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Sample records for psychiatric hospital beds

  1. Psychiatric hospital beds and prison populations in South America since 1990: does the Penrose hypothesis apply?

    Science.gov (United States)

    Mundt, Adrian P; Chow, Winnie S; Arduino, Margarita; Barrionuevo, Hugo; Fritsch, Rosemarie; Girala, Nestor; Minoletti, Alberto; Mitkiewicz, Flávia; Rivera, Guillermo; Tavares, María; Priebe, Stefan

    2015-02-01

    In 1939, English mathematician, geneticist, and psychiatrist Lionel Sharples Penrose hypothesized that the numbers of psychiatric hospital beds and the sizes of prison populations were inversely related; 75 years later, the question arises as to whether the hypothesis applies to recent developments in South America. To explore the possible association of changes in the numbers of psychiatric hospital beds with changes in the sizes of prison populations in South America since 1990. We searched primary sources for the numbers of psychiatric hospital beds in South American countries since 1990 (the year that the Latin American countries signed the Caracas Declaration) and compared these changes against the sizes of prison populations. The associations between the numbers of psychiatric beds and the sizes of prison populations were tested using fixed-effects regression of panel data. Economic variables were considered as covariates. Sufficiently reliable and complete data were obtained from 6 countries: Argentina, Bolivia, Brazil, Chile, Paraguay, and Uruguay. The numbers of psychiatric beds and the sizes of prison populations. Since 1990, the numbers of psychiatric beds decreased in all 6 countries (ranging from -2.0% to -71.9%), while the sizes of prison populations increased substantially (ranging from 16.1% to 273.0%). Panel data regression analysis across the 6 countries showed a significant inverse relationship between numbers of psychiatric beds and sizes of prison populations. On average, the removal of 1 bed was associated with 5.18 more prisoners (95% CI, 3.10-7.26; P = .001), which was reduced to 2.78 prisoners (95% CI, 2.59-2.97; P prison populations remained practically unchanged when income inequality was considered as a covariate (-4.28 [95% CI, -5.21 to -3.36]; P prison populations have increased against a background of strong economic growth. The changes appear to be associated because the numbers of beds decreased more extensively when and

  2. Psychiatric Hospital Bed Numbers and Prison Population Sizes in 26 European Countries: A Critical Reconsideration of the Penrose Hypothesis.

    Science.gov (United States)

    Blüml, Victor; Waldhör, Thomas; Kapusta, Nestor D; Vyssoki, Benjamin

    2015-01-01

    Recently, there has been a revived interest in the validity of the Penrose hypothesis, which was originally postulated over 75 years ago. It suggests an inverse relationship between the numbers of psychiatric hospital beds and the sizes of prison population. This study aims to investigate the association between psychiatric hospital beds and prison populations in a large sample of 26 European countries between 1993 and 2011. The association between prison population sizes and numbers of psychiatric hospital beds was assessed by means of Spearman correlations and modeled by a mixed random coefficient regression model. Socioeconomic variables were considered as covariates. Data were retrieved from Eurostat, the statistical office of the European Union. Mean Spearman correlation coefficients between psychiatric beds and prison population showed a significant negative association (-0.35; p = hypothesis. Notably, the results of the mixed-model show a significant variation in the magnitude and direction of the association of psychiatric hospital bed numbers and the prison population sizes between countries. In this sense, our results challenge the prevalent opinion that a reduction of psychiatric beds subsequently leads to increasing incarcerations. These findings also work against the potential stigmatization of individuals suffering from mental disorders as criminals, which could be an unintentional byproduct of the Penrose hypothesis.

  3. Practice Hospital Bed Safety

    Science.gov (United States)

    ... Updates Practice Hospital Bed Safety Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Hospital Bed Entrapment Zones An ... the side edge of the head or foot board 7. between the head or foot board and ...

  4. Characteristics and Needs of Psychiatric Patients with Prolonged Hospital Stay

    National Research Council Canada - National Science Library

    Aflalo, Marc; Soucy, Nathalie; Xue, Xiaoqing; Colacone, Antoinette; Jourdenais, Emmanuelle; Boivin, Jean-François

    2015-01-01

    Objective: To describe the characteristics and needs prior to, on admission, during the first month in hospital, at the thirtieth day of hospitalization and posthospital discharge of psychiatric patients occupying acute beds. Methods...

  5. When should governments increase the supply of psychiatric beds?

    Science.gov (United States)

    Allison, S; Bastiampillai, T; Licinio, J; Fuller, D A; Bidargaddi, N; Sharfstein, S S

    2017-07-11

    Low numbers of hospital-based psychiatric beds create problems for people with severe mental illness (SMI), when they face extended emergency department (ED) waits, higher thresholds for admission to an acute bed, and short revolving-door stays with high rates of rehospitalisation. Limited access to inpatient treatment has been associated with higher suicide risk, premature mortality, homelessness, violent crime and incarceration. Ultimately, people with SMI can be transinstitutionalised to the criminal justice system. In the USA, for example, prisons have replaced mental hospitals as the largest institutions housing people with SMI. There is no international consensus on the safe minimum numbers of acute, forensic and rehabilitation beds needed to reduce these risks. As a consequence, Organisation for Economic Cooperation and Development (OECD) countries have wide variations in the mix of hospital beds with an average of 71 beds per 100 000 population. Policymakers face difficult choices with few studies to guide decisions on supplying beds. The UK Royal College of Psychiatrists offered a policy framework, which was adapted for Australia. The government of the State of South Australia increased the supplies of crisis, acute and forensic beds to meet a mandatory target to safely reduce mental health boarding in the EDs.Molecular Psychiatry advance online publication, 11 July 2017; doi:10.1038/mp.2017.139.

  6. OCCUPATIONAL ROLE AFTER PSYCHIATRIC HOSPITALIZATION

    Directory of Open Access Journals (Sweden)

    GH.R GHASSEMI

    2003-03-01

    Full Text Available Introduction: Severe Psychiatricillness is accompanied by gross disturbances in patient's occupational role. This study presents a comparative picture of work performance before and after psychiatric hospitalization. Method: Subjects comprised 440 psychiatric admitters from Noor Medical center - Isfahan - Iran, who were followed from November 1999 to November 2000. Their work adjustment was measured by means of Weiss man's index. Data were computer analyzed using SPSS by running paired t- student and ANOVA. Results: Majority of the patients (53 % were without permanent sources of income before psychiatric hospitalization, about 12 percent of those who were working prior to hospitalization lost their job after being discharged from hospital. Better work adjustment before hospitalization was positively correlated with better work adjustment after discharge for working patients (r =0/66. Working ability of the patients after discharge was lesser than before the attack f9r patients with regular and irregular job (P < 001. Discussion: Job loss or poor working ability after psychiatric admission reported by several researchers and has bean confirmed in this study as well. These observatoins have been discussed in view of the current socio economic problems in the society and nature of psychiatric disturbances.

  7. Inappropriate involuntary admissions to psychiatric hospitals | van ...

    African Journals Online (AJOL)

    Inappropriate involuntary admissions to psychiatric hospitals. P L van der Merwe, A Allan, M M Allan. Abstract. Background. In order to preserve scarce resources, treabnent in tertiary psychiatric hospitals should be restricted to those whose treatment needs make admission to such hospitals essential. However, anecdotal ...

  8. Variation in use of coercive measures in psychiatric hospitals.

    Science.gov (United States)

    Lay, B; Nordt, C; Rössler, W

    2011-05-01

    The use of coercive measures in psychiatry is still poorly understood. Most empirical research has been limited to compulsory admission and to risk factors on an individual patient level. This study addresses three coercive measures and the role of predictive factors at both patient and institutional levels. Using the central psychiatric register that covers all psychiatric hospitals in Canton Zurich (1.3 million people), Switzerland, we traced all inpatients in 2007 aged 18-70 (n = 9698). We used GEE models to analyse variation in rates between psychiatric hospitals. Overall, we found quotas of 24.8% involuntary admissions, 6.4% seclusion/restraint and 4.2% coerced medication. Results suggest that the kind and severity of mental illness are the most important risk factors for being subjected to any form of coercion. Variation across the six psychiatric hospitals was high, even after accounting for risk factors on the patient level suggesting that centre effects are an important source of variability. However, effects of the hospital characteristics 'size of the hospital', 'length of inpatient stay', and 'work load of the nursing staff' were only weak ('bed occupancy rate' was not statistically significant). The significant variation in use of coercive measures across psychiatric hospitals needs further study. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  9. Psychiatric referrals in two general hospitals.

    Directory of Open Access Journals (Sweden)

    Doongaji D

    1989-07-01

    Full Text Available A prospective study was undertaken to compare the patterns of psychiatric referrals in two general hospitals in Bombay viz. the King Edward Memorial Hospital (64 cases and the Jaslok Hospital and Research Centre (62 cases. It was observed that depressive symptoms were the most common presenting symptoms in these patients attending either of the hospitals. Similarly, the commonest diagnoses were depression and organic mental disorder. Attempted suicide with organophosphorous compounds was the commonest reason for hospitalization at K.E.M. Hospital (p less than 0.001. A significant number of these patients were females (p less than 0.05. The psychiatric referrals at Jaslok had been hospitalized mainly for suspected medical or neurological illness (p less than 0.001. These patients belonged to higher economic strata and hence had a better paying capacity compared to patients at KEM hospital, a significant number of whom were unemployed (p less than 0.001. The duration of pre-referred illness of patients and their stay at Jaslok hospital were longer as compared to those at KEM Hospital (p less than 0.01. The number of non-relevant special investigations carried out on patients in Jaslok was more (p less than 0.01. Further analysis of diagnoses revealed that a significant number of patients at KEM Hospital were admitted as primary psychiatric illness (p less than 0.05.

  10. Service dogs, psychiatric hospitalization, and the ADA.

    Science.gov (United States)

    Muramatsu, Russ S; Thomas, Kelly Jones; Leong, Stephanie L; Ragukonis, Frank

    2015-01-01

    A service dog is defined as "any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability." Some psychiatric patients may depend on a service dog for day-to-day functioning. The Americans with Disabilities Act (ADA) established certain rights and responsibilities for individuals with disabilities and health care providers. Psychiatric hospitalization of a patient with a service dog may pose a problem and involves balancing the requirement to provide safe and appropriate psychiatric care with the rights of individuals with disabilities. This Open Forum examines issues that arise in such circumstances, reviews the literature, and provides a foundation for the development of policies and procedures.

  11. Association between bullying and pediatric psychiatric hospitalizations

    Science.gov (United States)

    Leader, Hadassa; Singh, Jasmine; Ghaffar, Ayesha; de Silva, Cheryl

    2018-01-01

    Objectives: Bullying is a serious public health issue. We sought to demonstrate an association between bullying victimization and hospital admissions for acute psychiatric problems. We described the demographics and types of bullying in a sample of hospitalized patients in Staten Island, NY, and compared bullying victimization scores with psychiatric versus medical admissions. Methods: Patients in grades 3–12 were recruited from the Staten Island University Hospital Inpatient Pediatrics unit and emergency department. Patients completed the validated Olweus Bully/Victim Questionnaire (OBQ) was analyzed to formulate a report of bullying in our sample as well as a sub-score measurement of bullying victimization. Pediatric residents simultaneously documented whether the subject was a medical versus an in-patient psychiatry admission. Statistical analysis was performed to look for an association between the victimization sub-score and a psychiatric indication for admission. Results: A total of 185 surveys were analyzed. Peak bullying occurred in 7th and 8th grades. Demographics and types of bullying in our sample were described. A strong association between bullying victimization and hospitalization for in-patient psychiatry was demonstrated. Association between bullying victimization and suicidal ideation, psychiatry, and social work consults was also shown. Concern for an association between hospitalization for psychogenic illness and bullying victimization was also raised. Conclusions: There is a significant association between bullying victimization and psychiatric hospital admissions. This raises the specter of the serious consequences of bullying as it is the first study to prospectively link hospital admissions to bullying. Studies using a valid measure of psychogenic illness to look for an association with bullying victimization are needed. PMID:29326819

  12. [SEXUALITY IN PSYCHIATRIC HOSPITALIZATION: REALITY VERSUS POLICY].

    Science.gov (United States)

    Shalev, Anat; Weil, Gabriel; Rubinstein, Ludmila

    2016-12-01

    Psychiatric hospitalization might be a necessity for certain groups of patients with mental illness, involving acute symptoms and substantial disability which do not allow independent living in the community. In such situations, it is crucial to enable inpatients to enjoy the best possible quality of life, including the right for sexual autonomy as a basic human right. Satisfying sexual life is part of meaningful life and plays an important role in personal and social recovery. On the other hand, sexual relations in psychiatric wards raise many dilemmas, including the need to protect inpatients from sexual abuse and victimization, particularly when mental illness involves judgment deficits and decreased ability to express autonomous will. In spite of its' importance, this subject receives little attention in policy guidelines and clinical practice and is largely ignored. The article reviews literature examining various aspects of sexual behavior in psychiatric facilities, revealing ethical dilemmas, risks and the role of policy guidelines to address this subject. We present viewpoints of practitioners, consumers and family members concerning sexual behavior in psychiatric hospitalization. We conclude with implications that emerge from accumulated knowledge with regard to policy making and proposed frameworks for change.

  13. Flexible bed allocations for hospital wards.

    Science.gov (United States)

    Bekker, René; Koole, Ger; Roubos, Dennis

    2017-12-01

    Flexibility in the usage of clinical beds is considered to be a key element to efficiently organize critical capacity. However, full flexibility can have some major drawbacks as large systems are more difficult to manage, lack effective care delivery due to absence of focus and require multi-skilled medical teams. In this paper, we identify practical guidelines on how beds should be allocated to provide both flexibility and utilize specialization. Specifically, small scale systems can often benefit from full flexibility. Threshold type of control is then effective to prioritize patient types and to cope with patients having diverse lengths of stay. For large scale systems, we assert that a little flexibility is generally sufficient to take advantage of most of the economies of scale. Bed reservation (earmarking) or, equivalently, organizing a shared ward of overflow, then performs well. The theoretical models and guidelines are illustrated with numerical examples. Moreover, we address a key question stemming from practice: how to distribute a fixed number of hospital beds over the different units?

  14. The periodicities in and biometeorological relationships with bed occupancy of an acute psychiatric ward in Antwerp, Belgium

    Science.gov (United States)

    Maes, M.; de Meyer, F.; Peeters, D.; Meltzer, H.; Schotte, C.; Scharpe, S.; Cosyns, P.

    1993-06-01

    Recently, some investigators have established a seasonal pattern in normal human psychology, physiology and behaviour, and in the incidence of psychiatric psychopathology. In an attempt to elucidate the chronopsy and meteotropism in the latter, we have examined the chronograms of, and the biometeorological relationships to bed occupancy of the psychiatric ward of the Antwerp University Hospital during three consecutive calendar years (1987 1989). Weather data for the vicinity were provided by a local meteorological station and comprise mean atmospheric pressure, air temperature, relative humidity, wind speed and minutes of sunlight and precipitation/day. The number of psychiatric beds occupied during the study period exhibited a significant seasonal variation. Peaks in bed occupancy were observed in March and November, with lows in August. An important part of the variability in the number of beds occupied could be explained by the composite effects of weather variables of the preceding weeks. Our results suggest that short-term fluctuations in atmospheric activity may dictate some of the periodicities in psychiatric psychopathology.

  15. Psychiatric Disorders and Trends in Resource Use in Pediatric Hospitals.

    Science.gov (United States)

    Zima, Bonnie T; Rodean, Jonathan; Hall, Matt; Bardach, Naomi S; Coker, Tumaini R; Berry, Jay G

    2016-11-01

    To describe recent, 10-year trends in pediatric hospital resource use with and without a psychiatric diagnosis and examine how these trends vary by type of psychiatric and medical diagnosis cooccurrence. A retrospective, longitudinal cohort analysis using hospital discharge data from 33 tertiary care US children's hospitals of patients ages 3 to 17 years from January 1, 2005 through December 31, 2014. The trends in hospital discharges, hospital days, and total aggregate costs for each psychiatric comorbid group were assessed by using multivariate generalized estimating equations. From 2005 to 2014, the cumulative percent growth in resource use was significantly (all P < .001) greater for children hospitalized with versus without a psychiatric diagnosis (hospitalizations: +137.7% vs +26.0%; hospital days: +92.9% vs 5.9%; and costs: +142.7% vs + 18.9%). During this time period, the most substantial growth was observed in children admitted with a medical condition who also had a cooccurring psychiatric diagnosis (hospitalizations: +160.5%; hospital days: +112.4%; costs: +156.2%). In 2014, these children accounted for 77.8% of all hospitalizations for children with a psychiatric diagnosis; their most common psychiatric diagnoses were developmental disorders (22.3%), attention-deficit/hyperactivity disorder (18.1%), and anxiety disorders (14.2%). The 10-year rise in pediatric hospitalizations in US children's hospitals is 5 times greater for children with versus without a psychiatric diagnosis. Strategic planning to meet the rising demand for psychiatric care in tertiary care children's hospitals should place high priority on the needs of children with a primary medical condition and cooccurring psychiatric disorders. Copyright © 2016 by the American Academy of Pediatrics.

  16. High tuberculosis prevalence in a psychiatric hospital in Vietnam

    NARCIS (Netherlands)

    van Duc, L.; Vree, M.; Cobelens, F. G.; Phuc, L. T.; Sy, D. N.

    2008-01-01

    Little is known about tuberculosis (TB) prevalence in psychiatric hospitals in Vietnam, but prevalence may be higher than in the general population. We assessed the TB prevalence among in-patients of a psychiatric hospital in 2005 in Danang City, Vietnam. Of 300 in-patients, 70 had an abnormal X-ray

  17. Treatment profiles in a Danish psychiatric university hospital department

    DEFF Research Database (Denmark)

    Okkels, Niels; Mogensen, Rasmus Beyer; Crean, Lea Catherine

    2017-01-01

    BACKGROUND: Despite concerns about rising treatment of psychiatric patients with psychotropic medications and declining treatment with psychotherapy, actual treatment profiles of psychiatric patients are largely unknown. AIMS: To describe patterns in the treatment of patients in a large psychiatric...... university hospital department. METHODS: A descriptive mapping of treatment of in- and outpatients in a psychiatric department at Aarhus University Hospital Risskov, Denmark. Information was collected by healthcare staff using a 25-item survey form. The p-value was calculated with a chi-squared test and p...

  18. Celebrating our past. The history of Hamilton Psychiatric Hospital.

    Science.gov (United States)

    Forchuk, C; Tweedell, D

    2001-10-01

    1. There is a risk of losing important parts of our psychiatric nursing history as a result of the rapid rate of mental health reform and the closing or changing of governance of major psychiatric facilities. 2. Hamilton Psychiatric Hospital provided leadership in psychiatric nursing in Canada for more than a century and is now changing governance from being a provincial psychiatric hospital to part of a community general hospital. 3. The hospital's tradition includes nonrestrictive care policies that have been in place for more than a century, a humanistic approach to care, being the first facility in Canada to require theory-based nursing care from all nursing staff, innovative practice models, and achieving authorship or co-authorship from more than 17% of the RN staff.

  19. Long stay patients in a psychiatric hospital in Lagos, Nigeria

    African Journals Online (AJOL)

    confinement or long-stay for psychiatrically ill offenders.5,6. Over the years, these asylums were converted to fully- ... study center; or, in the alternative provision of mid–way facilities for their rehabilitation. Key Words: Long-stay; Psychiatric hospital; ..... The DSM–III concepts of schizophrenic disorder and schizophrenifrom ...

  20. Inpatient treatment of major depression in Austria between 1989 and 2009: impact of downsizing of psychiatric hospitals on admissions, suicide rates and outpatient psychiatric services.

    Science.gov (United States)

    Vyssoki, B; Willeit, M; Blüml, V; Höfer, P; Erfurth, A; Psota, G; Lesch, O M; Kapusta, N D

    2011-09-01

    During the last 20 years Austrian psychiatric services underwent fundamental changes, as a focus was set on downsizing psychiatric hospitals. Little is known about how restructuring of mental health services affected patients with major depression and suicide rates. Monthly hospital discharges from all hospitals in Austria with the diagnosis of unipolar major depression as primary reason for inpatient treatment were obtained for the time period between 1989 and 2008. These data were correlated with relevant parameters from the general health system, such as number of hospital beds, suicide rate, density of psychotherapists and sales of antidepressants. While the number of psychiatric beds was reduced by almost 30%, the total annual numbers of inpatient treatment episodes for depression increased by 360%. This increase was stronger for men than for women. Further on this development was accompanied by a decrease in the suicide rate and an improvement in the availability of professional outpatient mental health service providers. Only aggregated patient data and no single case histories were available for this study. The validity of the correct diagnosis of unipolar major depression must be doubted, as most likely not all patients were seen by a clinical expert. Our data show that although inpatient treatment for unipolar major depression dramatically increased, reduction of psychiatric beds did not lead to an increase of suicide rates. Copyright © 2011 Elsevier B.V. All rights reserved.

  1. Service Dogs, Psychiatric Hospitalization, and the ADA

    National Research Council Canada - National Science Library

    Muramatsu, Russ S; Thomas, Kelly Jones; Leong, Stephanie L; Ragukonis, Frank

    A service dog is defined as “any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability...

  2. Hospital Related Stress Among Patients Admitted to a Psychiatric In-patient Unit in India

    Directory of Open Access Journals (Sweden)

    Latha KS

    2011-04-01

    Full Text Available The psychiatric patient’s attitudes towards hospitalization have found an association between patient perceptions of the ward atmosphere and dissatisfaction. The aim of the study was to determine the aspects of stress related to hospitalization in inpatients admitted to a psychiatric facility. Fifty in-patients of both sexes admitted consecutively to a psychiatric unit in a General Hospital were asked to rate the importance of, and their satisfaction with, 38 different aspects of in-patient care and treatment. Results showed that the major sources of stress were related to having a violent patient near to his/her bed; being away from family; having to stay in closed wards; having to eat cold and tasteless food; losing income or job due to illness, being hospitalized away from home; not able to understand the jargons used by the clinical staff and not getting medication for sleep. A well-differentiated assessment of stress and satisfaction has implications for the evaluation of the quality of psychiatric care and for the improvement of in-patient psychiatric care.

  3. A Controlled Comparison of Psychiatric Day Treatment and Inpatient Hospitalization

    Science.gov (United States)

    Washburn, Stephen; And Others

    1976-01-01

    Seriously ill female psychiatric patients (N=59) were randomly assigned to an inpatient or day service. Data indicate the day treatment is, on the whole, superior to inpatient treatment in subjective distress, community functioning, family burden, total hospital cost, and days of attachment to the hospital program. (Author)

  4. [The relation of selected psychiatric disorders to occurrence of suicide attempts among teenage psychiatrically hospitalized patients].

    Science.gov (United States)

    Krajewska, Katarzyna; Gawlik-Kotelnicka, Oliwia; Gmitrowicz, Agnieszka

    2015-06-01

    Suicide is the third cause of death globally in the age group 10-19. Multiple risk factors (genetic, psychiatric, psychological, familial, social) increased number of suicide attempts. The aim of this study was to explore whether mental disorders are associated with the number of suicide attempts among psychiatric hospitalized adolescents. Retrospective, chart-based analysis of 119 patients, aged 13-18, treated in 2013-2014 in the Department of Adolescent Psychiatry in Łódź. Inclusion criteria was diagnosis of schizophrenia, schizotypal and delusional disorders, mood disorders, neurotic, stress-related and somatoform disorders, behavioral and emotional disorders according to ICD 10. Exclusion criteria were other psychiatric diagnosis, incomplete information about intention of self-harm behaviors. For statistical analysis used Statistica 9.1. Among psychiatricaly hospitalized patients, 51.2% of people attempted suicide. No relationship was found (p > 0.05) between psychiatric diagnosis and frequency of suicide attempts in adolescents, but the most common suicide attempts related to people with a diagnosis of mood disorders (59.3%) and neurotic disorders (54.6%), and least frequently in patients with a diagnosis of schizophrenia , schizotypal and delusional disorders (40%) and behavioral and emotional disorders (44.4%). There is no relation between the occurrence of suicide attempts and the type of mental disorders among psychiatrically hospitalized adolescents. © 2015 MEDPRESS.

  5. Relative performance of for-profit psychiatric hospitals in investor-owned systems and nonprofit psychiatric hospitals.

    Science.gov (United States)

    McCue, M J; Clement, J P

    1993-01-01

    The authors analyzed the differences in operational and financial performance between 42 matched pairs of for-profit psychiatric hospitals belonging to multifacility organizations and nonprofit psychiatric hospitals for the fiscal years ending in 1986 through 1990. The pairs of short-term hospitals were matched according to location, standard metropolitan statistical area, or wage index. Analyses were based on data on these hospitals from the Health Care Financing Administration. The groups of variables studied included the hospitals' operational performance and productivity, profitability and payer mix, revenue and expenses, and capital structure. Differences in the mean values of the variables for the for-profit hospitals and the nonprofit hospitals were analyzed by pairwise t tests. The for-profit organization hospitals had significantly higher net revenue, lower salary expenses, and higher profits than the nonprofit hospitals. Patients in the for-profit hospitals had longer stays, and these hospitals had fewer full-time employees per adjusted inpatient day and per adjusted discharge. The higher prices and operating margins of the for-profit hospitals belonging to investor-owned systems reflect the profit-maximizing goal of these facilities. The ability of for-profit organization hospitals to achieve economies of scale in expenses, however, was not evident except in the case of salary expenses.

  6. Hospital utilization and personality characteristics of veterans with psychiatric problems.

    Science.gov (United States)

    Williams, W; Weiss, T W; Edens, A; Johnson, M; Thornby, J I

    1998-03-01

    The relationship between hospital utilization and psychometric, demographic, and diagnostic data was examined among veterans with psychiatric problems. Data were obtained from the records of 500 psychiatric inpatients admitted to a Veterans Affairs medical center between 1984 and 1987 and followed for four years. All patients completed the Minnesota Multiphasic Personality Inventory, the California Personality Inventory, the Millon Clinical Multiaxial Inventory, and the Psychological Inventory of Personality and Symptoms. Stepwise linear regression analysis was used to predict the number and length of inpatient stays, and Cox and logistic regression analyses predicted rehospitalization. Higher rates of psychiatric hospital utilization were found among patients who were unmarried, who had disabilities connected with their military service, who had lower levels of adaptive functioning, and who were diagnosed as having posttraumatic stress disorder, drug or alcohol use disorder, or passive-aggressive or antisocial personality disorder. Higher utilization was also found among those whom psychometric data characterized as less responsible and more compulsive. The data also predicted the length of subsequent medical hospitalization and identified patients who stayed out of the hospital longer and who were not rehospitalized. Hospital utilization was found to be a function of psychiatric diagnosis, marital status, and various personality factors. Factors relating to social disadvantage also played a role. Axis I diagnoses, particularly substance use disorders, were as important as, if not more important than, axis II diagnoses in predicting utilization.

  7. The medication process in a psychiatric hospital

    DEFF Research Database (Denmark)

    Soerensen, Ann Lykkegaard; Lisby, Marianne; Nielsen, Lars Peter

    2013-01-01

    Purpose: To investigate the frequency, type, and potential severity of errors in several stages of the medication process in an inpatient psychiatric setting. Methods: A cross-sectional study using three methods for detecting errors: (1) direct observation; (2) unannounced control visits....... The observational unit: The individual handling of medication (prescribing, dispensing, and administering). Results: In total, 189 errors were detected in 1,082 opportunities for error (17%) of which 84/998 (8%) were assessed as potentially harmful. The frequency of errors was: prescribing, 10/189 (5%); dispensing......, 18/189 (10%); administration, 142/189 (75%); and discharge summaries, 19/189 (10%). The most common errors were omission of pro re nata dosing regime in computerized physician order entry, omission of dose, lack of identity control, and omission of drug. Conclusion: Errors throughout the medication...

  8. Medication Discontinuation in Patients After Discharge From a Psychiatric Hospital.

    Science.gov (United States)

    Abdullah-Koolmees, Heshu; Gardarsdottir, Helga; Yazir, Dilek; Stoker, Lennart J; Vuyk, Judith; Egberts, Toine C G; Heerdink, Eibert R

    2015-10-01

    Patients discharged from psychiatric hospitals may be at risk for intentional or unintentional discontinuation of their medication. To describe and assess the discontinuation of, and changes to, psychiatric and/or somatic medication in patients after discharge from psychiatric hospitals. A retrospective follow-up study was conducted in patients discharged from 4 psychiatric hospitals in The Netherlands between 2006 and 2009. Patients' medication use during the last 2 days of hospitalization was compared with medication dispensed during the 3 months following discharge. Changes in psychiatric and somatic medication were investigated and defined as medication discontinuation, start, or switch. Patients were classified as continuing users, when there were no changes to the medication after discharge. Relative risks with 95% confidence intervals to measure differences in discontinuation were estimated using Cox regression analysis. This study included 1324 patients, 69.8% of whom discontinued medication, and 9.7% switched one or more medications. Nearly half (47.4%) of all patients started a medication other than that dispensed during the last 2 days of hospitalization, and 13.7% of all patients experienced no changes to their medication regimen. Approximately 40% of the patients discontinued one or more medications for chronic conditions. From these, 68% discontinued psychiatric medications and 49.4% discontinued somatic medications. A quarter (25.2%) of the 644 patients discontinued using antipsychotics. More than a quarter (28.4%) of the 292 patients using medications for cardiovascular problems discontinued. Patients using as-needed medication prior to discharge were more likely to discontinue their medication (relative risk = 1.85; 95% confidence interval = 1.55-2.20). Discharge from a psychiatric hospital led to medication discontinuation in approximately 70% of all patients. Approximately 40% of the patients discontinued medications for chronic conditions

  9. Case-based reimbursement for psychiatric hospital care.

    Science.gov (United States)

    Sederer, L I; Eisen, S V; Dill, D; Grob, M C; Gougeon, M L; Mirin, S M

    1992-11-01

    A fixed-prepayment system (case-based reimbursement) for patients initially requiring hospital-level care was evaluated for one year through an arrangement between a private nonprofit psychiatric hospital and a self-insured company desiring to provide psychiatric services to its employees. This clinical and financial experiment offered a means of containing costs while monitoring quality of care. A two-group, case-control study was undertaken of treatment outcomes at discharge, patient satisfaction with hospital care, and service use and costs during the program's first year. Compared with costs for patients in the control group, costs for those in the program were lower per patient and per admission; cumulative costs for patients requiring rehospitalization were also lower. However, costs for outpatient services for patients in the program were not calculated. Treatment outcomes and patients' satisfaction with hospital care were comparable for the two groups.

  10. Long stay patients in a psychiatric hospital in Lagos, Nigeria

    African Journals Online (AJOL)

    Introduction. In psychiatric practice, some mentally ill patients spend their life in continuous or prolonged hospitalization; that is, as long stay patients.1,2 This is due among other reasons to severe mental illness with poor symptom control, substance dependence, homelessness and abandonment by the patients' relatives.3 ...

  11. Superficial mycoses among psychiatric patients in Mathari hospital ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of superficial mycoses among psychiatric patients. Design: Randomised Prospective study. Setting: Mathari Mental Hospital, and Jomo Kenyatta University of Agriculture and Technology, Nairobi Kenya. Results: A study was conducted on prevalence of superficial fungal infections ...

  12. Shared Decision Making for Psychiatric Rehabilitation Services Before Discharge from Psychiatric Hospitals.

    Science.gov (United States)

    Zisman-Ilani, Yaara; Roe, David; Elwyn, Glyn; Kupermintz, Haggai; Patya, Noa; Peleg, Ido; Karnieli-Miller, Orit

    2018-02-02

    Shared decision making (SDM) is an effective health communication model designed to facilitate patient engagement in treatment decision making. In mental health, SDM has been applied and evaluated for medications decision making but less for its contribution to personal recovery and rehabilitation in psychiatric settings. The purpose of this pilot study was to assess the effect of SDM in choosing community psychiatric rehabilitation services before discharge from psychiatric hospitalization. A pre-post non-randomized design with two consecutive inpatient cohorts, SDM intervention (N = 51) and standard care (N = 50), was applied in two psychiatric hospitals in Israel. Participants in the intervention cohort reported greater engagement and knowledge after choosing rehabilitation services and greater services use at 6-to-12-month follow-up than those receiving standard care. No difference was found for rehospitalization rate. Two significant interaction effects indicated greater improvement in personal recovery over time for the SDM cohort. SDM can be applied to psychiatric rehabilitation decision making and can help promote personal recovery as part of the discharge process.

  13. Psychiatric hospitalization among children with autism spectrum disorders.

    Science.gov (United States)

    Mandell, David S

    2008-07-01

    This study examined predictors of psychiatric hospitalization among children with autism spectrum disorders (ASD). Data were collected from 760 caregivers of children with ASD. Cox regression was used to determine factors associated with hospitalization. Almost 11% were hospitalized. Youth in single parent homes were more likely to be hospitalized (OR = 2.54), as were youth diagnosed at a later age (OR = 1.10). Engaging in self-injurious behavior (OR = 2.14), aggressive behavior (OR = 4.83), and being diagnosed with depression (OR = 2.48) or obsessive compulsive disorder (OR = 2.35) increased the odds of hospitalization. Risk for hospitalization increased with age and over time. The results suggest early diagnosis and community-based interventions for aggressive and self-injurious behaviors may reduce hospitalizations.

  14. [Public music concerts in a psychiatric hospital: effects on public opinion and as therapy for patients].

    Science.gov (United States)

    Takasaka, Y; Yokota, O; Tanioka, T; Nagata, K; Yasuoka, K; Toda, H

    2001-01-01

    We investigate the effects of music therapy concerts, which were held 60 times over a four year period, 1992 to 1996, in Geiyo Psychiatric Hospital, Kochi Prefecture and found that; 1) Musicians who performed at the concerts were not only from Kochi prefecture but also from other prefectures (10 times) and from four foreign countries (7 times). 2) Live concerts in a small hall had a positive influence on patients and drew the patient's attention and interest away from their hallucinations and delusions to the real world. Moreover, the concerts provided the patients with chances to acquire social graces such as being well-groomed. 3) Explanations by the musicians, interviews with the musicians and the seasonal choruses accompanied by the musicians were helpful to give the patients motives for recovering communication skills and to interact with society. 4) Inquiries to the patients about the concerts indicated discrepancies between the poor observed estimations during the concerts (83.3%) and the good subjective impressions expressed by the patients (82.0%), suggesting that the patients were not good at expressing their internal emotions through facial expressions or attitudes. 5) Many citizens including children came to the concerts and/or gave aid to the hospital because the concerts were open to the public and we suggest that this contributed to improving the general publics' image of psychiatric hospitals. Questionnaires revealed that 90% of people in a control group had a bad image of psychiatric hospitals in Japan, but only 32% of the members of the general public who attended our concerts had a bad image of psychiatric hospitals. In addition, the revolving ratio of the hospital beds rose from 0.4 to 1.2 over the four years, which also suggests a beneficial effect on the patients.

  15. Attitudes towards patient gender among psychiatric hospital staff: results of a case study with focus groups.

    Science.gov (United States)

    Krumm, Silvia; Kilian, Reinhold; Becker, Thomas

    2006-03-01

    There is an increasing awareness of gender-related issues in psychiatry. However, empirical findings on attitudes of psychiatric staff towards patient gender are limited. Gender-related issues are particularly relevant in the debate about mixed versus segregated sex wards, yet while the appropriateness of mixed-sex wards is questioned in Great Britain this is not the case in Germany. To investigate attitudes of psychiatric staff towards both patient gender and mixed versus segregated sex wards, we conducted a case study using focus groups with members of professional teams. We evaluated the transition process from two single-sex wards to two mixed-sex wards in a 330-bed psychiatric hospital in a rural area in south Germany. Staff described female patients as more externally oriented, motivating of others, demanding, and even sexually aggressive. Male patients, on the other hand, were described as more quiet, modest, or lazy. Furthermore, participants described the mixing process as a positive development whereas they did not see a need for gender-separated wards in order to protect vulnerable female patients. Some gender descriptions by professionals are "reversed" in comparison with gender stereotypes supposed to be present in wider society. The perception of crossed gender norms may affect staff attitudes towards the vulnerability of female patients in psychiatric settings and the provision of single-sex wards in in-patient psychiatric care. Practical implications are discussed against the background of a high rate of female patients with sexual abuse histories.

  16. Admission of people with dementia to psychiatric hospitals in Japan: factors that can shorten their hospitalizations.

    Science.gov (United States)

    Morikawa, Takako; Maeda, Kiyoshi; Osaki, Tohmi; Kajita, Hiroyuki; Yotsumoto, Kayano; Kawamata, Toshio

    2017-11-01

    People exhibiting serious behavioural and psychological symptoms of dementia are usually voluntarily or involuntarily committed to psychiatric hospitals for treatment. In Japan, the average hospital stay for individuals with dementia is about 2 years. Ideally, individuals should be discharged once their symptoms have subsided. However, we see cases in Japan where individuals remain institutionalized long after behavioural and psychological symptoms of dementia are no longer apparent. This study will attempt to identify factors contributing to shorter stays in psychiatric hospitals for dementia patients. Questionnaires consisting of 17 items were mailed to 121 psychiatric hospitals with dementia treatment wards in western Japan. Out of 121 hospitals that received the questionnaires, 45 hospitals returned them. The total number of new patient admissions at all 45 hospitals during the month of August 2014 was 1428, including 384 dementia patients (26.9%). The average length of stay in the dementia wards in August 2014 was 482.7 days. Our findings revealed that the rate of discharge after 2 months was 35.4% for the dementia wards. In addition, we found that the average stay in hospitals charging or planning to charge the rehabilitation fee to dementia patients was significantly shorter than in hospitals not charging the rehabilitation fee. In Japan, dementia patients account for over 25% of new admissions to psychiatric hospitals with dementia wards. The average length of stay in a psychiatric hospital dementia ward is more than 1 year. A discharge after fewer than 2 months is exceedingly rare for those in a dementia ward compared with dementia patients in other wards. If institutions focus on rehabilitation, it may be possible to shorten the stay of dementia patients in psychiatric hospitals. © 2017 Japanese Psychogeriatric Society.

  17. Subjective sleep quality and sleep duration of patients in a psychiatric hospital

    OpenAIRE

    Müller, Matthias J; Olschinski, Christiane; Kundermann, Bernd; Cabanel, Nicole

    2016-01-01

    Sleep complaints and sleep disturbances are highly prevalent in patients with psychiatric disorders. During hospitalization the patients? condition may be even worse but little is known about the subjective sleep quality in psychiatric hospitals. Thus, we have investigated subjective sleep quality and mean sleep duration in patients with different psychiatric disorders at the end of hospitalization. For a period of one year, inpatients of a psychiatric hospital with diagnosis of substance use...

  18. Correlation between Anger and Job Motivation among Psychiatric Nurses in Kashan Psychiatric Hospital

    Directory of Open Access Journals (Sweden)

    Kouchaki E.

    2016-12-01

    Full Text Available Abstract Aims: In general, nurses who work in department of psychiatric are in fact interacting with emotional disorders of patients once providing their care services. higher levels of job motivation and satisfaction can markedly foster service improvement. The aim of this study was to evaluate the correlation between anger and job motivation in nurses of a psychiatric hospital. Instrument & Methods: In this cross-sectional descriptive research in 2014, all 50 psychiatry nurses working at Kargarnejad Hospital of Kashan City, Iran, were entirely studied. A demographical questionnaire, the Anger Multiple Scale and the Job Motivation Scale were used for data gathering. Data were analyzed by SPSS 19 software using Pearson correlation coefficient. Findings: The mean score of anger was 3.01±0.36 and of job motivation was 1.70±0.86. There was a significant relationship between job motivation and the number of family members and conditions of employment of nurses (p=0.001. There was a significant inverse relationship between scores of anger and job motivation of psychiatry nurses of the hospital (r=-0.712; p=0.001. Conclusion: There is a relationship between anger and job motivation in nurses of Kashan Psychiatric hospital.

  19. [Violence, Burnout and Minor Psychiatric Disorders in Hospital Work].

    Science.gov (United States)

    Pai, Daiane Dal; Lautert, Liana; Souza, Sônia Beatriz Cocaro de; Marziale, Maria Helena Palucci; Tavares, Juliana Petri

    2015-06-01

    Identifying the violence suffered by the health team workers and their association with Burnout and minor psychiatric disorders. Cross-sectional study with 269 health team professionals of a public hospital in southern Brazil. Data were collected through the use of the Survey Questionnaire: Workplace Violence in the Health Sector, Maslach Inventory Burnout and Self-Report Questionnaire. Workplace violence struck 63.2% of workers, prevailing mostly in women (p = 0.001), among nursing auxiliaries/technicians (p=0.014) and was associated with minor psychiatric disorders (pBurnout dimensions were also associated to violence at work (pworkers experience violence in the workplace and this exposure is associated with Burnout symptoms and minor psychiatric disorders.

  20. Violence, Burnout and Minor Psychiatric Disorders in Hospital Work

    Directory of Open Access Journals (Sweden)

    Daiane Dal Pai

    2015-06-01

    Full Text Available OBJECTIVE Identifying the violence suffered by the health team workers and their association with Burnout and minor psychiatric disorders. METHODS Cross-sectional study with 269 health team professionals of a public hospital in southern Brazil. Data were collected through the use of the Survey Questionnaire: Workplace Violence in the Health Sector, Maslach Inventory Burnout and Self-Report Questionnaire. RESULTS Workplace violence struck 63.2% of workers, prevailing mostly in women (p = 0.001, among nursing auxiliaries/technicians (p=0.014 and was associated with minor psychiatric disorders (p<0.05, as exposure to different forms of violence increased the chances of these disorders by 60% (CI 95%: 1.2-2.1. The three Burnout dimensions were also associated to violence at work (p<0.05. CONCLUSION Health workers experience violence in the workplace and this exposure is associated with Burnout symptoms and minor psychiatric disorders.

  1. Violence, Burnout and Minor Psychiatric Disorders in Hospital Work

    Directory of Open Access Journals (Sweden)

    Daiane Dal Pai

    Full Text Available OBJECTIVE Identifying the violence suffered by the health team workers and their association with Burnout and minor psychiatric disorders. METHODS Cross-sectional study with 269 health team professionals of a public hospital in southern Brazil. Data were collected through the use of the Survey Questionnaire: Workplace Violence in the Health Sector, Maslach Inventory Burnout and Self-Report Questionnaire. RESULTS Workplace violence struck 63.2% of workers, prevailing mostly in women (p = 0.001, among nursing auxiliaries/technicians (p=0.014 and was associated with minor psychiatric disorders (p<0.05, as exposure to different forms of violence increased the chances of these disorders by 60% (CI 95%: 1.2-2.1. The three Burnout dimensions were also associated to violence at work (p<0.05. CONCLUSION Health workers experience violence in the workplace and this exposure is associated with Burnout symptoms and minor psychiatric disorders.

  2. Superficial mycoses among psychiatric patients in Mathari Hospital, Nairobi, Kenya.

    Science.gov (United States)

    Ogutu, M; Ng'ang'a, Z; Namasaka, M; Wambura, M

    2010-09-01

    To determine the prevalence of superficial mycoses among psychiatric patients. Randomised Prospective study Mathari Mental Hospital, and Jomo Kenyatta University of Agriculture and Technology, Nairobi Kenya. A study was conducted on prevalence of superficial fungal infections among psychiatric patients in Mathari Hospital, Nairobi, Kenya during the period of July to November 2009. 152 patients were assessed and samples collected from 25 patients with clinically suggestive symptoms of dermatomycosis revealed a 12.5% prevalence of superficial mycosis. There was no significant difference between males and females with superficial mycosis (P>0.05). Twenty percent of the patients who were on topical application had no viable organisms. Microsporum was the predominant species isolated while the skin was the site most commonly affected (64 %). Epidermophyton was the least prevalent. Terbinafin was the most effective antifungal while ketoconazole was the least effective. All patients admitted at Mathari hospital should be screened for fungal infection and treated. Terbinafin can be used as first line treatment of dermatomycosis after screening all psychiatric patients in Mathari Mental Hospital.

  3. [The process of institutional transformation of San Luis Psychiatric Hospital].

    Science.gov (United States)

    Pellegrini, Jorge L

    2009-01-01

    This article focuses on the human and institutional contradictions involved in the transformation process of a classic psychiatric hospital in the province of San Luis, Argentina. This process has to resolve clinical, cultural, ideological, political conflicts, in the heart of the chosen path, in order to affirm the existence of the mental illness, the need to find new treatments for the new sufferings involved in leaving enclosure opting for freedom and the accompaniment of those who suffer.

  4. Violence, Burnout and Minor Psychiatric Disorders in Hospital Work

    OpenAIRE

    Daiane Dal Pai; Liana Lautert; Sônia Beatriz Cocaro de Souza; Maria Helena Palucci Marziale; Juliana Petri Tavares

    2015-01-01

    OBJECTIVE Identifying the violence suffered by the health team workers and their association with Burnout and minor psychiatric disorders. METHODS Cross-sectional study with 269 health team professionals of a public hospital in southern Brazil. Data were collected through the use of the Survey Questionnaire: Workplace Violence in the Health Sector, Maslach Inventory Burnout and Self-Report Questionnaire. RESULTS Workplace violence struck 63.2% of workers, prevailing mostly in women (p = 0.001...

  5. [Psychopathology of anxiety-phobic disorders that led to hospitalization in a psychiatric hospital].

    Science.gov (United States)

    Chugunov, D A; Schmilovitch, A A

    2017-01-01

    To study the psychopathology of anxiety-phobic disorders and motives of hospitalization of patients in a psychiatric hospital. One hundred and thirty-two patients were examined, 72 patients of the main group were admitted to general psychiatric departments, 60 patients of the control group in the sanatorium psychiatric departments. Clinical-psychopathological, follow-up, psychometric and statistical methods were used. Patients with hospital anxiety-phobic disorders had agoraphobia with panic disorder, social phobias, hypochondriacal phobias, specific phobias and multiple phobias. The main reasons for hospitalization were: the intensity of anxiety-phobic disorders, contrast content of phobias, multiplicity of anxiety-phobic disorders, ambulance calls, personality accentuations and rental aims.

  6. Association between childhood abuse and psychiatric morbidities among hospitalized patients

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    Kshirod Kumar Mishra

    2016-01-01

    Full Text Available Background: Childhood abuse has been linked with increased risk of adult psychiatric disorders including major depression, substance abuse, anxiety disorders, posttraumatic stress disorder, and personality disorders. However, only a few from India attempted to study long-term consequences of childhood abuse. Our study aimed to understand the role of physical, sexual, and emotional abuse along with psychiatric co-morbidities in hospitalized patients. Materials and Methods: Patients admitted to psychiatric inpatient services in the age group of 14-45 years for the 1 st time were evaluated for a history of physical, sexual, and emotional abuse on the basis of retrospective chart review. Semi-structured Performa was used to evaluate the patient with a history of child abuse, and they were diagnosed according to International Classification of Diseases-10 diagnostic criteria. Result: The prevalence of child abuse in our inpatient services was 43.29%; emotional abuse (61.9% was most commonly reported among patient followed by physical (21.43% and sexual abuse (16.67%. We observed a significant difference in terms of length of hospital stay between abuse (10.29 ± 6.01 days and nonabuse group (5.90 ± 2.43 days (t = 4.902, df = 95, P < 0.0001. The boys experienced physical abuse at a younger age (7.43 ± 2.50 years than girls (13.50 ± 0.70 years. The sexual abuse and emotional abuse were reported at a younger age in girls than boys. We found high prevalence of substance use disorders (40.47%, psychosis (19.04%, and mood disorder (28.57% among abuse group. Conclusions: The study findings highlight the developing importance of the different forms of abuse on adult psychiatric diagnosis in India. The abused patients are at high risk of the development of psychiatric disorder than the nonabuse group. The increased length of hospitalization among abused group reflects severity and complexity of child abuse. The early detection of social factors

  7. [Reality of treatment in psychotherapy: Results of a survey of German psychiatric hospitals].

