the specific group therapeutic factors. The objectives of this study were to preliminarly validate Therapeutic Factors Inventory-8 (TFI-8) Italian version and identify group therapeutic factors. In a psychiatric residential facility, a weekly psychotherapeutic group was evaluated during 1 year. One scale on group process (TFI-8, Ferrara-Group Experience Scale) and three clinical scales (Brief Symptom Inventory-53, Sheehan Disability Scale, WHO Quality of Life-Bref) were administered to participating patients. Internal consistency, Exploratory Factor Analysis (EFA), convergent validity of TFI-8 were assessed. Correlations between TFI-8 and other scale scores and selected variables were pwerformed. Our sample consisted of 64 participants. TFI-8 showed good internal consistency (Chronbach's alpha = 0.84), concurrent validity with Fe-GES (Rho = 0.42, p = 0.0008). EFA highlighted a single Factor, accounting for 92% of variance. TFI-8 was not significantly related to clinical scale scores. TFI-8 Italian version proved to be a valid and reliable tool which allowed us to identify one therapeutic factor indicating relational attraction in group therapy, composed of three dimensions: infusion of hope, cohesion and social learning.
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Affiliation(s)
- Giulia Landi
- Residential Facilities and Forensic Psychopathology Complex Unit, Department of Mental Health and Drug Abuse, AUSL Parma, Str. Quartiere, 2/A, 43126, Parma, Italy
| | - Elena Simoni
- Villa Rosa, Private Accredited Hospital, Via Fratelli Rosselli, 83, 41125, Modena, Italy
| | - Isotta Landi
- Bruno Kessler Foundation (FBK) & University of Trento, via Sommarive, 18, Povo, 38122, Trento, Italy
| | - Gian Maria Galeazzi
- Section of Clinical Neuroscience, Department of Biomedical, Metabolic, and Neurosciences, University of Modena and Reggio Emilia, Via Campi, 287, 41125, Modena, Italy
| | - Maria Moscara
- Psychoanalytic Center Bologna, Department of Mental Health and Drug Abuse, AUSL Modena, via Del Pozzo, 71, 41124, Modena, Italy
| | - Marcella Pighi
- Villa Rosa, Private Accredited Hospital, Via Fratelli Rosselli, 83, 41125, Modena, Italy
| | - Paola Ferri
- Section of Clinical Neuroscience, Department of Biomedical, Metabolic, and Neurosciences, University of Modena and Reggio Emilia, Via Campi, 287, 41125, Modena, Italy
| | - Rosaria Di Lorenzo
- Psychiatric Intensive Treatment Facility, Department of Mental Health and Drug Abuse, AUSL Modena, 41122, Modena, Italy.
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Ertekin Pinar S, Sabanciogullari S. The relationship between functional recovery and quality of life in patients affected by schizophrenia and treated at a community mental health center in Turkey. Perspect Psychiatr Care 2020; 56:448-454. [PMID: 31746001 DOI: 10.1111/ppc.12454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 10/12/2019] [Accepted: 11/12/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The study was conducted to determine the levels of functional recovery and quality of life (QOL) among a group of patients suffering from schizophrenia treated at a Community Mental Health Center (CMHC) and to evaluate the relationship between these two treatment outcomes. DESIGN AND METHODS This observational study was implemented among 132 patients affected by schizophrenia treated at a CMHC in Turkey. FINDINGS A statistically significant positive correlation was found between the general and subscale mean scores of the functional remission of general schizophrenia scale and the mean score of all domains of the World Health Organization QOL (r = 0.63-0.33; P < .001). PRACTICE IMPLICATIONS QOL increases as the functional recovery levels increase. Nursing practices should be planned to improve functional recovery levels of patients.
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Affiliation(s)
| | - Selma Sabanciogullari
- Department of Psychiatric Nursing, School of Susehri Health High, Cumhuriyet University, Sivas, Turkey
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