    Science.gov (United States)

    Laux, G; Sander, K; Artmann, S; Dreher, J; Lenz, J; Hauth, I

    2015-05-01

    Since the introduction of the qualification as specialist for psychiatry and psychotherapy, in addition to psychopharmacotherapy psychotherapy is an integral component of the treatment of mentally ill people. A survey was carried out to evaluate the reality of clinical routine use of psychotherapy in German psychiatric hospitals. Between October 2011 and March 2012 German hospitals of psychiatry and psychotherapy were contacted by the head organization, the conference of national directors (Bundesdirektorenkonferenz), to participate in a survey regarding the application of psychotherapy in the real clinical world of daily treatment. With an anonymous questionnaire, data were requested as either a printed form or online version. Data from 25 psychiatric hospitals in the year 2010 could be analysed (average number of beds 300 of which 53 were for psychosomatic/psychotherapeutic patients) and a total of 87,000 inpatients were treated whereby 34 % were diagnosed as F1 addictive disorders and 24 % as F3 affective disorders. More than 80 % of the hospitals applied group therapies of relaxation, cognitive behavior therapy, social competence training and specific techniques, such as dialectic-behavior therapy. As individual treatment methods, patients with depressive disorders were treated with cognitive behavior therapy, interpersonal psychotherapy or psychodynamic therapy in more than 50 % of the cases. Relaxation techniques were offered in most cases by the nursing staff, behavior therapy by psychologists and physicians and psychodynamic therapy mainly by psychiatrists.

  8. Hospital bed ventilation: impact of operation mode on exposure

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Barova, Mariya

    2014-01-01

    Full-scale measurements were performed in a climate chamber set as a two-bed hospital room with overhead ventilation. Air temperature was kept constant at 22 °C. Two breathing thermal manikins were used to mimic a sick patient lying sideways in one of the beds and a doctor. A thermal dummy mimicked...... units were not operated the room was ventilated at 3, 6 or 12 ACH. The background ventilation was kept at 3 ACH when the units were used. The ‘sick patient’ was exhaling through the mouth and inhaling from the nose. Tracer gas (R 134a) was mixed with the exhaled air to mimic airborne droplets...

  9. Day hospital versus admission for acute psychiatric disorders

    Science.gov (United States)

    Marshall, Max; Crowther, Ruth; Sledge, William Hurt; Rathbone, John; Soares-Weiser, Karla

    2014-01-01

    Background Inpatient treatment is an expensive way of caring for people with acute psychiatric disorders. It has been proposed that many of those currently treated as inpatients could be cared for in acute psychiatric day hospitals. Objectives To assess the effects of day hospital versus inpatient care for people with acute psychiatric disorders. Search methods We searched the Cochrane Schizophrenia Group Trials Register (June 2010) which is based on regular searches of MEDLINE, EMBASE, CINAHL and PsycINFO. We approached trialists to identify unpublished studies. Selection criteria Randomised controlled trials of day hospital versus inpatient care, for people with acute psychiatric disorders. Studies were ineligible if a majority of participants were under 18 or over 65, or had a primary diagnosis of substance abuse or organic brain disorder. Data collection and analysis Two review authors independently extracted and cross-checked data. We calculated risk ratios (RR) and 95% confidence intervals (CI) for dichotomous data. We calculated weighted or standardised means for continuous data. Day hospital trials tend to present similar outcomes in slightly different formats, making it difficult to synthesise data. We therefore sought individual patient data so that we could re-analyse outcomes in a common format. Main results Ten trials (involving 2685 people) met the inclusion criteria. We obtained individual patient data for four trials (involving 646 people). We found no difference in the number lost to follow-up by one year between day hospital care and inpatient care (5 RCTs, n = 1694, RR 0.94 CI 0.82 to 1.08). There is moderate evidence that the duration of index admission is longer for patients in day hospital care than inpatient care (4 RCTs, n = 1582, WMD 27.47 CI 3.96 to 50.98). There is very low evidence that the duration of day patient care (adjusted days/month) is longer for patients in day hospital care than inpatient care (3 RCTs, n = 265, WMD 2.34 days

  10. The Use of Physical Restraint in Norwegian Adult Psychiatric Hospitals

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    Rolf Wynn

    2015-01-01

    Full Text Available Background. The use of coercion within the psychiatric services is problematic and raises a range of ethical, legal, and clinical questions. “Physical restraint” is an emergency procedure used in psychiatric hospitals to control patients that pose an imminent physical danger. We wished to review the literature published in scientific peer-reviewed journals describing studies on the use of physical restraint in Norway, in order to identify the current state of knowledge and directions for future research. Design. The databases PubMed, PsycINFO, CINAHL, Web of Science, and Embase were searched for studies relating to physical restraint (including holding in Norwegian psychiatric hospitals, supplemented with hand searches. Results. 28 studies were included. Most of the studies were on rates of restraint, but there were also some studies on perceptions of patients and staff, case studies, and ethnographic studies. There was only one intervention study. There are differences in use between wards and institutions, which in part may be explained by differences in patient populations. Staff appear to be less negative to the use of restraint than patients. Conclusions. The studies that were identified were primarily concerned with rates of use and with patients’ and staff’s perspectives. More interventional studies are needed to move the field forward.

  11. What is a hospital bed day worth? A contingent valuation study of hospital Chief Executive Officers.

    Science.gov (United States)

    Page, Katie; Barnett, Adrain G; Graves, Nicholas

    2017-02-14

    Decreasing hospital length of stay, and so freeing up hospital beds, represents an important cost saving which is often used in economic evaluations. The savings need to be accurately quantified in order to make optimal health care resource allocation decisions. Traditionally the accounting cost of a bed is used. We argue instead that the economic cost of a bed day is the better value for making resource decisions, and we describe our valuation method and estimations for costing this important resource. We performed a contingent valuation using 37 Australian Chief Executive Officers' (CEOs) willingness to pay (WTP) to release bed days in their hospitals, both generally and using specific cases. We provide a succinct thematic analysis from qualitative interviews post survey completion, which provide insight into the decision making process. On average CEOs are willing to pay a marginal rate of $216 for a ward bed day and $436 for an Intensive Care Unit (ICU) bed day, with estimates of uncertainty being greater for ICU beds. These estimates are significantly lower (four times for ward beds and seven times for ICU beds) than the traditional accounting costs often used. Key themes to emerge from the interviews include the importance of national funding and targets, and their associated incentive structures, as well as the aversion to discuss bed days as an economic resource. This study highlights the importance for valuing bed days as an economic resource to inform cost effectiveness models and thus improve hospital decision making and resource allocation. Significantly under or over valuing the resource is very likely to result in sub-optimal decision making. We discuss the importance of recognising the opportunity costs of this resource and highlight areas for future research.

  12. Language proficiency among hospitalized immigrant psychiatric patients in Italy.

    Science.gov (United States)

    Ventriglio, Antonio; Baldessarini, Ross J; Iuso, Salvatore; La Torre, Antonella; D'Onghia, Antonio; La Salandra, Michela; Mazza, Maristella; Bellomo, Antonello

    2014-05-01

    and aim: Lack of cultural adaptation may risk or worsen mental illness among immigrants, and interfere with assessment and treatment. Language proficiency (LP) seems essential for access to foreign environments, and the limited research concerning its effects on mental health care encouraged this preliminary study. We reviewed clinical records of all immigrant psychiatric patients hospitalized at the University of Foggia in 2004-09 (N = 85), and compared characteristics of patients with adequate versus inadequate LP. Subjects (44 men, 41 women; aged 35.7±10.0 years) represented 3.62±0.94% of all hospitalizations in six years. (2004-09). Most (60.0%) had emigrated from other European countries. Many were diagnosed with a DSM-IV unspecified psychosis (40.0%) or adjustment disorder (18.8%), and 45.9% were in first-lifetime episodes. Average comprehension and spoken LP was considered adequate in 62.4% and inadequate in 37.6%. In multivariate modelling, adequate LP was more prevalent among women, emigration from another European country, receiving more psychotropic drugs at hospitalization, and having entered Italy legally. Findings support an expected importance of LP among immigrant psychiatric inpatients, and encourage language assessment and training as part of the comprehensive support of such patients, especially men.

  13. An Intelligent Robotic Hospital Bed for Safe Transportation of Critical Neurosurgery Patients Along Crowded Hospital Corridors.

    Science.gov (United States)

    Wang, Chao; Savkin, Andrey V; Clout, Ray; Nguyen, Hung T

    2015-09-01

    We present a novel design of an intelligent robotic hospital bed, named Flexbed, with autonomous navigation ability. The robotic bed is developed for fast and safe transportation of critical neurosurgery patients without changing beds. Flexbed is more efficient and safe during the transportation process comparing to the conventional hospital beds. Flexbed is able to avoid en-route obstacles with an efficient easy-to-implement collision avoidance strategy when an obstacle is nearby and to move towards its destination at maximum speed when there is no threat of collision. We present extensive simulation results of navigation of Flexbed in the crowded hospital corridor environments with moving obstacles. Moreover, results of experiments with Flexbed in the real world scenarios are also presented and discussed.

  14. Psychiatric disorders and clinical correlates of suicidal patients admitted to a psychiatric hospital in Tokyo

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    Ishimoto Kayo

    2010-12-01

    Full Text Available Abstract Background Patients admitted to a psychiatric hospital with suicidal behavior (SB are considered to be especially at high risk of suicide. However, the number of studies that have addressed this patient population remains insufficient compared to that of studies on suicidal patients in emergency or medical settings. The purpose of this study is to seek features of a sample of newly admitted suicidal psychiatric patients in a metropolitan area of Japan. Method 155 suicidal patients consecutively admitted to a large psychiatric center during a 20-month period, admission styles of whom were mostly involuntary, were assessed using Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID-I CV and SCID-II and SB-related psychiatric measures. Associations of the psychiatric diagnoses and SB-related characteristics with gender and age were examined. Results The common DSM-IV axis I diagnoses were affective disorders 62%, anxiety disorders 56% and substance-related disorders 38%. 56% of the subjects were diagnosed as having borderline PD, and 87% of them, at least one type of personality disorder (PD. SB methods used prior to admission were self-cutting 41%, overdosing 32%, self-strangulation 15%, jumping from a height 12% and attempting traffic death 10%, the first two of which were frequent among young females. The median (range of the total number of SBs in the lifetime history was 7 (1-141. Severity of depressive symptomatology, suicidal intent and other symptoms, proportions of the subjects who reported SB-preceding life events and life problems, and childhood and adolescent abuse were comparable to those of the previous studies conducted in medical or emergency service settings. Gender and age-relevant life-problems and life events were identified. Conclusions Features of the studied sample were the high prevalence of affective disorders, anxiety disorders and borderline PD, a variety of SB methods used prior to admission

  15. Producing Marat/Sade: theater in a psychiatric hospital.

    Science.gov (United States)

    Brookes, J M

    1975-07-01

    When a drama group in a small private psychiatric hospital decided to present Marat/Sade, a play about inmates in an insane asylum, some patients and many staff members reacted negatively. However, the drama group carried out its usual rehearsal activities, including improvisations, theater games, and exercises to work out characters' backgrounds, motivations, and feelings. The set and costumes were designed through elaborate improvisations during rehearsals. The group had to overcome various problems in producing the play, but they were no worse than those encountered in previous productions. The director believes that a hospital theater must have the same high standards as a good theater in any setting and that patients' drama groups can handle any aspect of theater.

  16. Organization development in a psychiatric hospital: creating desirable changes.

    Science.gov (United States)

    Cope, D; Cox, S

    1980-07-01

    The organization of the way in which hospitals and hospital staff provide a service to patients is obviously of critical importance to their effectiveness, yet it is clear that rigidities and inappropriate and ineffective procedures frequently intrude. It is commonly held that changing hospitals as organizations is difficult to acomplish, and indeed, reported attempts at such change reflect this. The project reported here was a successful attempt at changing a number of different aspects of the culture of a psychiatric hospital which included managerial practices and structure, aspects of patient care, multidisciplinary team work, and staff development. The present paper concentrates on some specific outcomes at ward level. The general pattern for bringing about change involves the collection of (valid) data and then feeding this back to the staff involved so that they can take appropriate action. The data discussed here concerned ward nursing staff's attitude to the 'climate' of the hospital, their job satisfaction and aspects of patient care. This was fed back to nursing, managerial and medical staff, and action plans were agreed to overcome the difficulties highlighted. Outcomes have included the production of ward and unit objectives and changes in treatment programmes and aspects of patient care on the wards.

  17. Subjective Evaluation of the Microenvironment Generated by a Hospital Bed with Localized Ventilation System

    DEFF Research Database (Denmark)

    Kehayova, Nushka; Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor

    2016-01-01

    A novel method for local hospital bed ventilation, called HBIVCU (Hospital Bed with Integrated Ventilation and Cleansing Unit), was studied in a human subject experiment. The goal of this study was to identify human response to the microenvironment generated by a hospital bed with installed HBIVCU...... and to compare with human response to the micro-environment at a hospital bed without local ventilation. 32 participants took part in two experimental conditions - hospital bed with and without installed HBIVCU. Subject’s votes on the bed microenvironment were collected via standardized questionnaires....... The subjects evaluated the perceived air quality in the ventilated bed as better compared to that in the non-ventilated bed. The whole body thermal sensation (WTS) and acceptability votes were decreasing over time for the non-ventilated bed condition. Significant differences in the local thermal sensation LTS...

  18. The dignity of the child in a psychiatric hospital

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    Błażej Kmieciak

    2012-12-01

    Full Text Available The right to respect the dignity of children using medical services in psychiatric units is regulated among other by the Patients’ Rights act and the Patients’ Rights Ombudsman act, Physician and Dentist Professions Act and the Medical Ethics Code. Although since 1994 the Mental Health Protection Act has existed, some information appears about the violation of the dignity of the child in psychiatric hospitals. Material and methods: Analysis of the information obtained from different sources (the media, the Internet, from patients and/or their legal guardians, peror Psychiatric Hospital Patients’ Ombudsman allowed to draw up a list of repeated situations in psychiatric units for children and adolescents where the dignity of the juvenile/minor patient may be violated. Results: The most frequently reported issues are: reduction of the minor/juvenile patients’ access to “privileges” (such as direct contacts with colleagues, lack of privacy (such as controls in toilets and bathrooms, irregularities during the use of direct coercion, lack of regular access to a mobile phone, the Internet, stereo equipment, lack of juvenile/minor patients’ consent for treatment (including the double permission, engaging the patients to cleaning work, and medical staff’s interventions of educational and corrective character (the patients perceive this as the use of penalties. Discussion: It was found out that the reaction of a minor/juvenile psychiatric unit patient or her/his carers to the detachment from her/his surroundings, favourite activities or things, and educational interventions are related to precise determination of diagnostic and therapeutic procedures and rules prevalent in the group, privileges, consequences, and application of behavioural effects in the form of negative reinforcements (so-called penalties and positive reinforcements (rewards. A strong response to infringement of the rules may be perceived by the patients as a violation of

  19. An observational study in psychiatric acute patients admitted to General Hospital Psychiatric Wards in Italy

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    Margari Francesco

    2007-01-01

    Full Text Available Abstract Objectives this Italian observational study was aimed at collecting data of psychiatric patients with acute episodes entering General Hospital Psychiatric Wards (GHPWs. Information was focused on diagnosis (DSM-IV, reasons of hospitalisation, prescribed treatment, outcome of aggressive episodes, evolution of the acute episode. Methods assessments were performed at admission and discharge. Used psychometric scales were the Brief Psychiatric Rating Scale (BPRS, the Modified Overt Aggression Scale (MOAS and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30. Results 864 adult patients were enrolled in 15 GHPWs: 728 (320 M; mean age 43.6 yrs completed both admission and discharge visits. A severe psychotic episode with (19.1% or without (47.7% aggressive behaviour was the main reason of admission. Schizophrenia (42.8% at admission and 40.1% at discharge and depression (12.9% at admission and 14.7% at discharge were the predominant diagnoses. The mean hospital stay was 12 days. The mean (± SD total score of MOAS at admission, day 7 and discharge was, respectively, 2.53 ± 5.1, 0.38 ± 2.2, and 0.21 ± 1.5. Forty-four (6.0% patients had episodes of aggressiveness at admission and 8 (1.7% at day 7. A progressive improvement in each domain/item vs. admission was observed for MOAS and BPRS, while NOSIE-30 did not change from day 4 onwards. The number of patients with al least one psychotic drug taken at admission, in the first 7 days of hospitalisation, and prescribed at discharge, was, respectively: 472 (64.8%, 686 (94.2% and 676 (92.9%. The respective most frequently psychotic drugs were: BDZs (60.6%, 85.7%, 69.5%, typical anti-psychotics (48.3%, 57.0%, 49.6%, atypical anti-psychotics (35.6%, 41.8%, 39.8% and antidepressants (40.9%, 48.8%, 43.2%. Rates of patients with one, two or > 2 psychotic drugs taken at admission and day 7, and prescribed at discharge, were, respectively: 24.8%, 8.2% and 13.5% in mono-therapy; 22.0%, 20

  20. Substance use disorders as risk factors for psychiatric hospitalization in bipolar disorder.

    Science.gov (United States)

    Hoblyn, Jennifer C; Balt, Steve L; Woodard, Stephanie A; Brooks, John O

    2009-01-01

    This study developed risk profiles of psychiatric hospitalization for veterans diagnosed as having bipolar disorder. This study included 2,963 veterans diagnosed as having bipolar disorder (types I, II, or not otherwise specified) during the 2004 fiscal year. Data were derived from the Veterans Affairs administrative database. Risk profiles for psychiatric hospitalization were generated with an iterative application of the receiver operating characteristic. In this sample 20% of the patients with bipolar disorder were hospitalized psychiatrically during the one-year study period. Patients diagnosed as having both an alcohol use disorder and polysubstance dependence and who also were separated from their spouse or partner had a 100% risk of psychiatric hospitalization; risk of psychiatric hospitalization decreased to 52% if the patients were not separated from their partner. Patients who were not diagnosed as having alcohol use disorders or polysubstance dependence and who were not separated from their partners exhibited the lowest risk of psychiatric hospitalization (12%). Among patients with a psychiatric hospitalization, 41% had longer lengths of stay (<14 days), with the strongest predictor of a longer length of stay being an age older than 77 years, which conferred a 77% risk. Alcohol use and polysubstance dependence can significantly affect the course of bipolar disorder, as evidenced by their associations with psychiatric hospitalizations. Increased focus on substance abuse among older adults with bipolar disorder may decrease length of psychiatric hospitalization. Our findings suggest that implementing substance treatment programs early in the course of bipolar disorder could reduce health service use.

  1. Main clinical features in patients at their first psychiatric admission to Italian acute hospital psychiatric wards. The PERSEO study

    Directory of Open Access Journals (Sweden)

    Russo Federico

    2007-01-01

    Full Text Available Abstract Background Few data are available on subjects presenting to acute wards for the first time with psychotic symptoms. The aims of this paper are (i to describe the epidemiological and clinical characteristics of patients at their first psychiatric admission (FPA, including socio-demographic features, risk factors, life habits, modalities of onset, psychiatric diagnoses and treatments before admission; (ii to assess the aggressive behavior and the clinical management of FPA patients in Italian acute hospital psychiatric wards, called SPDCs (Servizio Psichiatrico Diagnosi e Cura = psychiatric service for diagnosis and management. Method Cross-sectional observational multi-center study involving 62 Italian SPDCs (PERSEO – Psychiatric EmeRgency Study and EpidemiOlogy. Results 253 FPA aged Conclusion Subjects presenting at their first psychiatric ward admission have often not undergone previous adequate psychiatric assessment and diagnostic procedures. The first hospital admission allows diagnosis and psychopharmacological treatment to be established. In our population, aggressive behaviors were rather frequent, although most commonly verbal. Psychiatric symptoms, as evaluated by psychiatrists and patients, improved significantly from admission to discharge both for FPA and non-FPA patients.

  2. A latent class analysis of brief postpartum psychiatric hospital admissions.

    Science.gov (United States)

    Shlomi Polachek, Inbal; Fung, Kinwah; Putnam, Karen; Brody, Samantha Meltzer; Vigod, Simone N

    2017-09-11

    Almost 40% of postpartum psychiatric hospital admissions are brief, lasting 72h or less. We aimed to identify unique subgroups of women within this group to inform better intervention. All women in Ontario, Canada with a brief postpartum psychiatric admission (≤ 72h) (2007-2012)(N = 631) were studied using latent class analysis. We identified distinct subtypes of women and compared women within each subtype on post-discharge mental health indicators: physician visits, emergency department (ED) visits and readmissions. We identified four clinically distinct classes: (1)women with no diagnosed mental illness (2 years before delivery) (n = 179; 28.4% of the sample); (2)women with pre-existing history of severe mental illness (i.e. psychosis) (n = 161; 25.5%); (3)women with pre-existing history of non-psychotic mental illness (n = 211; 33.4%); and (4)adolescent rural-dwelling women with alcohol and substance use disorders (n = 80; 12.7%). In the 1 year post-discharge, women in classes 1-3 were more likely to have post-discharge physician visit than women in class 4 (p class 2 were most likely to be readmitted (p planning. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Prevalence of stalking in a psychiatric hospital population.

    Science.gov (United States)

    Dressing, Harald; Gass, Peter

    2010-08-01

    Study of the lifetime prevalence of stalking and types of stalking in a sample of psychiatric inpatients. A total of 300 patients consecutively admitted to the psychiatric hospital of the Central Institute of Mental Health (Zentralinstitut für Seelische Gesundheit) in Mannheim were studied by means of the Stalking Behaviour Questionnaire (Stalking-Verhaltens-Fragebogen). Of the sample, 21% at some time in their lives had been the victim of stalking. Men were affected as often as women were. The course of stalking was more difficult and more violent in this sample than in a sample taken from the general population in Mannheim. In the majority of the cases the mental disorder had manifested itself before the first stalking incident. In only four out of 64 cases did the responsible physicians know of the previous or ongoing stalking victimization of their patients. Mentally ill individuals are more often affected by stalking than the general population. The topic of stalking should thus be addressed more frequently when taking the case histories of mentally ill patients, in order to provide them with the appropriate type of medical care and support.

  4. [Cytogenetic study of 257 mentally deficient patients in psychiatric hospitals].

    Science.gov (United States)

    Bourgeois, M; Bénézech, M; Tournier-Zerbid, N; Constant-Boy, M; Benazet-Rissou, J

    1975-11-01

    Cytogenetic survey of 257 mentally retarded individuals. A cytogenetic inquiry was undertaken among 257 patients with mental retardation of two psychiatric hospitals. 25 patients show chromosomes anomalies (10%). We found: --18 trisomy 21 (Down's syndrome); --3 sexual chromosome anomalies: 47, XYY syndrome; 47, XYY/46, XY mosaïcism; 47, XXY, or Klinefelter syndrom; --1 partial delection of long arm of chromosome number 18 (46, XX, 18 q--); --3 translocations; 45, XX, t (1, 13) (p 36, q 11); 46, XX, t (5 p--, 18 p+) (p 12, p 11); 46, XY, t (9, 19) (q 21, p 18). We also found 9 large Y chromosomes (46, XY q+), 8 cases of variant chromosomes, 1 case with chromosomes associations..., we report a case of masculine Turner phenotype or Noonan syndrom.

  5. Coping Strategies of Family Members of Hospitalized Psychiatric Patients

    Directory of Open Access Journals (Sweden)

    Phyllis M. Eaton

    2011-01-01

    Full Text Available This exploratory research paper investigated the coping strategies of families of hospitalized psychiatric patients and identified their positive and negative coping strategies. In this paper, the coping strategies of 45 family members were examined using a descriptive, correlational, mixed method research approach. Guided by the Neuman Systems Model and using the Family Crisis Oriented Personal Evaluation Scales and semistructured interviews, this paper found that these family members used more emotion-focused coping strategies than problem-focused coping strategies. The common coping strategies used by family members were communicating with immediate family, acceptance of their situation, passive appraisal, avoidance, and spirituality. The family members also utilized resources and support systems, such as their immediate families, mental health care professionals, and their churches.

  6. [Discharge Dynamics and Related Factors of Long-stay Patients in Psychiatric Hospitals].

    Science.gov (United States)

    Kono, Toshiaki; Shiraishi, Hiromi; Tachimori, Hisateru; Koyama, Asuka; Naganuma, Yoichi; Takeshima, Tadashi

    2015-01-01

    A longstanding challenge in Japan is prolonged psychiatric hospitalization and the associated difficulty of discharge, lost opportunities for patients' social participation, and stagnant reallocation of medical resources. Although the length of stay has been shortened recently on average, its distribution tends to be polarized into high-turnover and long-stay groups. To resolve these problems, we must understand the discharge dynamics of long-stay patients. Three questionnaires were sent to 733 randomly selected psychiatric hospitals (response rate: 24.3%; 178 hospitals, 2,480 patients). One questionnaire was on hospitalized patient numbers for one-year or longer stays as at the end of June 2007, recording each combination of Group (A or B), diagnosis, and hospitalization type. Group A referred to patients continuously hospitalized as at the end of June 2008; Group B referred to those discharged between July 2007 and June 2008. The second questionnaire was on hospital characteristics (founder, bed number, medical function, etc.), and the third questionnaire was on detailed patient characteristics (residential setting post-discharge, etc., for each Group B patient; a maximum of 20 patients per hospital consecutively in order of discharge). Valid data were obtained from 171 hospitals and 2,419 patients, with the latter increasing to 3,543 after weighting. The annual discharge rate (ADR; B/[A+B]) for the entire sample was 16.3%. Regarding the diagnosis, dementia showed the highest ADR (27.8%) and schizophrenia the lowest (13.5%). The ADRs for depression, bipolar disorder, and alcoholism were 23.9, 20.6, and 23.7% respectively. Regarding the hospitalization type, voluntary hospitalization (16.0%) and hospitalization for medical care and protection (16.8%) showed similar ADRs. Regarding the district, ADRs were high in Kinki (19.9%) and Kyushu (18.8%), and low in Kanto (14.1%) and Chugoku/Shikoku (14.2%). Multivariate analyses revealed that discharge within one year was

  7. Exposure measurement in the neighboring hospital beds during an x-ray procedure in hospitalization unit

    Energy Technology Data Exchange (ETDEWEB)

    Goto, Rafael E.; Capeleti, Felipe F.; Cabete, Henrique V., E-mail: rafael.goto@fcmsantacasasp.edu.br, E-mail: felipe.capeleti@fcmsantacasasp.edu.br, E-mail: henrique@gmpbrasil.com.br [Faculdade de Ciencias Medicas da Santa Casa Sao Paulo, SP (Brazil); GMP Consultoria em Radioprotecao e Fisica Medica e Assessoria LTDA, Sao Paulo, SP (Brazil)

    2017-11-01

    There are lots of discussion about the exposure in hospitalization units in Brazil, especially around labor legislation and economic advantages of unhealthiness. With the attention focused on hospitalized patients, there were measured the exposure in neighboring beds of the patient submitted to an X-ray procedure with a mobile X-ray system that could be used to illustrate the discussion with consistent values. The most common X-ray procedure made in hospitalization units are chests images with techniques between 70 to 120 kV and 5 to 20 mAs. The measurement was made during routine exposure and simulations using a scattering phantom with Radcal AccuPro electrometer and 1800cc ionization chamber in a private hospital and a philanthropic hospital, both in Sao Paulo, Brazil. The ionization chambers are placed at 2 meters distance of the patient exposed of both sides during the routine procedure. During the simulation, a nylon phantom of 20 centimeters thick and 30 x 30 cm² size was placed on the bed, a typical exposure technique was used and the exposure was measured surrounding the phantom at 0.6, 1.0 and 2.0 meters distance for scattered radiation characterization. Initial results showed that the neighboring exposure at about 2 meters distance from the exposed patient bed have low values, even when exposure is integrated during the length of hospital stay. Therefore, the exposure in hospitalization units are very low compared to the exams doses. (author). (author)

  8. Surveying Substance Abuse Frequency in Hospitalized Patients in Psychiatric Ward of Farshchian Hospital in Hamadan

    Directory of Open Access Journals (Sweden)

    A. Ghaleiha

    2010-04-01

    Full Text Available Introduction & Objective: Substance abuse is believed to be one of the greatest social, economical ,and cultural problems all over the world and it is commonly observed among all social classes especially among mental disorder patients. Substance abuse can influence on the receptive-mental states such as mood and on the external visible activities such as behaviors. The aim of this study is to survey the frequency of Substance abuse in hospitalized mental-psychic patients in psychiatric ward of Farshchian hospital in Hamadan. Materials & Methods: In this descriptive and retrospective study, available sampling method was used along with examining filed records in which the records of 400 hospitalized patients (293 men and 107 women from September 2000 to 2001 were checked and required data such as demographic information, infliction duration, substance abuse duration, psychiatric diagnosis were extracted and registered. The data were analyzed with descriptive statistical methods.Results: About half of the hospitalized patients in the psychiatric ward had simultaneous substance abuse. Men had substance abuse more than women and the youths aged 20-39 more than the other groups. The study showed that widowing had positive relationship and higher education negative relationship with substance abuse.Conclusion: Mood disorders with 90.53%, schizophrenia with 8.29%, and other diagnostics with 1.18% were observed in persons with substance abuse and these diagnostics in non substance abuse persons were 79.22% ,11.26% and 9.52% respectively.

  9. Online comments on smoking bans in psychiatric hospitals units.

    Science.gov (United States)

    Brown-Johnson, Cati G; Sanders-Jackson, Ashley; Prochaska, Judith J

    2014-01-01

    Individuals with mental health concerns are disproportionately affected by and suffer the negative consequences of tobacco use disorder, perhaps because smoking has historically been part of psychiatry's culture. In the early 1990s, psychiatric inpatient facilities were exempted from U.S. hospital smoking bans, in response to public outcry with national media attention. Almost 2 decades later, the current study characterizes online conversation about psychiatric hospital smoking bans. Previous commenting studies have demonstrated commenting's negativity, documenting the "nasty effect" wherein negative comments color perceptions of neutral articles. Thus, we focused particular attention on cited barriers to implementing health-positive smoke-free policies. We collected online comments (N = 261) responding to popular media articles on smoking bans in inpatient psychiatry between 2013 and 2014 and conducted an inductive and exploratory qualitative content analysis. Verifying previous studies documenting the prevalence of negative commenting, of the comments explicitly supporting or refuting psychiatry smoking bans, there were over twice as many con comments (n = 44) than pro (n = 18). Many commenters argued for access to outdoor smoking areas and warned of patient agitation and risk posed to care workers. Identified content themes included psychiatric medication and negative side effects, broken mental health systems and institutions, denigration of the health risks of tobacco in the context of mental illness, typical pro-smoking arguments about "smokers' rights" and alternatives (including e-cigarettes), addiction, and stigma. The current findings provide a platform to begin to understand how people talk about mental health issues and smoking. Our analysis also raised complex issues concerning forces that impact U.S. patients with serious mental illness but over which they have little control, including medication, the U.S. health system, stigma, perceptions that

  10. Chemical restraint in routine clinical practice: a report from a general hospital psychiatric ward in Greece

    Directory of Open Access Journals (Sweden)

    Papamichael Georgios

    2011-02-01

    Full Text Available Abstract Background There is a dearth of studies regarding chemical restraint in routine clinical psychiatric practice. There may be wide variations between different settings and countries. Methods A retrospective study on chemical restraint was performed in the 11-bed psychiatric ward of the General Hospital of Arta, in northwestern Greece. All admissions over a 2-year-period (from March 2008 to March 2010 were examined. Results Chemical restraint was applied in 33 cases (10.5% of total admissions. From a total of 82 injections, 22 involved a benzodiazepine and/or levomepromazine, whereas 60 injections involved an antipsychotic agent, almost exclusively haloperidol (96.7% of cases, usually in combination with a benzodiazepine (61.7% of cases. In 36.4% of cases the patient was further subjected to restraint or seclusion. Conclusions In our unit, clinicians prefer the combined antipsychotic/benzodiazepine regimen for the management of patients' acute agitation and violent behaviour. Conventional antipsychotics are administrated almost exclusively and in a significant proportion of cases further coercive measures are applied. Studies on the practice of chemical restraint should be regularly performed in clinical settings.

  11. How common are errors in the medication process in a psychiatric hospital?

    DEFF Research Database (Denmark)

    Sørensen, Ann Lykkegaard; Mainz, Jan; Lisby, Marianne

    How common are errors in the medication process in a psychiatric hospital? Background and purpose: Medication errors in psychiatric care is a problem in need of attention in Denmark. Studies are sparse and does not investigate all stages of the medication process. There is an urgent need...... for clarifying studies concerning prevalence and nature of medication errors in psychiatric care, as well as studies concerning associations related to medication errors. This is the basis for quality improving interventions in relation to medication safety in psychiatric care. The aim of this study was to asses...... frequency, type and potential clinical consequences of errors in all stages of the medication process in an inpatient psychiatric setting. Methods and materials: A cross-sectional study in two general psychiatric wards and one acute psychiatric ward. Participants were eligible psychiatric in...

  12. Satisfaction of patients hospitalised in psychiatric hospitals: a randomised comparison of two psychiatric-specific and one generic satisfaction questionnaires

    Directory of Open Access Journals (Sweden)

    Cléopas Agatta

    2006-08-01

    Full Text Available Abstract Background While there is interest in measuring the satisfaction of patients discharged from psychiatric hospitals, it might be important to determine whether surveys of psychiatric patients should employ generic or psychiatry-specific instruments. The aim of this study was to compare two psychiatric-specific and one generic questionnaires assessing patients' satisfaction after a hospitalisation in a psychiatric hospital. Methods We randomised adult patients discharged from two Swiss psychiatric university hospitals between April and September 2004, to receive one of three instruments: the Saphora-Psy questionnaire, the Perceptions of Care survey questionnaire or the Picker Institute questionnaire for acute care hospitals. In addition to the comparison of response rates, completion time, mean number of missing items and mean ceiling effect, we targeted our comparison on patients and asked them to answer ten evaluation questions about the questionnaire they had just completed. Results 728 out of 1550 eligible patients (47% participated in the study. Across questionnaires, response rates were similar (Saphora-Psy: 48.5%, Perceptions of Care: 49.9%, Picker: 43.4%; P = 0.08, average completion time was lowest for the Perceptions of Care questionnaire (minutes: Saphora-Psy: 17.7, Perceptions of Care: 13.7, Picker: 17.5; P = 0.005, the Saphora-Psy questionnaire had the largest mean proportion of missing responses (Saphora-Psy: 7.1%, Perceptions of Care: 2.8%, Picker: 4.0%; P P Conclusion Despite differences in the intended target population, content, lay-out and length of questionnaires, none appeared to be obviously better based on our comparison. All three presented advantages and drawbacks and could be used for the satisfaction evaluation of psychiatric inpatients. However, if comparison across medical services or hospitals is desired, using a generic questionnaire might be advantageous.

  13. The opinion of patients with mental disorder about tobacco and its prohibition in psychiatric hospitalization

    Directory of Open Access Journals (Sweden)

    Renata Marques de Oliveira

    2014-06-01

    Full Text Available Objective: To identify the opinion of patients with mental disorder about tobacco and its prohibition during psychiatric hospitalization. Method: An exploratory study with 96 patients smokers with mental disorders hospitalized in a psychiatric ward of a general hospital. The interviews were conducted individually, using an instrument designed for this study. The content from the interviews was recorded, transcribed and submitted to a thematic content analysis. Results: The patients with mental disorder were identified as perceiving smoking during the psychiatric hospitalization as a help to support the difficulties in socialization and in the lack of activities. The permission for smoking is seen as a signal of respect to their needs. The subjects mentioned to not accept the total smoking prohibition. Conclusion: Tobacco helps to face difficulties and conflicts in the psychiatric hospitalization. There is resistance regarding the possibility to totally withdraw the smoking permission during hospitalization.

  14. [THE CLINICAL ORGANIZATIONAL SUBSTANTIATION OF NEW TECHNOLOGY OF HOSPITAL PSYCHIATRIC CARE].

    Science.gov (United States)

    Podsevatkin, V G; Blinov, D S; Podsevatkin, D V; Podsevatkina, S V; Smirnova, O A

    2015-01-01

    The new technology of hospital psychiatric care, developed and implemented in the Mordovia republican clinical hospital, permits resolving problems of hospitalism, lethality, pharmaceutical resistance and others. The essence of this technology is in staging of hospital care under condition of intensification and standardization of curative diagnostic process, implementation of complex approach to treatment of psychiatric disorders. The patient sequentially passes through three stages: intensive diagnostics and intensive treatment (intensive care department, intensive therapy department), supportive therapy (general psychiatric department); rehabilitation measures (curative rehabilitative department). The concentration of resources at the first stage, application of intensive therapy techniques permit in the shortest period to arrest acute psychotic symptomatic. The described new technology of hospital psychiatric care permits enhancing effectiveness of treatment, significantly shorten period of hospitalization (37.5 days), to obtain lasting and qualitative remission, to rehabilitate most fully social working status of patient and to significantly decrease lethality.

  15. Daily weather variables and affective disorder admissions to psychiatric hospitals

    Science.gov (United States)

    McWilliams, Stephen; Kinsella, Anthony; O'Callaghan, Eadbhard

    2014-12-01

    Numerous studies have reported that admission rates in patients with affective disorders are subject to seasonal variation. Notwithstanding, there has been limited evaluation of the degree to which changeable daily meteorological patterns influence affective disorder admission rates. A handful of small studies have alluded to a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (heat waves in particular), wind direction and sunshine. We used the Kruskal-Wallis test, ARIMA and time-series regression analyses to examine whether daily meteorological variables—namely wind speed and direction, barometric pressure, rainfall, hours of sunshine, sunlight radiation and temperature—influence admission rates for mania and depression across 12 regions in Ireland over a 31-year period. Although we found some very weak but interesting trends for barometric pressure in relation to mania admissions, daily meteorological patterns did not appear to affect hospital admissions overall for mania or depression. Our results do not support the small number of papers to date that suggest a link between daily meteorological variables and affective disorder admissions. Further study is needed.

  16. Smoking bans in secure psychiatric hospitals and prisons.

    Science.gov (United States)

    Sullivan, Danny H; Rees, Megan A

    2014-09-01

    The proposal of complete smoking bans in closed institutions, such as prisons and psychiatric hospitals, creates a tension between individual "rights" and the health of all members of that community. Smokers in closed institutions generally smoke more, suffer more health consequences and are less likely to quit than smokers in other settings. Complete smoking bans do not cause an increase in behavioural problems, nor do bans cause worsening of mental illness or quality of life. Although infrequently tested, the responsibility of public institutions to protect others from second-hand smoke has usually outweighed any individual "right to smoke" in legal judgments. A substantial cultural shift may be required from considering smoking a "rare pleasure" during detention to the realisation that smoking is the most significant reversible health risk factor for this population. The implementation of complete smoking bans in closed institutions is challenging and requires careful and proactive planning by staff. As complete smoking bans are being considered in many institutions and jurisdictions, this column presents a review of the evidence base and ethical issues involved.

  17. Sudden Cardiac Death in Young Adults With Previous Hospital-Based Psychiatric Inpatient and Outpatient Treatment

    DEFF Research Database (Denmark)

    Risgaard, Bjarke; Waagstein, Kristine; Winkel, Bo Gregers

    2015-01-01

    hospital contact and was identified using The Danish Psychiatric Central Research Register. All diagnoses in Danish registries are coded according to ICD-8 or ICD-10. All hospital records were retrieved manually. Results: Among 5,178 deaths, 395 were due to SCD and autopsies were performed on 262 (66......Introduction: Psychiatric patients have premature mortality compared to the general population. The incidence of sudden cardiac death (SCD) in psychiatric patients is unknown in a nationwide setting. The aim of this study was to compare nationwide SCD incidence rates in young individuals...... with and without previous psychiatric disease. Method: Nationwide, retrospective cohort study including all deaths in people aged 18–35 years in 2000–2006 in Denmark. The unique Danish death certificates and autopsy reports were used to identify SCD cases. Psychiatric disease was defined as a previous psychiatric...

  18. Physician-patient communication in single-bedded versus four-bedded hospital rooms.

    NARCIS (Netherlands)

    Glind, I. van de; Dulmen, S. van; Goossensen, A.

    2008-01-01

    Objective: To examine whether physician-patient communication in multi-bedded rooms differs from communication in single rooms during ward rounds. Methods: Ward rounds in single bedded patient rooms and ward rounds in four bedded rooms were audiotaped and analyzed with an adapted version of MIARS.

  19. An analysis of acute admissions to a general hospital psychiatric unit

    African Journals Online (AJOL)

    Rapid turnover of patients in a general hospital psychiatric unit demands stabilization and discharge as soon as possible. It is likely that patients are being prematurely discharged because of this pressure. Aim: The study sought to analyse admissions to an acute psychiatric unit with a view to determining the demographic ...

  20. Ten-year mortality review in a pioneer psychiatric hospital in West ...

    African Journals Online (AJOL)

    Objective: To determine the mortality among admitted patients in the study centre, a pioneer psychiatric facility in the West African sub-region. Design: A detailed retrospective study of the records of all deaths among the inpatients during the ten-year period of January, 1991 to December, 2000. Setting: Psychiatric Hospital ...

  1. Transitioning Children from Psychiatric Hospitals to Schools: The Role of the Special Educator

    Science.gov (United States)

    Simon, Joan B.; Savina, Elena A.

    2010-01-01

    Over a quarter of a million U.S. students each year reside for a period of time in a psychiatric inpatient hospital setting to receive mental health treatment. Following inpatient treatment, most children are transitioned from the hospital into a regular school setting. Little is known about how these transitions are managed by hospital or school…

  2. The Measurement, Analysis and Implementation of a Corporate Image Program: The Case of a Psychiatric Hospital.

    Science.gov (United States)

    Elbeck, Matt A.; Buchanan, Gary W.

    1987-01-01

    Measured a psychiatric hospital's image, using qualitative and quantitative methods. Used data from the consumer public to illustrate the development and implementation of an image program stressing multi-public awareness, preference and utilization of the hospital's services vis-a-vis the hospital's mission statement. This study demonstrated…

  3. [Prediction model of health workforce and beds in county hospitals of Hunan by multiple linear regression].

    Science.gov (United States)

    Ling, Ru; Liu, Jiawang

    2011-12-01

    To construct prediction model for health workforce and hospital beds in county hospitals of Hunan by multiple linear regression. We surveyed 16 counties in Hunan with stratified random sampling according to uniform questionnaires,and multiple linear regression analysis with 20 quotas selected by literature view was done. Independent variables in the multiple linear regression model on medical personnels in county hospitals included the counties' urban residents' income, crude death rate, medical beds, business occupancy, professional equipment value, the number of devices valued above 10 000 yuan, fixed assets, long-term debt, medical income, medical expenses, outpatient and emergency visits, hospital visits, actual available bed days, and utilization rate of hospital beds. Independent variables in the multiple linear regression model on county hospital beds included the the population of aged 65 and above in the counties, disposable income of urban residents, medical personnel of medical institutions in county area, business occupancy, the total value of professional equipment, fixed assets, long-term debt, medical income, medical expenses, outpatient and emergency visits, hospital visits, actual available bed days, utilization rate of hospital beds, and length of hospitalization. The prediction model shows good explanatory and fitting, and may be used for short- and mid-term forecasting.

  4. Felt stigma and self-esteem among psychiatric hospital outdoor and community camp attending patients

    OpenAIRE

    Shantna Kumari; Inderjeet Banerjee; G Majhi; Suprakash Chaudhury; Amool R Singh; A N Verma

    2014-01-01

    Background: Self-stigma of people with mental illness is a major obstacle to recovery, limiting opportunities and undermining self-esteem. Aim: The aim of this study is to compare felt stigma and self-esteem in psychiatric patients receiving treatment from hospital outdoor clinic or from Community Outreach Program (COP). Materials and Methods: This cross-sectional study was conducted on psychiatric patients who were on outpatient treatment for at least 6 months, but had never been hospitalize...

  5. A prospective study of smoking in young women and risk of later psychiatric hospitalization

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M

    2011-01-01

    It is not known whether smoking is a risk factor for mental disorders. Aims: To investigate the prospective associations between cigarette smoking in pregnant women and a range of psychiatric hospital diagnoses.......It is not known whether smoking is a risk factor for mental disorders. Aims: To investigate the prospective associations between cigarette smoking in pregnant women and a range of psychiatric hospital diagnoses....

  6. Involuntary Psychiatric Admissions and Development of Psychiatric Services as an Alternative to Full-Time Hospitalization in France.

    Science.gov (United States)

    Gandré, Coralie; Gervaix, Jeanne; Thillard, Julien; Macé, Jean-Marc; Roelandt, Jean-Luc; Chevreul, Karine

    2017-09-01

    The development of alternatives to full-time hospitalization in psychiatry is limited because consensus about the benefits of such alternatives is lacking. This study assessed whether the development of such alternatives in French psychiatric sectors was associated with a reduction in involuntary inpatient care, taking into account other factors that are potentially associated with involuntary admission. Data on whether a patient had at least one involuntary full-time admission in 2012 were extracted from the French national discharge database for psychiatric care. The development of alternatives to full-time hospitalization was estimated as the percentage of human resources allocated to these alternatives out of all human resources allocated to psychiatry, measured at the level of the hospital hosting each sector. Other factors potentially associated with involuntary admission (characteristics of patients, health care providers, and the environment) were extracted from administrative databases, and a multilevel logistic model was carried out to account for the nested structure of the data. Significant variations were observed between psychiatric sectors in rates of involuntary inpatient admissions. A large portion of the variation was explained by characteristics of the sectors. A significant negative association was found between involuntary admissions and the development of alternatives to full-time hospitalization, after adjustment for other factors associated with involuntary admissions. Findings suggest that the development of alternatives to full-time hospitalization is beneficial for quality of care, given that it is negatively associated with involuntary full-time admissions. The reduction of such admissions aligns with international recommendations for psychiatric care.

  7. Potentially inappropriate prescribing in older patients admitted to psychiatric hospital

    NARCIS (Netherlands)

    Rongen, S.; Kramers, C.; O'Mahony, D.; Feuth, T.; Olde Rikkert, M.G.M.; Ahmed, A.I.A.

    2016-01-01

    OBJECTIVES: The objectives of this study are to determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs) and to assess related risk factors in older people with major psychiatric illness.

  8. Psychiatric hospital treatment of children with autism and serious behavioral disturbance.

    Science.gov (United States)

    Siegel, Matthew; Gabriels, Robin L

    2014-01-01

    Children with autism spectrum disorder are psychiatrically hospitalized much more frequently than children in the general population. Hospitalization occurs primarily because of externalizing behaviors and is associated with behavioral disturbance, impaired emotion regulation, and psychiatric comorbidity. Additionally, a lack of practitioner and/or administrator training and experience with this population poses risks for denial of care by third-party payers or treatment facilities, inadequate treatment, extended lengths of stay, and poor outcomes. Evidence and best practices for the inpatient psychiatric care of this population are presented. Specialized treatment programs universally rely on multidisciplinary approaches, including behaviorally informed interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Satisfaction of patients hospitalised in psychiatric hospitals: a randomised comparison of two psychiatric-specific and one generic satisfaction questionnaires.

    Science.gov (United States)

    Peytremann-Bridevaux, Isabelle; Scherer, Frédy; Peer, Laurence; Cathieni, Federico; Bonsack, Charles; Cléopas, Agatta; Kolly, Véronique; Perneger, Thomas V; Burnand, Bernard

    2006-08-28

    While there is interest in measuring the satisfaction of patients discharged from psychiatric hospitals, it might be important to determine whether surveys of psychiatric patients should employ generic or psychiatry-specific instruments. The aim of this study was to compare two psychiatric-specific and one generic questionnaires assessing patients' satisfaction after a hospitalisation in a psychiatric hospital. We randomised adult patients discharged from two Swiss psychiatric university hospitals between April and September 2004, to receive one of three instruments: the Saphora-Psy questionnaire, the Perceptions of Care survey questionnaire or the Picker Institute questionnaire for acute care hospitals. In addition to the comparison of response rates, completion time, mean number of missing items and mean ceiling effect, we targeted our comparison on patients and asked them to answer ten evaluation questions about the questionnaire they had just completed. 728 out of 1550 eligible patients (47%) participated in the study. Across questionnaires, response rates were similar (Saphora-Psy: 48.5%, Perceptions of Care: 49.9%, Picker: 43.4%; P = 0.08), average completion time was lowest for the Perceptions of Care questionnaire (minutes: Saphora-Psy: 17.7, Perceptions of Care: 13.7, Picker: 17.5; P = 0.005), the Saphora-Psy questionnaire had the largest mean proportion of missing responses (Saphora-Psy: 7.1%, Perceptions of Care: 2.8%, Picker: 4.0%; P < 0.001) and the Perceptions of Care questionnaire showed the highest ceiling effect (Saphora-Psy: 17.1%, Perceptions of Care: 41.9%, Picker: 36.3%; P < 0.001). There were no differences in the patients' evaluation of the questionnaires. Despite differences in the intended target population, content, lay-out and length of questionnaires, none appeared to be obviously better based on our comparison. All three presented advantages and drawbacks and could be used for the satisfaction evaluation of psychiatric inpatients

  10. Improving Psychiatric Hospital Care for Pediatric Patients with Autism Spectrum Disorders and Intellectual Disabilities

    Directory of Open Access Journals (Sweden)

    Robin L. Gabriels

    2012-01-01

    Full Text Available Pediatric patients with autism spectrum disorders (ASD and/or intellectual disabilities (ID are at greater risk for psychiatric hospitalization compared to children with other disorders. However, general psychiatric hospital environments are not adapted for the unique learning styles, needs, and abilities of this population, and there are few specialized hospital-based psychiatric care programs in the United States. This paper compares patient outcomes from a specialized psychiatric hospital program developed for pediatric patients with an ASD and/or ID to prior outcomes of this patient population in a general psychiatric program at a children’s hospital. Record review data indicate improved outcomes for patients in the specialized program of reduced recidivism rates (12% versus 33% and decreased average lengths of inpatient stay (as short as 26 days versus 45 days. Available data from a subset of patients (=43 in the specialized program showed a decrease in irritability and hyperactivity behaviors from admission to discharge and that 35 previously undetected ASD diagnoses were made. Results from this preliminary study support specialized psychiatric care practices with this population to positively impact their health care outcomes.

  11. Competence to consent to voluntary psychiatric hospitalization: a test of a standard proposed by APA. American Psychiatric Association.

    Science.gov (United States)

    Appelbaum, B C; Appelbaum, P S; Grisso, T

    1998-09-01

    In the wake of the U.S. Supreme Court's 1990 decision in Zinermon v. Burch, renewed attention has been given to capacities patients must have to be considered competent to consent to voluntary hospitalization. An American Psychiatric Association (APA) task force suggested that strong policy interests support the establishment of a low threshold for competence in this situation. The study examined whether, as previous research suggested, patients would have difficulty meeting even this lenient standard. One hundred voluntarily hospitalized psychiatric patients were read two brief paragraphs, one explaining the purposes of psychiatric hospitalization and and the other explaining policies for discharge. The paragraphs' readability measured about eighth-grade level. After each paragraph, participants were read two sets of questions, one testing recall of the presented information and the other testing recognition of the information in a true-false format. The scores of patients grouped by selected demographic and clinical variables were compared. The vast majority of patients were able to comprehend the information that the APA task force suggested was relevant to their decision. However, a subgroup of patients who were initially admitted involuntarily had significantly poorer performance and may constitute a group who need special educational efforts focused on the consequences of voluntary admission.

  12. Trends in the prescription of clozapine in a psychiatric hospital: a 5-year observational study

    Directory of Open Access Journals (Sweden)

    Gabriela Danielski Niehues

    2017-07-01

    Full Text Available Abstract Introduction Clozapine is a well-recognized effective treatment for some patients with treatment-resistant schizophrenia (TRS. Although it has potential benefits and approximately 30% of patients have a clinical indication for clozapine use, prescription rates are low. Objective To evaluate clozapine prescription trends over a 5-year period in a tertiary psychiatric hospital. Methods In this observational study, data prospectively collected by the Medical and Statistical File Service (Serviço de Arquivo Médico e Estatístico and the Pharmacy Division of Instituto de Psiquiatria de Santa Catarina between January 2010 and December 2014 were summarized and analyzed by investigators blinded to data collection. The number of 100 mg clozapine pills dispensed by the Pharmacy Division to the inpatient units was the outcome and considered a proxy measure of clozapine prescriptions. The number of occupied inpatient unit beds and the number of patients admitted with F20-F29 (ICD-10 diagnoses during the study period were considered to be possible confounders. Results A multiple linear regression model showed that time in months was independently associated with an increase in the number of clozapine pills dispensed by the Pharmacy Division (β coefficient = 15.82; 95% confidence interval 10.88-20.75. Conclusion Clozapine prescriptions were found to have increased during the 5-year period studied, a trend that is opposite to reports from several other countries.

  13. Trends in the prescription of clozapine in a psychiatric hospital: a 5-year observational study.

    Science.gov (United States)

    Niehues, Gabriela Danielski; Balan, Alexandre Balestieri; Prá, Vinicius Brum; Pellizzaro, Raphaela Santos; da Silva, Paulo Roberto Antunes; Niehues, Manuela Danielski; Costa, Ana Paula; Schwarzbold, Marcelo Liborio; Diaz, Alexandre Paim

    2017-01-01

    Clozapine is a well-recognized effective treatment for some patients with treatment-resistant schizophrenia (TRS). Although it has potential benefits and approximately 30% of patients have a clinical indication for clozapine use, prescription rates are low. To evaluate clozapine prescription trends over a 5-year period in a tertiary psychiatric hospital. In this observational study, data prospectively collected by the Medical and Statistical File Service (Serviço de Arquivo Médico e Estatístico) and the Pharmacy Division of Instituto de Psiquiatria de Santa Catarina between January 2010 and December 2014 were summarized and analyzed by investigators blinded to data collection. The number of 100 mg clozapine pills dispensed by the Pharmacy Division to the inpatient units was the outcome and considered a proxy measure of clozapine prescriptions. The number of occupied inpatient unit beds and the number of patients admitted with F20-F29 (ICD-10) diagnoses during the study period were considered to be possible confounders. A multiple linear regression model showed that time in months was independently associated with an increase in the number of clozapine pills dispensed by the Pharmacy Division (β coefficient = 15.82; 95% confidence interval 10.88-20.75). Clozapine prescriptions were found to have increased during the 5-year period studied, a trend that is opposite to reports from several other countries.

  14. Validation of the Children's Interview for Psychiatric Syndromes (ChIPS) with Psychiatrically Hospitalized Adolescents

    Science.gov (United States)

    Swenson, Lance P.; Esposito-Smythers, Christianne; Hunt, Jeffrey I.; Hollander, Beth L. G.; Dyl, Jennifer; Rizzo, Christie J.; Steinley, Douglas L.; Spirito, Anthony

    2007-01-01

    A study was conducted to examine the concurrent validity of the Children's Interview for Psychiatric Syndromes (ChIPS) for adolescent inpatients aged 12 to 18. The results reveal moderate agreement between ChIPS diagnoses and Schedule for Affective Disorder sand Schizophrenia for School-Age Children-Present and Lifetime version diagnoses.

  15. [Therapeutic community model in short psychiatric hospitalization. Descriptive study on the dynamic psychiatric inpatient unit of the Italian hospital of Buenos Aires].

    Science.gov (United States)

    Matusevich, Daniel; Ruiz, Martín; Vairo, María; Girard, Paula; Rozadilla, Gustavo; Castagnola, Guido; Job, Alfredo; Pinto, Inés; Finkelsztein, Carlos

    2006-01-01

    the aim of this paper is to communicate a project of short term psychiatric hospitalization, based on a therapeutic community model, considering qualitative and quantitative aspects in the present socio - cultural context. this psychiatric hospitalization model that embraces psychodynamic and pharmacological interventions is focused in the intensity of interactions between members of the therapeutic community and integrated to the administrative structure of a general hospital; this will be the key to consider patient's return to the community and to move forward over the prejudices that inpatients suffer. quantitative, prospective, observational and transversal study on a Dynamic Psychiatric Inpatient Unit. 605 patients were included. mean length of stay was 16.34 days; principal causes of admission were depression (19.4%), suicide ideas (17.7%), suicide attempt (17.6%), substance abuse or dependence (14.3%), psychosis (13.8%), behavioral and psychological symptoms of dementia (6%). There were 75 readmissions. 14.88% patients were physically restrained. Principal Axis I diagnosis were depression (32.1%), substance dependence (13.2%), bipolar disorder (10.2%), dementia (7.6%), schizophrenia (7.5%), and psychotic disorder (5.8). Axis II diagnosis were borderline personality disorder (27.3%), narcissistic personality disorder (8.9%), histrionic personality disorder (5.3%). this kind of approach shows a structural model that allows possible and persistent favorable changes for psychiatric inpatients.

  16. Pattern of Urine Toxicology Screening in a Lagos Psychiatric Hospital

    African Journals Online (AJOL)

    Toxicology screening has clinical and forensic applications in evaluating severe or life-threatening symptoms in patients presenting with signs and symptoms suggestive of intoxication or overdose. In both acute psychiatric and medical settings, urine toxicology has been found helpful in detection of substances of abuse.

  17. Significance of personality disorders in the face of drop-outs from psychiatric hospitalizations. The case of selected psychiatric units.

    Science.gov (United States)

    Biała, Maja; Kiejna, Andrzej

    2017-06-18

    The World Health Organization's estimations indicate that about 50% of patients in well-developed countries may not adhere to long-term therapies. In the field of psychiatry, drop-outs from psychiatric treatment are particularly important. Personality disorders are a significant part of this sphere. The aim of this research was to empirically verify the hypothesis regarding the relation between comorbid personality disorders and drop-outs from treatment among patients of psychiatric wards. This study was a prospective cohort study. 110 patients, hospitalized in 3 different psychiatric wards, were included. Personality disorders were assessed with the Structured Clinical Interview For DSM-IV Personality Disorders (SCID-II). The research was financed by the Polish National Science Center (DEC-2011/01/N/NZ5/05364). The response rate was 89.1%. 72.56% of patients suffered from personality disorders (SCID-II) (among them the most prevalent were: personality disorder - not otherwise specified - 40.7% and borderline personality disorder - 12.38%; 22.95% of patients dropped out from treatment). However, occurrence of personality disorders was not relevant for those drop-outs. On the other hand, relationships at the level of certain criteria of borderline personality disorders and passive-aggressive personality have been revealed. These relationships became stronger when considered from the perspective of differences in the organization of treatment at individual wards. Some personality disorders may play an important role in drop-outs from psychiatric treatment. Presented results require further research.

  18. [Psychiatric and Psychotherapeutic Care of Refugees by Reference of a Large Psychiatric Care Hospital in Western Germany].

    Science.gov (United States)

    Schaffrath, Jonas; Schmitz-Buhl, Mario; Gün, Ali Kemal; Gouzoulis-Mayfrank, Euphrosyne

    2017-04-01

    Medical and psychological care of refugees is among the most important current challenges in German health politics. Work with patients from this heterogeneous group who have often faced severe stress before, during and after their migration is currently based on a thin data foundation. Based on introductory information on current knowledge concerning psychiatric morbidity of refugees this article presents the psychiatric care of refugees at LVR Clinics Cologne - a psychiatric specialty hospital situated in North Rhine-Westphalia, Germany. A sample of 239 cases of refugee patients who were referred to in- and outpatient departments of the LVR Clinics Cologne between April 2015 and March 2016 are evaluated in respect of diagnoses, admission modalities and socio-demographic variables. The majority of principal diagnoses (40.2%) belong to the group of stress-related and somatoform disorders (F4 in ICD-10). Mood disorders (F3 in ICD-10) represented 31.0%, followed by mental and behavioral disorders due to psychoactive substance use (F1 in ICD-10) with 15.1%. Posttraumatic Stress Disorder (PTSD) was the most prevalent diagnose (13.0%). Among the 29 countries of the patients' origin Afghanistan (10,0%), Serbia (9.6%) and Kosovo (8.8%) were the most abundant. The diagnoses and the high rate of acute psychiatric events reflect the massive psychological pressure of the patients. The important role of interpreters and mediators specialized in language and integration in the treatment process is emphasized. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Human rights abuses at a psychiatric hospital in KwaZulu-Natal ...

    African Journals Online (AJOL)

    Abstract. Background. Following allegations of human rights abuses at a psychiatric hospital in Pietermaritzburg, KwaZulu-Natal, that were reported in one of the local newspapers, the national and provincial Ministers of Health visited the hospital. Because of the seriousness of the allegations, the national Minister of Health ...

  20. Felt stigma and self-esteem among psychiatric hospital outdoor and community camp attending patients

    Directory of Open Access Journals (Sweden)

    Shantna Kumari

    2014-01-01

    Full Text Available Background: Self-stigma of people with mental illness is a major obstacle to recovery, limiting opportunities and undermining self-esteem. Aim: The aim of this study is to compare felt stigma and self-esteem in psychiatric patients receiving treatment from hospital outdoor clinic or from Community Outreach Program (COP. Materials and Methods: This cross-sectional study was conducted on psychiatric patients who were on outpatient treatment for at least 6 months, but had never been hospitalized. The study sample included 130 patients receiving outdoor treatment from a Psychiatric Hospital and a matched group of 140 patients receiving treatment from COP of the same hospital. Demographic and clinical details of the patients were recorded on a specially designed proforma. Modified felt stigma scale and Rosenberg self-esteem scale were used to assess stigma and self-esteem, respectively. Results: On the modified felt stigma scale, the mean (±standard deviation [SD] score of psychiatric hospital outpatients (31.89 ± 6.51 was significantly higher than the scores of patients attending COP (29.20 ± 6.80. On Rosenberg self-esteem scale, mean (±SD scores of patients with psychosis (17.98 ± 1.69 was significantly lower compared to scores of patients with epilepsy (21.83 ± 1.60. There was no significant correlation between stigma and self-esteem. Conclusion: As psychiatric hospital outpatients have significantly more self-stigma when compared to patients attending community outreach camps, the availability of more community outreach camps along with educating people about psychiatric illnesses may help in lowering stigma of psychiatric disorders.

  1. Burden of Hospitalized Pediatric Morbidity and Utilization of Beds in a Tertiary Care Hospital of Kolkata, India

    Directory of Open Access Journals (Sweden)

    Rabindra Nath Roy

    2012-01-01

    Full Text Available Background: Childhood morbidity consumes a substantial portion of health care resources in terms of hospital bed utilization, and overload in hospital ward remains a major concern in many countries, including India. A possible way to minimize the problem of scarcities of bed is to analyze the pattern of bed utilization by causes and plan services accordingly. Objectives: To determine the burden of pediatric morbidity and utilization pattern of pediatric beds in a tertiary care hospital. Materials and Methods: A retrospective analysis of pediatric inpatient′s records was conducted over a period of 1 year from 1 January 2007 to 31 December 2007. Results: Of 3983 total admitted cases, about one-third were infants, of which neonatal and post-neonatal age group constituted 45% and 55% of the cases, respectively. In terms of bed-day utilization, infants, 1-4 years and 5-11 years age group accounted for 35.10%, 32.58% and 32.32% of total days of admission, respectively. Utilization of pediatric beds by major causes of morbidity was respiratory tract infection (22.23%, convulsive disorder (12.68%, accident and poisoning (6.07%, diarrheal disease (4.97% and chronic hemolytic anemia (4.42%. Conclusion: A minor change in admission policy through provision of day care unit for management of certain cases would allow efficient use of hospital beds.

  2. The effectiveness of psychiatric partial hospitalization and day care

    NARCIS (Netherlands)

    Schene, A. H.

    2004-01-01

    Purpose of review The aim of this article is to review recent literature on partial hospitalization and day care in order to answer the following questions: (1) For what percentage of patients otherwise hospitalized is partial hospitalization a good alternative? (2) What is the (cost)-effectiveness

  3. Motivational Factors that Help in Coping with Barriers to Provision of Psychiatric Nursing Care: Perspective of Psychiatric Nurses in a Hospital Setting in Nigeria.

    Science.gov (United States)

    Gimba, Solomon Musa; Duma, Sinegugu

    2015-07-01

    This qualitative case study explored barriers to provision of psychiatric nursing care in a hospital in Plateau State, Nigeria, and revealed motivational factors that helped the nurses to cope with these barriers. Data collection methods included grand tour and in-depth interviews and participant observation. Motivational factors were related to the psychiatric nurse's individual intrinsic belief system, as well as to their intrinsic belief system as influenced by the environment. These motivational factors highlight how psychiatric nurses continue to cope with the barriers they face in provision of care. The findings indicate the need for hospital management to create and sustain an environment to complement the existing intrinsic motivation of psychiatric nurses to provide psychiatric nursing care, and to provide prompt and appropriate emotional and psychological support to psychiatric nurses worldwide.

  4. Examining patients' perceptions of care to identify opportunities for quality improvement in psychiatric inpatient hospitals.

    Science.gov (United States)

    Ortiz, Glorimar

    2014-01-01

    Our objectives were to examine patients' perceptions with psychiatric care to prioritize action for quality improvement (QI), and to explore differences in care experiences across domains of care by sample subgroups in psychiatric inpatient hospitals. Analysis of frequency, central tendency, and variation examined the distribution of 11,778 Inpatient Consumer Surveys (ICS), from 67 psychiatric inpatient hospitals, by domain of care and Likert scale. The percentage of patients responding positively to each domain of care was evaluated. A performance-importance matrix was constructed to identify key drivers and prioritize action for QI. Chi-squared, t test, and analysis of variance (ANOVA) analyses evaluated the experiences of care by sample subgroups. Overall, patients tended to be satisfied with the care received. However, patients perceived their care differently across hospitals. Hospitals scored lower in the rights domain, mainly attributed to problems with communication between patients and hospital staff. Patients' care experiences varied among sample subgroups; however, four sample characteristics were common to all domains of care. Patients who were Latinos, aged 65 years and older, who completed the survey at discharge, before leaving the hospital, had a higher perception of care across all domains of care. Either an examination of the individual items on the ICS or the aggregation of them by domain of care, the ICS could be a significant tool for hospitals that continuously strive to improve the quality of care provided to psychiatric patients in a time driven by the needs and expectations of consumers.

  5. Mortality, Rehospitalisation and Violent Crime in Forensic Psychiatric Patients Discharged from Hospital: Rates and Risk Factors.

    Directory of Open Access Journals (Sweden)

    Seena Fazel

    Full Text Available To determine rates and risk factors for adverse outcomes in patients discharged from forensic psychiatric services.We conducted a historical cohort study of all 6,520 psychiatric patients discharged from forensic psychiatric hospitals between 1973 and 2009 in Sweden. We calculated hazard ratios for mortality, rehospitalisation, and violent crime using Cox regression to investigate the effect of different psychiatric diagnoses and two comorbidities (personality or substance use disorder on outcomes.Over mean follow-up of 15.6 years, 30% of patients died (n = 1,949 after discharge with an average age at death of 52 years. Over two-thirds were rehospitalised (n = 4,472, 69%, and 40% violently offended after discharge (n = 2,613 with a mean time to violent crime of 4.2 years. The association between psychiatric diagnosis and outcome varied-substance use disorder as a primary diagnosis was associated with highest risk of mortality and rehospitalisation, and personality disorder was linked with the highest risk of violent offending. Furthermore comorbid substance use disorder typically increased risk of adverse outcomes.Violent offending, premature mortality and rehospitalisation are prevalent in patients discharged from forensic psychiatric hospitals. Individualised treatment plans for such patients should take into account primary and comorbid psychiatric diagnoses.

  6. Psychiatric hospital nursing staff's experiences of participating in group-based clinical supervision:

    DEFF Research Database (Denmark)

    Buus, Niels; Angel, Sanne; Traynor, Michael

    2010-01-01

    Group-based clinical supervision is commonly offered as a stress-reducing intervention in psychiatric settings, but nurses often feel ambivalent about participating. This study aimed at exploring psychiatric nurses' experiences of participating in groupbased supervision and identifying psychosocial...... reasons for their ambivalence. Semi-structured interviews were conducted with 22 psychiatric nurses at a Danish university hospital. The results indicated that participation in clinical supervision was difficult for the nurses because of an uncomfortable exposure to the professional community. The sense...... of exposure was caused by the particular interactional organisation during the sessions, which brought to light pre-existing but covert conflicts among the nurses....

  7. Workplace violence in the hospital psychiatric setting. An occupational health perspective.

    Science.gov (United States)

    Hansen, B

    1996-12-01

    1. Assault directed against psychiatric staff is emerging as a serious occupational health problem. Governmental regulatory agencies, unions, and academic research have identified workplace assault in the psychiatric setting as a serious workplace health issue. 2. Violence directed against psychiatric nursing personnel is increasing. Increases in assault are related to shorter hospitalizations, cutbacks in mental health services, and the increasing number of clients with criminal histories and personality disorders. 3. Reduction in staff assault can best be accomplished using an injury epidemiology occupational health focus. Identifying hazards, energy transfer mechanisms, and other environmental factors contributing to staff injuries can reduce or eliminate the morbidity associated with client assault.

  8. [State of suicide and effective efforts in suicide prevention in psychiatric hospitals and clinics].

    Science.gov (United States)

    Orui, Masatsugu; Hirokawa, Seiko; Akazawa, Masato; Tachimori, Hisateru; Kawano, Kenji; Mori, Takao; Akita, Hiroya; Takeshima, Tadashi

    2012-01-01

    Although factors related to suicide are complicated, mental health disorders are an important risk factor. It is anticipated that suicide prevention measures will be implemented from the perspective of improved psychiatric medicine. No national-scale study has been carried out in Japan on the state of psychiatric medicine and its influence on suicide since 2000. Moreover, many efforts not intended for suicide prevention have been shown to be effective for this purpose. Here, we conducted surveys to obtain basic data on suicide prevention and improvements in mental health care among 1,728 psychiatric hospitals and clinics in Japan in 2010. The incidence of suicide in psychiatric hospitals and clinics from January to December 2009 was estimated to be 100.5 for outpatients and 154.5 for inpatients per 100,000 patients. Regarding the duration from consultation to suicide, 87% of outpatients committed suicide less than one month following their last consultation. Moreover, approximately two-thirds of patients had undergone consultations for more than one year. A number of suicides in psychiatric hospitals and clinics occurred while patients were continuously undergoing treatment. Efforts shown to be effective in suicide prevention included risk assessment with multiple medical staff (i.e., doctors and nurses), a 24-hour crisis line, and a follow-up system for discontinued outpatients. We expect that the results of this survey will aid in the implementation of effective suicide prevention in psychiatric medicine.

  9. Using technology for bed management in public hospitals - A strategic analysis and change management plan

    OpenAIRE

    Brayan, Daniel Joseph

    2005-01-01

    As healthcare organisations in New South Wales, Australia, are facing the increased demands of an aging population, new approaches to improving access to services are being sought. This project explores the potential of applying information technology to the management of beds in a large Sydney public hospital. More specifically, this project addresses the cultural and organizational aspects of hospital environments and factors them into a change management plan for implementing bed managemen...

  10. Hospital staff nurse perceptions of competency to care for patients with psychiatric or behavioral health concerns.

    Science.gov (United States)

    Rutledge, Dana N; Wickman, Mary E; Cacciata, Marysol; Winokur, Elizabeth J; Loucks, Jeannine; Drake, Diane

    2013-01-01

    Disruptive behaviors are common among hospitalized patients with psychiatric and substance abuse behaviors. Nurses working on nonpsychiatric units, however, may lack competencies to care for patients with such behaviors. A survey was developed and administered to 844 nurses across three hospital settings that revealed a lack of nurse confidence to intervene in situations that require de-escalation techniques and crisis communication. This study provides direction for further research and interventions in hospital settings with similar professional development needs.

  11. Outcomes of discharged females versus those waiting for discharge from Vlore Psychiatric Hospital (Albania).

    Science.gov (United States)

    Carta, Mauro Giovanni; Agaj, Antonela; Harapej, Eljesa; Lecca, Maria Efisia; Xhelili, Gentiana; Altoé, Gianmarco; Mura, Gioia; Moro, Maria Francesca; Angermeyer, Matthias C

    2013-11-01

    This study examines the psychosocial outcomes of women discharged from the Vlore Psychiatric Hospital in Albania. The study was designed as a controlled, not randomized, follow-up study. It included 16 women diagnosed with psychosis who were discharged from a psychiatric hospital to live in group homes in the community. The control group included 20 women diagnosed with psychosis who lived at the psychiatric hospital while awaiting discharge. All subjects were assessed twice using the HoNOS-Rome tool, at the start of the study (T0) and 12 months later (T1). Both groups showed an improvement in the HoNOS total score between T0 and T1 (p Albania to follow European standards of mental health care.

  12. Nurses' caring and empathy in Jordanian psychiatric hospitals: A national survey.

    Science.gov (United States)

    Alhadidi, Majdi M B; Abdalrahim, Maysoon S; Al-Hussami, Mahmoud

    2016-08-01

    Nurses working in psychiatric hospitals need to acquire the skills of therapeutic communication and empathy, and have higher levels of caring. The present study aims to investigate the level of caring and empathy among nurses working in psychiatric hospitals. A cross-sectional survey was utilized to collect data from 205 nurses recruited from three psychiatric hospitals in Jordan. The Background Information Questionnaire, Modified Caring Dimensions Inventory, and Toronto Empathy Questionnaire were administered to the recruited participants. The findings revealed that the sampled nurses had a high level of caring and empathy. Significant correlations were found between caring and having a specialized training in mental health nursing, and having organizational and managerial support. However, no significant correlations were found between empathy and participants' characteristics. Specialized training in mental health nursing, having organizational and managerial support, and empathy were found predictors for caring. © 2016 Australian College of Mental Health Nurses Inc.

  13. [Fates at the psychiatric hospital of Klagenfurt during National Socialism].

    Science.gov (United States)

    Oberlerchner, Herwig; Stromberger, Helge

    2013-01-01

    In this article the fate of Mr. B. is described as an example for the fate of hundreds of mentally ill patients of the "Landes-Irrenanstalt of Klagenfurt", murdered during the era of National Socialism. This extraordinary fate marks two outstanding aspects of history of medicine, the treatment of syphilis with malaria and the organised mass murder of mentally ill people during the cynic era of National Socialism. Beyond this historical perspective reconstructive biographical work together with relatives is presented as a proactive duty of psychiatric institutions.

  14. Significance of clay art therapy for psychiatric patients admitted in a day hospital.

    Science.gov (United States)

    de Morais, Aquiléia Helena; Roecker, Simone; Salvagioni, Denise Albieri Jodas; Eler, Gabrielle Jacklin

    2014-01-01

    To understand the significance of clay art therapy for psychiatric patients admitted in a day hospital. Qualitative, descriptive and exploratory research, undertaken with 16 patients in a day hospital in Londrina, in the state of Parana, Brazil, who participated in seven clay therapy sessions. Data collection took place from January to July 2012 through interviews guided by a semi structured questionnaire and the data were submitted to content analysis. Three themes emerged: Becoming familiar with clay art therapy; Feeling clay therapy; and Realizing the effect of clay therapy. The use of clay as a therapeutic method by psychiatric patients promoted creativity, self-consciousness, and benefited those who sought anxiety relief.

  15. Psychiatric diagnoses during institutionalization: an investigation of 1334 psychiatric patients hospitalized in an Italian asylum during the 20th century.

    Science.gov (United States)

    Tatarelli, Roberto; Serafini, Gianluca; Innamorati, Marco; Lester, David; Girardi, Paolo; Pompili, Maurizio

    2011-03-01

    Interest in the history of psychiatry continues to grow, with an increasing emphasis on topics of current interest such as the history of nosology and the interplay between psychiatry and society. The present study was designed to investigate diagnoses and sociodemographic characteristics of patients during the course of the last century in a sample of Italian psychiatric inpatients. The study also throws light on changes in the practice of explaining and classifying mental disorders. This was a chart analysis of clinical records of 1334 patients hospitalized at "Santa Maria della Pietà" in Rome from 1920 to 1980. We chose every tenth year and the month of May because, on average, there was a reasonable number of admissions compared with the peak of admissions in August and an almost lack of admissions in January. There were relevant differences in diagnostic nomenclature and course of illnesses from 1920 to 1980 in Italy. Schizophrenia was first diagnosed in 1930 and 1940 and then rapidly declined; melancholia was first diagnosed in 1930 but rapidly decreased, whereas dysthymia appeared later in 1960. Dysthymia, manic, and depressive disorders rapidly appeared since 1980. In the "other disorders" group category, there were three peaks in frequency--one in 1930, another in 1940, and the most frequent in 1980. The consistency in diagnosis and the organization of psychiatric services in the last century were quite poor. Improving psychiatric services and quality of care remain a relevant challenge for physicians.

  16. Mood disorders in general hospital inpatients: one year data from a psychiatric consultation-liaison service.

    Science.gov (United States)

    Elisei, Sandro; Pauselli, Luca; Balducci, Pierfrancesco Maria; Moretti, Patrizia; Quartesan, Roberto

    2013-09-01

    Mood disorders (MD) show higher prevalence among psychiatric disorders. As a matter of fact 10% of inpatients in non psychiatric health care structures are affected by MD. A consultation-liaison service bridges the gap between psychiatric and other medical disciplines and increases the cooperation in the context of care, improving the diagnostic process for all inpatients in medical wards. Our sample is composed of 1702 patients assessed from 1 January 2012 to 31 December 2012 referred from the wards for psychiatric specialist evaluation in Santa Maria della Misericordia, Perugia, Italy. Each patient was assessed by a consultant psychiatrist performing a psychiatric interview leading to a diagnosis according to DSM-IV-TR criteria. Clinical and sociodemographic data were collected and registrered in the clinical records. SPSS software (ver. 18) was used for data analysis. Chi-square test and T-student tests were performed as appropriate. A p-valueconsultation referral urgent status we found that 84% of requests needed to be seen within 24 h, most of them come from Emergency room. Statistically significant correlations can be found between the source of referrals, the reasons for the referrals, psychiatric care prior to the evaluation and the psychiatric disorder which was diagnosed during the assessment. Consultation-liaison service for MD in an italian general hospital is generally based on emergency/urgency referrals from the Emergency room for patients already assessed to mental care facilities by private or national health service psychiatrists.

  17. Bed net related burns at Mulago national referral hospital, Uganda: a case series report.

    Science.gov (United States)

    Kalanzi, Edris W; O'Hara, Lyndsay M; O'Hara, Nathan N; Boyle, James C

    2014-05-01

    Insecticide-treated bed nets are essential tools to prevent malaria in endemic regions, however, increasing trends in bed net related burns in Kampala, Uganda are concerning. Data were collected from burns unit admission records at Mulago National Referral Hospital in Kampala, Uganda for the years 2008-2011 inclusive. Retrospective analyses on the characteristics of patients admitted with bed net related burns within this period were conducted. A total of 45 patients were admitted to the burns unit with bed net related burns during the study period. Most burns occurred among individuals who were 0-1 years old (33.3%) and 26-35 years old (24.2%) and the majority were male (71%). Bed net related burns at Mulago Hospital are severe, as evidenced by the fact that 15 of 45 patients died (crude mortality rate=33%) and that 26 patients (57.8%) had total body surface area burn percentages that were greater than 20%. The average length of stay in hospital for patients with bed net related burns was 30.4 days. Organizations responsible for malaria prevention should consider incorporating fire and burn prevention awareness, strategies and training into their bed net distribution programs. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  18. Diagnoses, Requests and Timing of 503 Psychiatric Consultations in Two General Hospitals

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    Elahe Sahimi Izadian

    2012-01-01

    Full Text Available The high comorbidity of medical and psychiatric diagnoses in the general hospital population requires collaboration between various medical fields to provide comprehensive health care. This study aims to find the rate of psychiatric consultations, their timing and overall diagnostic trend in comparison to previous studies. Tehran University of Medical Sciences has got an active psychiatric consultation-liaison service which includes services provided by four faculty psychiatrists (two full-time and two part-time. This study was done in two general hospitals by simple sampling in available cases. For each consultation, a board-certified faculty psychiatrist conducted a clinical evaluation based on DSM-IV-TR. Other than psychiatric diagnoses, socio-demographic variables, relative consultation rates, reasons for referral, medical diagnoses and the time stay after admission were assessed. Among 503 patients who were visited by the consultation-liaison service, there were 54.3% female with mean age of 39.8 years. In 90.1% of consultations, at least one DSM-IV-TR diagnosis was made. The most frequent diagnosis groups were mood disorder (43.5%, adjustment disorder (10.9% and cognitive disorder (7.6%. In about 10.9% of the consultations, multiple psychiatric diagnoses were made. The mean length of hospital stay before the consultation was 12.56 days (range=1-90, SD=13. Based on our findings, the mood and cognitive disorders still remain major foci of consultation-liaison practice in general hospitals; however our findings showed high rate of adjustment disorders diagnosis and ambiguous request for psychiatric consultation which need more interdisciplinary interaction.

  19. EARLY INTERVENTION PROGRAM FOR PSYCHOTIC DISORDERS AT THE PSYCHIATRIC HOSPITAL ''SVETI IVAN

    OpenAIRE

    Restek-Petrović, Branka; Mihanović, Mate; Grah, Majda; Molnar, Sven; Bogović, Anamarija; Agius, Mark; Kezić, Slobodanka; Grošić, Vladimir; Mayer, Nina; Svrdlin, Pero; Dominis, Vesna; Goršić, Lada; Kamerman, Nenad; Pavlović, Irena; Švagelj, Ana

    2012-01-01

    The Early intervention program for the first episodes of psychotic disorders (RIPEPP) at the Psychiatric Hospital “Sveti Ivan“ in Zagreb encompasses patients hospitalized due to various psychoses (acute psychotic disorder, schizophrenia, schizoaffective and delusional disorder, bipolar affective disorder with psychotic symptoms) in the “critical period“ of illness, i.e. within five years after the occurrence of the first symptoms. The RIPEPP Program consists of an in- and out-patient...

  20. Racial Disparities in Mental Health Outcomes after Psychiatric Hospital Discharge among Individuals with Severe Mental Illness

    Science.gov (United States)

    Eack, Shaun M.; Newhill, Christina E.

    2012-01-01

    Racial disparities in mental health outcomes have been widely documented in noninstitutionalized community psychiatric samples, but few studies have specifically examined the effects of race among individuals with the most severe mental illnesses. A sample of 925 individuals hospitalized for severe mental illness was followed for a year after…

  1. Incipient offending among schizophrenia patients after first contact to the psychiatric hospital system

    DEFF Research Database (Denmark)

    Munkner, Runa; Haastrup, Soeren; Joergensen, Torben

    2005-01-01

    The study examines how age, sex and substance use disorder are associated with the risk of committing a criminal offence. The study explicitly examines the risk after the first contact to the psychiatric hospital system and after the diagnosis of schizophrenia for those with no previous criminal...

  2. Reconceptualizing Stabilization for Counseling Adolescents in Brief Psychiatric Hospitalization: A New Model

    Science.gov (United States)

    Balkin, Richard S.; Roland, Catherine B.

    2007-01-01

    This research examined goal attainment as it is related to client stability in the process of counseling adolescents admitted to a crisis residence. Data were collected from licensed master's-level clinicians treating adolescent clients admitted to an acute care psychiatric program at 1 of 2 hospitals located in the mid-South. There was a…

  3. Intellectual Ability and Achievement in Psychiatrically Hospitalized Children with Conduct, Anxiety, and Affective Disorders.

    Science.gov (United States)

    Hodges, Kay; Plow, Jean

    1990-01-01

    Examined intelligence quotient and academic achievement of 76 psychiatrically hospitalized children (mean age 10 years). Found relative deficit in verbal abilities for conduct-disordered children. Depressed children were characterized by underachievement. Children with anxiety disorder had lower intelligence quotient than children without anxiety…

  4. superficial mycoses among psychiatric patients in mathari hospital ...

    African Journals Online (AJOL)

    East African Medical Journal Vol. 87 No. 9 September 2010. SUPERFICIAL MYCOSES AMONG PSYCCHIATRIC PATIENTS IN MATHARI HOSPITAL, NAIROBI, KENYA. M.Ogutu, BSc.MMed, Micro, Senior Technologist, Department of Medical Laboratory Sciences, Z. Ng'ang'a, PhD, Director. Institute of Tropical Medicine, ...

  5. Community-oriented services in a psychiatric hospital. Effort to ...

    African Journals Online (AJOL)

    “Yaba apa osi” (Yaba to the left side). Consequently, in the year 2000 the hospital stepped up its efforts on destigmatization through public enlightenment programmes and provision of commercial /social as well as general health care services in the institution that would bring or attract the citizenry to its facilities. We carried ...

  6. A descriptive analysis of admissions to Amanuel Psychiatric Hospital ...

    African Journals Online (AJOL)

    Schizophrenia and bipolar disorder were the top two discharge diagnoses. The median length of hospital stay (LOS) was 63 days. Diagnosis of schizophrenia and place of residence, i.e. living outside of Addis Ababa independently predicted LOS above the median. Conclusion: Admission data demonstrated a huge mental ...

  7. Transmission of Clostridium difficile spores in isolation room environments and through hospital beds.

    Science.gov (United States)

    Sjöberg, Maria; Eriksson, Mats; Andersson, Josefin; Norén, Torbjörn

    2014-09-01

    The aim of this study was to determine the dissemination of Clostridium difficile (CD) spores in a hospital setting where the potassium monopersulfate-based disinfectant Virkon™ was used for cleaning. In the initial part of the study, we sampled 16 areas of frequent patient contact in 10 patient rooms where a patient with CD infection (CDI) had been accommodated. In the second part of the study, we obtained samples from 10 patient beds after discharge of CDI patients, both before and after the beds were cleaned. In the first part, CDspores were isolated in only 30% of the rooms. In the second part, which focused on transmission to hospital beds, C. difficile was found in four of 10 beds either before or after cleaning. In conclusion, in both parts of the study, we demonstrated a moderate spread of CD spores to the environment despite routine cleaning procedures involving Virkon™. © 2014 APMIS. Published by John Wiley & Sons Ltd.

  8. Pathway for inpatients with depressive episode in Flemish psychiatric hospitals: a qualitative study

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    Simoens Steven R

    2009-10-01

    Full Text Available Abstract Background Within the context of a biopsychosocial model of the treatment of depressive episodes, a multidisciplinary approach is needed. Clinical pathways have been developed and implemented in hospitals to support multidisciplinary teamwork. The aim of this study is to explore current practice for the treatment of depressive episodes in Flemish psychiatric hospitals. Current practice in different hospitals is studied to get an idea of the similarities (outlined as a pathway and the differences in the treatment of depressive episodes. Methods A convenience sample of 11 Flemish psychiatric hospitals participated in this qualitative study. Semi-structured interviews were conducted with different types of health care professionals (n = 43. The websites of the hospitals were searched for information on their approach to treating depressive episodes. Results A flow chart was made including the identified stages of the pathway: pre-admission, admission (observation and treatment, discharge and follow-up care. The characteristics of each stage are described. Although the stages are identified in all hospitals, differences between hospitals on various levels of the pathway exist. Hospitals emphasized the individual approach of each patient. The results point to a biopsychosocial approach to treating depressive episodes. Conclusion This study outlined current practice as a pathway for Flemish inpatients with depressive episodes. Within the context of surveillance of quality and quantity of care, this study may encourage hospitals to consider developing clinical pathways.

  9. Relationship between aggression, interpersonal style, and therapeutic alliance during short-term psychiatric hospitalization.

    Science.gov (United States)

    Cookson, Amy; Daffern, Michael; Foley, Fiona

    2012-02-01

    Aggression during psychiatric hospitalization is frequent, problematic, and a major challenge for nurses and mental health services more generally. The strength of the therapeutic alliance between nursing staff and patients has been posited as an important protective factor that can limit the likelihood of aggression. This study examined the relationship between interpersonal style, perceived coercion, and psychiatric symptoms on the therapeutic alliance between patients and staff, and how each, in turn, is related to aggression. Participants in this study were 79 patients admitted to an acute psychiatric hospital. Each participant was interviewed to determine perceived coercion, symptoms of psychiatric illness, interpersonal style, and therapeutic alliance. Incidents of aggression were recorded at discharge through a review of incident forms, file review, and interviews with unit nursing staff. The results showed that a hostile-dominant interpersonal style and symptoms of paranoia predicted poor therapeutic alliance, contributing 14% of the variance in therapeutic alliance scores. A dominant interpersonal style predicted aggression towards staff. Therapeutic alliance, perceived coercion, and symptoms of psychiatric illness did not predict aggression. Implications for engagement in treatment and the prevention of aggression are discussed. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

  10. Diagnosis-related frequency of compulsory measures in 10 German psychiatric hospitals and correlates with hospital characteristics.

    Science.gov (United States)

    Steinert, Tilman; Martin, Veronika; Baur, Manfred; Bohnet, Ulrich; Goebel, Rita; Hermelink, Gottfried; Kronstorfer, Rita; Kuster, Wolfgang; Martinez-Funk, Beate; Roser, Martin; Schwink, Albrecht; Voigtländer, Wolfram

    2007-02-01

    To investigate the incidence of coercive measures in standard psychiatric care in different psychiatric hospitals. We developed a common documentation of mechanical restraint, seclusion, and medication by coercion, and introduced it in 10 participating hospitals. We developed software able to process the data and to calculate four key indicators for routine clinical use. 9.5% of 36,690 cases treated in 2004 were exposed to coercive measures with the highest percentage among patients with organic psychiatric disorders (ICD-10 F0) (28.0%). Coercive measures were applied a mean 5.4 times per case and lasted a mean 9.7 h each. The incidence and duration of coercive measures varied highly between different diagnostic groups and different hospitals. Use of detailed guidelines for seclusion and restraint was associated with a lower incidence of coercive measures. Data interpretation should consider numerous confounding factors such as case mix and hospital characteristics. Suggestions on how to cope with ethical and technical problems in the processing of large multi-site data sets in routine clinical use are made.

  11. Geographic distribution of hospital beds throughout China: a county-level econometric analysis.

    Science.gov (United States)

    Pan, Jay; Shallcross, David

    2016-11-08

    Geographical distribution of healthcare resources is an important dimension of healthcare access. Little work has been published on healthcare resource allocation patterns in China, despite public equity concerns. Using national data from 2043 counties, this paper investigates the geographic distribution of hospital beds at the county level in China. We performed Gini coefficient analysis to measure inequalities and ordinary least squares regression with fixed provincial effects and additional spatial specifications to assess key determinants. We found that provinces in west China have the least equitable resource distribution. We also found that the distribution of hospital beds is highly spatially clustered. Finally, we found that both county-level savings and government revenue show a strong positive relationship with county level hospital bed density. We argue for more widespread use of disaggregated, geographical data in health policy-making in China to support the rational allocation of healthcare resources, thus promoting efficiency and equity.

  12. Frequency of Djinnati Syndrome among Inpatient Admissions at Baharan Psychiatric Hospital in Zahedan, Iran

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    Sanaz Ghasemi

    2014-08-01

    Full Text Available Background: A culture-bound syndrome common in Baluchistan is Djinnati that is classified as trance and possession state, a sub-class of dissociative disorders NOS, in DSM IV-TR. The present study aims to determine the frequency of Djinnati syndrome among in-patients at Baharan psychiatric hospital in Zahedan, Iran. Materials and Methods: In this descriptive study, the statistical community includes all patients (N=773 who were admitted in Baharan psychiatric hospital during a 6 months period. After considering the inclusion and exclusion criteria, 150 subjects (61 males and 89 females were selected. Semi-structural interview and Dissociative Experience Scale (DES questionnaire were performed for them. Spearman’s rank correlation coefficient, χ2, and t-tests were employed for analysis of data in SPSS-18. Results: Frequency of Djinnati syndrome among patients admitted in this referral psychiatric hospital was 4.1% and this syndrome showed a significant dominance in female sex (M/F=1/3. There was also a positive and significant correlation between child abuse and dissociative experiences including Djinnati. Conclusion: The study has shown that dissociative disorders NOS, in the form of trance and possession states (such as Djinnati, are not rare especially in the eastern parts of Iran and among poor and young women. It is important to define Djinnati syndrome in this region and prepare medical students and psychiatric residents for diagnosing and managing this condition. Its relationship with child abuse should be considered in preventive medicine.

  13. Risk of obstructive sleep apnea and excessive daytime sleepiness in hospitalized psychiatric patients

    Directory of Open Access Journals (Sweden)

    Talih FR

    2017-04-01

    Full Text Available Farid R Talih,1 Jean J Ajaltouni,1 Hani M Tamim,2 Firas H Kobeissy3 1Department of Psychiatry, 2Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon; 3Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon Objectives: This study evaluated the risk of developing obstructive sleep apnea (OSA and excessive daytime sleepiness (EDS in hospitalized psychiatric patients at the American University of Beirut Medical Center (AUB-MC. Factors associated with OSA and EDS occurrence in this sample were also examined. Methods: The Berlin questionnaire and the Epworth sleepiness scale; which respectively evaluate OSA and EDS symptoms, were administered to individuals hospitalized at an acute psychiatric treatment unit at the AUB-MC between the dates of January 2014 and October 2016. Additional data collected included general demographics, psychiatric diagnoses, and questionnaires evaluating depression and anxiety symptoms. Statistical analyses utilizing SPSS were performed to determine the prevalence of OSA and EDS, as well as their respective associations with patient profiles. Results: Our results showed that 39.5% of participants were found to have a high risk of sleep apnea and 9.9% of the participants were found to have abnormal daytime sleepiness. The risk of developing OSA was associated with a higher body mass index (BMI (P=0.02, and depression severity (patient health questionnaire 9 score (P=0.01. Increasing severity of depressive symptoms was associated with a higher risk of sleep apnea (P=0.01. BMI (odds ratio [OR] =5.97, 95% confidence interval [CI] 1.89–18.82 and depression severity (OR =4.04, 95% CI 1.80–9.07 were also found to be predictors of OSA. The psychiatric diagnoses of the participants were not found to have a significant association with the risk of sleep apnea. Conclusion: The risk of OSA is increased among hospitalized

  14. Processes of In-Hospital Psychiatric Care and Subsequent Criminal Behaviour Among Patients With Schizophrenia

    DEFF Research Database (Denmark)

    Pedersen, Charlotte Gjørup; Olrik Wallenstein Jensen, Signe; Johnsen, Søren Paaske

    2013-01-01

    Objectives: It is unknown whether evidence-based, in-hospital processes of care may influence the risk of criminal behaviour among patients with schizophrenia. Our study aimed to examine the association between guideline recommended in-hospital psychiatric care and criminal behaviour among patients...... with schizophrenia. Methods: Danish patients with schizophrenia (18 years or older) discharged from a psychiatric ward between January 2004 and March 2009 were identified using a national population-based schizophrenia registry (n = 10 757). Data for in-hospital care and patient characteristics were linked with data...... on criminal charges obtained from the Danish Crime Registry until November 2010. Results: Twenty per cent (n = 2175) of patients were charged with a crime during follow-up (median = 428 days). Violent crimes accounted for 59% (n = 1282) of the criminal offences. The lowest risk of crime was found among...

  15. Risk factors leading to increased rehospitalization rates among adolescents admitted to an acute care child and adolescent psychiatric hospital.

    Science.gov (United States)

    McCarthy, Logan; Pullen, Lisa M; Savage, Jennifer; Cayce, Jonathan

    2017-05-01

    Suicide is the third leading cause of death in adolescents in the United States, with suicidal behavior peaking in adolescence. Suicidal and self-harming behavior is often chronic, with an estimated 15-30% of adolescents who attempt suicide having a second suicide attempt within a year. The focus of acute psychiatric hospitalization is on stabilization of these psychiatric symptoms resulting at times in premature discharge. Finding from studies based on high rehospitalization rates among adolescents admitted to an acute psychiatric hospital indicates that adolescents continue to experience crisis upon discharge from an acute psychiatric hospital, leading to the question of whether or not these adolescents are being discharged prematurely. A chart review was performed on 98 adolescent clients admitted to an acute psychiatric hospital to identify risk factors that may increase rehospitalization among adolescents admitted to an acute psychiatric hospital. Clients admitted to the hospital within a 12-month time frame were compared to clients who were not readmitted during that 12-month period. History of self-harming behavior and length of stay greater than 5 days were found to be risk factors for rehospitalization. Adolescent clients who are admitted to an acute psychiatric hospital with a history of self-harming behavior and extended length of stay need to be identified and individualized treatment plans implemented for preventing repeat hospitalizations. © 2017 Wiley Periodicals, Inc.

  16. Novel bed integrated ventilation method for hospital patient rooms

    DEFF Research Database (Denmark)

    Bivolarova, Mariya Petrova; Melikov, Arsen Krikor; Kokora, Monika

    2014-01-01

    This study presents a novel method for advanced ventilation of hospital wards leading to improved air quality at reduced ventilation rate. The idea is to evacuate the bio-effluents generated from patients’ body by local exhaustion before being spread in the room. This concept was realized by usin...

  17. High Levels Of Bed Occupancy Associated With Increased Inpatient And Thirty-Day Hospital Mortality In Denmark

    DEFF Research Database (Denmark)

    Madsen, Flemming; Ladelund, Steen; Linneberg, Allan

    2014-01-01

    to low bed occupancy rates. Being admitted to a hospital outside of normal working hours or on a weekend or holiday was also significantly associated with increased mortality. The health risks of bed shortages, including mortality, could be better documented as a priority health issue. Resources should......High bed occupancy rates have been considered a matter of reduced patient comfort and privacy and an indicator of high productivity for hospitals. Hospitals with bed occupancy rates of above 85 percent are generally considered to have bed shortages. Little attention has been paid to the impact...... of these shortages on patients' outcomes. We analyzed all 2.65 million admissions to Danish hospitals' departments of medicine in the period 1995-2012. We found that high bed occupancy rates were associated with a significant 9 percent increase in rates of in-hospital mortality and thirty-day mortality, compared...

  18. Hours and Miles: Patient and Health System Implications of Transfer for Psychiatric Bed Capacity

    Directory of Open Access Journals (Sweden)

    Amy M. O’Neil

    2016-11-01

    Full Text Available Introduction: An increasing number of behavioral health (BH patients are presenting to the emergency department (ED while BH resources continue to decline. This situation may lead to more external transfers to find care. Methods: This is a retrospective cohort study of consecutive patients presenting to a tertiary care academic ED from February 1, 2013, through January 31, 2014. Patients were identified through electronic health record documentation of psychiatric consultation during ED evaluation. We reviewed electronic health records for demographic characteristics, diagnoses, payer source, ED length of stay, ED disposition, arrival method, and distance traveled to an external facility for inpatient admission. Univariable and multivariable associations with transfer to an external facility in comparison with patients admitted internally were evaluated with logistic regression models and summarized with odds ratios (OR. Results: We identified 2,585 BH visits, of which 1,083 (41.9% resulted in discharge. A total of 1,502 patient visits required inpatient psychiatric admission, and of these cases, 177 patients (11.8%; 95% CI = [10.2-13.5] required transfer to an external facility. The median ED length of stay for transferred patients was 13.9 hours (interquartile range [IQR], 9.3-20.2 hours; range, 3.0-243.0 hours. The median distance for transport was 83 miles (IQR, 42-111 miles; range, 42-237 miles. In multivariable analysis, patients with suicidal or homicidal ideation had increased risk of transfer (odds ratio [OR] [95% CI], 1.93 [1.22-3.06]; P=0.005. Children younger than 18 years (OR [95% CI], 2.34 [1.60- 3.40]; P<0.001 and adults older than 65 years (OR [95% CI], 3.46 [1.93-6.19]; P<0.001 were more likely to require transfer and travel farther to access care. Conclusion: Patients requiring external transfer for inpatient psychiatric care were found to have prolonged ED lengths of stay. Patients with suicidal and homicidal ideation as well

  19. [Cost-effectiveness of two hospital care schemes for psychiatric disorders].

    Science.gov (United States)

    Nevárez-Sida, Armando; Valencia-Huarte, Enrique; Escobedo-Islas, Octavio; Constantino-Casas, Patricia; Verduzco-Fragoso, Wázcar; León-González, Guillermo

    2013-01-01

    In Mexico, six of every twenty Mexicans suffer psychiatric disorders at some time in their lives. This disease ranks fifth in the country. The objective was to determine and compare the cost-effectiveness of two models for hospital care (partial and traditional) at a psychiatric hospital of Instituto Mexicano del Seguro Social (IMSS). a multicenter study with a prospective cohort of 374 patients was performed. We made a cost-effectiveness analysis from an institutional viewpoint with a six-month follow-up. Direct medical costs were analyzed, with quality of life gains as outcome measurement. A decision tree and a probabilistic sensitivity analysis were used. patient care in the partial model had a cost 50 % lower than the traditional one, with similar results in quality of life. The cost per successful unit in partial hospitalization was 3359 Mexican pesos while in the traditional it increased to 5470 Mexican pesos. treating patients in the partial hospitalization model is a cost-effective alternative compared with the traditional model. Therefore, the IMSS should promote the infrastructure that delivers the psychiatric services to the patient attending to who requires it.

  20. The Relationship between Job Satisfaction and Burnout among Rehabilitation Personnel of Razi Psychiatric Hospital in Tehran

    Directory of Open Access Journals (Sweden)

    MH Haghighizadeh

    2013-06-01

    Full Text Available Background and purpose: The study about effective management dimensions in hospital staff performance is important. This study was done to survey the relationship between job satisfaction and burnout in the rehabilitation personnel of Razi Psychiatric Hospital in Tehran. Materials & Methods: In this cross-sectional study, 77 subjects including psychometrics, general practitioners, specialists, nurses, social workers, occupational therapists and psychologists were selected randomly among rehabilitation staff in Razi Psychiatric Hospital in 2011. The data were collected using Maslach Burnout Inventory (MBI and Minnesota Job Satisfaction Questionnaire (MSQ.The data were analyzed using Pearson’s correlation method. Results: Job satisfaction had an inverse relationship with "emotional exhaustion" and "depersonalization"(p<0.001, but there was not a significant relationship between "personal accomplishment" and "job satisfaction". The mean of emotional exhaustion was 68.18, depersonalization 68.4 and personal accomplishment 29.36. In addition, the results of this study showed that 36.6 percent of rehabilitation team employees in Razi Psychiatric Hospital were satisfied with their jobs. Conclusion: As the results show, it is necessary to perform further research to find the main reasons of intensifying job burnout and then reduce these critical factors leading to personnel dissatisfaction from their jobs and any probable consequence of this dissatisfaction.

  1. Emotional reactions to involuntary psychiatric hospitalization and stigma-related stress among people with mental illness.

    Science.gov (United States)

    Rüsch, Nicolas; Müller, Mario; Lay, Barbara; Corrigan, Patrick W; Zahn, Roland; Schönenberger, Thekla; Bleiker, Marco; Lengler, Silke; Blank, Christina; Rössler, Wulf

    2014-02-01

    Compulsory admission to psychiatric inpatient treatment can be experienced as disempowering and stigmatizing by people with serious mental illness. However, quantitative studies of stigma-related emotional and cognitive reactions to involuntary hospitalization and their impact on people with mental illness are scarce. Among 186 individuals with serious mental illness and a history of recent involuntary hospitalization, shame and self-contempt as emotional reactions to involuntary hospitalization, the cognitive appraisal of stigma as a stressor, self-stigma, empowerment as well as quality of life and self-esteem were assessed by self-report. Psychiatric symptoms were rated by the Brief Psychiatric Rating Scale. In multiple linear regressions, more self-stigma was predicted independently by higher levels of shame, self-contempt and stigma stress. A greater sense of empowerment was related to lower levels of stigma stress and self-contempt. These findings remained significant after controlling for psychiatric symptoms, diagnosis, age, gender and the number of lifetime involuntary hospitalizations. Increased self-stigma and reduced empowerment in turn predicted poorer quality of life and reduced self-esteem. The negative effect of emotional reactions and stigma stress on quality of life and self-esteem was largely mediated by increased self-stigma and reduced empowerment. Shame and self-contempt as reactions to involuntary hospitalization as well as stigma stress may lead to self-stigma, reduced empowerment and poor quality of life. Emotional and cognitive reactions to coercion may determine its impact more than the quantity of coercive experiences. Interventions to reduce the negative effects of compulsory admissions should address emotional reactions and stigma as a stressor.

  2. Occupational stressors, burnout and coping strategies between hospital and community psychiatric nurses in a Dublin region.

    Science.gov (United States)

    McTiernan, K; McDonald, N

    2015-04-01

    Burnout negatively impacts the delivery of mental health services. Psychiatric nurses face stressors that are distinct from other nursing specialities. The research was conducted in Ireland and captured a relatively large sample of respondents. The results compared the stressors, coping strategies and burnout levels between hospital and community-based psychiatric nurses. Occupational stress can negatively impact on the well-being of psychiatric nurses, which in turn can lead to poor client care. There is a dearth of published research conducted in Ireland that examines stress within the discipline. A between-groups study, undertaken in February 2011, investigated stressors, burnout and coping strategies between hospital and community-based psychiatric nurses in a Dublin region. Sixty-nine participants (8 males and 61 females), aged between 18 to 60 years voluntarily completed the Mental Health Professional Stress Scale, the Maslach Burnout Inventory and the PsychNurse Methods of Coping Scale. The findings revealed that nurses were operating in a moderately stressful environment. Stressors focused on organizational issues as opposed to client issues. The main stressors identified were lack of resources, workload and organizational structures/processes. Both groups reported average levels of emotional exhaustion, low levels of depersonalization and average levels of personal accomplishment. A Mann-Whitney U-test and Independent Samples t-test found significant differences between hospital and community-based nurses regarding depersonalization and personal accomplishment, respectively. Hospital nurses reported higher depersonalization scores, and community nurses had a greater sense of personal accomplishment. The personal accomplishment scores of hospital nurses were below mental health professional norms. No significant differences emerged regarding coping strategies. Avoidant coping strategies were favoured by both groups. It is recommended that interventions

  3. [A wide-ranging project to the best use of S. Niccolo Psychiatric Hospital].

    Science.gov (United States)

    Vannozzi, Francesca

    2007-01-01

    The S. Niccolò Psychiatric Hospital was one of the most important health institutions not only for Siena but for the entire Tuscan district and beyond. It was known to serve all the catchment area for mentally ill patients coming from other cities. At a national level, it is also one of the most beautiful models of hospital architecture of the "village" type, the expression of a late nineteenth-century tendency to perceive mental disorders as illnesses that could be improved and cured through "moral treatment", with work and distraction as the principal therapeutic instruments. The closure of the psychiatric hospital in Siena provided for by the Italian psychiatric reform of 1978 actually took place over an extremely long period of time. It was definitively closed only on 30 September 1999 and was the last psychiatric hospital in Tuscany to cease its activity. Its history, the importance it had for the considerable number of committed patients, the extension of the area of the hospital over 183,574 m2 and its organization in 16 edifices, mean that S. Niccolò is now an architectonic complex of great value and interest but also subject to progressive deterioration. This reality, together with the urgency of salvaging the collections of books from its very rich library and its archives of administrative documents and medical records, has led the author to prepare a wide-ranging and extremely complex project that aims at the best use of S. Niccolò. Thanks to the collaboration of a group of experts from various Faculties of the University of Siena, and beginning with a multidisciplinary study of S. Niccolò's history, the project proceeds to the identification of concrete actions of cultural policy as well.

  4. Descriptive epidemiology and underlying psychiatric disorders among hospitalizations with self-directed violence.

    Directory of Open Access Journals (Sweden)

    Natalya S Weber

    Full Text Available BACKGROUND: Suicide claims over one million lives worldwide each year. In the United States, 1 per 10,000 persons dies from suicide every year, and these rates have remained relatively constant over the last 20 years. There are nearly 25 suicide attempts for each suicide, and previous self-directed violence is a strong predictor of death from suicide. While many studies have focused on suicides, the epidemiology of non-fatal self-directed violence is not well-defined. OBJECTIVE: We used a nationally representative survey to examine demographics and underlying psychiatric disorders in United States (US hospitalizations with non-fatal self-directed violence (SDV. METHOD: International Classification of Disease, 9(th Revision (ICD-9 discharge diagnosis data from the National Hospital Discharge Survey (NHDS were examined from 1997 to 2006 using frequency measures and adjusted logistic regression. RESULTS: The rate of discharges with SDV remained relatively stable over the study time period with 4.5 to 5.7 hospitalizations per 10,000 persons per year. Excess SDV was documented for females, adolescents, whites, and those from the Midwest or West. While females had a higher likelihood of self-poisoning, both genders had comparable proportions of hospitalizations with SDV resulting in injury. Over 86% of the records listing SDV also included psychiatric disorders, with the most frequent being affective (57.8% and substance abuse (37.1% disorders. The association between psychiatric disorders and self-injury was strongest for personality disorders for both males (OR = 2.1; 95% CI = 1.3-3.4 and females (OR = 3.8; 95% CI = 2.7-5.3. CONCLUSION: The NHDS provides new insights into the demographics and psychiatric morbidity of those hospitalized with SDV. Classification of SDV as self-injury or self-poisoning provides an additional parameter useful to epidemiologic studies.

  5. Descriptive epidemiology and underlying psychiatric disorders among hospitalizations with self-directed violence.

    Science.gov (United States)

    Weber, Natalya S; Fisher, Jared A; Cowan, David N; Postolache, Teodor T; Larsen, Rakel A; Niebuhr, David W

    2013-01-01

    Suicide claims over one million lives worldwide each year. In the United States, 1 per 10,000 persons dies from suicide every year, and these rates have remained relatively constant over the last 20 years. There are nearly 25 suicide attempts for each suicide, and previous self-directed violence is a strong predictor of death from suicide. While many studies have focused on suicides, the epidemiology of non-fatal self-directed violence is not well-defined. We used a nationally representative survey to examine demographics and underlying psychiatric disorders in United States (US) hospitalizations with non-fatal self-directed violence (SDV). International Classification of Disease, 9(th) Revision (ICD-9) discharge diagnosis data from the National Hospital Discharge Survey (NHDS) were examined from 1997 to 2006 using frequency measures and adjusted logistic regression. The rate of discharges with SDV remained relatively stable over the study time period with 4.5 to 5.7 hospitalizations per 10,000 persons per year. Excess SDV was documented for females, adolescents, whites, and those from the Midwest or West. While females had a higher likelihood of self-poisoning, both genders had comparable proportions of hospitalizations with SDV resulting in injury. Over 86% of the records listing SDV also included psychiatric disorders, with the most frequent being affective (57.8%) and substance abuse (37.1%) disorders. The association between psychiatric disorders and self-injury was strongest for personality disorders for both males (OR = 2.1; 95% CI = 1.3-3.4) and females (OR = 3.8; 95% CI = 2.7-5.3). The NHDS provides new insights into the demographics and psychiatric morbidity of those hospitalized with SDV. Classification of SDV as self-injury or self-poisoning provides an additional parameter useful to epidemiologic studies.

  6. Self-harm induced somatic admission after discharge from psychiatric hospital - a prospective cohort study.

    Science.gov (United States)

    Mellesdal, L; Kroken, R A; Lutro, O; Wentzel-Larsen, T; Kjelby, E; Oedegaard, K J; Jørgensen, H A; Mehlum, L

    2014-05-01

    Few studies have examined rate and predictors of self-harm in discharged psychiatric patients. To investigate the rate, coding, timing, predictors and characteristics of self-harm induced somatic admission after discharge from psychiatric acute admission. Cohort study of 2827 unselected patients consecutively admitted to a psychiatric acute ward during three years. Mean observation period was 2.3 years. Combined register linkage and manual data examination. Cox regression was used to investigate covariates for time to somatic admission due to self-harm, with covariates changing during follow-up entered time dependently. During the observation period, 10.5% of the patients had 792 somatic self-harm admissions. Strongest risk factors were psychiatric admission due to non-suicidal self-harm, suicide attempt and suicide ideation. The risk was increased throughout the first year of follow-up, during readmission, with increasing outpatient consultations and in patients diagnosed with recurrent depression, personality disorders, substance use disorders and anxiety/stress-related disorders. Only 49% of the somatic self-harm admissions were given hospital self-harm diagnosis. Self-harm induced somatic admissions were highly prevalent during the first year after discharge from acute psychiatric admission. Underdiagnosing of self-harm in relation to somatic self-harm admissions may cause incorrect follow-up treatments and unreliable register data. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  7. Expected hazards and hospital beds in host cities of the 2014 FIFA World Cup in Brazil

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    Elaine Silva Miranda

    Full Text Available Planning for mass gatherings involves health system preparedness based on an understanding of natural and technological hazards identified through prior risk assessment. We present the expected hazards reported by health administrators of the host cities for the 2014 FIFA World Cup in Brazil and discuss the hazards considering minimal available public hospital beds in the 12 cities at the time of the event. Four different groups of respondents were interviewed: pharmaceutical service administrators and overall health administrators at both the municipal and hospital levels. The hospital bed occupancy rate was calculated, based on the Brazilian Health Informatics Department (DATASUS. The number of surplus beds was calculated using parameters from the literature regarding surge and mass casualty needs and number of unoccupied beds. In all groups, physical injuries ranked first, followed by emerging and endemic diseases. Baseline occupancy rates were high (95%CI: 0.93-2.19 in all 12 cities. Total shortage, considering all the cities, ranged from -47,670 (for surges to -60,569 beds (for mass casualties. The study can contribute to discussions on mass-gathering preparedness.

  8. Expected hazards and hospital beds in host cities of the 2014 FIFA World Cup in Brazil.

    Science.gov (United States)

    Miranda, Elaine Silva; Shoaf, Kimberley; Silva, Raulino Sabino da; Freitas, Carolina Figueiredo; Osorio-de-Castro, Claudia Garcia Serpa

    2017-06-12

    Planning for mass gatherings involves health system preparedness based on an understanding of natural and technological hazards identified through prior risk assessment. We present the expected hazards reported by health administrators of the host cities for the 2014 FIFA World Cup in Brazil and discuss the hazards considering minimal available public hospital beds in the 12 cities at the time of the event. Four different groups of respondents were interviewed: pharmaceutical service administrators and overall health administrators at both the municipal and hospital levels. The hospital bed occupancy rate was calculated, based on the Brazilian Health Informatics Department (DATASUS). The number of surplus beds was calculated using parameters from the literature regarding surge and mass casualty needs and number of unoccupied beds. In all groups, physical injuries ranked first, followed by emerging and endemic diseases. Baseline occupancy rates were high (95%CI: 0.93-2.19) in all 12 cities. Total shortage, considering all the cities, ranged from -47,670 (for surges) to -60,569 beds (for mass casualties). The study can contribute to discussions on mass-gathering preparedness.

  9. Evaluating Amphetamine and Methamphetamine Abuse Frequency in Hospitalized Patients of the Psychiatric Ward of Farshchian Hospital in Hamadan City

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    Jahangard L

    2017-06-01

    Full Text Available Introduction: Amphetamine and methamphetamine are man-made materials. They were only used as drugs at the beginning, but gradually outspreaded as psychedelics because of their sympathomimetic effects. Different studies have shown that the frequency of amphetamine and methamphetamine abuse has been increasing; also, there is a close relationship in amphetamine and methamphetamine abuse with psychiatric disorders. Therefore, this study aimed to investigate the frequency of amphetamine and methamphetamine abuse in psychiatric inpatients and evaluate the effects of different factors on that. Methods: In this cross-sectional-descriptive study, 2543 patients were admitted to the psychiatric ward of Hamadan Farshchian hospital in 2013; in order to evaluate amphetamine and methamphetamine abuse, they were enrolled. For detection of amphetamine and methamphetamine, urine test using immunochemical and chromatographic methods was conducted. Results: The frequency of amphetamine and methamphetamine abuse in psychiatric inpatients was 7.3% (186 cases. Most of the abusers were male (87%, young (mean age: 36 years and married (60%. However, there was no significant association between age, gender, marital status and frequency of abuse (P > 0.05. Half of abusers were unemployed and 67% of them did not have high school diploma. The most important psychiatric disorder among the abusers of these two substances was bipolar mood disorder (65.1%. Moreover, in this study, there was no significant association between amphetamine and methamphetamine test results (P > 0.05. Conclusions: The results showed that the frequency of amphetamine and methamphetamine abuse in psychiatric patients was more than other people and patients with mood disorders were at a greater risk. Furthermore, this study indicated that the prevalence of abuse of these substances among females has increased compared to previous studies.

  10. [Our social dilemma: prison or psychiatric hospital? Is the Penrose thesis valid for Hungary at the turn of the millennium?].

    Science.gov (United States)

    Kalapos, Miklós Péter

    2007-10-07

    According to the Penrose's law, outlined on the basis of a comparative study of European statistics, there is an inverse relationship between the number of psychiatric beds and prison population in a given country. The paper examines the relationship between the number of psychiatric beds and prison population in Hungary in the period of 1990 and 2005. Data are taken from the databases of the Central Bureau of Statistics. To analyze the relationships among the data, mathematical statistical methods are applied. An inverse relationship between the number of psychiatric beds and prison population is seen in Hungary, too. The number of involuntarily treated patients has risen in parallel with the increase of the prison population and has shown an inverse relationship with the number of psychiatric beds. Both the prison and the treatment in a psychiatric department are presented for the public as applicable segregation techniques in order to give a response to a social phenomenon. On the basis of data, it can be assumed that the members of pretty much the same population are confined to both systems. To get to the core of essential relationships of the phenomenon, a nationwide examination seems to be necessary.

  11. Characteristics of unrecognised bipolar disorder in patients treated for major depressive disorder in China: general versus psychiatric hospitals.

    Science.gov (United States)

    Chen, F Z; Xiang, Y T; Lu, Z; Wang, G; Hu, C; Kilbourne, A M; Ungvari, G S; Fang, Y R; Si, T M; Yang, H C; Lai, K Yc; Hu, J; Chen, Z Y; Huang, Y; Sun, J; Wang, X P; Li, H C; Zhang, J B; Zhang, X Y; Chiu, H F K

    2013-12-01

    Bipolar disorder is often misdiagnosed as major depressive disorder. Such misdiagnosis partly depends on the type of treatment setting. This study compared general hospital psychiatric units with psychiatric hospitals in China with respect to basic demographic and clinical characteristics of patients with unrecognised bipolar disorder who are treated for major depressive disorder. Patients treated for major depressive disorder were consecutively examined in 13 health centres (6 general hospital psychiatric units and 7 psychiatric hospitals) in China. Their socio-demographic and clinical features were recorded using a standardised protocol and data collection procedure. The DSM-IV diagnoses were established using the Mini-International Neuropsychiatric Interview. Of the 1487 patients included in the study, 309 (20.8%) were diagnosed with bipolar disorder. There was no significant difference between general hospital psychiatric units and psychiatric hospitals in the ratio of all types of unrecognised bipolar disorders (χ2 = 0.008, degrees of freedom = 1, p = 0.9) and bipolar II disorders (χ2 = 3.1, degrees of freedom = 1, p = 0.08). The proportions of unrecognised bipolar I disorders (χ2 = 4.1, degrees of freedom = 1, p = 0.04) differed significantly between the 2 types of study site. Multivariate analyses showed that patients with bipolar I disorders with more seasonal depressive episodes were more likely to receive treatment in general hospital psychiatric units (odds ratio = 3.3, 95% confidence interval = 1.1-9.8). Patients with bipolar I disorders receiving treatment in general hospital psychiatric units had different clinical characteristics compared to their counterparts treated in psychiatric hospitals in China.

  12. Trends in suicide risk associated with hospitalized psychiatric illness: a case-control study based on danish longitudinal registers

    DEFF Research Database (Denmark)

    Qin, Ping; Nordentoft, Merete; Hansen Høyer, Eyd

    2006-01-01

    is mainly accounted for by the reduction among patients who had been discharged from psychiatric hospitals for more than 1 year. For patients who had been discharged from hospitals within 1 year, the reduction is similar to that of the general population; while for patients hospitalized for treatment...... at the time of suicide or the index date, the reduction in suicide rate is relatively slower. Such trends hold for all diagnostic groups. Further analyses stratified by age indicate that the faster reduction in suicide rate associated with history of hospitalized psychiatric illness is more pronounced among...... patients aged 36 years and older. CONCLUSION: The reduction in suicide rate is substantial for patients who have been discharged from psychiatric hospitals for more than 1 year and for middle-aged and older patients. Recent improvement in psychiatric care and treatment and promotion of new generation...

  13. Compulsory psychiatric hospitalization as a measure for the protection of older people

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    Priscila Freitas Ramos

    2016-02-01

    Full Text Available Psychiatric hospitalization is controversial, especially when there is no consent of the subject. Even in contemporary times, compulsory psychiatric hospitalization (IPC, is considered as a specific sector protective measure against the violation of elderly people’s rights. This paper identifies, based on court proceedings, how IPCs are done in a midsize city in the state of São Paulo. We used the documentary analysis of civil cases prosecutors, in the light of public health policies, of the mental health and of the Federal Constitution. The protection of the elderly is established via removal of the offender from his home. Actions by the Network of Guaranteed Inter-sectorial Care in the current public policies, previous to the IPC, were not identified.

  14. [Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization].

    Science.gov (United States)

    Domingos, Thiago da Silva; Braga, Eliana Mara

    2015-06-01

    To investigate the effectiveness of aromatherapy massage using the essential oils (0.5%) of Lavandula angustifolia and Pelargonium graveolens for anxiety reduction in patients with personality disorders during psychiatric hospitalization. Uncontrolled clinical trial with 50 subjects submitted to six massages with aromatherapy, performed on alternate days, on the cervical and the posterior thoracic regions. Vital data (heart and respiratory rate) were collected before and after each session and an anxiety scale (Trait Anxiety Inventory-State) was applied at the beginning and end of the intervention. The results were statistically analyzed with the chi square test and paired t test. There was a statistically significant decrease (p Aromatherapy has demonstrated effectiveness in anxiety relief, considering the decrease of heart and respiratory rates in patients diagnosed with personality disorders during psychiatric hospitalization.

  15. Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization

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    Thiago da Silva Domingos

    Full Text Available OBJECTIVE To investigate the effectiveness of aromatherapy massage using the essential oils (0.5% of Lavandula angustifolia and Pelargonium graveolens for anxiety reduction in patients with personality disorders during psychiatric hospitalization. METHOD Uncontrolled clinical trial with 50 subjects submitted to six massages with aromatherapy, performed on alternate days, on the cervical and the posterior thoracic regions. Vital data (heart and respiratory rate were collected before and after each session and an anxiety scale (Trait Anxiety Inventory-State was applied at the beginning and end of the intervention. The results were statistically analyzed with the chi square test and paired t test. RESULTS There was a statistically significant decrease (p < 0.001 of the heart and respiratory mean rates after each intervention session, as well as in the inventory score. CONCLUSION Aromatherapy has demonstrated effectiveness in anxiety relief, considering the decrease of heart and respiratory rates in patients diagnosed with personality disorders during psychiatric hospitalization.

  16. Self-Determination Theory and Outpatient Follow-Up After Psychiatric Hospitalization.

    Science.gov (United States)

    Sripada, Rebecca K; Bowersox, Nicholas W; Ganoczy, Dara; Valenstein, Marcia; Pfeiffer, Paul N

    2016-08-01

    The objective of this study was to assess whether the constructs of self-determination theory-autonomy, competence, and relatedness-are associated with adherence to outpatient follow-up appointments after psychiatric hospitalization. 242 individuals discharged from inpatient psychiatric treatment within the Veterans Health Administration completed surveys assessing self-determination theory constructs as well as measures of depression and barriers to treatment. Medical records were used to count the number of mental health visits and no-shows in the 14 weeks following discharge. Logistic regression models assessed the association between survey items assessing theory constructs and attendance at mental healthcare visits. In multivariate models, none of the self-determination theory factors predicted outpatient follow-up attendance. The constructs of self-determination theory as measured by a single self-report survey may not reliably predict adherence to post-hospital care. Need factors such as depression may be more strongly predictive of treatment adherence.

  17. Care in psychiatric hospital under the perspective of a nursing team

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    Claudia Mara de Melo Tavares

    2014-06-01

    Full Text Available The present study is aimed at describing the perception of the nursing team concerning the care in a psychiatric hospital. The research used a qualitative approach, exploratory type, using focus group technique, with five participants, in August 2011, in Niteroi, RJ, Brazil. From the data analysis five categories emerged, covering: sensitive listening; personal availability; therapeutic projects; human issues of the team; Traditional Psychiatry vs. Psychosocial Paradigm tension. It was concluded that despite the research, the subjects were still working at the hospital model. It was possible to bring awareness in a human, comprehensive and complete manner. But this perception of care has frailties once it does not bring any evidence of scientific basis of nursing. It is recommended that the professional nursing team invest in their role of caring in the context of the Psychiatric Reform, in the pursuit of an approach centered on the subject and in his way of living.

  18. Significance of clay art therapy for psychiatric patients admitted in a day hospital

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    Aquiléia Helena de Morais

    2014-04-01

    Full Text Available Objective. To understand the significance of clay art therapy for psychiatric patients admitted in a day hospital. Methodology. Qualitative, descriptive and exploratory research, undertaken with 16 patients in a day hospital in Londrina, in the state of Parana, Brazil, who participated in seven clay therapy sessions. Data collection took place from January to July 2012 through interviews guided by a semi structured questionnaire and the data were submitted to content analysis. Results. Three themes emerged: Becoming familiar with clay art therapy; Feeling clay therapy; and Realizing the effect of clay therapy. Conclusion. The use of clay as a therapeutic method by psychiatric patients promoted creativity, self-consciousness, and benefited those who sought anxiety relief.

  19. Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization

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    Thiago da Silva Domingos

    2015-06-01

    Full Text Available OBJECTIVE To investigate the effectiveness of aromatherapy massage using the essential oils (0.5% of Lavandula angustifolia and Pelargonium graveolens for anxiety reduction in patients with personality disorders during psychiatric hospitalization. METHOD Uncontrolled clinical trial with 50 subjects submitted to six massages with aromatherapy, performed on alternate days, on the cervical and the posterior thoracic regions. Vital data (heart and respiratory rate were collected before and after each session and an anxiety scale (Trait Anxiety Inventory-State was applied at the beginning and end of the intervention. The results were statistically analyzed with the chi square test and paired t test. RESULTS There was a statistically significant decrease (p < 0.001 of the heart and respiratory mean rates after each intervention session, as well as in the inventory score. CONCLUSION Aromatherapy has demonstrated effectiveness in anxiety relief, considering the decrease of heart and respiratory rates in patients diagnosed with personality disorders during psychiatric hospitalization.

  20. Characteristics of Military Members Hospitalized with a Psychiatric Diagnosis During the Persian Gulf War

    Science.gov (United States)

    1992-01-01

    are not classified as specific types of Adjustment Disorder . Clearly, many of the same symptoms (e.g., psychological withdrawl, restlessness... Disorder 2 2.0 Paranoid Disorder 3 3.0 Organic Delusional Disorder 1 1.0 Psychotic episode 6 6.1 Group V 4 4.0 Schizophrenia 1 1.0 Schizoaffective Disorder 1...experienced a great deal of psychological distress and post-traumatic stress disorder . Lastly, several military women were hospitalized with a psychiatric

  1. Twenty years of electroconvulsive therapy in a psychiatric unit at a university general hospital

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    Amilton dos Santos Jr.

    2013-01-01

    Full Text Available Objective: To describe the sociodemographic and clinical profile of patients who underwent electroconvulsive therapy (ECT at a university general hospital. Method: In this retrospective study, records from all patients undergoing ECT between January 1988 and January 2008 at the psychiatric unit of the general hospital of Universidade Estadual de Campinas (UNICAMP were reviewed. Telephone contact was made with patients/relatives to collect follow-up data. Results: A total of 200 charts were reviewed. The majority of patients were women, with a mean age of 39 years, and history of psychiatric hospitalization. The main indications for ECT were depression and catatonia. Complications were observed in less than half of the cases, and most were temporary and not severe. There was a good psychiatric outcome for 89.7% of the patients, especially for catatonic patients (100%, p = 0.02. Thirty-four percent of the cases were later contacted by telephone calls, at a mean of 8.5 years between the procedure and the contact. Among these, three (1.5% reported persistent memory disorders and 73% considered ECT a good treatment. Conclusion: ECT has been performed according to international guidelines. In the vast majority of cases, undesirable effects were temporary and not severe. Response to ECT was positive in most cases, particularly in catatonic patients.

  2. [The morning report - an important item in the training of psychiatrists in residence at psychiatric hospitals].

    Science.gov (United States)

    Con, D; Goethals, K

    2015-01-01

    In this article we focus on the role, function and composition of the morning report in the training of psychiatrists in residence at psychiatric hospitals. We also pay attention to the way in which the case should be presented in the morning report. To make some proposals regarding ways in which the efficiency of the morning report and the case presented in that report can be improved. We studied currently available literature and publications about the morning report and we also drew on our own experience with the morning report. We found very few publications that dealt specifically with morning report in the psychiatric teaching hospital. However, our studies have shown that the morning report should not be regarded purely as an instrument for passing on care details about the patient; it should also be seen as an essential link in the chain of instruction required by trainee psychiatrist. On the basis of rhetoric, constructivism and social-constructionism, we present a model for case presentation. Making improvements in the quality of the morning report is an important way of contributing to the learning process of trainee psychiatrists and staff members and should therefore enhance the status of the psychiatric hospital as a teaching community.

  3. Periodontal Health among Non-Hospitalized Chronic Psychiatric Patients in Mangaluru City-India.

    Science.gov (United States)

    Nayak, Sangeeta Umesh; Singh, Rashmi; Kota, Keshava Pai

    2016-08-01

    A substantial section of society constituting the mentally ill and psychiatric patients deserve special attention. Evidence has suggested that psychological factors have contributed to an increase in the susceptibility to periodontal disease. The aim of the study was to evaluate the gingival and periodontal health of chronically non-hospitalized psychiatric patients in Mangaluru city, India. Forty one psychiatric patients having chronic psychiatric illness and on neuroleptic medications for a minimum of 2 years were included in the study. The control group consisted of 41 healthy dental patients who were selected to match the study group by age and gender, and for both groups 20 teeth excluding the third molars should be present. Demographic characteristics, dental examination including gingival index and periodontal health according to the community periodontal index were recorded for each patient in both the groups. In the psychiatric patient group (Group A) 47.1% subjects were suffering from schizophrenia and 17.6% subjects were having mood disorder. Gingivitis varied from mild to severe among the patients of both the groups. Bleeding on probing (CPI 1) was recorded in 23.5% in Group A and 14.6% in Group B. Dental calculus (CPI 2) in 38.2% in Group A and 58.5% in Group B of the subjects, 20.6% with at least one 4mm to 5mm pocket (CPI 3), and 17.6% with at least one 6mm pocket (CPI 4). The present study underlines a considerable need for prevention and treatment of periodontal disease among chronic psychiatric patients in Mangaluru city. Every effort should be made to increase the awareness of this cohort regarding the importance of oral hygiene practices and on the early diagnosis of periodontal problems.

  4. Audit of hand hygiene at Broadmoor, a high secure psychiatric hospital.

    Science.gov (United States)

    Ahmed, K

    2010-06-01

    Increased security measures at high secure psychiatric hospitals can complicate hand hygiene. This audit assessed the availability of appropriate hand hygiene equipment and the practice of good hand hygiene at Broadmoor Hospital using the local hand hygiene policy as the standard for comparison. A data collection tool used to audit the hand hygiene equipment on 23 wards in the hospital showed that there were significant deficits in the supply of hand hygiene equipment on the wards. In addition, a staff survey was conducted using a questionnaire designed to assess awareness, training and hand decontamination practice among nursing staff. This survey identified a need to increase awareness of the hand hygiene policy and the appropriate timing of hand decontamination procedures. As a result of the audit, appropriate equipment was ordered and the duties of infection prevention link nurses on each ward were made more explicit; namely, to check and order equipment for hand hygiene as necessary, to conduct regular reminder sessions of the hand decontamination procedure and to raise awareness of hand hygiene policy. Posters were also placed on wards in patient areas to increase awareness of hand hygiene among patients, and alcohol gel dispensers were introduced into nursing stations. Similar audits may prove beneficial at other psychiatric hospitals. (c) 2009 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

  5. Clinical and demographic differences between voluntary and involuntary psychiatric admissions in a university hospital in Brazil

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    Tais Michele Minatogawa Chang

    2013-11-01

    Full Text Available To assess the frequency of involuntary psychiatric hospitalizations from 2001 to 2008 and to determine associated clinical and socio-demographic characteristics, a retrospective cohort study was conducted. Adult admission data were collected from a university hospital in Brazil. Hospitalizations were classified as voluntary (VH or involuntary (IH. Groups were compared using chi-square test for categorical variables and Mann-Whitney test for continuous non-parametric variables. The relative risk of certain events was estimated by the odds ratio statistic. Of 2,289 admissions, 13.3% were IH. The proportion of IH increased from 2.5% to 21.2% during the eight year period. IH were more frequently associated with female gender, unmarried status, unemployment, and more than 9 years of schooling. Psychotic symptoms were more common among IH. There were no differences in age, duration of hospitalization, or rate of attendance at first appointment after hospital discharge. Understanding of the characteristics associated with IH is necessary to improve the treatment of psychiatric disorders.

  6. Psychiatric hospitalizations due to alcohol and drug consumption among young people in Ceará, Brazil

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    Alexandre Dido Balbinot

    2017-04-01

    Full Text Available Introduction: This study aimed to analyze the evolution of psychiatric hospitalizations among children and adolescents due to psychoactive substance use in the public health system in the state of Ceará, Brazil. Hospitalizations between 2000 and 2015 were used as indicators. Methods: Ecological study using secondary data. Data analysis was performed with the software Stata 11.1® from StataCorp LLC (Texas/USA using Poisson regression with robust variance and Spearman correlation. A 95% confidence interval was adopted and significance level was set at 5%. Results: The variables hospitalization rates and mean length of hospital stay did not vary significantly. There was no variation when data were stratified by sex. A negative correlation was found between hospitalization rates and mean length of hospital stay (P < 0.05 among girls, but not among boys or overall population. Conclusion: In Ceará, the creation of alternative mechanisms to hospital admission has not resulted in reduced hospitalization rates. Keywords: Hospitalization, Ceará (Brazil, mental health, public health system.

  7. Clinical features and therapeutic management of patients admitted to Italian acute hospital psychiatric units: the PERSEO (psychiatric emergency study and epidemiology survey

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    Russo Federico

    2007-11-01

    Full Text Available Abstract Background The PERSEO study (psychiatric emergency study and epidemiology is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management. The aims of this paper are: (i to describe the epidemiological and clinical characteristics of patients, including sociodemographic features, risk factors, life habits and psychiatric diagnoses; and (ii to assess the clinical management, subjective wellbeing and attitudes toward medications. Methods A total of 62 SPDCs distributed throughout Italy participated in the study and 2521 patients were enrolled over the 5-month study period. Results Almost half of patients (46% showed an aggressive behaviour at admission to ward, but they engaged more commonly in verbal aggression (38%, than in aggression toward other people (20%. A total of 78% of patients had a psychiatric diagnosis at admission, most frequently schizophrenia (36%, followed by depression (16% and personality disorders (14%, and no relevant changes in the diagnoses pattern were observed during hospital stay. Benzodiazepines were the most commonly prescribed drugs, regardless of diagnosis, at all time points. Overall, up to 83% of patients were treated with neuroleptic drugs and up to 27% received more than one neuroleptic either during hospital stay or at discharge. Atypical and conventional antipsychotics were equally prescribed for schizophrenia (59 vs 65% during stay and 59 vs 60% at discharge, while atypical drugs were preferred in schizoaffective psychoses (72 vs 49% during stay and 70 vs 46% at discharge and depression (41 vs 32% during stay and 44 vs 25% at discharge. Atypical neuroleptics were slightly preferred to conventional ones at hospital discharge (52 vs 44%. Polypharmacy was in general widely used. Patient attitudes toward medications were on average positive and self

  8. [Closing forensic psychiatric hospitals in Italy: a new deal for mental health care?].

    Science.gov (United States)

    Casacchia, Massimo; Malavolta, Maurizio; Bianchini, Valeria; Giusti, Laura; Di Michele, Vittorio; Giosuè, Patricia; Ruggeri, Mirella; Biondi, Massimo; Roncone, Rita

    2015-01-01

    The date of March 31, 2015, following the Law 81/2014, has marked a historical transition with the final closure of the six forensic psychiatric hospitals in Italy. This law identifies a new pathway of care that involves small-scale high therapeutic profile facilities (Residenze per la Esecuzione della Misura di Sicurezza, REMS) instead of the old forensic psychiatric hospitals. The Law promotes a new recovery-oriented rehabilitation approach for the persons with mental disorders who committed a criminal offence, but lack criminal responsibility and deemed as socially dangerous. After a brief description of what happens abroad, this article highlights the positive aspects of the law that, as a whole, has to be considered innovative and unavoidable. The main debated problems are also reviewed, including the lack of changes to the Criminal Code; the improper equation between insanity and mental illness and social dangerousness; the evaluation of "socially dangerousness", based solely on "subjective qualities" of the person, assessed out of his/her context, without paying attention to family and social conditions suitable for discharge; the expensive implementation of the REMS, mainly based on security policies and less on care and rehabilitation, the delay in their construction, and the search for residential alternatives structures; the uncertain boundaries of professional responsibility. Finally, several actions are suggested that can support the implementation of the law: information programs addressed to the general population; training activities for mental health professionals; systematic monitoring and evaluation of the outcomes of the care provided to the forensic psychiatric population; implementation of Agreement Protocols and a better cooperation with the judiciary. Scientific societies dealing with psychosocial rehabilitation need to be involved in such issues relating to the identification of the best care and rehabilitation pathways, which should be

  9. Psychopathology of the General Population Referred by Primary Care Physicians for Urgent Assessment in Psychiatric Hospitals

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    Judith McLenan

    2016-12-01

    Full Text Available Objective: The aim of this study was to evaluate the type, severity and progression of psychiatric pathologies in a sample of 372 outpatients (age range 18–65 years referred by their primary general practitioners (GPs to an Urgent Referral Team (URT based in a psychiatric hospital in Aberdeen, Scotland. This team offers immediate appointments (1- to 7-day delays for rapid assessments and early interventions to the outpatients referred by their primary family doctors.Method: One-sample t-test and z statistic were used for data analysis. From the total population, a convenience sample of 40 people was selected and assessed to evaluate whether follow-up appointments after the first visit could reduce the severity of suicidal ideation, depression and anxiety in the outpatients seen by the URT. A two-sample t-test and a Wilcoxon signed-rank test were used to assess the variations in the scores during the follow-up visits.Results: We found a statistically significant prevalence of depressive disorders, comorbid with anxiety at first presentation in people who were females, white, never married, living with a partner, not studying and not in paid employment. The common presentation of borderline personality disorder and dysthymia in this population underscores its vulnerability to major socioeconomic challenges.Conclusion: The data confirmed the impact that primary care cooperation with psychiatric hospitals can have on the psychiatric system, and as a reflection, on the population’s mental health and well-being. In fact, active cooperation and early diagnosis and intervention will help detect cases at risk in the general population and reduce admissions into hospitals.

  10. Impact on the psychotic vulnerability of the therapeutic approachin the Prison Psychiatric Hospital in Seville (Spain

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    P. Massé-García

    Full Text Available Objectives: to analyze changes in psychotic vulnerability following the implementation of a program of prison psychiatric treatment, recidivism after the release and various descriptive variables of criminological interest. Materials and methods: review of a sample consisting of 50 patients diagnosed with schizophrenia admitted to the Prison Psychiatric Hospital of Seville. Results: there was a statistically significant reduction of psychotic vulnerability according to an assessment using the Frankfurt psychopathological inventory (FBF-3, after conducting a complete psychiatric, psychological, social and rehabilitation approach in the prison environment. The core symptoms relating to complex perception and language also decreased significantly. The reduction is particularly noticeable in the number of patients categorized as medium-high and high severity. Recidivism in the follow-up of release of patients in the study sample is low (6% and there were no cases of serious felony or grievous bodily harm. Recidivism, when it occurs, is not immediate. Although there is some criminal versatility, it is limited. The most frequent victims are parents with a previous relationship with the patient. Most of the patients in the sample, and all recidivists, have comorbid substance abuse (dual diagnosis. Discussion: we need more comprehensive studies to establish causal relationships between the decrease in psychotic vulnerability and an integrated psychiatric, psychological, social and rehabilitation approach in prisons; or to attribute the low rate of recidivism to the decline of psychotic vulnerability.

  11. A preliminary study of Patient Dignity Inventory validation among patients hospitalized in an acute psychiatric ward

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    Di Lorenzo R

    2017-01-01

    Full Text Available Rosaria Di Lorenzo,1 Giulio Cabri,2 Eleonora Carretti,3 Giacomo Galli,4 Nina Giambalvo,4 Giulia Rioli,4 Serena Saraceni,4 Giulia Spiga,4 Cinzia Del Giovane,5 Paola Ferri6 1Mental Health Department, Service of Psychiatric Diagnosis and Treatment in NOCSAE General Hospital, 2Private Accredited Psychiatric Hospital villa Igea, Modena, 3Nursing Home of Rubiera, Reggio Emilia, 4Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, 5PhD Statistics Unit, Department of Diagnostic, Clinical and Public Health Medicine, 6Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy Purpose: To investigate the perception of dignity among patients hospitalized in a psychiatric setting using the Patient Dignity Inventory (PDI, which had been first validated in oncologic field among terminally ill patients. Patients and methods: After having modified two items, we administered the Italian version of PDI to all patients hospitalized in a public psychiatric ward (Service of Psychiatric Diagnosis and Treatment of a northern Italian town, who provided their consent and completed it at discharge, from October 21, 2015 to May 31, 2016. We excluded minors and patients with moderate/severe dementia, with poor knowledge of Italian language, who completed PDI in previous hospitalizations and/or were hospitalized for <72 hours. We collected the demographic and clinical variables of our sample (n=135. We statistically analyzed PDI scores, performing Cronbach’s alpha coefficient and principal factor analysis, followed by orthogonal and oblique rotation. We concomitantly administered to our sample other scales (Hamilton Rating Scales for Depression and Anxiety, Global Assessment of Functioning and Health of the Nation Outcome Scales to analyze the PDI concurrent validity. Results: With a response rate of 93%, we obtained a mean PDI score of 48.27 (±19.59 SD with

  12. Caregivers’ acceptance of alternatives to long-term psychiatric hospitalization; lessons and debates from the South Korean situation

    OpenAIRE

    Lee, Myung-Soo; Park, Jong-Ik

    2014-01-01

    Background A political movement towards building alternatives to long-term hospitalization of psychiatric patients in Korea has gained momentum. We aimed to provide sturdy foundation needed to formulate the most rational policy by review of caregiver’s opinion to the political alternatives under discussion for facilitating discharge of long-term stayed psychiatric patients in Korea. Discussion Caregivers in Korea, whose family members had been hospitalized longer than 6 months and all of whom...

  13. [Discharge dynamics and related factors of newly-admitted patients in psychiatric hospitals].

    Science.gov (United States)

    Kono, Toshiaki; Shiraishi, Hiromi; Tachimori, Hisateru; Koyamas, Asuka; Naganuma, Yoichi; Takeshima, Tadashi

    2012-01-01

    The focus of psychiatric services in Japan is being shifted from hospitalization to community care, and the Ministry of Health, Labour and Welfare aims for the prompt discharge of newly-admitted patients. Correspondingly, it set a goal to lower the "mean residual rate (MRR)", which indicates the discharge dynamics of newly-admitted patients, to 24%. As a measure to achieve this goal, the present situation should be investigated in each homogeneous patient group. In this study, we conducted a survey of newly-admitted patients to investigate discharge dynamics and related factors by the diagnosis and type of hospitalization. Out of 1,459 psychiatric hospitals to which we sent questionnaires, 183 (12.5%) replied. Each hospital completed questionnaires regarding a maximum of 5 patients for each type of hospitalization (voluntary hospitalization [VH], hospitalization for medical care and protection [HMCP], and involuntary hospitalization ordered by the prefectural governor [IHOPG]) between October 2005 and January 2006. We weighted the obtained patient data in proportion to the estimated total number of patients, and analyzed valid data on 1,784 patients. The MRR for the whole sample was 29.4%. By diagnosis, dementia showed the highest MRR (45.6%), followed by schizophrenia (34.9%); depression, bipolar disorder, and alcoholism showed the lowest MRRs (20-21%). We calculated MRRs by the type of hospitalization for dementia and the other diagnoses separately, considering confounding effect between the diagnosis and type of hospitalization (markedly high proportion of HMCP observed in dementia). In dementia, HMCP showed a higher MRR (46.8%) than VH (43.7%). In the other diagnoses, IHOPG showed the highest MRR (43.7%), followed by HMCP (34.5%) and VH (25.6%). Dementia differed from the other diagnoses in the distribution of residential settings before admission, with a higher proportion of residential care facilities (25.5%) and hospitalization in other departments (19

  14. Ethnicity and dangerousness criteria for court ordered admission to a psychiatric hospital.

    Science.gov (United States)

    Vinkers, D J; de Vries, S C; van Baars, A W B; Mulder, C L

    2010-02-01

    Black and minority ethnic (BME) populations are disproportionately detained in psychiatric hospitals. To examine the dangerousness criteria for compulsory court ordered admission to a psychiatric hospital in White and BME persons. We examined the psychiatric examinations for court ordered compulsory admissions in 506 White and 299 BME persons from October 2004 until January 2008 in Rotterdam, the Netherlands. The White and BME groups are compared using Chi-square tests and in case of significant differences with logistic regression models adjusted for age, gender, mental disorders and socio-economic background. In BME persons, violence towards others and neglect of relatives were more often reasons to request court order admission as compared with Whites (39.8 vs. 25.3%, P mental disorders and socio-economic background [OR 1.56 (95% CI 1.12-2.18), P = 0.01, respectively; OR 3.08 (95% CI 1.31-7.26), P = 0.01]. The other reasons for a request of court order admission had a similar prevalence in both groups (suicide or self-harm, social decline, severe self-neglect, arousal of aggression of others, danger to the mental health of others, and the general safety of persons and goods). Violence towards others and neglect of relatives are more often a reason to request court ordered admission in BME than in White persons. BME patients are more often perceived as potentially dangerous to others.

  15. Estimating the costs of psychiatric hospital services at a public health facility in Nigeria.

    Science.gov (United States)

    Ezenduka, Charles; Ichoku, Hyacinth; Ochonma, Ogbonnia

    2012-09-01

    Information on the cost of mental health services in Africa is very limited even though mental health disorders represent a significant public health concern, in terms of health and economic impact. Cost analysis is important for planning and for efficiency in the provision of hospital services. The study estimated the total and unit costs of psychiatric hospital services to guide policy and psychiatric hospital management efficiency in Nigeria. The study was exploratory and analytical, examining 2008 data. A standard costing methodology based on ingredient approach was adopted combining top-down method with step-down approach to allocate resources (overhead and indirect costs) to the final cost centers. Total and unit cost items related to the treatment of psychiatric patients (including the costs of personnel, overhead and annualised costs of capital items) were identified and measured on the basis of outpatients' visits, inpatients' days and inpatients' admissions. The exercise reflected the input-output process of hospital services where inputs were measured in terms of resource utilisation and output measured by activities carried out at both the outpatient and inpatient departments. In the estimation process total costs were calculated at every cost center/department and divided by a measure of corresponding patient output to produce the average cost per output. This followed a stepwise process of first allocating the direct costs of overhead to the intermediate and final cost centers and from intermediate cost centers to final cost centers for the calculation of total and unit costs. Costs were calculated from the perspective of the healthcare facility, and converted to the US Dollars at the 2008 exchange rate. Personnel constituted the greatest resource input in all departments, averaging 80% of total hospital cost, reflecting the mix of capital and recurrent inputs. Cost per inpatient day, at $56 was equivalent to 1.4 times the cost per outpatient visit at

  16. The Factors Influencing Economic Efficiency of the Hospital Bed Care in Terms of the Regional Allowance Organizations

    Directory of Open Access Journals (Sweden)

    Vaňková Ivana

    2014-09-01

    Full Text Available This paper aims to provide an efficiency evaluation of selected hospital bed care providers during years 2010 -2012 with respect to selected factors: The size of the hospital establishment according to number of beds, number of hospitalized patients, the average length of stay per a patient in care, total staff cost calculated per bed, total revenues calculated per bed, and total costs calculated per bed. For this purpose, hospitals providing primarily acute bed care were chosen. From the legal point of view, they are allowance organizations of a particular region. The evaluation concerns both allocative efficiency and technical efficiency. The allocative efficiency is treated from the proper algorithm point of view and it compares total costs calculated per bed with total revenues calculated per bed. A method denominated Data Envelopment Analysis was applied for the calculation of the technical efficiency of units. To be more specific, it was input-oriented model with constant returns to scale (CCR. The input parameters involve the number of beds, the average length of stay and costs per day of stay. Output parameters were as follows: Bed occupancy in days and the number of hospitalized patients. The data published by the Institute of Health Information and Statistic of the Czech Republic and by ÚFIS system (the Data Base of Ministry of Finance of the Czech Republic were used as the source of data. The evaluation implies that only three hospitals were economically-effective: Silesian Hospital in Opava, Hospital Jihlava, and TGM Hospital Hodonín. The most significant factor influencing the efficiency was determined - the average length of stay.

  17. Functional Deficits and Aggressive Behaviors in an Inpatient Psychiatric Hospital: Description and Clinical Implications.

    Science.gov (United States)

    Jones, Nicole Tuomi; McGill, Amanda C; Vogler, Jason E; Oxley, Stephen

    2017-01-01

    The primary goals of compulsory, inpatient, psychiatric treatment are to decrease dangerous behaviors and help improve functioning so that a safe discharge to a less restrictive environment can be obtained. This study examined the aggression rates, levels of functioning, and treatment adherence for persons treated for schizophrenia (N = 506) compared with persons treated for borderline personality disorder (BPD) (N = 98) in an inpatient psychiatric facility. Over half of persons engaged in at least one incident of aggressive behavior during hospitalization. Differences in the types of aggression and functional deficits between these two clinical sub-groups were found. In addition, overall impairment increased the likelihood of aggressive behavior for persons diagnosed with schizophrenia, whereas irritability and social dependence increased the risk of aggression for persons diagnosed with BPD. Treatment interventions that target the improvement of these deficits may help reduce the intensity and severity of aggressive behaviors and help improve functioning and discharge readiness.

  18. Death anxiety (Thanatophobia) among drug dependents in an Arabic psychiatric hospital.

    Science.gov (United States)

    Daradkeh, Fares; Moselhy, Hamdy Fouad

    2011-05-01

    The primary aim of this study was, for the first time to our knowledge, to examine the level of death anxiety (thanatophobia) in drug dependents attending the outpatient clinic in a psychiatric hospital and to examine the relationship of demographic variables to death anxiety. Eighty-five patients were recruited from outpatient psychiatric attendees at the psychiatric hospital, Kingdom of Bahrain. The death anxiety scale was administered to assess death anxiety, and a clinical psychiatric interview was used to assess psychopathology. The mean age of the sample was 36.8 years (SD = 8.8). All subjects who participated in the study were Arabic males; the majority of them were primary school (i.e. first 5 years of education or schooling) educated (n = 57; 67%) and single (n = 48; 56.5%). The total mean of death anxiety score of the drug abusers was high (3.52±.95). One-way ANOVA showed that there was no significant difference among the scores the drug dependents received on the death anxiety scale related to different groups of age, education, type of the drug used, or the number of times of taking drugs per day. However, there was a significant difference in the level of control of use, marital status, duration of use, cigarettes smoking, and level of religiosity. The results of this study indicate that the level of death anxiety is high, in general, among drug abusers and that being divorced, not actively practicing a religious faith, having at least 1-10 years or more than 20 years history of drug abuse, and smoking at least 20 or more cigarettes per day significantly increases the level of death anxiety.

  19. Bed blockers: A study on the elderly patients in a teaching hospital in India

    Directory of Open Access Journals (Sweden)

    Praveen Kumar N

    2010-07-01

    Full Text Available A cross-sectional study of in-patients over the age of 60 years was conducted at district McGann Hospital, Shimoga on patients who were classified as bed blockers. Level of dependency and cognitive function of these patients were assessed using Barthel scale and Abbreviated mental test (AMT respectively. Median age of the study population was 67 years; majority of them were men. Most of them were admitted in the medical ward and the median time to be labeled as bed blocker was 32 days. These bed blockers were a weak group of patients with an average 3.1 pathology per case. Majority of them suffered from neurological disorders and cardiovascular disease. High level of dependence was noted with a mean Barthel score of 29.68 (Range 0 -100. Low levels of cognitive function was also noted among these patients with a mean AMT of 4.76 (Range 0 -10.These findings demonstrate that the bed blockers in McGann hospital suffer not only from genuine health problems but also have a high dependency level in activities of daily living which hamper their discharge to the community. Community based rehabilitation using an intersectoral approach may help at least the less dependent to return home.

  20. Thrombolysis in acute ischemic stroke is associated with lower long-term hospital bed day use

    DEFF Research Database (Denmark)

    Terkelsen, Thorkild; Schmitz, Marie Louise; Simonsen, Claus Z

    2016-01-01

    Background  Thrombolysis with intravenous recombinant tissue-type plasminogen activator improves functional outcome in acute ischemic stroke. Few studies have investigated the effects of thrombolysis in a real-world setting. We evaluated the impact of thrombolysis on long-term hospital bed day use...... patients admitted to stroke centers not yet offering thrombolysis in 2004-2006. The outcomes were length of the stroke admission, total all-cause hospital bed day use during the first year after the stroke, and the long-term risk of readmissions. Thrombolysed and non-thrombolysed patients were compared......-thrombolysed group (adjusted geometric mean ratio, 0.88; 95% CI: 0.78-1.00). The median all-cause hospital bed day use within the first year was 12 days in the thrombolysed group and 19 days in the non-thrombolysed group (adjusted geometric mean ratio, 0.82; 95% CI: 0.73-0.92). There was no significant difference...

  1. A 5-year retrospective study of demographic, anamnestic, and clinical factors related to psychiatric hospitalizations of adolescent patients

    Directory of Open Access Journals (Sweden)

    Di Lorenzo R

    2016-01-01

    Full Text Available Rosaria Di Lorenzo,1 Nina Cimino,2 Elena Di Pietro,3 Gabriella Pollutri,4 Vittoria Neviani,5 Paola Ferri2 1Service of Psychiatric Diagnosis and Treatment, Department of Mental Health, AUSL Modena, Modena, 2School of Nursing, University of Modena and Reggio Emilia, 3School of Neuro-Psychiatry, 4School of Psychiatry, University of Modena and Reggio Emilia, 5 “The Medlar”, Villa Igea Hospital, Modena, Italy Background: Psychiatric emergencies of children and adolescents have greatly increased during the last years, but this phenomenon has not been studied in detail. The aim of this study was to analyze the correlation between acute psychiatric hospitalizations of adolescents and selected variables to highlight risk factors for psychiatric emergencies. Methods: This retrospective research was conducted in the acute psychiatric public ward, Service of Psychiatric Diagnosis and Treatment (SPDT, and in the residential facility for adolescents, “The Medlar”, located in Modena. The sample was constituted by all adolescent patients (n=101, age range 14–18 who had acute hospitalizations (n=140 in SPDT and had been successively transferred to “The Medlar” (n=83, from February 2, 2010 to January 31, 2015. From clinical charts, we extracted demographic and anamnestic characteristics of patients and clinical variables related to hospitalizations. Data were statistically analyzed. Results: Sixty-one percent of our patients lived with one divorced parent, with adoptive or immigrant family, or in institutions; 51% had experienced stressful events during childhood; 81% had a normal intellective level, but only 6% presented regular school performance. Parental psychiatric illness was negatively related, in a statistically significantly way, with onset age of adolescent mental disorders (coefficient -2.28, 95% confidence interval [CI]: -3.53 to 1.01, P<0.001, single linear regression; odds ratio: 4.39, 95% CI: 1.43–13.47, P<0.010, single logistic

  2. Analysis of information security management systems at 5 domestic hospitals with more than 500 beds.

    Science.gov (United States)

    Park, Woo-Sung; Seo, Sun-Won; Son, Seung-Sik; Lee, Mee-Jeong; Kim, Shin-Hyo; Choi, Eun-Mi; Bang, Ji-Eon; Kim, Yea-Eun; Kim, Ok-Nam

    2010-06-01

    The information security management systems (ISMS) of 5 hospitals with more than 500 beds were evaluated with regards to the level of information security, management, and physical and technical aspects so that we might make recommendations on information security and security countermeasures which meet both international standards and the needs of individual hospitals. The ISMS check-list derived from international/domestic standards was distributed to each hospital to complete and the staff of each hospital was interviewed. Information Security Indicator and Information Security Values were used to estimate the present security levels and evaluate the application of each hospital's current system. With regard to the moderate clause of the ISMS, the hospitals were determined to be in compliance. The most vulnerable clause was asset management, in particular, information asset classification guidelines. The clauses of information security incident management and business continuity management were deemed necessary for the establishment of successful ISMS. The level of current ISMS in the hospitals evaluated was determined to be insufficient. Establishment of adequate ISMS is necessary to ensure patient privacy and the safe use of medical records for various purposes. Implementation of ISMS which meet international standards with a long-term and comprehensive perspective is of prime importance. To reflect the requirements of the varied interests of medical staff, consumers, and institutions, the establishment of political support is essential to create suitable hospital ISMS.

  3. Measuring safety culture in belgian psychiatric hospitals: validation of the dutch and French translations of the hospital survey on patient safety culture.

    Science.gov (United States)

    Vlayen, Annemie; Hellings, Johan; Claes, Neree; Abdou, Emba Aissami; Schrooten, Ward

    2015-03-01

    To measure safety culture in Belgian psychiatric hospitals on 12 dimensions and to examine the psychometric properties of the Dutch and French translations of the Hospital Survey on Patient Safety Culture (HSPSC) for use in psychiatric hospitals. The authors analyzed 6,658 completed questionnaires (70.5% response rate) from a baseline measurement (2007-2009) in 44 psychiatric hospitals and 8,353 questionnaires (71.5% response rate) from a follow-up measurement (2011) in 46 psychiatric hospitals. Psychometric properties of the questionnaire were evaluated using item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), reliability analysis (Cronbach's alpha), and analysis of composite scores and inter-correlations. For both translations, CFA showed an acceptable fit with the original 12-dimensional model. For the Dutch and French translations, EFA showed a 10-factor and a 9-factor optimal measurement model, respectively. Cronbach's alpha indicated an acceptable level of reliability (≥ 0.70) for 7 of 12 dimensions. Most pair-wise correlations were significant and safety culture in psychiatric hospitals. Our results also suggest the use of combinations of specific dimensions as recommended in previous research.

  4. Medicare Program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system changes and FY2011 rates; provider agreements and supplier approvals; and hospital conditions of participation for rehabilitation and respiratory care services; Medicaid program: accreditation for providers of inpatient psychiatric services. Final rules and interim final rule with comment period.

    Science.gov (United States)

    2010-08-16

    : We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems and to implement certain provisions of the Affordable Care Act and other legislation. In addition, we describe the changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital-related costs. We also are setting forth the update to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. We are updating the payment policy and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and setting forth the changes to the payment rates, factors, and other payment rate policies under the LTCH PPS. In addition, we are finalizing the provisions of the August 27, 2009 interim final rule that implemented statutory provisions relating to payments to LTCHs and LTCH satellite facilities and increases in beds in existing LTCHs and LTCH satellite facilities under the LTCH PPS. We are making changes affecting the: Medicare conditions of participation for hospitals relating to the types of practitioners who may provide rehabilitation services and respiratory care services; and determination of the effective date of provider agreements and supplier approvals under Medicare. We are also setting forth provisions that offer psychiatric hospitals and hospitals with inpatient psychiatric programs increased flexibility in obtaining accreditation to participate in the Medicaid program. Psychiatric hospitals and hospitals with inpatient psychiatric programs will have the choice of undergoing a State survey or of obtaining accreditation from a national accrediting organization whose hospital accreditation

  5. To provide care and be cared for in a multiple-bed hospital room.

    Science.gov (United States)

    Persson, Eva; Määttä, Sylvia

    2012-12-01

    To illuminate patients' experiences of being cared for and nurses' experiences of caring for patients in a multiple-bed hospital room. Many patients and healthcare personnel seem to prefer single-bed hospital rooms. However, certain advantages of multiple-bed hospital rooms (MBRs) have also been described. Eight men and eight women being cared for in a multiple-bedroom were interviewed, and two focus-group interviews (FGI) with 12 nurses were performed. A qualitative content analysis was used. One theme--Creating a sphere of privacy--and three categories were identified based on the patient interviews. The categories were: Being considerate, Having company and The patients' area. In the FGI, one theme--Integrating individual care with care for all--and two categories emerged: Experiencing a friendly atmosphere and Providing exigent care. Both patients and nurses described the advantages and disadvantages of multiple-bed rooms. The patient culture of taking care of one another and enjoying the company of room-mates were considered positive and gave a sense of security of both patients and nurses. The advantages were slight and could easily become disadvantages if, for example, room-mates were very ill or confused. The patients tried to maintain their privacy and dignity and claimed that there were small problems with room-mates listening to conversations. In contrast, the nurses stressed patient integrity as a main disadvantage and worked to protect the integrity of individual patients. Providing care for all patients simultaneously had the advantage of saving time. The insights gained in the present study could assist nurses in reducing the disadvantages and taking advantage of the positive elements of providing care in MBRs. Health professionals need to be aware of how attitudes towards male and female patients, respectively, could affect care provision. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

  6. Recycling former psychiatric hospitals in New Zealand: echoes of deinstitutionalisation and restructuring.

    Science.gov (United States)

    Joseph, Alun E; Kearns, Robin A; Moon, Graham

    2009-03-01

    This paper addresses a gap in the understanding of the geography of deinstitutionalisation: the fate of closed asylums. We contend that the closure process was an exercise in both deinstitutionalisation and welfare state restructuring, and examine discourses surrounding the re-use of two former psychiatric hospitals in New Zealand-Seaview in Hokitika and Kingseat near Auckland. Drawing on an analysis of media coverage and field observation, we consider former asylums as sites of celebrity. We find the shadow of stigma to be prominent, manifested directly in suggestions that the former hospitals be used as prisons and in the partial redevelopment of one as a 'horror theme park'. Indirectly, we see stigma reflected in the physical deterioration of the asylums prior to closure. While this stigmatising is attributable in the first instance to deinstitutionalisation, the evidence suggests strongly that it was co-opted and exploited by the forces of restructuring.

  7. Early intervention program for psychotic disorders at the psychiatric hospital "Sveti Ivan".

    Science.gov (United States)

    Restek-Petrović, Branka; Mihanović, Mate; Grah, Majda; Molnar, Sven; Bogović, Anamarija; Agius, Mark; Kezić, Slobodanka; Grošić, Vladimir; Mayer, Nina; Svrdlin, Pero; Dominis, Vesna; Goršić, Lada; Kamerman, Nenad; Pavlović, Irena; Svagelj, Ana; Vrbek, Petra

    2012-09-01

    The Early intervention program for the first episodes of psychotic disorders (RIPEPP) at the Psychiatric Hospital "Sveti Ivan" in Zagreb encompasses patients hospitalized due to various psychoses (acute psychotic disorder, schizophrenia, schizoaffective and delusional disorder, bipolar affective disorder with psychotic symptoms) in the "critical period" of illness, i.e. within five years after the occurrence of the first symptoms. The RIPEPP Program consists of an in- and out-patient part, and includes psychotherapeutic and psychoeducative components as well as the administration of antipsychotics. The Psychotherapeutic part, conducted by psychotherapists - group analysts, comprises psychodynamic group psychotherapy for patients and for family members. The Psychoeducative part, led by cognitive-behavioral therapists, is carried out through educative interactive workshops for both patients and their family members. The paper describes the theoretical framework, as well as the professional, personnel, educative and organizational basis of the Program, the principles of evaluation and some experiences after five years of implementation.

  8. Prevalence of periodontal disease among inpatients in a psychiatric hospital in India.

    Science.gov (United States)

    Gopalakrishnapillai, Ajithkrishnan Champettil; Iyer, Ramya Radhakrishnan; Kalantharakath, Thanveer

    2012-01-01

    This paper assessed the periodontal status of inpatients at Government Mental Hospital, Vadodara, India, and studied the possible relationship between periodontal status and age, length of hospitalization, type of mental illness, and medication and tobacco use. Information about psychiatric diagnosis, length of hospitalization, and prescribed medication was obtained from hospital records. We interviewed 165 inpatients and recorded their chief dental complaints (if any) and relevant histories. Periodontal status was assessed using the Community Periodontal Index (CPI). Descriptive statistics, nonparametric tests, and multiple logistic regression analyses were used. The most prevalent periodontal condition was shallow pockets (47.27%). Some subjects (10.3%) had loss of attachment (LOA) of 9-11 mm. Age and length of hospitalization were significantly associated with periodontal status. Multiple logistic regression revealed that only age was significantly associated with periodontal pockets. Male gender, age, and tobacco-related habits were significantly associated with LOA of more than 0-3 mm. © 2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

  9. Distribution of hospital beds in Tehran Province based on Gini coefficient and Lorenz curve from 2010 to 2012.

    Science.gov (United States)

    Asl, Iravan Masoudi; Abolhallaje, Masoud; Raadabadi, Mehdi; Nazari, Hamed; Nazari, Aslan; Salimi, Mohammad; Javani, Ali

    2015-12-01

    Fair distribution of hospital beds across various regions is a controversial subject. Resource allocation in health systems rarely has focused on those who need it most and, in addition, is often influenced by political interests. The study assesses the distribution of hospital beds in different regions in Tehran, Iran, during 2010-2012. This cross-sectional study was conducted in all regions of Tehran (22 regions) during 2010 to 2012. All hospital beds in these regions are included in the study. Data regarding populations of each region were obtained from the Statistics Center of Iran. According to the data, the total number of beds (N.B) and population (P) in 2010 (N.B=19075, P= 7585000), 2011 (N.B=21632, P= 9860500), and 2012 (N.B=21808, P=12818650). The instrument was a form, including the name of the hospital, the district in which the hospital was located, the number of staffed beds, the name of each region, and its population. Data analysis was performed using DASP software version 2.3. The results demonstrate that the Gini coefficient of distributed beds in 22 regions of Tehran was 0.46 in all three years and specifically calculated 0.4666 in 2010, 0.4658 in 2011 and 0.4652 in 2012. The Gini coefficient of beds in 22 regions of Tehran is not fair in comparison with the population of each region during the years 2010 to 2012. The results demonstrate that the distribution of beds in regions in Tehran is not fair in relation to the population of each region-and some regions had no hospitals. Therefore, it is essential for policymakers to frequently monitor this issue and investigate the fair distribution of hospital beds.

  10. Suicide Risk Among Holocaust Survivors Following Psychiatric Hospitalizations: A Historic Cohort Study.

    Science.gov (United States)

    Lurie, Ido; Gur, Adi; Haklai, Ziona; Goldberger, Nehama

    2017-09-19

    The association between Holocaust experience, suicide, and psychiatric hospitalization has not been unequivocally established. The aim of this study was to determine the risk of suicide among 3 Jewish groups with past or current psychiatric hospitalizations: Holocaust survivors (HS), survivors of pre-Holocaust persecution (early HS), and a comparison group of similar European background who did not experience Holocaust persecution. In a retrospective cohort study based on the Israel National Psychiatric Case Register (NPCR) and the database of causes of death, all suicides in the years 1981-2009 were found for HS (n = 16,406), early HS (n = 1,212) and a comparison group (n = 4,286). Age adjusted suicide rates were calculated for the 3 groups and a logistic regression model was built to assess the suicide risk, controlling for demographic and clinical variables. The number of completed suicides in the study period was: HS-233 (1.4%), early HS-34 (2.8%), and the comparison group-64 (1.5%). Age adjusted rates were 106.7 (95% CI 93.0-120.5) per 100,000 person-years for HS, 231.0 (95% CI 157.0-327.9) for early HS and 150.7 (95% CI 113.2-196.6) for comparisons. The regression models showed significantly higher risk for the early HS versus comparisons (multivariate model adjusted OR = 1.68, 95% CI 1.09-2.60), but not for the HS versus comparisons. These results may indicate higher resilience among the survivors of maximal adversity compared to others who experienced lesser persecution.

  11. Psychiatric comorbidity in patients with substance use disorder: A hospital-based study

    Directory of Open Access Journals (Sweden)

    Ab Majid Gania

    2017-01-01

    Full Text Available Background: Pattern of substance use, profile of substance users, and treatment-seeking differ across cultures and continents. These differences could potentially affect the pattern and perhaps prevalence of dual diagnosis. However, the study of dual diagnosis from de-addiction clinics in India is limited in number and methodology. In this study, we report the prevalence and patterns of psychiatric disorders in subjects attending a de-addiction clinic in a teaching hospital in Srinagar, Kashmir. Methodology: In this cross-sectional study, 300 subjects (>18 years of age seeking treatment for substance use disorders were screened with Mini International Neuropsychiatric Interview Plus for the presence of psychiatric comorbidity. Subjects were assessed after 4 weeks of complete abstinence from psychoactive substances. Results: Cannabis (26% was the most common single-use substance. It was followed by polysubstance use (22.3% and opioids (21.3%. Among the 300 subjects assessed for the purpose of the study, 174 (58% were found to have dual diagnosis. Psychotic disorders (34% were the most common psychiatric comorbidity, and it was followed by major depressive disorder (16% and bipolar affective disorder (16%. Posttraumatic stress disorder (PTSD was present in 20 (11.5% subjects. When the groups with or without dual diagnosis were compared, cannabis and benzodiazepine dependence was found to be significantly common in the dual diagnosis group. Conclusions: A high prevalence of dual diagnoses, especially psychotic disorders and also PTSD, in our predominantly cannabis-using subjects attending hospital located in a distinct sociocultural setting in India, highlights the importance of taking into consideration the sociocultural context in which substance use as well as dual diagnoses should be understood.

  12. Proteomic changes in Corbicula fluminea exposed to wastewater from a psychiatric hospital.

    Science.gov (United States)

    Bebianno, M J; Sroda, S; Gomes, T; Chan, P; Bonnafe, E; Budzinski, H; Geret, F

    2016-03-01

    The increase use of pharmaceutical compounds in veterinary practice and human population results in the ubiquitous presence of these compounds in aquatic ecosystems. Because pharmaceuticals are highly bioactive, there is concern about their toxicological effects in aquatic organisms. Therefore, the aim of this study was to assess the effects of an effluent from a psychiatric hospital (containing a complex mixture of 25 pharmaceutical compounds from eleven therapeutic classes) on the freshwater clam Corbicula fluminea using a proteomic approach. The exposure of C. fluminea to this complex effluent containing anxiolytics, analgesics, lipid regulators, beta blockers, antidepressants, antiepileptics, antihistamines, antihypertensives, antiplatelets and antiarrhythmics induced protein changes after 1 day of exposure in clam gills and digestive gland more evident in the digestive gland. These changes included increase in the abundance of proteins associated with structural (actin and tubulin), cellular functions (calreticulin, proliferating cell nuclear antigen (PCNA), T complex protein 1 (TCP1)) and metabolism (aldehyde dehydrogenase (ALDH), alcohol dehydrogenase, 6 phosphogluconate dehydrogenase). Results from this study indicate that calreticulin, PCNA, ALDH and alcohol dehydrogenase in the digestive gland and T complex protein 1 (TCP1)) and 6 phosphogluconate dehydrogenase in the gills represent useful biomarkers for the ecotoxicological characterization of psychiatric hospital effluents in this species.

  13. Aggression in psychiatric hospitalizations: a qualitative study of patient and provider perspectives.

    Science.gov (United States)

    Lamanna, Denise; Ninkovic, Danijela; Vijayaratnam, Vinothini; Balderson, Ken; Spivak, Harold; Brook, Shelley; Robertson, David

    2016-12-01

    When the people hospitalized in psychiatric units demonstrate aggression, it harms individuals and creates legal and financial issues for hospitals. Aggression has been linked to inpatient, clinician and environmental characteristics. However, previous work primarily accessed clinicians' perspectives or administrative data and rarely incorporated inpatients' insights. This limits validity of findings and impedes comparisons of inpatient and clinician perspectives. This study explored and compared inpatient and clinician perspectives on the factors affecting verbal and physical aggression by psychiatric inpatients. This study used an interpretive theoretical framework. Fourteen inpatients and 10 clinicians were purposefully sampled and completed semi-structured interviews. Data were analyzed using inductive thematic analysis. Six themes were identified at personal and organizational levels. The three person-level themes were major life stressors, experience of illness and interpersonal connections with clinicians. The three organization-level themes were physical confinement, behavioural restrictions and disengagement from treatment decisions. Aggression is perceived to have a wide range of origins spanning personal experiences and organizational policies, suggesting that a wide range of prevention strategies are needed.

  14. [Smoking habits of employees and patients in the psychiatric department of a general hospital].

    Science.gov (United States)

    Schulz, M; Töpper, M; Behrens, J

    2004-02-01

    Health promotion is becoming an increasingly more meaning in hospitals within their health promotion, primary and secondary prevention programmes. With reference to the preventive measures regarding nicotine dependence, it was first of all the objective of this study to determine the smoking habits of employees and patients in a psychiatric clinic. The question was also which implications for clinical practice could be drawn from this. Apart from the Fagerstroem Test for nicotine dependence, a new questionnaire was developed, supported by the questionnaire "Smoke free in hospital", developed by the Federal Agency for Health Education, and implemented. 382 Patients and 484 employees were questioned. The statistical analysis was done using SPSS, and in addition thereto, the T-Test and the chi (2)-Test were used. Definite gender differences pertaining to smoking habits could be demonstrated. Women smoked less often (p change are still not available. Added to that, it must be tested within the German Health System, whether a clinically supervised smoking cessation programme complementing the treatment of the main diagnosis (a psychiatric disease) is demanded by the affected person, whether the clinic can finance it, and whether it can be successfully implemented.

  15. A review on equipped hospital beds with wireless sensor networks for reducing bedsores.

    Science.gov (United States)

    Ajami, Sima; Khaleghi, Lida

    2015-10-01

    At present, the solutions to prevent bedsore include using various techniques for movement and displacement of patients, which is not possible for some patients or dangerous for some of them while it also poses problems for health care providers. On the other hand, development of information technology in the health care system including application of wireless sensor networks (WSNs) has led to easy and quick service-providing. It can provide a solution to prevent bedsore in motionless and disabled patients. Hence, the aim of this article was first to introduce WSNs in hospital beds and second, to identify the benefits and challenges in implementing this technology. This study was a nonsystematic review. The literature was searched for WSNs to reduce and prevent bedsores with the help of libraries, databases (PubMed, SCOPUS, and EMBASE), and also searches engines available at Google Scholar including during 1974-2014 while the inclusion criteria were applied in English and Persian. In our searches, we employed the following keywords and their combinations: "wireless sensor network," "smart bed," "information technology," "smart mattress," and "bedsore" in the searching areas of titles, keywords, abstracts, and full texts. In this study, more than 45 articles and reports were collected and 37 of them were selected based on their relevance. Therefore, identification and implementation of this technology will be a step toward mechanization of traditional procedures in providing care for hospitalized patients and disabled people. The smart bed and mattress, either alone or in combination with the other technologies, should be capable of providing all of the novel features while still providing the comfort and safety features usually associated with traditional and hospital mattresses. It can eliminate the expense of bedsore in the intensive care unit (ICU) department in the hospital and save much expense there.

  16. A review on equipped hospital beds with wireless sensor networks for reducing bedsores

    Directory of Open Access Journals (Sweden)

    Sima Ajami

    2015-01-01

    Full Text Available At present, the solutions to prevent bedsore include using various techniques for movement and displacement of patients, which is not possible for some patients or dangerous for some of them while it also poses problems for health care providers. On the other hand, development of information technology in the health care system including application of wireless sensor networks (WSNs has led to easy and quick service-providing. It can provide a solution to prevent bedsore in motionless and disabled patients. Hence, the aim of this article was first to introduce WSNs in hospital beds and second, to identify the benefits and challenges in implementing this technology. This study was a nonsystematic review. The literature was searched for WSNs to reduce and prevent bedsores with the help of libraries, databases (PubMed, SCOPUS, and EMBASE, and also searches engines available at Google Scholar including during 1974-2014 while the inclusion criteria were applied in English and Persian. In our searches, we employed the following keywords and their combinations: "wireless sensor network," "smart bed," "information technology," "smart mattress," and "bedsore" in the searching areas of titles, keywords, abstracts, and full texts. In this study, more than 45 articles and reports were collected and 37 of them were selected based on their relevance. Therefore, identification and implementation of this technology will be a step toward mechanization of traditional procedures in providing care for hospitalized patients and disabled people. The smart bed and mattress, either alone or in combination with the other technologies, should be capable of providing all of the novel features while still providing the comfort and safety features usually associated with traditional and hospital mattresses. It can eliminate the expense of bedsore in the intensive care unit (ICU department in the hospital and save much expense there.

  17. Medication adherence and its determinants among psychiatric patients in an Ethiopian referral hospital

    Directory of Open Access Journals (Sweden)

    Demoz Z

    2014-09-01

    Full Text Available Zaid Demoz,1 Befikadu Legesse,1 Gebrehiwot Teklay,1 Birhanu Demeke,1 Tewodros Eyob,2 Zewdneh Shewamene,3 Mubarek Abera4 1Department of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, 2Department of Pharmacy, College of Public Health and Medical Sciences, Jimma University, Jimma, 3Department of Pharmacology, School of Pharmacy, University of Gondar, Gondar, 4Department of Psychiatry, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia Background: The degree to which an individual follows medical advice is a major concern in every medical specialty. Non-adherence to psychiatric treatment regimens has a pro­found impact on the disease course, relapse, future recovery, cost of health care, and the outcome for the patient. The aim of this study was to assess medication adherence and its correlates among psychiatric patients at Ayder Referral Hospital, Northern Ethiopia.Methods: A cross-sectional study was conducted from June to September 2013 at Ayder Referral Hospital, where 423 patients were selected by a systematic random sampling technique from all patients attending the psychiatric clinic at the hospital. Data were collected by trained data collectors through interview of the patients using a structured questionnaire. The collected data were entered into Epi Info version 7 and analyzed by Statistical Package for the Social Sciences version 16 software. Logistic regression was used to assess independent predictors of adherence. Results: A total of 387 patients completed the interview. Two hundred and sixteen (55.8% and 113 (29.2% were patients with a diagnosis of schizophrenia and mood disorder, respectively, while 35 (9% and 23 (5.9% had a diagnosis of drug addiction and autistic disorder. Two hundred and seven (71.6% patients were found to be adherent to their medication. When adherence rates were observed according to type of disorder, 60 (53.1%, 24 (68.6%, 149 (69%, and 18 (78.3% of patients

  18. The Design and Simulation of Natural Personalised Ventilation (NPV System for Multi-Bed Hospital Wards

    Directory of Open Access Journals (Sweden)

    Zulfikar A. Adamu

    2015-05-01

    Full Text Available Adequate ventilation is necessary for thermal comfort and reducing risks from infectious bio-aerosols in hospital wards, but achieving this with mechanical ventilation has carbon and energy implications. Natural ventilation is often limited to window-based designs whose dilution/mixing effectiveness are subject to constraints of wind speed, cross ventilation, and in the case of hospital wards, proximity of patients to external walls. A buoyancy-driven natural ventilation system capable of achieving dilution/mixing was shown to be feasible in a preceding study of novel system called natural personalised ventilation (NPV. This system combined both architecture and airflow engineering principles of space design and buoyancy and was tested and validated (salt-bath experiment for a single bed ward. This research extends the previous work and is proof-of-concept on the feasibility of NPV system for multi-bed wards. Two different four-bed ward types were investigated of using computational fluid dynamics (CFD simulations under wind-neutral conditions. Results predict that NPV system could deliver fresh air to multiple patients, including those located 10 m away from external wall, with absolute flow rates of between 32 L·s−1 and 54 L·s−1 for each patient/bed. Compared to same wards simulated using window design, ingress of airborne contaminants into patients’ breathing zone and summer overheating potential were minimised, while overall ward dilution was maximised. Findings suggest the NPV has potentials for enabling architects and building service engineers to decouple airflow delivery from the visualisation and illumination responsibilities placed upon windows.

  19. Assessing the Need for Hospitalization in Order to Conduct a Psychiatric Evaluation as part of Criminal Law Procedure.

    Science.gov (United States)

    Olmer, Ahikam; Greenberg, Binyamin; Strous, Rael D

    2015-09-01

    In criminal law, psychiatrists are consulted regarding the "insanity defense" and the defendant's competency to stand trial. Court-ordered hospital admissions for such evaluations are on the increase, creating a major burden on the health system. To assess, in a hospital setting, whether hospitalization of the defendant is necessary for conducting a psychiatric evaluation. A 6 month prospective observational study exploring the phenomenon was conducted at the Beer Yaakov Mental Health Center. The psychiatrist was asked both at the initiation and at the end of the assessment process whether the subject was competent to stand trial and responsible for his/her actions and if hospitalization was necessary in order to conduct the evaluation. During the study period there were 112 admissions with a court request for a psychiatric evaluation. In 73 of the cases (65.2%) the evaluating psychiatrist believed there was no need for hospitalization. This assessment did not change by the end of the hospitalization in all cases. Employment and alcohol use were the only factors associated with a lower need for hospitalization (OR 0.24, 95% CI 0.07-0.77, and OR 0.34, 95% CI 0.13-0.90, respectively). In the majority of cases, based on the evaluating psychiatrist's responses, the evaluation could have been conducted without need for hospitalization. The findings indicate that an outpatient unit designated to write court-requested psychiatric evaluations could significantly reduce the rates of hospital admissions for this purpose.

  20. The Attitude of Psychiatric and Non-psychiatric Health-care Workers Toward Suicide in Malaysian Hospitals and Its Implications for Training.

    Science.gov (United States)

    Siau, Ching Sin; Wee, Lei-Hum; Yacob, Sapini; Yeoh, Seen Heng; Binti Adnan, Tassha Hilda; Haniff, Jamaiyah; Perialathan, Komathi; Mahdi, Aziman; Rahman, Abu Bakar; Eu, Choon Leng; Binti Wahab, Suzaily

    2017-08-01

    This research is aimed to examine the attitude of health-care workers toward suicidal patients in Malaysian hospitals, comparing responses from psychiatric and non-psychiatric workers, and to identify specific needs in suicide prevention and management training. This is a multi-site cross-sectional study. The authors conducted a survey based on a translated self-administered questionnaire to participants from seven core hospital departments. While most health-care workers regardless of department and specialty took their duty to prevent suicide seriously, a large majority of them expressed negative attitudes such as finding suicidal behavior irritating, and more than half believed suicidal attempts were a way of making others sorry. However, psychiatric workers were less likely to have judgmental attitudes that included believing suicide attempters as being selfish or trying to get sympathy from others. As there were more similarities than differences in health-care workers' attitudes toward suicide, recommendations on basic and continuous suicide prevention and management training among hospital workers were made. The interventions focused on improving knowledge, affective, and skill-based areas that were aimed to correct the wrongful understanding of and to minimize the negative attitudes toward suicidal individuals indicated by the study results.

  1. Applying Toyota Production System principles to a psychiatric hospital: making transfers safer and more timely.

    Science.gov (United States)

    Young, John Q; Wachter, Robert M

    2009-09-01

    Health care organizations have increasingly embraced industrial methods, such as the Toyota Production System (TPS), to improve quality, safety, timeliness, and efficiency. However, the use of such methods in psychiatric hospitals has been limited. A psychiatric hospital applied TPS principles to patient transfers to the outpatient medication management clinics (MMCs) from all other inpatient and outpatient services within the hospital's system. Sources of error and delay were identified, and a new process was designed to improve timely access (measured by elapsed time from request for transfer to scheduling of an appointment and to the actual visit) and patient safety by decreasing communication errors (measured by number of failed transfers). Complexity was substantially reduced, with one streamlined pathway replacing five distinct and more complicated pathways. To assess sustainability, the postintervention period was divided into Period 1 (first 12 months) and Period 2 (next 24 months). Time required to process the transfer and schedule the first appointment was reduced by 74.1% in Period 1 (p < .001) and by an additional 52.7% in Period 2 (p < .0001) for an overall reduction of 87% (p < .0001). Similarly, time to the actual appointment was reduced 31.2% in Period 1 (p < .0001), but was stable in Period 2 (p = .48). The number of transfers per month successfully processed and scheduled increased 95% in the postintervention period compared with the pre-implementation period (p = .015). Finally, data for failed transfers were only available for the postintervention period, and the rate decreased 89% in Period 2 compared with Period 1 (p = .017). The application of TPS principles enhanced access and safety through marked and sustained improvements in the transfer process's timeliness and reliability. Almost all transfer processes have now been standardized.

  2. Protection Against Cross Infection in Hospital Beds with Integrated Personalized Ventilation

    DEFF Research Database (Denmark)

    Nielsen, Peter V.; Polak, Marcin; Jiang, Hao

    2008-01-01

    to supply air directly to the breathing zone when people are lying in beds, e.g. in a hospital ward. This principle, called "Personalized Ventilation" has shown to be very efficient in the protection of people from cross infection. The system supplies fresh air into the breathing zone through a pillow...... or a blanket. The system can also be used to reduce the emission of viruses or bacteria from the exhalation of a source patient. The air supplied from the personalized ventilation (PV) diffuser rises to the ceiling and with the right air distribution system it can be removed from the room. The experiments...

  3. Psychiatric disorders in ASEAN-migrants in Malaysia--a university hospital experience.

    Science.gov (United States)

    Krahl, W; Hashim, A

    1998-09-01

    Malaysia's workforce presently includes 13% foreigners most coming from the neighboring ASEAN-countries. No data of the prevalence of psychiatric disorders amongst this population is currently available. All patients from ASEAN-countries admitted to the University Hospital, Kuala Lumpur between January 1994 and June 1996 were included in a prospective study. During the study period 39 patients were admitted. Five patients were male (12.8%) and 34 female (87.2%). Most came from Indonesia (51.3%) and the Philippines (41.0%), while one each was from Brunei, Singapore and Thailand. Thirty (76.9%) were working in Malaysia as unskilled workers, 23 (59.0%) as maids. Six of the patients (15.4%) were married to Malaysians and only three (7.2%) held white-collar jobs. Three patients (7.2%) received the diagnosis schizophrenia and ten (25.6%) acute and transient psychotic disorder. Two (5.1%) were diagnosed as bipolar affective disorder--manic and two (5.1%) as depression without psychotic features. Five patients (12.8%) were depressed and had as well presence of psychotic features. Adjustment disorders mostly with depressed mood was diagnosed in fourteen (35.9%), three (7.2%) received another diagnosis. The study showed high rates of acute and transient psychosis as well as adjustment disorders indicating high stress level in this population. In particular maids from Indonesia and the Philippines with their dependent and isolated situation seem vulnerable to develop psychiatric disorders. However, overall the rates of psychiatric admissions (only 1.3%) in the ASEAN-nationals is relatively low and tends to support the view that migrants do not suffer from an excess of mental disorders.

  4. The experience of admission to psychiatric hospital among Chinese adult patients in Hong Kong

    Directory of Open Access Journals (Sweden)

    Lam Linda

    2008-10-01

    Full Text Available Abstract Background The paper reports on a study to evaluate the psychometric properties and cultural appropriateness of the Chinese translation of the Admission Experience Survey (AES. Methods The AES was translated into Chinese and back-translated. Content validity was established by focus groups and expert panel review. The Chinese version of the Admission Experience Survey (C-AES was administered to 135 consecutively recruited adult psychiatric patients in the Castle Peak Hospital (Hong Kong SAR, China within 48 hours of admission. Construct validity was assessed by comparing the scores from patients admitted voluntarily versus patients committed involuntarily, and those received physical or chemical restraint versus those who did not. The relationship between admission experience and psychopathology was examined by correlating C-AES scores with the Brief Psychiatric Rating Scale (BPRS scores. Results Spearman's item-to-total correlations of the C-AES ranged from 0.50 to 0.74. Three factors from the C-AES were extracted using factor analysis. Item 12 was omitted because of poor internal consistency and factor loading. The factor structure of the Process Exclusion Scale (C-PES corresponded to the English version, while some discrepancies were noted in the Perceived Coercion Scale (C-PCS and the Negative Pressure Scale (C-NPS. All subscales had good internal consistencies. Scores were significantly higher for patients either committed involuntarily or subjected to chemical or physical restrain, independent on severity of psychotic symptoms. Conclusion The Chinese AES is a psychometrically sound instrument assessing the three different aspects of the experience of admission, namely "negative pressure, "process exclusion" and "perceived coercion". The potential of C-AES in exploring subjective experience of psychiatric admission and effects on treatment adherence should be further explored.

  5. [Psychiatric Disorders in Pediatric Patients With Systemic Lupus Erythematosus in a Reference Hospital].

    Science.gov (United States)

    Zuñiga Zambrano, Yenny Carolina; Vásquez, Rafael

    2014-01-01

    To describe the psychiatric manifestations in pediatric patients with systemic erythematous lupus seen in the Fundación Hospital de la Misericordia. Observational descriptive study. Medical charts and test results of inpatients and outpatients between 2007 and2013 were reviewed; 39 patients were selected. SPSS 19 was used for statistical analysis. Statistical significance was considered with P=.05. Mean age was 13.7 (2.33), with 78.9% female. The most frequent psychiatric manifestation was anxiety (52.6%), followed by adjustment disorder and depression (36.8% each one), psychosis (10%), conversion disorder (7.9%), and obsessive compulsive disorder (5.3%). The mean SLICC score was 2.76 (2.8), and the mean SLEDAI score was 20.81 (20.82). Antinuclear antibodies were positive in 81.25%. Neuropsychiatric lupus was diagnosed in 65.8% of patients; seizures were observed in 23.7%, headache in 36.8%, stroke in 13.2%, vasculitis, chorea 5.3%, and meningitis 5.3% of patients. The mean time from lupus diagnosis was 20.47 (22.2) months, with the shortest period for adjustment disorder and the longest period in patients with conversion disorder (pseudo-seizures) being 15 months and 31 months, respectively. The highest SLEDAI score was in patients with psychosis (35.5 [16.21] vs 19.08 [13.72]; P=.032), and also the highest disease damage (SLICC, 4.25 [4.03] vs 2.58 [2.67]; P=.27) in comparison with the other manifestations. The most frequent psychiatric manifestations were anxiety, depression, and adjustment disorder, with a higher frequency than other studies, and with lupus activity principally in patients with psychosis. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  6. Study of coercive measures in prisons and secure psychiatric hospitals: the views of inmates and caregivers

    Directory of Open Access Journals (Sweden)

    A. Runte-Geidel

    2014-06-01

    Full Text Available Aim: The aim of the study was to ascertain the opinions of both inmates and staff of prison establishments about the use of coercive measures justified for clinical reasons for people with mental health problems and about the need to create protocols to regulate the application of these measures. Method: These opinions were gathered in a Qualitative Study with Focus Groups (prison inmates and prison staff from the Granada Penitentiary Centre and the Alicante Penitentiary Psychiatric Hospital, both in Spain. Results: The results showed that forced medication is the most commonly used coercive measure in these institutions. The inmates did not understand and rejected the use of this measure, above all because they were poorly informed about their illness and the medication required to treat it. The staff however defended the benefits of psychiatric medicine, even when administered without the patient's consent. Conclusions: Both inmates and staff agreed that it would be useful to have a protocol regulating the use of coercive measures. The study has also identified a number of important factors that could help to reduce the need for coercive measures or make their use unnecessary.

  7. Study of coercive measures in prisons and secure psychiatric hospitals: the views of inmates and caregivers.

    Science.gov (United States)

    Runte-Geidel, A; Girela, E; López, A; Ruiz, F; Torres-González, F

    2014-01-01

    The aim of the study was to ascertain the opinions of both inmates and staff of prison establishments about the use of coercive measures justified for clinical reasons for people with mental health problems and about the need to create protocols to regulate the application of these measures. These opinions were gathered in a Qualitative Study with Focus Groups (prison inmates and prison staff) from the Granada Penitentiary Centre and the Alicante Penitentiary Psychiatric Hospital, both in Spain. The results showed that forced medication is the most commonly used coercive measure in these institutions. The inmates did not understand and rejected the use of this measure, above all because they were poorly informed about their illness and the medication required to treat it. The staff however defended the benefits of psychiatric medicine, even when administered without the patient's consent. Both inmates and staff agreed that it would be useful to have a protocol regulating the use of coercive measures. The study has also identified a number of important factors that could help to reduce the need for coercive measures or make their use unnecessary.

  8. Factors influencing adherence to standard precautions among nursing professionals in psychiatric hospitals

    Directory of Open Access Journals (Sweden)

    Thaís Helena Piai-Morais

    2015-06-01

    Full Text Available OBJECTIVE Evaluate and correlate individual, work-related and organizational factors that influence adherence to standard precautions among nursing professionals of psychiatric hospitals in São Paulo. METHOD An exploratory cross-sectional study conducted with 35 nursing professionals, using the assessment tool for adherence to standard precautions through the Likert scale, ranging from 1 to 5. RESULTS Knowledge of the precautions received a high score (4.69; adherence received (3.86 and obstacles (3.78, while intermediaries and the scales of organizational factors received low scores (2.61. There was a strong correlation between the magnitude adherence scale and the personal protective equipment availability (r = 0.643; p = 0.000. The training scale for prevention of HIV exposure (p = 0.007 was statistically different between the nurses and nursing assistants. CONCLUSION The organizational factors negatively contributed to adherence to standard precautions, indicating that psychiatric institutions lack safe working conditions, ongoing training and management actions to control infections.

  9. Concomitant Psychiatric and Nonalcohol-Related Substance Use Disorders Among Hospitalized Patients with Alcoholic Liver Disease in the United States.

    Science.gov (United States)

    Jinjuvadia, Raxitkumar; Jinjuvadia, Chetna; Puangsricharoen, Pimpitcha; Chalasani, Naga; Crabb, David W; Liangpunsakul, Suthat

    2018-02-01

    Despite that the epidemiological studies on the comorbidity of alcohol misuse and psychiatric disorders have been studied, less is known about the magnitude of these disorders among patients with alcoholic liver disease (ALD). Our aim was to determine the prevalence of psychiatric and substance use disorders among hospitalized ALD patients in the United States. We utilized a single-level clinical classification software to identify patients with ALD and psychiatric/substance use disorders from the 2011 National Inpatient Sample data. The primary outcome was the prevalence of these disorders among hospitalized patients with ALD (n = 74,972) compared to those with chronic liver diseases not caused by alcohol (n = 350,140) and those without underlying liver diseases (n = 1,447,063). The prevalence of adjustment disorder, anxiety disorder, posttraumatic stress disorder, and depression was significantly higher among hospitalized patients with ALD when compared to those with chronic liver diseases not caused by alcohol (all with p-values disorders among hospitalized patients with ALD. Hospitalized patients with ALD have significantly high prevalence of concomitant psychiatric and substance abuse disorders when compared to those with chronic liver diseases not caused by alcohol and those without underlying liver diseases. Screening and appropriate intervention should be implemented as part of routine clinical care for these patients. Copyright © 2017 by the Research Society on Alcoholism.

  10. Psychiatric morbidity associated with caesarean section: a study from Wesley Guild Hospital, Ilesa, Nigeria.

    Science.gov (United States)

    Ukpong, D I; Owolabi, A T

    2004-11-01

    Fifty-five women who presented at Wesley Guild Hospital, Ilesa, Nigeria, for either elective or emergency caesarean section during a 5-month period (1 December 2003 - 30 April 2004) were recruited consecutively and assessed for psychiatric morbidity using the General Health Questionnaire (GHQ-30), the Beck Depression Inventory (BDI) and the State Version of the State-Trait Anxiety Inventory (STAI). Twenty-two women (40%), were cases on the GHQ, and the BDI was able to pick 11 women with depression in the study sample. The mean anxiety score for the entire study population was 41.7, which was higher than the usually accepted threshold of 40 for clinical disorder on the scale. Thirty-three women (60%) were initially reluctant to give consent for the operation and they had higher mean STAI scores than those who willingly consented to the procedure, and the difference in scores was statistically significant. The implications of these findings are discussed.

  11. Incipient offending among schizophrenia patients after first contact to the psychiatric hospital system

    DEFF Research Database (Denmark)

    Munkner, Runa; Haastrup, Soeren; Joergensen, Torben

    2005-01-01

    The study examines how age, sex and substance use disorder are associated with the risk of committing a criminal offence. The study explicitly examines the risk after the first contact to the psychiatric hospital system and after the diagnosis of schizophrenia for those with no previous criminal...... record; the association between previous non-violent criminality and later violent criminality is also analysed. The study sample comprised 4619 individuals ever diagnosed with schizophrenia. All solved offences were accessible. Data were analysed using Cox's regression. Schizophrenic men had twice...... the risk of schizophrenic women of committing both violent and non-violent offences. A registered substance use disorder increased the risk 1.9- to 3.7-fold, depending on the starting point for the analyses, while increasing age on first contact or when diagnosed with schizophrenia diminished the risk...

  12. Long-Term Survival of Patients Receiving Artificial Nutrition in Japanese Psychiatric Hospitals

    Directory of Open Access Journals (Sweden)

    Keiichi Abe

    2016-10-01

    Full Text Available Background/Aims: Most patients with dementia suffer from dysphagia in the terminal stage of the disease. In Japan, most elderly patients with dysphagia receive either tube feeding or total parenteral nutrition. Methods: In this study, we investigated the factors determining longer survival with artificial nutrition. Various clinical characteristics of 168 inpatients receiving artificial nutrition without oral intake in psychiatric hospitals in Okayama Prefecture, Japan, were evaluated. Results: Multiple logistic regression analysis showed that the duration of artificial nutrition was associated with a percutaneous endoscopic gastrostomy (PEG tube, diagnosis of mental disorder, low MMSE score, and absence of decubitus. Conclusion: Patients with mental disorders survived longer than those with dementia diseases on artificial nutrition. A PEG tube and good nutrition seem to be important for long-term survival.

  13. Psychiatric social workers in legal aid services in hospitals: Exploring roles in Indian context

    Directory of Open Access Journals (Sweden)

    Priya Treesa Thomas

    2017-01-01

    Full Text Available Mental health and legal problems are interlinked in many ways. People facing legal issues may develop mental health problems, and people with mental illness and family also face legal issues. In India, Legal Services Authorities Act, 1987 gives provision for free legal aid services for the poor sections of society. Authors explain the roles of psychiatric social workers in legal aid services in hospitals. Social case work as a method of social work is suitable in legal aid services. Counseling, referrals, collateral contacts, advocacy and networking are major services from the social work perspective. Knowledge about laws and mental illness is essential for social workers to work in legal aid clinics (LACs.

  14. Organizational culture of a psychiatric hospital and resilience of nursing workers.

    Science.gov (United States)

    Rocha, Fernanda Ludmilla Rossi; Gaioli, Cheila Cristina Leonardo de Oliveira; Camelo, Silvia Helena Henriques; Mininel, Vivian Aline; Vegro, Thamiris Cavazzani

    2016-01-01

    to analyze the organizational culture of a psychiatric hospital and identify the capacity of resilience of nursing workers. quantitative research. For data collection, were used the Brazilian Instrument for Evaluation of Organizational Culture (IBACO - Instrumento Brasileiro para Avaliação da Cultura Organizacional) and the Resilience Scale (RS). participants reported the existence of centralization of power and devaluation of workers, despite recognizing the existence of collaboration at work and practices for improving interpersonal relations. In relation to the capacity of resilience, 50% of workers showed high level, and 42.9% a medium level of resilience. The correlation tests revealed negative values between the IBACO and RS domains, indicating that the lower the appreciation of individuals in the institution, the greater their capacity of resilience. the organizational values reflect the work organization model in the institution that devalues the workers' needs and requires greater capacity of resilience.

  15. Assessment of service delays and impact on bed utilisation in a major teaching hospital.

    LENUS (Irish Health Repository)

    Conway, R

    2010-12-14

    BACKGROUND: Increasing economic pressures coupled with an expanding and ageing population and a hostile economic climate have led to growing interest in the optimisation of bed usage within hospitals. There are many causes for delay in a patient\\'s discharge. METHODS: This prospective observational study assessed consecutive patients admitted and discharged from hospital within a 52-day period for waiting times in the provision of requested diagnostic tests and services. RESULTS: Seventy patients were included in the study. There were median delays of 2 and 3 days for an MRI and colonoscopy, a delay of 3 days for a Holter monitor report, and 9 days for an occupational therapy referral. The median wait for consults was 1 day across all three services. CONCLUSIONS: Significant remediable delays exist during the course of many acute medical admissions. Addressing these factors will enable the provision of a faster and more cost-efficient service.

  16. Biodegradation of pharmaceuticals in hospital wastewater by staged Moving Bed Biofilm Reactors (MBBR)

    DEFF Research Database (Denmark)

    Escola Casas, Monica; Chhetri, Ravi Kumar; Ooi, Gordon Tze Hoong

    2015-01-01

    during 10 months of continuous operation. After this adaption phase batch and continuous experiments were performed for the determination of degradation of pharmaceuticals. Removal of organic matter and nitrification mainly occurred in the first reactor. Most pharmaceuticals were removed significantly...... for hospital wastewater treatment. To investigate the potential of such a hybrid system for the removal of pharmaceuticals in hospital wastewater a pilot plant consisting of a series of one activated sludge reactor, two Hybas™ reactors and one moving bed biofilm reactor (MBBR) has been established and adapted......− 1 for first, second, third and fourth reactors respectively. Generally, the highest removal rate constants were found in the first and third reactors while the lowest were found in the second one. When the removal rate constants were normalized to biomass amount, the last reactor (biofilm only...

  17. Fatal foodborne Clostridium perfringens illness at a state psychiatric hospital--Louisiana, 2010.

    Science.gov (United States)

    2012-08-17

    Clostridium perfringens, the third most common cause of foodborne illness in the United States (1), most often causes a self-limited, diarrheal disease lasting 12-24 hours. Fatalities are very rare, occurring in illness (2). On May 7, 2010, 42 residents and 12 staff members at a Louisiana state psychiatric hospital experienced vomiting, abdominal cramps, and diarrhea. Within 24 hours, three patients had died. The three fatalities occurred among patients aged 41-61 years who were receiving medications that had anti-intestinal motility side effects. For two of three decedents, the cause of death found on postmortem examination was necrotizing colitis. Investigation by the Louisiana Office of Public Health (OPH) and CDC found that eating chicken served at dinner on May 6 was associated with illness. The chicken was cooked approximately 24 hours before serving and not cooled in accordance with hospital guidelines. C. perfringens enterotoxin (CPE) was detected in 20 of 23 stool specimens from ill residents and staff members. Genetic testing of C. perfringens toxins isolated from chicken and stool specimens was carried out to determine which of the two strains responsible for C. perfringens foodborne illness was present. The specimens tested negative for the beta-toxin gene, excluding C. perfringens type C as the etiologic agent and implicating C. perfringens type A. This outbreak underscores the need for strict food preparation guidelines at psychiatric inpatient facilities and the potential risk for adverse outcomes among any patients with impaired intestinal motility caused by medications, disease, and extremes of age when exposed to C. perfringens enterotoxin.

  18. Psychiatric morbidity of overseas patients in inner London: A hospital based study

    Directory of Open Access Journals (Sweden)

    Parshall Alice M

    2005-02-01

    Full Text Available Abstract Background Evaluation of the referral, admission, treatment, and outcome of overseas patients admitted to a psychiatric hospital in central London. Ethical, legal and economic implications, and the involvement of consulates in the admission process, are discussed. Method Assessment and review of overseas patients admitted between 1 January 1999 and 31 December 1999. Non-parametric statistical tests were used, and relevant outcomes described. Results 19% of admissions were overseas patients. Mean age was 38 years. 90% were unattached; 84% were white, 71% from European countries. 45% spoke fluent English. Differences in socio-economic status between home country and England were found. 74% were unwell on arrival; 65% travelled to England as tourists. 65% of admissions came via the police. 32% had been ill for more than one year before admission; 68% had psychiatric history. 77% were admitted and 48% discharged under section of the Mental Health Act. 74% had psychotic disorders, all of them with positive symptoms. 55% showed little to moderate improvement in mental state; 10% were on Enhanced Care Programme Approach. Relatives of 48% of patients were contacted. The Hospital repatriated 52% of patients; the Mental Health Team followed up 13% of those discharged. The average length of admission was 43.4 days (range 1–365. Total cost of admissions was GBP350, 600 ($577, 490; average individual cost was GBP11, 116 (range GBP200-81, 000. Conclusions Mentally ill overseas individuals are a vulnerable group that need recognition by health organisations to adapt current practice to better serve their needs. The involvement of consulates needs further evaluation.

  19. Self-Mutilation Among Patients With Psychiatric Disorders Referred to Lavasani Hospital, 2013 - 2014

    Directory of Open Access Journals (Sweden)

    Vahdat Shariatpanahi

    2016-09-01

    Full Text Available Background Self-injury is defined as the intentional injuring of one’s own body without apparent suicidal intent. Self-harm is encountered frequently in psychiatric hospitals. Deliberate self-harm may be found in patients with a variety of diagnoses, including substance abuse, major depression, schizophrenia and especially borderline personality disorder. Objectives This study aimed to investigate the prevalence of self-injury and possible relating factors in patients with psychiatric diseases. Patients and Methods In this cross-sectional study, 42 patients with self-injury referred to Lavasani hospital in Tehran, Iran, were selected by random sampling during 2013 - 2014. The prevalence of self-injury, site and tools of self-injury and also possible contributing factors were evaluated. T-test and Fisher’s exact test were used to analyze data. Results Mean distribution of self-injury in patients was 12.5%. Sharp object was the tool of injury in 90.5% of the patients, 4.8% by fire, 2.4% by stone and 2.4% by other attempted to self-injury. In 76.2% of the patients extremities were the site of injury. In 19%, 2.4% and 2.4% head and neck, trunk and abdomen were the sites of injury, respectively. There was a significant association between type of disorder and tool and body site of self-injury (P < 0.001. Conclusions It can be concluded that schizophrenia and drug-induced psychotic disorder were the most common types of disorders that are at risk of self-injury.

  20. [Evaluation of suicide risk factors based on a survey of suicides and suicidal attempts at psychiatric hospitals in Aichi Prefecture].

    Science.gov (United States)

    Mori, Takao

    2012-01-01

    This investigation examined cases of suicide, suicidal attempts, and risk factors in 41 psychiatric hospitals of Aichi Prefecture. As a result, some characteristics of psychiatric wards considered to be effective in suicide prevention were shown. In addition, as for measures to resolve risk factors and the state of the patients, there were many which were effective in the prevention of suicide attempts. Regarding measures to reduce risk factors for symptoms and treat patients, there were many techniques which were effective in the prevention of suicidal attempts, but, for cases which did not respond to treatment, suicide was frequent. In addition, a "suicide preventive manual in a psychiatric hospital" produced based on these results was distributed.

  1. A Comparative Study of United States Service Members With and Without a History of Inpatient Psychiatric Hospitalization on Post Deployment Trauma, Depression, and Hazardous Alcohol Use Symptoms

    Science.gov (United States)

    2014-01-01

    regression analyses were conducted to test study hypotheses. Results: Previously psychiatrically hospitalized service members demonstrated...predicting positive Two-Item Conjoint Screen (TICS) from history of inpatient psychiatric hospitalization (N = 492...positive Two-Item Conjoint Screen (TICS) in inpatient cases (Group 1; N = 246) . 63 Table 6. Summary of logistic regression model predicting positive Two

  2. Efficiency of a Bed Biofilm Reactor Using a LECA Carrier to Treat Hospital Wastewater

    Directory of Open Access Journals (Sweden)

    Reza Shokoohi

    2016-03-01

    Full Text Available Hospital wastewater is of great environmental concern because it contains a variety of hazardous microbial and chemical substances. This study aims to investigate the efficiency of a moving bed biofilm reactor (MBBR with a light expanded clay aggregate (LECA carrier for treating hospital wastewater. This pilot study used a Plexiglas reactor that had a volume of 100 L, a continuous up-flow hydraulic regime, and a LECA carrier to test removal of chemical oxygen demand (COD from wastewater in a public hospital. To assess MBBR efficiency, the study used retention times of 8, 12, and 24 hours, filling percentages of 30% and 50%, and mixed liquor suspended solids (MLSSs of 1000, 3000, and 5000 mg/L. The results indicated that using a single LECA carrier in an MBBR system was not sufficient to remove organic materials from hospital wastewater, because the carrier could not be completely suspended. After some modifications, consisting mainly of returning activated sludge, the system was 83% efficient at removing COD using a LECA carrier at a retention time of 24 hours, with 50% filling, and 5000 mg/L of MLSS.

  3. Family Assessment/Treatment/Evaluation Methods Integrated for Helping Teen Suicide Attempters/Families in Short Term Psychiatric Hospitalization Programs.

    Science.gov (United States)

    Shepard, Suzanne

    The assessment process can be integrated with treatment and evaluation for helping teenage suicide attempters and families in short term psychiatric hospitalization programs. The method is an extremely efficient way for the therapist to work within a given time constraint. During family assessment sufficient information can be gathered to…

  4. Development of psychiatric risk evaluation checklist and routine for nurses in a general hospital: ethnographic qualitative study.

    Science.gov (United States)

    Camargo, Ana Luiza Lourenço Simões; Maluf Neto, Alfredo; Colman, Fátima Tahira; Citero, Vanessa de Albuquerque

    2015-01-01

    There is high prevalence of mental and behavioral disorders in general hospitals, thus triggering psychiatric risk situations. This study aimed to develop a psychiatric risk assessment checklist and routine for nurses, the Psychiatric Risk Evaluation Check-List (PRE-CL), as an alternative model for early identification and management of these situations in general hospitals. Ethnographic qualitative study in a tertiary-level private hospital. Three hundred general-unit nurses participated in the study. Reports were gathered through open groups conducted by a trained nurse, at shift changes for two months. The questions used were: "Would you consider it helpful to discuss daily practice situations with a psychiatrist? Which situations?" The data were qualitatively analyzed through an ethnographic approach. The nurses considered it useful to discuss daily practice situations relating to mental and behavioral disorders with a psychiatrist. Their reports were used to develop PRE-CL, within the patient overall risk assessment routine for all inpatients within 24 hours after admission and every 48 hours thereafter. Whenever one item was present, the psychosomatic medicine team was notified. They went to the unit, gathered data from the nurses, patient files and, if necessary, attending doctors, and decided on the risk management: guidance, safety measures or mental health consultation. It is possible to develop a model for detecting and intervening in psychiatric and behavioral disorders at general hospitals based on nursing team observations, through a checklist that takes these observations into account and a routine inserted into daily practice.

  5. Brief Report: Understanding Crisis Behaviors in Hospitalized Psychiatric Patients with Autism Spectrum Disorder--Iceberg Assessment Interview

    Science.gov (United States)

    Stark, Kate H.; Barnes, Julia C.; Young, Nicholas D.; Gabriels, Robin L.

    2015-01-01

    Children and adolescents with autism spectrum disorder (ASD) are at risk for emotional dysregulation and behavior problems that can escalate to levels requiring psychiatric hospitalization. Evaluating the etiology of such behaviors can be challenging for health care providers, as individuals with ASD can have difficulty self-reporting concerns.…

  6. Caregivers' acceptance of alternatives to long-term psychiatric hospitalization; lessons and debates from the South Korean situation.

    Science.gov (United States)

    Lee, Myung-Soo; Park, Jong-Ik

    2014-01-17

    A political movement towards building alternatives to long-term hospitalization of psychiatric patients in Korea has gained momentum. We aimed to provide sturdy foundation needed to formulate the most rational policy by review of caregiver's opinion to the political alternatives under discussion for facilitating discharge of long-term stayed psychiatric patients in Korea. Caregivers in Korea, whose family members had been hospitalized longer than 6 months and all of whom applied to the Mental Health Review Board (MHRB) for an examination required for extended stay, have shown reluctance to take their patients back home. Especially, a half of them answered that if MHRB would order compulsory discharge, they would take their patients to another hospital instead of living together. Despite of those pessimistic attitudes, one of the promising solutions might be residential care as an alternative to the long-term hospital care, which is most preferred by caregivers. After all, the issue of who should take an accountability of the psychiatric patients is essential in establishing mental health policy. Korean government should analyze and reform mental health delivery systems such as residential service system, community-based case management programs and hospital treatment systems including payment program which can facilitate reasonable decision by professionals as well as caregivers for the appropriate admission rather than longer term hospitalizations.

  7. Stroke survivors with severe mental illness: Are they at-risk for increased non-psychiatric hospitalizations?

    Directory of Open Access Journals (Sweden)

    Flavius Robert Lilly

    Full Text Available This study examined outcomes for two groups of stroke survivors treated in Veteran Health Administration (VHA hospitals, those with a severe mental illness (SMI and those without prior psychiatric diagnoses, to examine risk of non-psychiatric medical hospitalizations over five years after initial stroke.This retrospective cohort study included 523 veterans who survived an initial stroke hospitalization in a VHA medical center during fiscal year 2003. The survivors were followed using administrative data documenting inpatient stroke treatment, patient demographics, disease comorbidities, and VHA hospital admissions. Multivariate Poisson regression was used to examine the relationship between patients with and without SMI diagnosis preceding the stroke and their experience with non-psychiatric medical hospitalizations after the stroke.The study included 100 patients with SMI and 423 without SMI. Unadjusted means for pre-stroke non-psychiatric hospitalizations were higher (p = 0.0004 among SMI patients (1.47 ± 0.51 compared to those without SMI (1.00 ± 1.33, a difference which persisted through the first year post-stroke (SMI: 2.33 ± 2.46; No SMI: 1.74 ± 1.86; p = 0.0004. Number of non-psychiatric hospitalizations were not significantly different between the two groups after adjustment for patient sociodemographic, comorbidity, length of stay and inpatient stroke treatment characteristics. Antithrombotic medications significantly lowered risk (OR = 0.61; 95% CI: 0.49-0.73 for stroke-related readmission within 30 days of discharge.No significant differences in medical hospitalizations were present after adjusting for comorbid and sociodemographic characteristics between SMI and non-SMI stroke patients in the five-year follow-up. However, unadjusted results continue to draw attention to disparities, with SMI patients experiencing more non-psychiatric hospitalizations both prior to and up to one year after their initial stroke. Additionally

  8. Psychiatric hospitalization and suicide among the very old in Denmark: population-based register study

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Mortensen, Preben Bo; Vach, Werner

    2005-01-01

    BACKGROUND: Very old people have higher suicide rates than the younger elderly population. Psychiatric disorders are known to have a strong association with suicide among elderly people. AIMS: To analyse the analyse the suicide risk associated with psychiatric hospitalisation among the very old......: The association between suicide and psychiatric hospitalisation is much weaker for the very old than for the old. Psychiatric disorders among very old people may be interacting with other disorders, may be underdiagnosed or treated in other healthcare settings....

  9. [Validity of the Child Psychiatric Hospital Teacher Questionnaire for the assessment of ADHD. Teacher's version].

    Science.gov (United States)

    Ulloa, R E; Narváez, M R; Arroyo, E; del Bosque, J; de la Peña, F

    2009-01-01

    Teacher's rating scales for the evaluation of attention deficit and superactivity disorder (TDAH) and conduct disorders have been shown to be useful and valid tools. The Child Psychiatric Hospital Teacher Questionnaire (CPHTQ) of the Hospital Psiquiátrico Infantil Dr. Juan N. Navarro was designed for the assessment of ADHD symptoms, externalizing symptoms and school functioning difficulties of children and adolescents. Internal consistency, criterion validity, construct validity and sensitivity of the scale to changes in symptom severity were evaluated in this study. The scale was administered to 282 teachers of children and adolescents aged 5 to 17 years who came to a unit specialized in child psychiatry. The validity analysis of the instrument showed that the internal consistency measured by Cronbach's alpha was 0.94. The factorial analysis yielded 5 factors accounting for 59.1% of the variance: hyperactivity and conduct symptoms, predatory, conduct disorder, inattentive, poor functioning and motor disturbances. The CPHTQ scores on the scale showed positive correlation with the Clinical Global impression (CGI) scale in the patients' response to drug treatment. The CPHTQ shows adequate validity characteristics that demonstrate its utility in the evaluation of patients with ADHD and its comorbidity with other behavior disorders.

  10. Resilience of the health team in caring for people with mental disorders in a psychiatric hospital.

    Science.gov (United States)

    Brolese, Débora Felippe; Lessa, Greice; Santos, José Luís Guedes Dos; Mendes, Jucimara da Silva; Cunha, Kamylla Santos da; Rodrigues, Jeferson

    2017-08-17

    Evaluating and understanding the resilience process of the health team in caring for people with mental disorders in a psychiatric hospital. A mixed-method study with concomitant triangulation of data from a cross-sectional study, with health professionals, and Grounded Theory in the data. Quantitative data were collected using the Resilience Scale and analyzed using descriptive and inferential statistics. Qualitative data were obtained from interviews and analyzed using initial and focused coding. 40 health professionals participated in the study. Mean responses of the participants in the resilience scale were 99.80 ± 12.86 points, with a minimum of 35 and a maximum of 114 points. From the qualitative data, we can highlight the professionals' commitment in developing competencies in caring for people with mental disorders; valorization of teamwork and positive impact on work for the re-signification of the meaning of life. Understanding this process of resilience enables developing strategies to improve the quality of life of workers in psychiatric hospitals. Avaliar e compreender o processo de resiliência da equipe de saúde no cuidado a pessoas com transtornos mentais em um hospital psiquiátrico. Estudo de método misto com triangulação concomitante de dados de um estudo transversal, com profissionais de saúde, e uma Teoria Fundamentada nos Dados. Os dados quantitativos foram coletados a partir da Escala de Resiliência e analisados por meio de estatística descritiva e inferencial. Os dados qualitativos foram obtidos a partir de entrevistas e analisados mediante codificação inicial e focalizada. Participaram da pesquisa 40 profissionais de saúde. Na escala de resiliência, a média das respostas dos participantes foi 99,80±12,86 pontos, o mínimo foi de 35 e o máximo de 114 pontos. Nos dados qualitativos, destacaram-se o empenho dos profissionais para o desenvolvimento de competências para o cuidado de pessoas com transtornos mentais, a valoriza

  11. Improving hospital bed utilisation through simulation and optimisation: with application to a 40% increase in patient volume in a Norwegian General Hospital.

    Science.gov (United States)

    Holm, Lene Berge; Lurås, Hilde; Dahl, Fredrik A

    2013-02-01

    This paper analyses the problem of allocating beds among hospital wards in order to minimise crowding. We present a generic discrete event simulation model of patient flow through the wards of a hospital. In the generic model, each ward can have separate probability distributions for arrival times and length of stay, which may be time dependent. Output of the model is a matrix, with statistics on the utilisation of different hypothetical numbers of beds for each ward. This matrix is fed into an allocation algorithm, which distributes the available beds among the wards in an optimal way. We define bed utilisation either in terms of how often it is in use (prevalence), or in terms of how often a newly arriving patient is placed in it (incidence). For these classes of utilisation measures we develop efficient allocation algorithms, which we prove to be optimal. The model was applied to Akershus University Hospital in Norway. In 2011, some of the wards of this hospital experienced a high occupancy rate, while others had a lower utilisation. Our model was applied in order to reallocate the hospital beds among the wards. For each ward, acute arrivals were modelled with Poisson-distributions with time-varying intensity, while elective arrivals were programmed to arrive in specific numbers at specific times. The arrival rates were based on empirical data for 2010, scaled up by an expected increase of 40% due to a restructuring of the hospital districts in Oslo and the greater metropolitan area in 2011. Length of stay was modelled as beta-distributions, using a combination of subject matter experts' evaluations and empirical data from 2010. The model has been verified and validated. Intuitively, both prevalence (average number of crowding beds in use) and incidence (number of patients placed in crowding beds) might seem like relevant optimisation criteria. However, our experiments show that prevalence optimisation gives more sensible solutions than incidence optimisation

  12. Qualitative study on the placement of Huntington disease patients in a psychiatric hospital: perceptions of Maltese nurses.

    Science.gov (United States)

    Scerri, Josianne; Cassar, Rebecca

    2013-12-01

    Individuals with adult or juvenile Huntington disease can be cared for within psychiatric hospitals. In this paper, nurses' perceptions about the appropriateness of a psychiatric setting for these patients were explored. Semistructured interviews were conducted with 10 Maltese nurses involved in the care of these individuals. Their responses were analyzed using thematic analysis. Three main themes were identified from this study: (i) Huntington disease is not a mental illness; (ii) the lack of specialized staff and equipment within a psychiatric setting; and (iii) a need for alternative care options. The findings provide an insight into the perceptions of nurses, as they play a key role in the care and management of individuals with Huntington disease in a psychiatric setting. The findings demonstrated the need to provide alternative residential options in the community, and to improve the care and support provided both within psychiatric hospitals and the community through staff education and the provision of necessary facilities and equipment. © 2013 Wiley Publishing Asia Pty Ltd.

  13. Duration of bed occupancy as calculated at a random chosen day in an acute care ward. Implications for the use of scarce resources in psychiatric care

    Directory of Open Access Journals (Sweden)

    Restan Asbjørn

    2005-05-01

    Full Text Available Abstract Background Psychiatric acute wards are obliged to admit patients without delay according to the Act on Compulsive Psychiatric Care. Residential long term treatment facilities and rehabilitation facilities may use a waiting list. Patients, who may not be discharged from the acute ward or should not wait there, then occupy acute ward beds. Materials and methods Bed occupancy in one acute ward at a random day in 2002 was registered (n = 23. Successively, the length of stay of all patients was registered, together with information on waiting time after a decision was made on further treatment needs. Eleven patients waited for further resident treatment. The running cost of stay was calculated for the acute ward and in the different resident follow-up facilities. Twenty-three patients consumed a total of 776 resident days. 425 (54.8% of these were waiting days. Patients waited up to 86 days. Results Total cost of treatment was 0.69 million Euro (0.90 mill. $, waiting costs were 54.8% of this, 0.38 million Euro (0.50 million $. The difference between acute care costs and the costs in the relevant secondary resident facility was defined as the imputed loss. Net loss by waiting was 0.20 million Euro (0.26 million $ or 28.8% of total cost. Discussion This point estimate study indicates that treating patients too sick to be released to anything less than some other intramural facility locks a sizable amount of the resources of a psychiatric acute ward. The method used minimized the chance of financially biased treatment decisions. Costs of frustration to staff and family members, and delayed effect of treatment was set to zero. Direct extrapolation to costs per year is not warranted, but it is suggested that our findings would be comparable to other acute wards as well. The study shows how participant observation and cost effectiveness analysis may be combined.

  14. An investigation of factors associated with psychiatric hospital admission despite the presence of crisis resolution teams

    Directory of Open Access Journals (Sweden)

    Nolan Fiona

    2007-10-01

    Full Text Available Abstract Background Crisis resolution teams (CRTs provide a community alternative to psychiatric hospital admission for patients presenting in crisis. Little is known about the characteristics of patients admitted despite the availability of such teams. Methods Data were drawn from three investigations of the outcomes of CRTs in inner London. A literature review was used to identify candidate explanatory variables that may be associated with admission despite the availability of intensive home treatment. The main outcome variable was admission to hospital within 8 weeks of the initial crisis. Associations between this outcome and the candidate explanatory variables were tested using first univariate and then multivariate analysis. Results Patients who were uncooperative with initial assessment (OR 10.25 95% CI-4.20–24.97, at risk of self-neglect (OR 2.93 1.42–6.05, had a history of compulsory admission (OR 2.64 1.07–6.55, assessed outside usual office hours (OR 2.34 1.11–4.94 and/or were assessed in hospital casualty departments (OR 3.12 1.55–6.26, were more likely to be admitted. Other than age, no socio-demographic features or diagnostic variables were significantly associated with risk of admission. Conclusion With the introduction of CRTs, inpatient wards face a significant challenge, as patients who cooperate little with treatment, neglect themselves, or have previously been compulsorily detained are especially likely to be admitted. The increased risk of admission associated with casualty department assessment may be remediable.

  15. Association of the World War II Finnish Evacuation of Children With Psychiatric Hospitalization in the Next Generation.

    Science.gov (United States)

    Santavirta, Torsten; Santavirta, Nina; Gilman, Stephen E

    2018-01-01

    Although there is evidence that adverse childhood experiences are associated with worse mental health in adulthood, scarce evidence is available regarding an emerging concern that the next generation might also be affected. To compare the risk of psychiatric hospitalization in cousins whose parents were vs were not exposed to the Finnish evacuation policy that involved a mean 2-year stay with a Swedish foster family. This multigenerational, population-based cohort study of Finnish individuals and their siblings born between January 1, 1933, and December 31, 1944, analyzed the association of evacuee status as a child during World War II in the first generation with the risk of psychiatric hospitalization among offspring in the second generation. Evacuee status during World War II was determined using the Finnish National Archive's registry of participants in the Finnish evacuation. Data on evacuee status were linked to the psychiatric diagnoses in the Finnish Hospital Discharge Register from January 1, 1971, through December 31, 2012, for offspring (n = 93 391) born between January 1, 1950, and December 31, 2010. Sex-specific Cox proportional hazards regression models were used to estimate hazard ratios for risk of psychiatric hospitalization during the follow-up period. Because offspring of evacuees and their nonevacuated siblings are cousins, the Cox proportional hazards regression models included fixed effects to adjust for confounding factors in families. Data analysis was performed from June 15, 2016, to August 26, 2017. Parental participation in the evacuation during World War II (coded 1 for parents who were evacuated and placed in foster care and 0 for those not evacuated). Offspring's initial admission to the hospital for a psychiatric disorder, obtained from the Finnish Hospital Discharge Register from January 1, 1971, through December 31, 2012. Of the 93 391 study persons, 45 955 (49.2%) were women and 47 436 (50.8) were men; mean (SD) age in

  16. Atmospheric fluidized-bed combustion (AFBC) co-firing of coal and hospital waste. Environmental Assessment

    Energy Technology Data Exchange (ETDEWEB)

    1993-02-01

    The proposed project involves co-firing of coal and medical waste (including infectious medical waste) in an atmospheric fluidized-bed combustor (AFBC) to safely dispose of medical waste and produce steam for hospital needs. Combustion at the design temperature and residence time (duration) in the AFBC has been proven to render infectious medical waste free of disease producing organisms. The project would be located at the Veterans Affairs (VA) Medical Center in Lebanon, Pennsylvania. The estimated cost of the proposed AFBC facility is nearly $4 million. It would be jointly funded by DOE, Veterans Affairs, and Donlee Technologies, Inc., of York, Pennsylvania, under a cooperative agreement between DOE and Donlee. Under the terms of this agreement, $3.708 million in cost-shared financial assistance would be jointly provided by DOE and the Veterans Affairs (50/50), with $278,000 provided by Donlee. The purposes of the proposed project are to: (1) provide the VA Medical Center and the Good Samaritan Hospital (GSH), also of Lebanon, Pennsylvania, with a solution for disposal of their medical waste; and (2) demonstrate that a new coal-burning technology can safely incinerate infectious medical waste, produce steam to meet hospital needs, and comply with environmental regulations.

  17. The closing of forensic psychiatric hospitals in Italy: Determinants, current status and future perspectives. A scoping review.

    Science.gov (United States)

    Di Lorito, Claudio; Castelletti, Luca; Lega, Ilaria; Gualco, Barbara; Scarpa, Franco; Vӧllm, Birgit

    Italy is the only country in the world to have closed forensic psychiatric hospitals and converted to fully-residential services. The international interest around this reform has not been matched by research. This scoping review aims to report the determinants of the reform, the most updated information on how the system operates, its benefits and its challenges. We further aim to discuss the implications for policy, research and practice. 1. Selection of relevant sources through electronic search on four databases, Google, relevant printed materials and personal communication with practitioners currently working in REMS. 2. Study quality monitoring. 3. Data extraction onto NVivo 4. Data synthesis through content analysis. 43 papers were selected for inclusion in our review. Two main themes were identified: 1. Historical chronology of the closure of forensic psychiatric hospitals; 2. The current model of residential forensic psychiatric care. The closing down of Italian forensic psychiatric hospitals represented a fundamental step for human rights. Further work is required to improve the current service, including potential reforming of the penal code, improved referral/admission processes and consistent monitoring to reduce service inequality across regions. Further research is crucial to test the effectiveness of the Italian model of care against traditional ones. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. A critical black feminist ethnography of treatment for women with co-occurring disorders in the psychiatric hospital.

    Science.gov (United States)

    Creswell, Laryssa M

    2014-04-01

    The purpose of this study was to explore the perspectives of women diagnosed with co-occurring disorders on the treatments provided by a state psychiatric hospital so that appropriate recommendations for changes in treatment may be made. Critical ethnography was used and the data was viewed through the lens of intersectionality from the black feminist perspective. Seven women hospitalized in one psychiatric hospital in the Mid-Atlantic region participated in the study. Data was collected via semistructured interviews, Consumer Perceptions of Care survey, researcher's observations, and archival data. Three major findings emerged: (1) Dialectical Behavioral Therapy (DBT) was identified as a beneficial treatment, (2) a lack of trust in the system and people in the system, and (3) housing or homelessness was perceived as a barrier. Based on the results of this study, it is recommended clinicians, administrators, and policy makers listen closely to individuals receiving treatment to make decisions regarding treatment accordingly.

  19. Compulsory and voluntary admission in psychiatric hospitals in northern Norway 2009-2010. A national registry-based analysis.

    Science.gov (United States)

    Norum, Jan; Olsen, Aina; Nybrodahl, Inger; Sørgaard, Knut W

    2013-02-01

    During the last decade, Norwegian healthcare authorities have been concerned about the frequent use of coercive measures in psychiatric care. On this background, we aimed to explore the voluntary and compulsory admissions in psychiatric hospitals in northern Norway, the University Hospital of North Norway in Tromsø (UNN-T) and the Nordland Hospital in Bodø (NH-B). All voluntary and compulsory admissions (2009-2010) among patients aged ≥18 years registered by the Norwegian Patient Registry (NPR) were analyzed retrospectively. Compulsory admission was registered according to the general practitioner's (GP's) decision and the patients were hospitalized in Bodø or Tromsø. A total of 12,237 admissions and 242,148 days in hospital were identified. The female/male ratio of admission and stay was 1.17 and 1.15, respectively. The admission rate (northern Norway =1.0) varied significantly from south to north (0.60-1.52). Whereas patients living close to the hospitals had the same admission rate as others, the mean hospital stay was significantly longer (ratio =1.32). Furthermore, the UNN-T had a higher re-admission rate (2% vs. 5%). Municipalities with District Psychiatric Centers (DPC) did not differ from others. A significant difference in the use of coercive measures was revealed between hospitals. Forced medication was the most frequent measure employed. The study documented a south-north gradient in admission rate and indicated differences in the use of coercion. Variation may partly be due to different reporting procedures. This finding and why patients living in the neighborhood of hospitals stay longer should be explored in future studies.

  20. Characteristics and associated factors in patient falls, and effectiveness of the lower height of beds for the prevention of bed falls in an acute geriatric hospital.

    Science.gov (United States)

    Menéndez, M D; Alonso, J; Miñana, J C; Arche, J M; Díaz, J M; Vazquez, F

    2013-01-01

    Whereas several studies about patient falls have provided data for long-term healthcare institutions, less information is available for acute care centres. The objective was to analyze the characteristics of the patient falls and associated factors, and the effectiveness of the lower beds' height to reduce the frequency and the harms of the patient falls in an acute geriatric hospital. A descriptive and retrospective study using a mandatory safety incident report, the IHI Global Trigger Tool, and the claims related to patient falls between 2007 and 2011 in a 200-bed university-associated geriatric hospital. The falls rate was 5.4 falls per 1000 patient days (1.3% of falls led to fractures) and there was exitus in 6 patients (0.6%). Nearly half of the falls ocurred during the night shift (42.4%). By wards, falls were more frequent in acute geriatric wards (42.9%). A 7.5% of patients had a fall before admission. 3 (0.2%) claims due to possible clinical negligence were found. A reduction (28.3%) of bed falls with the lower height of the bed and a 1.88 times less falls with harm (RR 0.53; CI 95% 0.83-0.34) (p=0.006) was observed. The prevention of patient falls is an important task in geriatric units with a potential reduction of harms and costs, some measures such as the lower height of the bed showed a significant reduction of the falls. Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.

  1. Dispersion of exhaled droplet nuclei in a two-bed hospital ward with three different ventilation systems

    DEFF Research Database (Denmark)

    Qian, H.; Li, Y.; Nielsen, Peter V.

    2006-01-01

    hospital ward with three ventilation systems, i.e. mixing, downward and displacement ventilation. Two life-size breathing thermal manikins were used to simulate a source patient and a receiving patient. The exhalation jet from a bed-lying manikin was visualized using smoke. N2O was used as tracer gas......Effective ventilation in general hospital wards is important for controlling the airborne transmission of infectious respiratory diseases. Experiments have been carried out to increase our understanding of the interaction of the breathing flows of two individuals in a full-scale experimental...

  2. Psychiatric consultations and the management of associated comorbid medical conditions in a regional referral hospital

    Directory of Open Access Journals (Sweden)

    Nkokone S Z Tema

    2015-05-01

    Full Text Available Background. Psychiatrists are often called upon to evaluate patients with a medical condition and psychiatric symptoms, either as a complication thereof or initial presenting symptoms. There are often grey areas with regard to neuropsychiatric disorders in which psychiatrists and specialists from other clinical disciplines would need to co-manage or share ideas on the comprehensive treatment of a presenting patient. Objectives. This study was undertaken to provide a demographic and clinical profile of all patients consulted by the consultation-liaison psychiatry (CLP service at the Helen Joseph Hospital (HJH in Johannesburg, and to describe the clinical management of patients admitted with a diagnosis of a mental disorder associated with a comorbid medical condition, including delirium, dementia and a mood or psychotic disorder due to a general medical condition. Methods. A retrospective record review of all patients referred to the HJH CLP team over a 6-month period. Results. A total of 884 routine and emergency consultations were done for 662 patients (males n=305; females n=357 between the ages of 13 and 90 years who were referred from various other clinical departments. The most common documented reason for referral was a request for assessment (n=182; 27.5%, which consisted of mental state assessment, reconsultation and assessing capacity. A total of 63 patients (10.0% of cases consulted were admitted to either the medical or psychiatric wards with a confirmed diagnosis of delirium, dementia and/or a mood or psychotic disorder due to a general medical condition (although admission wards were identified in 55 files only. The medical wards admitted the majority (n=37; 67.3% mostly for delirium (n=28; 50.9%. HIV was identified as the most common systemic aetiological factor (n=23; 67.7%. Conclusion. In this study, a female patient between 31 and 45 years of age was slightly more likely to be referred to the HJH CLP service for assessment, and

  3. [Rate and characteristics of dementia patients who visit psychiatric emergency hospitals for the treatment of behavioral and psychological symptoms of dementia (BPSD) in Japan].

    Science.gov (United States)

    Shimizu, Yoshiro; Kazui, Hiroaki; Sawa, Yutaka; Takeda, Masatoshi

    2013-01-01

    Neuropsychiatric symptoms and behavioral changes, known as behavioral and psychological symptoms of dementia (BPSD), are often observed in patients with dementia. BPSD impairs a patient's quality of life, increases the burden on the caregivers, and can be a predictor of the need for institutionalization. BPSD can aggravate on holidays or at night, when general psychiatric clinics are closed. When psychiatric symptoms aggravate on holidays or at night in patients with psychiatric disorders other than dementia, such as schizophrenia and manic psychosis, the patients visit psychiatric emergency hospitals. However, it has not been assessed whether patients with dementia visit psychiatric emergency hospitals for the treatment of BPSD on holidays or at night, although dementia patients are increasing and account for 10.5% of psychiatric outpatients in Japan. To determine the percentage of dementia patients with BPSD in all psychiatric patients who visit psychiatric emergency hospitals, and the characteristics of patients with BPSD in Japan. We developed two questionnaires. One was for psychiatric emergency hospitals and assessed the numbers of all patients, patients over 65 years old, and patients over 65 years and with BPSD or BPSD-like symptoms, who visited the psychiatric emergency hospitals on holidays or at night. The other questionnaire was for each patient over 65 years and with BPSD, and assessed the patients' characteristics, including their diagnosis, sex, what kinds of BPSD or BPSD-like symptoms brought them to the hospital, and whether they had visited a psychiatric clinic or hospital during the preceding 12 months. The questionnaires were sent to 360 hospitals that belong to the Japan Psychiatric Hospitals Association and treat patients with acute psychotic symptoms or dementia. This prospective survey was conducted from October 1 to November 30, 2009. One hundred and forty-three hospitals returned the questionnaires (response rate: 39.7%). In the survey

  4. Excess mortality in general hospital patients with delirium: A 5-year follow-up of 519 patients seen in psychiatric consultation

    NARCIS (Netherlands)

    A.M. van Hemert (Bert); R.C. van der Mast (Roos); M.W. Hengeveld (Michiel); M. Vorstenbosch (Marielle)

    1994-01-01

    textabstractMortality was determined in 519 patients with delirium who were seen in psychiatric consultation in two general hospitals. Among 419 patients with simple delirium (DSM-III: 293.00) in-hospital mortality was 26%. As compared to average hospital patients the age adjusted in-hospital excess

  5. Factors related to positive and negative outcomes in psychiatric inpatients in a General Hospital Psychiatric Unit: a proposal for an outcomes index

    Directory of Open Access Journals (Sweden)

    HUGO KARLING MORESCHI

    2015-02-01

    Full Text Available Background General Hospital Psychiatric Units have a fundamental importance in the mental health care systems. However, there is a lack of studies regarding the level of improvement of patients in this type of facility. Objective To assess factors related to good and poor outcomes in psychiatric inpatients using an index composed by clinical parameters easily measured. Methods Length of stay (LOS, Global Assessment of Functioning (variation and at discharge and Clinical Global Impression (severity and improvement were used to build a ten-point improvement index (I-Index. Records of psychiatric inpatients of a general hospital during an 18-month period were analyzed. Three groups (poor, intermediate and good outcomes were compared by univariate and multivariate models according to clinical and sociodemographic variables. Results Two hundred and fifty patients were included, with a percentage in the groups with poor, regular and good outcomes of 16.4%, 59,6% and 24.0% respectively. Poor outcome at the discharge was associated mainly with lower education, transient disability, antipsychotics use, chief complaint “behavioral change/aggressiveness” and psychotic features. Multivariate analysis found a higher OR for diagnoses of “psychotic disorders” and “personality disorders” and others variables in relation to protective categories in the poor outcome group compared to the good outcome group. Discussion Our I-Index proved to be an indicator of that allows an easy and more comprehensive evaluation to assess outcomes of inpatients than just LOS. Different interventions addressed to conditions such as psychotic disorders and disruptive chief complaints are necessary.

  6. What helps or undermines adolescents' anticipated capacity to cope with mental illness stigma following psychiatric hospitalization.

    Science.gov (United States)

    Moses, Tally

    2015-05-01

    Better understanding of the individual and environmental factors that promote adolescents' use of more or less adaptive coping strategies with mental illness stigma would inform interventions designed to bolster youth resilience. This cross-sectional study draws on data from research on adolescents' well-being after discharge from a first psychiatric hospitalization to explore the relationships between anticipated coping in reaction to a hypothetical social stigma scenario, and various factors conceptualized as 'coping resource' and 'coping vulnerability' factors. Focusing on coping strategies also identified in the companion article, we hypothesize that primary and secondary control engagement coping would relate to more coping resource and less coping vulnerability factors, and the opposite would be true for disengagement, aggression/confrontation and efforts to disconfirm stereotypes. Data were elicited from interviews with 102 adolescents within 7 days of discharge. Hypothesized coping resource factors included social resources, optimistic illness perceptions, better hospital experiences and higher self-esteem. Vulnerability factors included more previous stigma experiences, desire for concealment of treatment, more contingent self-worth, higher symptom levels and higher anticipated stress. Multivariate ordinary least squares (OLS) regression was used to analyze associations between coping strategy endorsement and correlates. Although some coping correlates 'behaved' contrary to expectations, for the most part, our hypotheses were confirmed. As expected, youth anticipating reacting to the stigmatizing situation with greater disengagement, aggression/confrontation or efforts to disconfirm stenotypes rated significantly lower on 'coping resources' such as self-esteem and higher on vulnerability factors such as symptom severity. The opposite was true for youth who anticipated exercising more primary and secondary control engagement coping. This study begins to

  7. Recognition of Depression and Anxiety by Non-Psychiatric Residents in a General Hospital

    Directory of Open Access Journals (Sweden)

    Ahmad-Reza Soroush

    2009-02-01

    Full Text Available "nObjective :The objective of this study was to determine the ability of non-psychiatric (medical and surgical residents residents on inpatient units to recognize patients with clinically significant depression and anxiety among a cohort admitted to the Dr. Shariati Hospital in Tehran. "nMethod: Patients within 72 hours of admission underwent screening with the Hospital Anxiety and Depression Scale(HADS. Simultanously the residents caring for the patients was assessed whether they believed that patients had significant depression or anxiety. They should also rate the degree of depression and anxiety of their patients in a 5 point Likert scale. "nResults: Assessments were completed for 401 patients. According to HADS score 136(34.25% patients had probable depressive disorders and 157(39.75% patients had probable anxiety disorders. The residents only asked from 26(6.4% and 32(8.2% patients about depression and anxiety respectively. They identified only 10.2% of patients with probable depressive disorder (HADS-D score>7 and10.8% of patients with probable anxiety disorder(HADS-A score>7. There was no significant correlation of residents' assessment of severity of depression and anxiety with HADS scores. Residents varied in their sensitivity to their patients' depression and anxiety. There was no correlation between residents characteristic (gender and medical or surgical disciplines and accuracy of probable diagnosis. "nConclusion: Medical and surgical residents routinely under-recognize depression and anxiety among inpatients in medical and surgical wards

  8. Acceptance of Medical Resume Completion at Dr. Radjiman Wediodiningrat Lawang Psychiatric Hospital

    Directory of Open Access Journals (Sweden)

    Silvia Shinta Devi

    2017-02-01

    Sistem kesehatan di Indonesia mengalami perubahan besar dengan diberlakukannya program Asuransi Kesehatan Nasional. Resume medis memiliki peran penting dalam klaim asuransi kesehatan, sehingga resume medis yang terlambat dan tidak lengkap akan mengganggu proses klaim asuransi. Penelitian ini bertujuan untuk mengetahui pengaruh persepsi kemudahan penggunaan, persepsi manfaat, dan sikap pada penerimaan dokter dalam menyelesaikan resume medis. di Dr Radjiman Wedyodiningrat Psychiatric Hospital Lawang berdasarkan Technology Acceptance Model. Technology Acceptance Model digunakan sebagai model dalam penelitian ini karena resume medis merupakan salah satu bentuk teknologi informasi yang masih dilakukan secara manual. Pengumpulan data untuk penelitian ini dilakukan pada bulan Maret 2016 dengan menggunakan kuesioner yang diberikan kepada 32 dokter di Rumah Sakit Jiwa Dr Radjiman Wediodiningrat Lawang. Skala Likert lima tingkat digunakan untuk mengukur setiap item variabel. Data dianalisis dengan menggunakan Partial Least Square. Hasil penelitian menunjukan bahwa secara umum, acceptance dokter di RSJ Dr. Radjiman Wediodiningrat Lawang terhadap pengisian resume medis masuk dalam kategori ringgi dan memiliki perceived usefulness and attitude yang dalam kategori baik, sedangkan perceived ease of use dalam kategori sedang.

  9. Recovery-oriented practices of psychiatric-mental health nursing staff in an acute hospital setting.

    Science.gov (United States)

    McLoughlin, Kris A; Du Wick, Amanda; Collazzi, Charlene M; Puntil, Cheryl

    2013-01-01

    There is a national initiative to integrate recovery-oriented practices into the delivery of mental health services. Few empirical studies have been conducted to measure these practices in psychiatric-mental health (PMH) nursing, particularly in short-term acute hospital settings. This study examined the reliability of the Recovery Self Assessment-Registered Nurse Version (RSA-RN) and explored recovery practices of PMH nurses and nursing staff in an acute treatment setting. A descriptive one-group design with convenience sampling was employed. One hundred and five participants completed the RSA-RN and the demographic data form. The RSA-RN full-scale instrument demonstrated excellent internal consistency, and the five subscales demonstrated acceptable internal consistency. Significant, favorable relationships were found between RSA-RN scores and nursing staff who (a) had formal education in mental health recovery, (b) considered themselves knowledgeable about recovery, and (c) considered their place of work to be "recovery-oriented." The RSA-RN is a useful tool in measuring recovery-oriented practice. Formal education should be considered as an intervention to increase recovery-oriented practices in PMH nursing.

  10. Experiences by student nurses during clinical placement in psychiatric units in a hospital

    OpenAIRE

    W.J.C. Van Rhyn; M.R. Gontsana

    2004-01-01

    An exploratory study was conducted with the aim of discovering and describing experiences of psychiatric nursing students during clinical placement in a psychiatric unit. For the purpose of the study an unstructured interview was conducted with each participant during their first placement in a psychiatric unit to identify the factors experienced as stressful. The results indicated that all eight participants experienced average to high stress. Sources of stress identified included, among oth...

  11. 42 CFR 413.114 - Payment for posthospital SNF care furnished by a swing-bed hospital.

    Science.gov (United States)

    2010-10-01

    ... hospitals (other than CAHs) is paid in accordance with the provisions of the prospective payment system for... located. The rates are calculated using the regions as defined in section 1886(d)(2)(D) of the Social... that number of “licensed” beds was available. After totalling the results, compute 15 percent of the...

  12. Analysis of the spatial dose according to the type of radiation source used in multi-bed hospital room

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Dong Gun [Dept. of Nuclear Medicine, Dongnam Institute of Radiological and Medical Sciences Cancer center, Busan (Korea, Republic of); Kim, Jung Hoon [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of); Park, Eun Tae [Dept. of Radiation Oncology, Busan Paik Hospital, Inje University, Busan (Korea, Republic of)

    2017-09-15

    Medical radiation offers significant benefits in diagnosing and treating patients, but it also generates unnecessary radiation exposure to those nearby. Accordingly, the objective of the present study was to analyze spatial dose rate according to types of radiation source term in multi-bed hospital rooms occupied by patients and general public. MCNPX was used for geometric simulation of multi-bed hospital rooms and radiation source terms, while the radiation source terms were established as whole body bone scan patients and imaging using a portable X-ray generator. The results of simulation on whole body bone scan patients showed 3.46 μSv/hr to another patient position, while experimental results on imaging using a portable X-ray generator showed 1.47 × 10{sup -8} μSv/irradiation to another patient position in chest imaging and 2.97 × 10{sup -8} μSv/irradiation to another patient position in abdomen imaging. Multi-bed hospital room, unnecessary radiation generated in the surrounding patients, while legal regulations and systematic measures are needed for radiation exposure in multi-bed hospital rooms that are currently lacking in Korea.

  13. Atopic dermatitis is associated with anxiety, depression, and suicidal ideation, but not with psychiatric hospitalization or suicide

    DEFF Research Database (Denmark)

    Thyssen, J P; Hamann, C R; Linneberg, A

    2017-01-01

    of hospitalization and suicide. METHODS: We utilized questionnaire data from a large general population study with data on social habits and psychiatric symptoms to compare prevalences of depression, anxiety, suicidal ideation, and anxiety attacks, in adults with and without a history of AD. Additionally, we used...... and anxiety more often than non-AD subjects, and had an increased prevalence of suicidal ideation and depressive symptoms. In the health registry study, moderate-severe AD patients had increased risk of antidepressant and anxiolytic medication use, while patients with mild AD only had increased risk...... of anxiolytic medication use. There was no increased risk of hospitalization or outpatient contacts due to depression or anxiety, or risk of suicide in AD patients. CONCLUSIONS: Depression, anxiety, and suicidal ideation are more common among AD individuals, but do not lead to psychiatric consultations...

  14. Prevalence and factors associated with minor psychiatric disorders in hospital housekeeping workers.

    Science.gov (United States)

    Marconato, Cintia da Silva; Magnago, Ana Carolina de Souza; Magnago, Tânia Solange Bosi de Souza; Dalmolin, Graziele de Lima; Andolhe, Rafaela; Tavares, Juliana Petri

    2017-06-12

    Investigating the prevalence and factors associated with minor psychiatric disorders (MPDs) in Hospital housekeeping workers. A cross-sectional study carried out in 2013 with workers from the cleaning service of a public university hospital in Rio Grande do Sul, Brazil. Data were collected through a form containing sociodemographic, occupational, habits and health variables. The Self-Reporting Questionnaire-20 was used in order to evaluate MPDs. The study population consisted of 161 workers. The overall prevalence of suspected MPD was 29.3%. The chances of suspected MPDs were higher in workers with Effort-Reward Imbalance, those who did not have time or who occasionally had time for leisure activities, and those taking medications. The prevalence of MPDs was similar to that found in the literature for health workers. Therefore, we consider it important to include these workers in institutional programs for continuing health education. Investigar a prevalência e os fatores associados aos Distúrbios Psíquicos Menores (DPMs) em trabalhadores do Serviço Hospitalar de Limpeza. Estudo transversal, realizado em 2013, com trabalhadores do serviço de limpeza de um hospital universitário público do Rio Grande do Sul, Brasil. Os dados foram coletados por meio de um formulário contendo variáveis sociodemográficas, laborais, hábitos e saúde. Para avaliação dos DPMs utilizou-se do Self-Reporting Questionnaire-20. A população do estudo foi composta pelos 161 trabalhadores. A prevalência global para suspeição de DPM foi de 29,3%. As chances de suspeição de DPMs foram maiores nos trabalhadores em Desequilíbrio Esforço-Recompensa, nos que não tinham ou às vezes tinham tempo para o lazer e naqueles que faziam uso de medicação. A prevalência de DPMs assemelhou-se à encontrada na literatura em trabalhadores da área saúde. Portanto, considera-se importante a inclusão desses trabalhadores em programas institucionais de educação permanente em saúde.

  15. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey.

    Science.gov (United States)

    Brand, Serge; Colledge, Flora; Beeler, Nadja; Pühse, Uwe; Kalak, Nadeem; Sadeghi Bahmani, Dena; Mikoteit, Thorsten; Holsboer-Trachsler, Edith; Gerber, Markus

    2016-01-01

    Physical activity and exercise programs (PAEPs) are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. All psychiatric hospitals (N=55) in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%), sports therapy (97%), activity-related psychotherapeutic interventions (95%), physiotherapy (85%), body therapies (59%), far-east techniques (57%), and hippotherapy (22%). Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not participate in PAEPs. Furthermore, those who do participate cannot continue to do so following discharge. PAEP providers need specific extended vocational trainings and believe that the potential of PA should be improved.

  16. Development of psychiatric risk evaluation checklist and routine for nurses in a general hospital: ethnographic qualitative study

    Directory of Open Access Journals (Sweden)

    Ana Luiza Lourenço Simões Camargo

    Full Text Available CONTEXT AND OBJECTIVE:There is high prevalence of mental and behavioral disorders in general hospitals, thus triggering psychiatric risk situations. This study aimed to develop a psychiatric risk assessment checklist and routine for nurses, the Psychiatric Risk Evaluation Check-List (PRE-CL, as an alternative model for early identification and management of these situations in general hospitals.DESIGN AND SETTING:Ethnographic qualitative study in a tertiary-level private hospital.METHOD:Three hundred general-unit nurses participated in the study. Reports were gathered through open groups conducted by a trained nurse, at shift changes for two months. The questions used were: "Would you consider it helpful to discuss daily practice situations with a psychiatrist? Which situations?" The data were qualitatively analyzed through an ethnographic approach.RESULTS:The nurses considered it useful to discuss daily practice situations relating to mental and behavioral disorders with a psychiatrist. Their reports were used to develop PRE-CL, within the patient overall risk assessment routine for all inpatients within 24 hours after admission and every 48 hours thereafter. Whenever one item was present, the psychosomatic medicine team was notified. They went to the unit, gathered data from the nurses, patient files and, if necessary, attending doctors, and decided on the risk management: guidance, safety measures or mental health consultation.CONCLUSION:It is possible to develop a model for detecting and intervening in psychiatric and behavioral disorders at general hospitals based on nursing team observations, through a checklist that takes these observations into account and a routine inserted into daily practice.

  17. An analysis of acute admissions to a general hospital psychiatric unit

    African Journals Online (AJOL)

    QuickSilver

    Aim: The study sought to analyse admissions to an acute psychiatric unit with a view to determining the demographic distribution of the patients, duration ... males with a past psychiatric history of either an Axis I or a co-morbid Axis II disorder, and had defaulted on their regular follow up. .... The effectiveness of stigma coping.

  18. [Guideline-adherent psychiatric-psychotherapeutic hospital care: Normative definition of staff required using the example of depression].

    Science.gov (United States)

    Berger, M; Wolff, J; Normann, C; Godemann, F; Schramm, E; Klimke, A; Heinz, A; Herpertz, S C

    2015-05-01

    Unipolar depression is of high relevance in German inpatient treatment. An effective psychiatric psychotherapeutic hospital treatment also requires sufficient staff for carrying out psychotherapeutic treatment. The aim of this study was to define the staff requirements for guideline-adherent psychiatric-psychotherapeutic inpatient treatment of depression on the basis of a weekly treatment schedule for a 5-week admission period. A further aim was to compare the staff required with the resources defined by the German psychiatric staffing regulations (Psych-PV). The weekly schedule was normatively defined on the basis of the current evidence for treatment efficacy and effectiveness. The staff required was calculated on the basis of the weekly schedule. The time for psychotherapy defined by the Psych-PV was calculated using the treatment classification provided by a large nationwide database. Regarding psychotherapy, 280 min per week is regarded as necessary and usually sufficient according to the current evidence. The results showed clearly higher requirements of working time of psychiatrists and psychologists than those defined by the Psych-PV. In particular, the Psych-PV allows only 72 min for psychotherapy per patient and week and only a limited amount of direct patient contact with psychiatrists. The figures provided impressively show that the Psych-PV does not allow effective guideline-adherent hospital treatment within a reasonable length of hospital stay. Despite its evidential effectiveness, psychotherapeutic treatment cannot be sufficiently provided under the current financing circumstances.

  19. Nurses' attitudes towards sexual relationships between patients in high security psychiatric hospitals in England: an exploratory qualitative study.

    Science.gov (United States)

    Ruane, Jean; Hayter, Mark

    2008-12-01

    The issue of relationships between patients in long-term care settings can present nurses with numerous challenges. However, addressing this element of patient care is recognised as an important element of nursing in this sphere of practice. What nurses think about patient sexual relationships and the difficulties of incorporating these into care is closely linked to the care they provide. However, the issue of patients sexual relationships within high security psychiatric hospitals is a relatively poorly researched area of clinical practice. To explore the attitudes towards patients' sexual relationships held by nurses working in high security psychiatric hospitals in England. A qualitative methodology was employed with data collected from 10 in-depth interviews with nurses working within secure psychiatric hospitals in England. Interview data were subjected to thematic analysis. Practitioners reject permissive policy in relation to patients' sexual relationships on account of perceived perpetuation of abuse and exploitation. Practices and attitudes are dominated by personal (lay) values that seek to restrict patient experience and undermine professional mores whilst also seeming to uphold a professional duty of care. Lay understandings are constructed as moral rights and priorities that are of higher order concern than professional values or the rights of the individual. This constitutes a clash of values and the minimisation of professional mores within the clinical context raises questions about the role of professional teaching, knowledge and policy in relation to professional socialisation.

  20. Smoking cessation care in state-operated or state-supported psychiatric hospitals: from policy to practice.

    Science.gov (United States)

    Ortiz, Glorimar; Schacht, Lucille; Lane, G Michael

    2013-07-01

    The aims of this study were to identify changes in smoking policies and their implementation and to determine the level of smoking cessation care provided at state-operated or state-supported psychiatric inpatient hospitals. Hospitals were surveyed in 2008 (N=219) and 2011 (N=206) about their smoking policies and practices, and changes in specific policies and practices, such as staff specialty training about smoking cessation care, assessment at intake, provision of smoking cessation treatment and education, and aftercare planning, were examined. Smoking cessation care was categorized as best, good, average, or poor. The survey was completed in both 2008 and 2011 by 108 hospitals. The number of hospitals prohibiting smoking rose by 73%, from 48% in 2008 to 83% in 2011. The provision of specialty training to staff did not significantly improve. Nearly all hospitals assessed smoking status at admission, and nicotine replacement therapy was provided by more hospitals than any other treatment in both 2008 and 2011. The number of hospitals providing no follow-up of smoking cessation care after discharge dropped significantly, from 64% to 41%, and significantly more provided good versus average smoking cessation care. Analysis of smoking policies at state-operated or state-supported psychiatric inpatient hospitals found significant movement in adopting nonsmoking policies and some increase in active treatment, notably wellness counseling. Educational resources have not reached full penetration, and continuum of care activities are also lagging behind. Additional resources and staff training may be needed to continue to address smoking cessation both during and after hospitalization.

  1. Psychiatric features in perpetrators of homicide-unsuccessful-suicide at Weskoppies Hospital in a 5-year period

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    Paul Sussman

    2013-03-01

    Full Text Available Background. In the absence of medical literature reporting on homicide-unsuccessful-suicide (HUS cases in which the perpetrator is referred for forensic psychiatric observation present an opportunity to explore psychiatric features pertaining to the event. Objective. To identify possible contributing psychiatric features in HUS cases. Method. A retrospective, single-centre, descriptive study was conducted, in which were reviewed clinical records of HUS subjects referred for observation to Weskoppies Hospital from December 2005 to January 2011. Socio-demographic and psychiatric information was obtained. Results. Nine cases were reviewed. The median age of the subjects was 29 years and 7 subjects were male. Five cases involved family members. Cases involving couples demonstrated male subjects and cases involving filicide demonstrated female subjects. Only 1 case involved the use of a firearm. At the time of the incident, 4 of the cases had no psychiatric diagnosis but notable interpersonal difficulties. Psychotic disorders were diagnosed in 3 subjects, a depressive disorder in 1 subject and a depressive and anxiety disorder in 1 subject. Conclusion. Subjects commonly used less lethal methods than shooting. The high rate of psychiatric disorders diagnosed is in keeping with court referrals occurring when a mental illness is suspected. Some cases may require specialised probing before psychosis becomes apparent. Identification of psychosocial stressors and failure of coping mechanisms during periods of strife within an intimate relationship may be a focus of future research in homicide-suicide cases. Separation should possibly be investigated as an independent factor which promotes the interpersonal difficulty associated with homicide-suicide.

  2. Psychiatric morbidity, phenomenology and management in hospitalized female foreign domestic workers in Lebanon.

    Science.gov (United States)

    Zahreddine, Nada; Hady, Rima Talaat; Chammai, Rabih; Kazour, François; Hachem, Dory; Richa, Sami

    2014-07-01

    40 million female domestic workers worldwide experience the inhumane conditions associated with this unregulated occupation, a situation that induces psychiatric morbidities in many. The case in Lebanon is not any better where it is estimated that one foreign domestic worker (FDW) commits suicide weekly. 33 female FDW and 14 female Lebanese (control group, CG) were enrolled. Brief Psychotic Rating Scale (BPRS) and Clinical Global Impression (CGI) scales were administered on admission and discharge and socio-demographic, living conditions, mental health care data and phenomenological observations were collected. Sexual, physical, and verbal abuses were detected in FDW (12.5, 37.5, and 50.0 %. respectively). 66.7 % of them were diagnosed with brief psychotic episode. The mean duration of hospital stay (13.1 days) was significantly lower in the FDW group. The mean cumulative antipsychotic dose of the FDW was 337.1 mg of chlorpromazine equivalent and the mean BPRS total pre-score of FDW was 66.4 with a much improved state on the CGI global improvement scale, all of which were nonsignificantly different from the CG. Striking phenomenological findings among FDW were acute anorexia (39.4 %), nudity (30.3 %), catatonic features (21.2 %), and delusion of pregnancy (12.1 %). Inpatient FDW are more diagnosed with psychotic than affective disorders and receive approximately similar treatment as controls in spite of the trend to rapidly discharge and deport the worker to limit the costs. Both groups presented with similar severity, although the FDW had peculiar phenomenological observations.

  3. Determinants of mental illness stigma for adolescents discharged from psychiatric hospitalization.

    Science.gov (United States)

    Moses, Tally

    2014-05-01

    Little is known about the factors that increase the risk for enacted mental illness stigma (i.e. rejection, devaluation and exclusion) as perceived by the stigmatized person. This is particularly true for the population of adolescents diagnosed with a mental illness. The aim of this study was to address this question and examine select social and clinical factors that predict enacted stigma (self-reported) with research that follows eighty American adolescents for 6 months following a first psychiatric hospitalization. Drawing on social identity theory, and research on stigma-threatening environments, social group identification and social support, this study tested four hypotheses: affiliation or identification with higher status and lower status peers predicts more and less stigma respectively (H1); a greater and more supportive social network, and more perceived family support predict less stigma (H2); greater severity of internalizing and externalizing symptoms predicts more stigma (H3); and poorer school functioning predicts more stigma (H4). Results indicated that about 70% of adolescents reported experiencing enacted stigma (at 6 months); disrespect or devaluation was more common than outright social rejection. Using OLS regression analyses, the results provided partial support for H1, H3 and H4, while H2 was not supported. The baseline factors found to be most predictive of enacted stigma ratings at 6-months were: affiliating with more friends with mental health problems, identifying with the 'populars' peer group, higher internalizing symptom ratings, and self-reported disciplinary problems at school. These four factors remained significant when controlling for initial enacted stigma ratings, pointing to their importance in determining changes in social stigma experiences in the follow-up period. They also remained significant when controlling for perceived public stigma ratings at follow-up, indicating that the findings were not due to generalized

  4. Revisiting the psychiatric day hospital experience 6 months after discharge: how was the transition and what have clients retained?

    Science.gov (United States)

    Larivière, Nadine; Desrosiers, Johanne; Tousignant, Michel; Boyer, Richard

    2010-06-01

    Psychiatric day hospitals offer intensive short-term multidisciplinary treatment. No study has examined in more depth the impact of this therapeutic experience in the life of participants and what they retained from their participation after discharge. A qualitative design using semi-structured individual interviews was completed with 18 participants of different gender, age and diagnosis, treated in a day hospital, 6 months after discharge. Interview themes addressed events and changes since discharge, learnings retained, appreciated components and suggestions. Results showed that the day hospital experience was particularly helpful to improve symptoms and relationship with self. It activated a self-transformation process that continued afterwards. Termination created for many an abrupt void. Issues at stake during the first 6 months were continuity of care, social support and putting learnings into practice. The program offered at the day hospital was generally appreciated but management of the waiting time and linkage to outpatient services needed improvement.

  5. Alcohol consumption and later risk of hospitalization with psychiatric disorders: prospective cohort study

    DEFF Research Database (Denmark)

    Flensborg-Madsen, Trine; Becker, Ulrik; Grønbæk, Morten

    2011-01-01

    .31-3.04) compared to women drinking below the sensible drinking limits. For men, the risk functions were slightly U-shaped; thus, a weekly low or moderate alcohol intake seemed to have a protective effect towards developing psychiatric disorders. The findings suggest sex differences in the association between...... alcohol consumption and risk of psychiatric disorders.......The potential effects of alcohol intake upon the risk of psychiatric disorders have not often been investigated. The purpose of this study was to investigate, in a population sample, the association between self-reported amount of alcohol intake and the later risk of being registered in a Danish...

  6. Considerations on occupational therapy in a custody and psychiatric treatment hospital: The psychosocial field versus the forensic psychiatry field

    Directory of Open Access Journals (Sweden)

    Ana Carolina Santos de Souza

    2014-12-01

    Full Text Available The Custody and Psychiatric Treatment Hospital (CPTH is ambivalent and ambiguous in its essence, because it gathers not only the characteristics of a mental institution, but also those of a prison – epitomized by the security system. By analyzing this context, one can perceive the importance of implementing some knowhow able to attend the real needs of the individuals hospitalized in this type of institution. This interpretation of their needs must be done in association with a work in mental health based on the principles of the Brazilian Psychiatric Reform and Psychosocial Field Practice. The objective of this study is to reflect on the real possibilities of implementing mental health work based on the Brazilian Psychiatric Reform, inserted in the Psychosocial Field, in institutions such as CPTHs. This reflection occurs from the conflicts arisen in the beginning of Occupational Therapy service in a CPTH located in the state of Sao Paulo, Brazil, as well as through the analysis of the reality in which this Custody Hospital is inserted. When studying the Psychiatric Reform Law, ordinance 28.195/1988, which deliberates on the functions of Occupational Therapy in the CPTHs of the state of Sao Paulo, and the Penal Execution Law, the reality was analyzed from its dimensions, to conclude that the institutional forces ruled the work process of occupational therapists. Therefore, the structural, particular, singular dimensions that rule the CPTH were understood and, after that, the “nodes” that hinder the implementation of mental health work in the Psychosocial Field in this type of institution were revealed.

  7. Carnitine and metabolic correlates in hospitalized psychiatric patients: a follow-through report.

    Science.gov (United States)

    Cuturic, Miroslav; Abramson, Ruth K; Moran, Robert R; Hardin, James W

    2011-01-01

    Carnitine deficiency may be encountered in the context of chronic psychiatric illness, particularly with the chronic use of valproic acid. Despite the importance of carnitine in lipid metabolism and mitochondrial function, its metabolic effects have not been studied in a psychiatric population. To raise awareness regarding the possible metabolic implications of carnitine homeostasis in psychiatric patients. Retrospective database review in a subgroup of 23 patients with documented hypo carnitinemia. Statistical analysis revealed a negative correlation between serum carnitine levels and lipid levels. Initial fasting plasma glucose levels correlated positively with acylcarnitine/free carnitine ratios, suggesting unfavorable secondary effects of carnitine insufficiency, which resolved once carnitine was supplemented. Carnitine is a plausible substrate for future investigations of metabolic status in psychiatric patients. Further studies are needed to evaluate whether serum carnitine levels may be useful as a marker for psychiatric patients at risk for developing metabolic syndrome, and whether carnitine supplementation may reduce that risk. (Journal of Psychiatric Practice 2011;17:35-40).

  8. Experiences by student nurses during clinical placement in psychiatric units in a hospital

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    W.J.C. Van Rhyn

    2004-09-01

    Full Text Available An exploratory study was conducted with the aim of discovering and describing experiences of psychiatric nursing students during clinical placement in a psychiatric unit. For the purpose of the study an unstructured interview was conducted with each participant during their first placement in a psychiatric unit to identify the factors experienced as stressful. The results indicated that all eight participants experienced average to high stress. Sources of stress identified included, among others, ineffective teaching and learning programmes, poor managerial governance of the service, detachment of professional nurses from their teaching role, poor relationships among staff, overreliance on the medical model of care and patient neglect. Psychiatric nursing students sampled indicated universal support for in-service education and training for professional nurses, attitude change of professional nurses towards students, support for student initiatives, student involvement in patient care and adequate allocation of resources for patient care and nurse training. The exploration and description of experiences of the psychiatric nursing students will help nurse educators plan clinical learning opportunities in such a way that they are less stressful, thus ensuring that psychiatric nursing students are equipped to utilise themselves as therapeutic instruments.

  9. Prevalence and influence of psychiatric comorbidity on rehabilitation outcome for older hospital inpatients.

    Science.gov (United States)

    Gluyas, Cathy; Lum, Carmel; Chong, Sinn Yuin; Borg, Cynthia; Haines, Terry P

    2011-11-01

    The objectives of this study were to characterize the psychiatric comorbidity of a group of older subacute inpatients and then determine whether their psychiatric comorbidity affected measures of rehabilitation outcomes. Eighty-eight older subacute inpatients were recruited for this prospective study. Psychiatric comorbidity was defined according to a participants' performance on four inventory scales: the Geriatric Depression Scale (GDS), Geriatric Anxiety Inventory (GAI), Brief Psychiatric Rating Scale and Health of the Nation Outcome Scale 65+. Rehabilitation outcome referred to the participants' length of stay and their performance at discharge on the EuroQol-5D health-related quality of life questionnaire and Barthel index. 68% of the participants scored in the clinical range on at least one of the four scales assessing psychiatric comorbidity at admission, with 51% in the clinical range for GDS and 32% for the GAI. The decrease in scores by the time of discharge was significant for all four scales. Linear regression analyses pointed to a trend for depressive symptoms at admission to be an influential but nonsignificant predictor of rehabilitation outcome. An interesting association was found between the length of the previous acute admission and the GDS score on admission to the subacute unit. A high prevalence of psychological symptoms was identified upon admission, with a significant decrease by the time of discharge. These factors did not significantly predict the selected measures of rehabilitation outcome. Opportunities for future longitudinal research on the prevalence and impact of psychiatric comorbidities on patient outcomes are considered.

  10. [Prevalence of Hypothyroidism in Major Psychiatric Disorders in Hospitalised Patients in Montserrat Hospital During the period March to October 2010].

    Science.gov (United States)

    Vargas Navarro, Pedro; Ibañez Pinilla, Edgar Antonio; Galeano España, Alejandra; Noguera Bravo, Ana María; Milena Pantoja, Sandra; Suárez Acosta, Ana María

    Hypothyroidism results from inadequate production of thyroid hormone. It is known that there is a relationship between the major psychiatric disorders and hypothyroidism. To determine the prevalence of hypothyroidism in patients admitted due to major psychiatric disorders in Montserrat Hospital during the period from March to October 2010. A descriptive cross-sectional study was conducted on 105 patients admitted to Montserrat Hospital with a primary diagnosis of major psychiatric disorder (major depression, bipolar affective disorder, generalised panic disorder, panic disorder, mixed anxiety-depressive disorder, and schizophrenia) in the aforementioned period. Thyroid Stimulating Hormone (TSH) was performed to assess the evidence of hypothyroidism. The overall prevalence of hypothyroidism was found to be 10.5% (95% CI; 5%-16%). It was 12.5% in anxiety disorder, 11.1% in depressive disorder, with a lower prevalence of 10.3% for bipolar disorder, and 9.9% for schizophrenia. The overall prevalence of hypothyroidism was found to be less than in the general population, which is between 4.64% and 18.5%, and hypothyroidism was found in disorders other than depression. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  11. Prevalence of Cannabis Residues in Psychiatric Patients: A Case Study of Two Mental Health Referral Hospitals in Uganda

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    Epaenetus A. Awuzu

    2014-01-01

    Full Text Available Various studies have reported that abuse of cannabis is a risk factor for psychosis. The aims of this study were to determine the prevalence of delta 9-tetrahydrocanabinol (Δ 9 -THC, a major metabolite of cannabis, in psychiatric patients in Uganda, and to assess the diagnostic capacity of two referral mental health hospitals to screen patients for exposure to cannabis in Uganda. Socio-demographic characteristics of the patients were collected through questionnaires and review of medical records. Urine samples were collected from 100 patients and analyzed using Δ 9 -THC immunochromatographic kit (Standard Diagnostics®, South Korea. Seventeen percent of the patients tested positive for Δ 9 -THC residues in their urine. There was strong association ( p < 0.05 between history of previous abuse of cannabis and presence of Δ 9 -THC residues in the urine. Alcohol, cocaine, heroin, pethidine, tobacco, khat and kuber were the other substances abused in various combinations. Both referral hospitals lacked laboratory diagnostic kits for detection of cannabis in psychiatric patients. In conclusion, previous abuse of cannabis is associated with occurrence of the residues in psychiatric patients, yet referral mental health facilities in Uganda do not have the appropriate diagnostic kits for detection of cannabis residues as a basis for evidence-based psychotherapy.

  12. Assessing the outcome of compulsory treatment orders on management of psychiatric patients at 2 McGill University-associated hospitals.

    Science.gov (United States)

    Nakhost, Arash; Perry, John Christopher; Frank, Daniel

    2012-06-01

    Some literature suggests that compulsory community treatment orders (CTOs) are effective in reducing hospitalizations in a subgroup of psychiatric patients with histories of repeated hospitalization, allowing them to be treated in the community under less restrictive measures. However, studies have yielded contradictory findings, in part because of methodological differences. Our study examines the effectiveness of CTOs in reducing hospitalizations and increasing community tenure of such patients. The sample included all psychiatric patients who had been given a CTO during a 9-year period at 2 of McGill University's hospitals. This is a naturalistic, observational, retrospective, before-and-after study where patients acted as their own control subjects. We examined variables, including the number, duration, and time to psychiatric admissions, comparing 4 time periods: early, pre-index, index (when the first CTO was in force), and post-index periods. The total study duration per subject encompasses the longest period of observation within existing studies in Canada. Psychiatric patients with histories of frequent readmissions demonstrated a significant reduction in their number of hospitalizations as well as an increase in the median time to re-hospitalization, during the period when they were treated under a CTO. This effect of CTO was sustained even after the CTO had expired. Our study suggests that CTOs are effective in assisting psychiatric patients with histories of repeated hospitalizations to live and be treated in the community, diminishing the occurrence of frequent hospitalization.

  13. Reducing transfers of psychiatric inpatients to emergency rooms of general hospitals in Singapore: a clinical practice improvement project.

    Science.gov (United States)

    Low, Tchern Kuang Lambert; Tay, Kai Hong; Fang, Tina; Fung, Daniel Shuen Sheng

    2017-03-01

    Patients admitted to a psychiatric hospital commonly suffer from comorbid medical problems which sometimes require urgent medical attention. Twenty-two percent of emergency medical transfers from the Institute of Mental Health (IMH) to the emergency rooms of general hospitals were preventable and could be managed at IMH itself. We undertook a quality improvement project to understand the reasons behind such preventable referrals and implemented changes to address this. Using the model for improvement, we deconstructed our processes and analysed root causes for such preventable referrals. Thereafter changes were implemented with Plan-Do-Study-Act (PDSA) cycles to analyse their outcomes. During the 6-month study period, we achieved a 100% reduction in preventable referrals through strategies aimed at reducing pressure on our on-call physicians in the making of medical decisions, maximising usage of our medical resources, constant education and raising awareness of this issue. Reducing preventable transfer of inpatients from a psychiatric hospital to the emergency departments of general hospitals is a worthwhile endeavour. Such initiatives optimise use of healthcare resources, improve patient care and increase satisfaction.

  14. Peripherally Inserted Central Catheters (PICCs) and Potential Cost Savings and Shortened Bed Stays In an Acute Hospital Setting.

    LENUS (Irish Health Repository)

    O’Brien, C

    2018-01-01

    Peripheral inserted central catheters (PICCs) have increasingly become the mainstay of patients requiring prolonged treatment with antibiotics, transfusions, oncologic IV therapy and total parental nutrition. They may also be used in delivering a number of other medications to patients. In recent years, bed occupancy rates have become hugely pressurized in many hospitals and any potential solutions to free up beds is welcome. Recent introductions of doctor or nurse led intravenous (IV) outpatient based treatment teams has been having a direct effect on early discharge of patients and in some cases avoiding admission completely. The ability to deliver outpatient intravenous treatment is facilitated by the placement of PICCs allowing safe and targeted treatment of patients over a prolonged period of time. We carried out a retrospective study of 2,404 patients referred for PICCs from 2009 to 2015 in a university teaching hospital. There was an exponential increase in the number of PICCs requested from 2011 to 2015 with a 64% increase from 2012 to 2013. The clear increase in demand for PICCs in our institution is directly linked to the advent of outpatient intravenous antibiotic services. In this paper, we assess the impact that the use of PICCs combined with intravenous outpatient treatment may have on cost and hospital bed demand. We advocate that a more widespread implementation of this service throughout Ireland may result in significant cost savings as well as decreasing the number of patients on hospital trollies.

  15. Aggression and violence in psychiatric hospitals with and without open door policies: A 15-year naturalistic observational study.

    Science.gov (United States)

    Schneeberger, Andres R; Kowalinski, Eva; Fröhlich, Daniela; Schröder, Katrin; von Felten, Stefanie; Zinkler, Martin; Beine, Karl H; Heinz, Andreas; Borgwardt, Stefan; Lang, Undine E; Bux, Donald A; Huber, Christian G

    2017-12-01

    Aggressive behavior and violence in psychiatric patients have often been quoted to justify more restrictive settings in psychiatric facilities. However, the effects of open vs. locked door policies on aggressive incidents remain unclear. This study had a naturalistic observational design and analyzed the occurrence of aggressive behavior as well as the use of seclusion or restraint in 21 German hospitals. The analysis included data from 1998 to 2012 and contained a total of n = 314,330 cases, either treated in one of 17 hospitals with (n = 68,135) or in one of 4 hospitals without an open door policy (n = 246,195). We also analyzed the data according to participants' stay on open, partially open, or locked wards. To compare hospital and ward types, we used generalized linear mixed-effects models on a propensity score matched subset (n = 126,268) and on the total dataset. The effect of open vs. locked door policy was non-significant in all analyses of aggressive behavior during treatment. Restraint or seclusion during treatment was less likely in hospitals with an open door policy. On open wards, any aggressive behavior and restraint or seclusion were less likely, whereas bodily harm was more likely than on closed wards. Hospitals with open door policies did not differ from hospitals with locked wards regarding different forms of aggression. Other restrictive interventions used to control aggression were significantly reduced in open settings. Open wards seem to have a positive effect on reducing aggression. Future research should focus on mental health care policies targeted at empowering treatment approaches, respecting the patient's autonomy and promoting reductions of institutional coercion. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Dating violence victimization, dispositional aggression, and nonsuicidal self-injury among psychiatrically hospitalized male and female adolescents.

    Science.gov (United States)

    Rizzo, Christie J; Esposito-Smythers, Christianne; Swenson, Lance; Hower, Heather M; Wolff, Jennifer; Spirito, Anthony

    2014-06-01

    The objective of the current study was to characterize the association between dating violence victimization and dispositional aggression in predicting nonsuicidal self-injury (NSSI) among psychiatrically hospitalized male and female adolescents. One hundred fifty-five adolescents (ages 13-17) and their parents completed the Schedule for Affective Disorders and Schizophrenia for School-Age Children clinical interview to assess NSSI and child abuse; adolescents completed self-report measures of aggression and dating violence victimization (verbal, physical, and sexual). Dating violence victimization and NSSI were found to be highly prevalent among both males and females in this psychiatric inpatient sample. Two moderational models were supported, wherein dating violence was associated with NSSI in the context of elevated trait anger in males and indirect aggression in females. Findings suggest that helping victims of dating violence acquire skills to address certain forms of dispositional aggression may attenuate NSSI. © 2014 The American Association of Suicidology.

  17. The potential consequences of informal interpreting practices for assessment of patients in a South African psychiatric hospital.

    Science.gov (United States)

    Kilian, Sanja; Swartz, Leslie; Dowling, Tessa; Dlali, Mawande; Chiliza, Bonginkosi

    2014-04-01

    In South Africa health care practitioners are commonly professionals who speak only one, or at most two, of the languages spoken by their patients. This provides for language provision challenges, since many patients are not proficient in English or Afrikaans and ad hoc and haphazard arrangements are made for interpreting by untrained personnel. As part of a larger study (conducted in 2010) in a public psychiatric hospital, we report here on the potential consequences for diagnostic assessments of 13 psychiatric evaluations mediated by ad hoc interpreters who were employed as health care workers and household aides. The psychiatric evaluations were recorded and transcribed verbatim. The first author checked for accuracy of transcription and translations, and the two members of the author team who are both senior African language academics rechecked transcription and translation. We used the typology developed by Vasquez and Javier (1991) to study interpreter errors (i.e. omissions, additions and substitutions). All errors were independently rated by a senior psychiatrist and a senior clinical psychologist to determine whether the errors were likely to have a bearing on clinical decisions concerning the patient and to rate whether errors deemed clinically significant contributed to making the patient appear more ill psychiatrically, or less ill. Of the 57 errors recorded, 46% were rated as likely to have an impact on the goal of the clinical session. Raters concurred that the clinically significant errors contributed towards potentially making the patient look more psychiatrically ill. Detailed analyses of evaluations demonstrate the complexity of informal interpreter positioning regarding issues of diagnosis and cultural factors in illness. Evaluations conducted where clinicians and interpreters are not trained in language and interpreting issues may create a distorted picture of the patients' mental health conditions. Copyright © 2014. Published by Elsevier Ltd.

  18. Bed utilization in two differently organized community mental health services in Northern Norway: the VELO-project.

    Science.gov (United States)

    Myklebust, Lars Henrik; Sørgaard, Knut; Bjorbekkmo, Svein; Nymann, Asle; Molvik, Stian; Olstad, Reidun

    2009-07-01

    The literature on the dynamics between community- and hospital services concerning utilization of psychiatric beds is inconclusive. The Norwegian VELO-project provides an opportunity to study this in a natural experiment. Two service-systems are compared. The "central-bed system" have mainly outpatient- and day-hospital services locally, with psychiatric beds at a central mental hospital. The "local-bed system" have only one outpatient clinic, with beds at three local inpatient units. Also utilization of sheltered homes was studied. Hypotheses were predicted from Goldberg and Huxley's' stage theory and the Thornicroft and Tansella's' hydraulic model. The case-registries of 2005 were linked across service levels by patients' 11-digit Social Security Number. From 1,865 single treatment episodes, 1,348 continuous courses by 1,253 individual patients were extracted. For overall utilization of psychiatric beds there was only a small difference, were the central-bed system utilized 10% less than the other. For utilization of emergency inpatient admissions and acute hospital beds, the rate was more than twice in the central-bed system compared to the other. For utilization of municipalities sheltered homes, the rate was three times higher in the local-bed system. There may be bedrock of need for psychiatric beds regardless of system-organization. Distance may in general be a minor issue for utilization of psychiatric beds, and may primarily interact with patient- or contextual characteristics associated with acute situations. Activity of day-hospital services rather than outpatient consultations may affect utilization of sheltered homes. The main theoretical models are conceptually useful, although more research is needed to specify mechanisms.

  19. Sociodemographic and clinical profile of patients in voluntary and involuntary psychiatric hospitalizations - doi:10.5020/18061230.2011.p361

    Directory of Open Access Journals (Sweden)

    Maria Selma Nogueira Oliveira

    2012-01-01

    Full Text Available Objective: To assess the sociodemographic and clinical profile of patients in psychiatric hospitalizations of voluntary inpatients (IPV and involuntary (IPI, in psychiatric hospitals of Fortaleza-CE, Brazil, under contract with the Unified Health System (SUS. Methods: A quantitative study, descriptive, cross-sectional and analytical. The sample comprised 393 patients, distributed among 253 IPV and 140 IPI, submitted to Psychiatry specialty treatment, in the year 2007. Results: For both patients, IPV and IPI, most were male: 185 (73.1% and 82 (58.6%; single: 181 (46.7% and 103 (26.5%; living in Fortaleza: 181 (71.5% and 95 (67.9%, respectively, and aged 20 to 60 years (mean age of 37 years. We observed significant difference between the type of hospital and patient gender (p = 0.003, which did not occur with marital status (p = 0.688 and origin (p = 0.95. The main symptom profiles which justified the clinical admission of these patients were the use of alcohol or drugs 70 (27.6%, changes in critical judgments 40 (28.6% and psychological distress 68 (26.9%. Family members were the main responsible for conducting these patients to the hospital. Conclusion: The results showed that patients on IPV and IPI, which joined in the study, had a socio-demographic and clinical profile characterized by: prevalence of male patients, from the capital Fortaleza, single, mean age of 37 years, having been brought to hospital by a relative, mainly due to alcohol use or drugs.

  20. Post-hospitalization course and predictive signs of suicidal behavior of suicidal patients admitted to a psychiatric hospital: a 2-year prospective follow-up study

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    Hayashi Naoki

    2012-10-01

    Full Text Available Abstract Background Suicidal patients admitted to a psychiatric hospital are considered to be at risk of suicidal behavior (SB and suicide. The present study aimed to seek predictors of SB recurrence of the high-risk patients by examining their post-hospitalization course. Method The design was 2-year prospective follow-up study of patients consecutively admitted with SB to a psychiatric center in Tokyo. The DSM-IV diagnoses and SB-related features of subjects were determined in structured interviews. Subsequently, the subjects underwent a series of follow-up assessments at 6-month intervals. The assessment included inquiries into SB recurrence, its accompanying suicidal intent (SI and SF-8 health survey. Analyses of serial change over time in the follow-up data and Cox proportional hazards regression analyses of SB recurrence were performed. Results 106 patients participated in this study. The dropout rate during the follow-up was 9%. Within 2 years, incidences of SB as a whole, SB with certain SI (suicide attempt and suicide were 67% (95% CI 58 - 75%, 38% (95% CI 29 - 47% and 6% (95% CI 3 - 12%, respectively. Younger age, number of lifetime SBs and maltreatment in the developmental period were predictive of SB as a whole, and younger age and hopelessness prior to index admission were predictive of suicide attempt. Regarding diagnostic variables, anxiety disorders and personality disorders appeared to have predictive value for SB. Additionally, poor physical health assessed during the follow-up was indicated as a possible short-term predictor of SB recurrence. Conclusions This study demonstrated a high incidence of SB and suicide and possible predictors of SB recurrence in the post-hospitalization period of psychiatric suicidal patients. Specialized interventions should be developed to reduce the suicide risk of this patient population.

  1. The burden experienced by family caregivers of patients with epilepsy attending the government psychiatric hospital, Kaduna, Nigeria.

    Science.gov (United States)

    Tajudeen Nuhu, Folorunsho; Jika Yusuf, Abdulkareem; Akinbiyi, Akinsola; Oluyinka Fawole, Joseph; Joseph Babalola, Obafemi; Titilope Sulaiman, Zainab; Oyeniran Ayilara, Olaniyi

    2010-06-01

    Caring for patients with chronic medical and psychiatric disorders is associated with significant burden. However little is known about the burden experience by caregivers of patients with epilepsy in Nigeria. The objective of this study, therefore, was to assess the level and correlates of burden among caregivers of patients with epilepsy. It was a cross-sectional study carried out among 231 eligible caregivers of patients with epilepsy attending the psychiatric clinic of government psychiatric hospital in Kaduna, Northern Nigeria. Sociodemographic/clinical characteristics of patients and socio-demographic characteristics of caregivers were recorded, and the Zarit Burden Interview administered to caregivers to assess their experience of burden. The mean age of the caregivers was 43.6 ± 9.5 years, 52.4% lived outside Kaduna and the mean seizure-free period for the patients was 26.4 ± 36.5 weeks. One hundred and twenty (51.9%) caregivers had high burden. High burden was significantly associated with patients aged less than 20 years, patient's unemployment, long duration of epilepsy, short seizure-free period, family history of epilepsy and living outside Kaduna (p valueburden while caring for their relatives and this is mainly associated with patient's factors and location of residence. Therefore efforts should be made control seizure and make health care available and affordable to all citizens irrespective of where they live.

  2. Mental illness stigma among nurses in psychiatric wards of teaching hospitals in the north-west of Iran.

    Science.gov (United States)

    Ebrahimi, Hossein; Namdar, Hossein; Vahidi, Maryam

    2012-11-01

    Stigma is one of the obstacles in the treatment and regaining the mental health of people with mental illness. The aim was determination of mental illness stigma among nurses in psychiatric wards. This study was conducted in psychiatric wards of teaching hospitals in Tabriz, Urmia, and Ardabil in the north-west of Iran. This research is a descriptive analysis study in which 80 nurses participated. A researcher-made questionnaire was used, which measured demographic characteristics and mental illness stigma in the three components of cognitive, emotional, and behavioral. All data were analyzed using SPSS13 software and descriptive and analytical statistics. Majority of nurses (72.5%) had medium level of stigma toward people with mental illness. About half of them (48.8%) had great inclination toward the social isolation of patients. The majority of them (62.5%) had positive emotional responses and 27.5% had stereotypical views. There was a significant correlation between experience of living with and kinship of nurses to person with mental illness, with prejudice toward and discrimination of patients. There was also a significant correlation between interest in the continuation of work in the psychiatric ward and prejudice, and also between educational degree and stereotypical views. The data suggest there is a close correlation between the personal experience of nurses and existence of mental illness stigma among them. Therefore, the implementation of constant educational programs on mental illness for nurses and opportunities for them to have direct contact with treated patients is suggested.

  3. Discharged from a mental health admission ward: is it safe to go home? A review on the negative outcomes of psychiatric hospitalization

    Directory of Open Access Journals (Sweden)

    Loch AA

    2014-04-01

    Full Text Available Alexandre Andrade LochLaboratory of Neurosciences, Department and Institute of Psychiatry, University of São Paulo, BrazilAbstract: Before psychiatry emerged as a medical discipline, hospitalizing individuals with mental disorders was more of a social stigmatizing act than a therapeutic act. After the birth of the mental health disciplines, psychiatric hospitalization was legitimized and has proven to be indispensable, preventing suicides and helping individuals in need. However, despite more than a century passing since this legitimization occurred, psychiatric hospitalization remains a controversial issue. There is the question of possible negative outcomes after a psychiatric admission ceases to take its protective effect, and even of whether the psychiatric admission itself is related to a negative setback after discharge. This review aims to summarize some of the most important negative outcomes after discharge from a psychiatric institution. These experiences were organized into two groups: those after a brief psychiatric hospitalization, and those after a long-stay admission. The author further suggests possible ways to minimize these adversities, emphasizing the need of awareness related to this important issue.Keywords: suicide, stigma, rehabilitation, relapse, rehospitalisation

  4. Processes of In-Hospital Psychiatric Care and Subsequent Criminal Behaviour Among Patients With Schizophrenia: A National Population-Based, Follow-Up Study

    DEFF Research Database (Denmark)

    Pedersen, Charlotte Gjørup; Olrik Wallenstein Jensen, Signe; Johnsen, Søren Paaske

    2013-01-01

    Objectives: It is unknown whether evidence-based, in-hospital processes of care may influence the risk of criminal behaviour among patients with schizophrenia. Our study aimed to examine the association between guideline recommended in-hospital psychiatric care and criminal behaviour among patien...

  5. Psychiatric disorders in cases of completed suicide in a hospital area in Spain between 2007 and 2010.

    Science.gov (United States)

    Gómez-Durán, Esperanza L; Forti-Buratti, M Azul; Gutiérrez-López, Beatriz; Belmonte-Ibáñez, Anna; Martin-Fumadó, Carles

    2016-01-01

    Suicide is an important Public Health problem. One of the most relevant known risk factors for suicide is suffering from a mental health disorder, identified in up to 90-95% of completed suicides, with this risk being increased if comorbidity is present. Findings from international research on the most common psychiatric disorders are dichotomous, divided into mood disorders and psychotic disorders. In Spain, data of this kind are scarce. This study describes the psychiatric and forensic characteristics of completed suicide cases (n=79) ocurred in a psychiatric hospital healthcare area (in Spain), between 2007 and 2010. The forensic data were obtained from the Institute of Legal Medicine of Catalonia and the clinical data by reviewing the clinical records. Most of the subjects in this sample were males (78.5%, 95% CI; 68.4%-87.3%). Almost half of the sample (45.4%, 95% CI; 33.8%-57.1%, 35/77) had records in the Mental Health Services Network (including substance misuse services). Two of the 79 were under 18, so we were not able to access the records. More than half (54.3%, 95% CI; 37.1%-71.4%) of those with psychiatric history suffered from a mood disorder; 37.1% (95% CI; 22.9%-51.4% from a depressive disorder; 14.3% (95% CI; 2.9%-25.7%) from a bipolar disorder, and 17.1% (95% CI; 5.7%-31.4%) suffered from a psychotic disorder. With regard to substance misuse, 42.9% (95% CI; 25.7%-60.0%) presented substance misuse, and 48.6% did not. Psychiatric and forensic characteristics of completed suicide in this Spanish sample confirm previous findings from international studies: there is a high rate of psychiatric disorders in those who complete suicide, and there is a specific pattern as regards the method used to complete it. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

  6. Study of the outcome of suicide attempts: characteristics of hospitalization in a psychiatric ward group, critical care center group, and non-hospitalized group

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    Kemuyama Nobuo

    2010-01-01

    Full Text Available Abstract Background The allocation of outcome of suicide attempters is extremely important in emergency situations. Following categorization of suicidal attempters who visited the emergency room by outcome, we aimed to identify the characteristics and potential needs of each group. Methods The outcomes of 1348 individuals who attempted suicide and visited the critical care center or the psychiatry emergency department of the hospital were categorized into 3 groups, "hospitalization in the critical care center (HICCC", "hospitalization in the psychiatry ward (HIPW", or "non-hospitalization (NH", and the physical, mental, and social characteristics of these groups were compared. In addition, multiple logistic analysis was used to extract factors related to outcome. Results The male-to-female ratio was 1:2. The hospitalized groups, particularly the HICCC group, were found to have biopsychosocially serious findings with regard to disturbance of consciousness (JCS, general health performance (GAS, psychiatric symptoms (BPRS, and life events (LCU, while most subjects in the NH group were women who tended to repeat suicide-related behaviors induced by relatively light stress. The HIPW group had the highest number of cases, and their symptoms were psychologically serious but physically mild. On multiple logistic analysis, outcome was found to be closely correlated with physical severity, risk factor of suicide, assessment of emergent medical intervention, and overall care. Conclusion There are different potential needs for each group. The HICCC group needs psychiatrists on a full-time basis and also social workers and clinical psychotherapists to immediately initiate comprehensive care by a medical team composed of multiple professionals. The HIPW group needs psychological education to prevent repetition of suicide attempts, and high-quality physical treatment and management skill of the staff in the psychiatric ward. The NH group subjects need a

  7. Between a Rock and a Hard Place: Ethical and Professional Dilemmas in a Psychiatric Hospital Under Missile Attacks.

    Science.gov (United States)

    Kagan, Ilya; Schor, Razia; Kigli-Shemesh, Ronit; Ovadia, Karin Lee; Melnikov, Semyon

    2016-09-01

    Israeli hospitals must continuously develop various mechanisms to protect both patients and staff against the physical threat of missile attacks during war situations. To examine the difficulties and dilemmas with which the staff of a psychiatric hospital had to deal during missile attacks. A quality improvement project consisting of three stages (1) establishment of a steering committee; (2) execution of a staff nurses' focus group; and (3) categorization of issues raised and suggestions for care improvement in future emergencies. The project stressed the challenges of dealing with restrained patients during missile alarms, waking up patients or dealing with those who refuse to enter the protected area, mismatching of the security needs in protected areas, and institutionalized emotional support for staff members. Suitable policies for clinical and management behavior and for information transfer between management and wards are essential during a continuous emergency. © The Author(s) 2016.

  8. Suicidal Ideation of Psychiatrically Hospitalized Adolescents has One-Year Predictive Validity for Suicide Attempts in Girls Only

    Science.gov (United States)

    Jiang, Qingmei; Czyz, Ewa K.; Kerr, David C. R.

    2016-01-01

    Clinicians commonly incorporate adolescents’ self-reported suicidal ideation into formulations regarding adolescents’ risk for suicide. Data are limited, however, regarding the extent to which adolescent boys’ and girls’ reports of suicidal ideation have clinically significant predictive validity in terms of subsequent suicidal behavior. This study examined psychiatrically hospitalized adolescent boys’ and girls’ self-reported suicidal ideation as a predictor of suicide attempts during the first year following hospitalization. A total of 354 adolescents (97 boys; 257 girls; ages 13–17 years) hospitalized for acute suicide risk were evaluated at the time of hospitalization as well as 3, 6, and 12 months later. Study measures included the Suicidal Ideation Questionnaire-Junior, Multidimensional Anxiety Scale for Children, Children’s Depression Rating Scale-Revised, Beck Hopelessness Scale, Youth Self-Report, and Personal Experiences Screen Questionnaire. The main study outcome was presence and number of suicide attempt(s) in the year after hospitalization, measured by the Diagnostic Interview Schedule for Children. Results indicated a significant interaction between suicidal ideation, assessed during first week of hospitalization, and gender for the prediction of subsequent suicide attempts. Suicidal ideation was a significant predictor of subsequent suicide attempts for girls, but not boys. Baseline history of multiple suicide attempts was a significant predictor of subsequent suicide attempts across genders. Results support the importance of empirically validating suicide risk assessment strategies separately for adolescent boys and girls. Among adolescent boys who have been hospitalized due to acute suicide risk, low levels of self-reported suicidal ideation may not be indicative of low risk for suicidal behavior following hospitalization. PMID:23996157

  9. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey

    Directory of Open Access Journals (Sweden)

    Br

    2016-06-01

    Full Text Available Serge Brand,1,2 Flora Colledge,2 Nadja Beeler,2 Uwe Pühse,2 Nadeem Kalak,1 Dena Sadeghi Bahmani,1 Thorsten Mikoteit,1 Edith Holsboer-Trachsler,1 Markus Gerber2 1Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, 2Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland Background: Physical activity and exercise programs (PAEPs are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. Methods: All psychiatric hospitals (N=55 in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Results: Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%, sports therapy (97%, activity-related psychotherapeutic interventions (95%, physiotherapy (85%, body therapies (59%, far-east techniques (57%, and hippotherapy (22%. Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. Conclusion: All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not

  10. Attachment style and suicide behaviors in high risk psychiatric inpatients following hospital discharge: The mediating role of entrapment.

    Science.gov (United States)

    Li, Shuang; Galynker, Igor I; Briggs, Jessica; Duffy, Molly; Frechette-Hagan, Anna; Kim, Hae-Joon; Cohen, Lisa J; Yaseen, Zimri S

    2017-11-01

    Insecure attachment is associated with suicidal behavior. This relationship and its possible mediators have not been examined in high-risk psychiatric inpatients with respect to the critical high-risk period following hospital discharge. Attachment styles and perception of entrapment were assessed in 200 high-risk adult psychiatric inpatients hospitalized following suicidal ideation or suicide attempt. Suicidal behaviors were evaluated with the Columbia Suicide Severity Rating Scale at 1-2 months post-discharge. Associations between different attachment styles and suicidal behaviors were assessed and mediation of attachment effects by entrapment was modeled. Fearful attachment was associated with post-discharge suicidal behavior and there was a trend-level negative association for secure attachment. In addition, entrapment mediated the relationship between fearful attachment and suicidal behavior. The current study highlights the mediating role of perceptions of entrapment in the contribution of fearful attachment to suicidal behavior in high-risk patients, suggesting entrapment as potential therapeutic target to prevent suicidal behavior in these individuals. Further research is warranted to establish the mechanisms by which entrapment experiences emerge in patients with insecure attachment styles. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Deliberate ingestion of foreign bodies by institutionalised psychiatric hospital patients and prison inmates.

    LENUS (Irish Health Repository)

    O'Sullivan, S T

    2012-02-03

    Deliberate and recurrent foreign body ingestion is a common problem among institutionalised patients. We review our experience with 36 cases of deliberate foreign body ingestion by prisoners or psychiatric patients, thirty of whom were institutionalised at the time of ingestion. Symptoms were frequently severe in the prison inmate group but, in contrast, psychiatric patients presented with few, if any, symptoms. A majority of objects pass spontaneously or remain in situ without complication. Twenty-four patients were discharged following initial evaluation and without specific treatment. Eight of these were reviewed electively and discharged within one week. Twelve patients were admitted for observation, seven of whom were discharged within 48 hrs. Upper gastrointestinal endoscopy was performed in four patients and an intragastric foreign body identified in two cases. Laparotomy was performed in two cases for unresolving mechanical intestinal obstruction. Management should be conservative when possible, with surgery indicated only for complications.

  12. Managing Depression: Stories of Patients and Their Families Pursuing Mental Health after Psychiatric Hospitalization

    OpenAIRE

    Thorne, Catherine B.

    2002-01-01

    This qualitative research study was designed to follow-up with ten participants in a relapse prevention program at an inpatient psychiatric unit with a diagnosis of major depression for the purpose of determining their experiences post-discharge in practicing relapse prevention and in pursuing and maintaining wellness in their mental health. It relied upon narrative theory, theories of self-efficacy, and theories of depression to guide the research process as well as the field of knowledge a...

  13. Bed-integrated local exhaust ventilation system combined with local air cleaning for improved IAQ in hospital patient rooms

    DEFF Research Database (Denmark)

    Bivolarova, Mariya Petrova; Melikov, Arsen Krikor; Mizutani, Chiyomi

    2016-01-01

    micro-environment was exhausted. Two modes of operation were studied: 1) the exhausted polluted air was discharged out of the room and 2) the polluted air was cleaned by the ACF material installed inside the mattress and recirculated back into the room. Both modes of operation efficiently reduced...... the generated bio-effluents in the room with about 70%. Reduction in the exposure to body-emitted ammonia was up to 96% when the VM was operated at only 1.5 L/s and the ACF was used as a blanket....... the exposure to body generated bio-effluents in a hospital room was determined. Full-scale experiments were conducted in a climate chamber furnished as a single-bed patient room. Two heated dummies were used to simulate a patient and a doctor in the room. The patient was lying on a bed equipped with the VM...

  14. Manicômio em circuito: os percursos dos jovens e a internação psiquiátrica The psychiatric hospital circuit: the trajectories of yong people prior to psychiatric hospitalization

    Directory of Open Access Journals (Sweden)

    Andrea Cristina Coelho Scisleski

    2008-02-01

    Full Text Available Este artigo analisa a internação psiquiátrica de jovens, tomando-a não a partir de uma perspectiva psicopatológica individual, mas de uma dimensão subjetivo-social com base nos percursos desses jovens até a internação. O estudo foi realizado no Centro Integrado de Atenção Psicossocial para crianças e adolescentes do Hospital Psiquiátrico São Pedro, na cidade de Porto Alegre, Rio Grande do Sul, Brasil, por meio de oficinas com os jovens que estavam em atendimento na internação deste serviço. Percebeu-se uma recorrência que marca o percurso desses jovens e expressa um determinado modo de funcionamento da rede de atenção até a internação, acarretando na produção de um certo perfil desses jovens: pobreza sócio-econômica, baixa escolaridade e uso de drogas. Outro aspecto importante é o papel da ordem judicial nos encaminhamentos à internação, que obedece tanto a uma lógica de punição aos jovens e aos serviços, como também, paradoxalmente, constitui-se numa estratégia de acesso aos serviços de saúde.This article analyzes psychiatric hospitalization of young patients from a contemporary social-subjective (rather than a psychopathological perspective, following the trajectory of these youth prior to their admission. The study was conducted at the Center for Comprehensive Psychosocial Care for Children and Adolescents, São Pedro Psychiatric Hospital, in the city of Porto Alegre, Rio Grande do Sul State, Brazil. Recurrent traits in the trajectory of these youth expressed how the health care network functioned with them prior to their hospitalization, with a consistent pattern of socioeconomic deprivation, low schooling, and drug use. Another key aspect was the role of the court system in referring them for hospitalization, adhering to a kind of logic that punished both the youth and the services and paradoxically formed a strategy for access to health services.

  15. Predominant diagnoses, gender, and admission duration in an adult psychiatric inpatient hospital in United Kingdom

    Directory of Open Access Journals (Sweden)

    Carlo Lazzari

    2017-12-01

    Full Text Available Introduction: The study objective was to epidemiologically analyse patients presenting at an adult and mixed-gender psychiatric inpatient unit in Essex, Kingswood Centre, UK, to report the predominant diagnoses, gender, and admission duration. Method and material: Meta-analysis and descriptive statistics analysed the year 2016 discharge data on Excel® for 162 patients. ICD-10 codes classified their mental illnesses. Results: Meta-analysis evidenced statistically significant heterogeneity in numbers admissions (I2=95%; p≤0.001, length (I2=78%; p≤0.001, and gender (I2=76%; p≤0.001. The prevailing diagnosis was borderline personality disorder (BPD (rate, 95% CI=0.46 [0.38-0.54]. The longest admission was for schizoaffective disorder (mean duration, 95% CI=53 [22.65-83.34], p=0.001. Gender presented a prevalence of male over female admissions for schizophrenia (OR, 95% CI=0.14 [0.05-0.35], p≤0.001 and BPD with prevalence of female over male admissions (OR, 95% CI=2.79 [1.35-5.76], p=0.05. Conclusion: Female patients with BPD were the most represented category in non-forensic psychiatric inpatient wards in the population studied. Male patients with schizophrenia represented the other gender highly represented. The longest admission was recorded for schizoaffective disorder due to the complexity to treat both mood and psychotic symptoms. It is likely that women with BPD will be the future recipients of psychiatric inpatient and outpatient healthcare services.

  16. Cross Infection in Hospital Wards with Downward Ventilation - Different Locations of Return Openings without and with Partitions between Beds

    DEFF Research Database (Denmark)

    Nielsen, Peter V.; Li, Yuguo; Buus, Morten

    2009-01-01

    postures of the patients. A textile partition between the beds, which is typical in a hospital ward, is used for protection of the patients in some of the experiments. Three different layouts of return openings are tested. One layout with one opening at the ceiling, another with four openings at the wall...... opposite to the inlet diffuser, and one with a high location of these four openings. The downward recirculating flow is on average parallel with the partition, and the partition does not decrease cross infection. A high location of the four return openings decreases the risk of cross infection....

  17. Spatio-temporal dependencies between hospital beds, physicians and health expenditure using visual variables and data classification in statistical table

    Directory of Open Access Journals (Sweden)

    Medyńska-Gulij Beata

    2016-06-01

    Full Text Available This paper analyses the use of table visual variables of statistical data of hospital beds as an important tool for revealing spatio-temporal dependencies. It is argued that some of conclusions from the data about public health and public expenditure on health have a spatio-temporal reference. Different from previous studies, this article adopts combination of cartographic pragmatics and spatial visualization with previous conclusions made in public health literature. While the significant conclusions about health care and economic factors has been highlighted in research papers, this article is the first to apply visual analysis to statistical table together with maps which is called previsualisation.

  18. Anxiety symptoms in crack cocaine and inhalant users admitted to a psychiatric hospital in southern Brazil.

    Science.gov (United States)

    Zubaran, Carlos; Foresti, Katia; Thorell, Mariana Rossi; Franceschini, Paulo Roberto

    2013-01-01

    The occurrence of psychiatric comorbidity among individuals with crack or inhalant dependence is frequently observed. The objective of this study was to investigate anxiety symptoms among crack cocaine and inhalant users in southern Brazil. The study investigated two groups of volunteers of equal size (n=50): one group consisted of crack cocaine users, and the other group consisted of inhalant users. Research volunteers completed the Portuguese versions of the State-Trait Anxiety Inventory (STAI), Hamilton Anxiety Rating Scale (HAM-A), and Self-Report Questionnaire (SRQ). Both crack and inhalant users experience significant symptoms of anxiety. Inhalant users presented significantly more anxiety symptoms than crack users according to the HAM-A questionnaire only. In contrast to the results of the HAM-A, the STAI failed to demonstrate a significant difference between the two groups of substance users. SRQ scores revealed that crack and inhalants users had significant degrees of morbidity. A significant difference regarding anxiety symptomatology, especially state anxiety, was observed among inhalant and crack users. Anxiety and overall mental psychopathology were significantly correlated in this sample. The results indicate that screening initiatives to detect anxiety and additional psychiatric comorbidities among crack and inhalant users are feasible and relevant. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

  19. Somatic symptoms, perceived stress and perceived job satisfaction among nurses working in an Indian psychiatric hospital.

    Science.gov (United States)

    Gandhi, Sailaxmi; Sangeetha, G; Ahmed, Nurnahar; Chaturvedi, S K

    2014-12-01

    High stress perception by nurses caring for psychiatric patients can lead to somatic symptoms which impact on their job satisfaction perception. To assess and correlate the level of somatic symptoms, perceived stress and perceived job satisfaction among the subjects. The authors used a descriptive correlation design to invite 150 nurses of both genders working for more than one year with psychiatric patients. The Scale for Assessment of Somatic Symptoms (Chaturvedi et al., 1987) and a Visual Analogue Scale (VAS) for stress and job satisfaction perception were used to collect data. The nurses (128) reported mainly pain related (4.87±2.97) somatic symptoms. Somatic symptoms positively correlated (r=0.302) with stress perception and negatively correlated (r=-0.231) with perceived job satisfaction, while perceived stress and perceived job satisfaction were negatively correlated (r=-0.460, p=0.000). The results indicate a need for stress management interventions. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Psychiatric disorders and psychiatric consultation in a general hospital: a case- control study Transtornos psiquiátricos e solicitações de interconsulta psiquiátrica em hospital geral: um estudo de caso controle

    Directory of Open Access Journals (Sweden)

    Sumaia Inaty Smaira

    2003-03-01

    Full Text Available INTRODUCTION: Psychiatric consultation (PC has been considered an efficient tool to develop research, to track and to give assistance benefiting patients, health professionals and the institution. However, it has not been much used in Brazil. Although 30 to 50% of general hospital (GH inpatients may present a psychiatric disorder, only 1 to 12% of them are referred to assessment. The aims of this study were: to assess mental disorders in a GH; to identify which of these patients are sent to psychiatric care; to verify alleged reasons for referral to psychiatric consultation, and to examine the relationship between PC and psychiatric learning (during medical school and residence. METHODS: A case-control patient study was conducted (47 cases and 94 controls to analyze in detail the following variables: socio-demographic; clinical; degree of information (about the disease and diagnostic/therapeutic procedures, and relationship between patient and health team. Psychiatric diagnoses were made according to the ICD-10 criteria. The Self Report Questionnaire (SRQ, the CAGE and Brief Psychiatric Rating Scale (BPRS were used as well as a specifically designed questionnaire to collect clinical and demographic data. RESULTS: Behavioral alterations, either of elation or of depression, were the main for requesting a PC ; 95.8% of the cases and 27.7% of the controls had a mental disorder. Organic mental disorders and alcohol-related disorders were the most frequent diagnoses in group I (cases, while anxiety, depressive and alcohol-related disorders were predominant in group II (controls. Control group patients were better informed and more able to establish an appropriate relationship with the health team than case patients. The logistic regression showed CAGE-positive patients having 12.85 times greater risk of being referred to PC, followed by unemployed patients (2.44 times more PC referrals. DISCUSSION: The SRQ and CAGE were quite useful in the screening

  1. Experiences and Perceptions of Nursing Staff Working With Long-Stay Patients in a High Secure Psychiatric Hospital Setting.

    Science.gov (United States)

    Dutta, Snigdha; Majid, Shazmin; Völlm, Birgit

    2016-01-01

    Forensic psychiatric nursing is a demanding nursing specialty that deals with a highly complex group of patients who are detained in restrictive environments, often for lengthy periods. There is little information about the daily experiences of these nurses. This study sought to explore the roles and relationships of forensic psychiatric nurses with long-stay patients in a high secure hospital in England. The study obtained data via three focus groups, and thematic analysis was carried out using NVIVO 10 software. Five prominent themes emerged: First, nurses elaborated on their roles with patients and the kinds of interactions they had with them. The next two themes explored the reasons why some patients are long-stay patients and the challenges nurses face while working with this group. The fourth theme was the impact of external support, such as the patient's families, on length of stay. The final theme covered the changes that the nurses observed in these patients and in themselves over time. It was noticeable that those interviewed were committed professionals, eager to provide an optimistic and hopeful environment for the patients to help them progress through "the system". The study presents a number of pertinent issues regarding long-stay patients that provide a basis for further research and to inform policy, educational reforms, and clinical practice.

  2. Treatment received, satisfaction with health care services, and psychiatric symptoms 3 months after hospitalization for self-poisoning

    Directory of Open Access Journals (Sweden)

    Grimholt Tine K

    2012-04-01

    Full Text Available Abstract Background Patients who self-poison have high repetition and high mortality rates. Therefore, appropriate follow-up is important. The aims of the present work were to study treatment received, satisfaction with health care services, and psychiatric symptoms after hospitalization for self-poisoning. Methods A cohort of patients who self-poisoned (n = 867 over a period of 1 year received a questionnaire 3 months after discharge. The Beck Depression Inventory (BDI, Beck Hopelessness Scale (BHS, and Generalized Self-Efficacy Scale (GSE were used. The participation rate was 28% (n = 242; mean age, 41 years; 66% females. Results Although only 14% of patients were registered without follow-up referrals at discharge, 41% reported no such measures. Overall, satisfaction with treatment was fairly good, although 29% of patients waited more than 3 weeks for their first appointment. A total of 22% reported repeated self-poisoning and 17% cutting. The mean BDI and BHS scores were 23.3 and 10.1, respectively (both moderate to severe. The GSE score was 25.2. BDI score was 25.6 among patients with suicide attempts, 24.9 for appeals, and 20.1 for substance-use-related poisonings. Conclusions Despite plans for follow-up, many patients reported that they did not receive any. The reported frequency of psychiatric symptoms and self-harm behavior indicate that a more active follow-up is needed.

  3. Work engagement supports nurse workforce stability and quality of care: nursing team-level analysis in psychiatric hospitals.

    Science.gov (United States)

    Van Bogaert, P; Wouters, K; Willems, R; Mondelaers, M; Clarke, S

    2013-10-01

    Research in healthcare settings reveals important links between work environment factors, burnout and organizational outcomes. Recently, research focuses on work engagement, the opposite (positive) pole from burnout. The current study investigated the relationship of nurse practice environment aspects and work engagement (vigour, dedication and absorption) to job outcomes and nurse-reported quality of care variables within teams using a multilevel design in psychiatric inpatient settings. Validated survey instruments were used in a cross-sectional design. Team-level analyses were performed with staff members (n = 357) from 32 clinical units in two psychiatric hospitals in Belgium. Favourable nurse practice environment aspects were associated with work engagement dimensions, and in turn work engagement was associated with job satisfaction, intention to stay in the profession and favourable nurse-reported quality of care variables. The strongest multivariate models suggested that dedication predicted positive job outcomes whereas nurse management predicted perceptions of quality of care. In addition, reports of quality of care by the interdisciplinary team were predicted by dedication, absorption, nurse-physician relations and nurse management. The study findings suggest that differences in vigour, dedication and absorption across teams associated with practice environment characteristics impact nurse job satisfaction, intention to stay and perceptions of quality of care. © 2012 John Wiley & Sons Ltd.

  4. [Incidence and Costs of 1:1 Care in Psychiatric Hospitals in Germany - A Descriptive Analysis Based on the VIPP Project Data Set].

    Science.gov (United States)

    Nienaber, André; Schulz, Michael; Noelle, Rüdiger; Wiegand, Hauke Felix; Wolff-Menzler, Claus; Häfner, Sibylle; Seemüller, Florian; Godemann, Frank; Löhr, Michael

    2016-05-01

    1:1 care is applied for patients requiring close psychiatric monitoring and care like patients with acute suicidality. The article describes the frequency of 1:1 care across different diagnoses and age groups in German psychiatric hospitals. The analysis was based on the VIPP Project from the years 2011 and 2012. A total of 47 hospitals with more than 120,000 cases were included. Object of the analysis was the OPS code 9-640.0 1:1 care. The evaluation was performed on case level. Data of 47 hospitals were included. Of the 121,454 cases evaluated in 2011 3.8 % documented a 1:1 care within the meaning of OPS 9-640.0 additional code. Of the 66 245 male cases a 1:1 care was documented in 3.5 % and the 55 207 female cases was 4.1 %. Compared to 2011, the proportion of 1:1 care in 2012 rose to 4.8 %. The results show that 1:1 care is frequently applied in German psychiatric hospitals. The Data of the VIPP project have proven to be a useful tool to gain information on the frequency of cost-intensive interventions in German psychiatric hospitals. Further analyses should create the possibility of evaluation at the level of the individual codes. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Themes and time use by participants in general team meetings at a psychiatric day hospital

    National Research Council Canada - National Science Library

    Scherer, Edson Arthur; Campos, Maria Auxiliadora; Scherer, Zeyne Alves Pires

    2007-01-01

    This naturalistic study was realized through observation and aimed to characterize general staff meetings held at a day hospital regarding theme and the professionals' participation in the use of time...

  6. Stigma, Social Structure, and the Biomedical Framework: Exploring the Stigma Experiences of Inpatient Service Users in Two Belgian Psychiatric Hospitals.

    Science.gov (United States)

    Sercu, Charlotte; Bracke, Piet

    2017-07-01

    The study discusses the stigma experiences of service users in mental health care, within the debate on the role of the biomedical framework for mental health care and power relations in society. Interview data of inpatient users ( n = 42) and care providers ( n = 43) from two Belgian psychiatric hospitals were analyzed using a constructivist grounded theory approach: Findings offer insight into how stigma experiences are affected by social structure. Stigma seemed to be related to the relation between care providers and service users their social position. The concept "mental health literacy" is used to frame this finding. In paying attention to the specific cultural and normative context, which influences the relationship between mental health literacy and stigma, it is further possible to cast some light on the meaning of the biomedical model for the construction and maintenance of power relations in mental health care and broader society.

  7. Pedagogical Mediation as an Educational Strategy for Students with Mental Illness in alphabetization level offered in the National Psychiatric Hospital

    Directory of Open Access Journals (Sweden)

    Karen Hidalgo-Montoya

    2013-03-01

    Full Text Available This study focuses on the work of teachers in the Open Education Program of the National Psychiatric Hospital (Costa Rica and identifies the learning barriers of the student population. It aims at promoting educational delivery strategies adapted to the needs of the community attending the literacy level. This is a qualitative study with a participatory action research design. Information was collected through interviews to teachers, observation, and pedagogical mediation with the teachers of the program. The results indicate that the pedagogical mediation methodology contributed to improve the access of students to the curriculum. Among the conclusions, it is recommended to implement significant curriculum modifications focused on the student population and a classroom methodology adjusted to the different learning needs. Finally, it is recommended to have an interdisciplinary team to support the teaching staff working with students with mental illness.

  8. Separate beds: a history of Indian hospitals in Canada, 1920s-1980s

    National Research Council Canada - National Science Library

    Lux, Maureen K

    2016-01-01

    .... Operated by the same bureaucracy that was expanding health care opportunities for most Canadians, the 'Indian Hospitals' were underfunded, understaffed, overcrowded, and rife with coercion and medical experimentation...

  9. Patient safety culture in two Finnish state-run forensic psychiatric hospitals.

    Science.gov (United States)

    Kuosmanen, Anssi; Tiihonen, Jari; Repo-Tiihonen, Eila; Eronen, Markku; Turunen, Hannele

    2013-01-01

    Safety culture refers to the way patient safety is regarded and implemented within an organization and the structures and procedures in place to support this. The aim of this study was to evaluate patient safety culture, identify areas for improvement, and establish a baseline for improving state hospitals in Finland. Cross-sectional design data were collected from two state-run forensic hospitals in Finland using an anonymous, Web-based survey targeted to hospital staff based on the Hospital Survey on Patient Safety Culture questionnaire. The response rate was 43% (n = 283). The overall patient safety level was rated as excellent or very good by 58% of respondents. The highest positive grade was for "teamwork within units" (72%). The lowest rating was for "nonpunitive response to errors" (26% positive). Good opportunities for supplementary education had a statistically significant (p ≤ 0.05) effect on 9 of 12 Hospital Survey on Patient Safety Culture dimensions. Statistically significant (p ≤ 0.05) differences in patient safety culture were also found in the staff's educational background, manager status, and between the two hospitals. These findings suggest there are a number of patient safety problems related to cultural dimensions. Supplementary education was shown to be a highly significant factor in transforming patient safety culture and should therefore be taken into account alongside sufficient resources.

  10. Neurasthenia, Generalized Anxiety Disorder, and the Medicalization of Worry in a Vietnamese Psychiatric Hospital.

    Science.gov (United States)

    Tran, Allen L

    2017-06-01

    This article examines two forms of the medicalization of worry in an outpatient psychiatric clinic in Ho Chi Minh City, Vietnam. Biomedical psychiatrists understand patients' symptoms as manifestations of the excessive worry associated with generalized anxiety disorder (GAD). Drawing on an ethnopsychology of emotion that reflects increasingly popular models of neoliberal selfhood, these psychiatrists encourage patients to frame psychic distress in terms of private feelings to address the conditions in their lives that lead to chronic anxiety. However, most patients attribute their symptoms to neurasthenia instead of GAD. Differences between doctors' and patients' explanatory models are not just rooted in their understandings of illness but also in their respective conceptualizations of worry in terms of emotion and sentiment. Patients with neurasthenia reject doctors' attempts to psychologize distress and maintain a model of worry that supports a sense of moral selfhood based on notions of obligation and sacrifice. © 2016 by the American Anthropological Association.

  11. The effects of daily weather variables on psychosis admissions to psychiatric hospitals.

    LENUS (Irish Health Repository)

    McWilliams, Stephen

    2012-08-02

    Several studies have noted seasonal variations in admission rates of patients with psychotic illnesses. However, the changeable daily meteorological patterns within seasons have never been examined in any great depth in the context of admission rates. A handful of small studies have posed interesting questions regarding a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (especially heat waves) and sunshine. In this study, we used simple non-parametric testing and more complex ARIMA and time-series regression analysis to examine whether daily meteorological patterns (wind speed and direction, barometric pressure, rainfall, sunshine, sunlight and temperature) exert an influence on admission rates for psychotic disorders across 12 regions in Ireland. Although there were some weak but interesting trends for temperature, barometric pressure and sunshine, the meteorological patterns ultimately did not exert a clinically significant influence over admissions for psychosis. Further analysis is needed.

  12. Assessing the diagnostic validity of a structured psychiatric interview in a first-admission hospital sample

    DEFF Research Database (Denmark)

    Nordgaard, Julie; Revsbech, Rasmus; Sæbye, Ditte

    2012-01-01

    The use of structured psychiatric interviews performed by non-clinicians is frequent for research purposes and is becoming increasingly common in clini-cal practice. The validity of such interviews has rarely been evaluated empirically. In this study of a sample of 100 diagnostically heterogeneous......, first-admitted inpatients, the results of an assessment with the Structured Clinical Interview for DSM-IV (SCID), yielding a DSM-IV diagnosis and performed by a trained non-clinician, were compared with a consensus lifetime best diagnostic estimate (DSM-IV) by two experienced research clinicians, based...... performed by non-clinicians are not recommendable for clinical work and should only be used in research with certain precautions. It is suggested that a revival of systematic theoretical and practical training in psychopathology is an obvious way forward in order to improve the validity and therapeutic...

  13. Infection control consultation in a 150-bed acute care hospital: making this unobserved and unmeasured critical job function visible.

    Science.gov (United States)

    Grant, Patti S; Kim, Alex T

    2007-08-01

    One qualified infection control director, reporting directly to administration, was responsible for the Infection Prevention and Control Program of a 150-bed acute care, non-teaching, for-profit hospital. To observe for potential trending, questions (consultations) and determinations related to infectious processes were documented. To explore the possibility of measuring the essential although "hidden" function of the infection control consultation (process), which is a role not formerly linked to infection rates (outcomes). A 7-year retrospective study was conducted of all infection control consultations requiring more than a 5-minute intervention, as part of routine job responsibilities. The XmR Statistical Process Control charts (XmR Charts) and Pearson's Correlation Coefficient were used to analyze the activity of infection control consultations. From January 1, 1998 to December 31, 2004, there were 770 infection control consultations logged for 375.1 hours. Beginning with 2003, the variation in both the number and duration of infection control consultations in the XmR Charts become more standardized and has a smaller moving range between data points. The Pearson's Correlation Coefficient shows statistical significance (P control consultations at this 150-bed hospital illustrates that this essential component can be measured, and should be formerly tracked to document overall assessment of infection prevention and control interdisciplinary interaction. The consultation process became more efficient over the 7-year study period because, as the number of questions increased, the duration required to achieve closure decreased.

  14. Tensions between policy and practice: A qualitative analysis of decisions regarding compulsory admission to psychiatric hospital.

    Science.gov (United States)

    Fistein, Elizabeth C; Clare, Isabel C H; Redley, Marcus; Holland, Anthony J

    2016-01-01

    The use of detention for psychiatric treatment is widespread and sometimes necessary. International human rights law requires a legal framework to safeguard the rights to liberty and personal integrity by preventing arbitrary detention. However, research suggests that extra-legal factors may influence decisions to detain. This article presents observational and interview data to describe how decisions to detain are made in practice in one jurisdiction (England and Wales) where a tension between policy and practice has been described. The analysis shows that practitioners mould the law into 'practical criteria' that appear to form a set of operational criteria for identifying cases to which the principle of soft paternalism may be applied. Most practitioners also appear willing, albeit often reluctantly, to depart from their usual reliance on the principle of soft paternalism and authorise detention of people with the capacity to refuse treatment, in order to prevent serious harm. We propose a potential resolution for the tension between policy and practice: two separate legal frameworks to authorise detention, one with a suitable test of capacity, used to enact soft paternalism, and the other to provide legal justification for detention for psychiatric treatment of the small number of people who retain decision-making capacity but nonetheless choose to place others at risk by refusing treatment. This separation of detention powers into two systems, according to the principle that justifies the use of detention would be intellectually coherent, consistent with human rights instruments and, being consistent with the apparent moral sentiments of practitioners, less prone to idiosyncratic interpretations in practice. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Supplier-induced demand for psychiatric admissions in Northern New England

    Science.gov (United States)

    2011-01-01

    Background The development of hospital service areas (HSAs) using small area analysis has been useful in examining variation in medical and surgical care; however, the techniques of small area analysis are underdeveloped in understanding psychiatric admission rates. We sought to develop these techniques in order to understand the relationship between psychiatric bed supply and admission rates in Northern New England. Our primary hypotheses were that there would be substantial variation in psychiatric admission across geographic settings and that bed availability would be positively correlated with admission rates, reflecting a supplier-induced demand phenomenon. Our secondary hypothesis was that the construction of psychiatric HSAs (PHSAs) would yield more meaningful results than the use of existing general medical hospital service areas. Methods To address our hypotheses, we followed a four-step analytic process: 1) we used small area analytic techniques to define our PHSAs, 2) we calculated the localization index for PHSAs and compared that to the localization index for general medical HSAs, 3) we used the number of psychiatric hospital beds, the number of psychiatric admissions, and census data to calculate population-based bed-supply and psychiatric admission rates for each PHSA, and 4) we correlated population-based admission rates to population-based psychiatric bed supply. Results The admission rate for psychiatric diagnosis varied considerably among the PHSAs, with rates varying from 2.4 per 100,000 in Portsmouth, NH to 13.4 per 100,000 in Augusta, ME. There was a positive correlation of 0.71 between a PHSA's supply of beds and admission rate. Using our PSHAs produced a substantially higher localization index than using general medical hospital services areas (0.69 vs. 0.23), meaning that our model correctly predicted geographic utilization at three times the rate of the existing model. Conclusions The positive correlation between admission and bed supply

  16. Coping strategies and self-stigma among adolescents discharged from psychiatric hospitalization: a 6-month follow-up study.

    Science.gov (United States)

    Moses, Tally

    2015-03-01

    The effects of mental illness stigma on adolescents receiving psychiatric treatment may largely be determined by their coping strategies. Yet, little is known about adolescents' use of stigma-coping strategies, or how helpful these are for addressing stigma-related stress. This study explores how adolescents discharged from psychiatric hospitalization anticipate coping with a hypothetical social stigma event related to hospitalization. We examine how well anticipated coping strategies predict adolescents' self-stigma ratings following 6 months. To evaluate the direction of causality, the reverse order of effects, the influence of self-stigma on coping strategies, is also assessed. A voluntary sample of 80 adolescents participated in two face-to-face interviews that assessed coping and self-stigma. Anticipated (baseline) and actual (follow-up) coping strategies were measured with a modified Response to Stress Questionnaire (primary and secondary control engagement coping, disengagement) and two stigma-specific strategies developed for this study (disconfirming stereotypes and aggression/confrontation). Relationships between anticipated coping strategies and self-stigma were assessed with ordinary least squares (OLS) regression; multivariate general linear modeling (GLM) and structural equation modeling (SEM) explored the reverse associations. Youth reporting higher self-stigma ratings at follow-up anticipated using more disengagement and effort to disconfirm stereotypes and less secondary control engagement coping at baseline. Anticipated use of secondary control engagement coping was uniquely significant in predicting participants' self-stigma when controlling for baseline self-stigma. At the same time, higher baseline self-stigma ratings predicted less adaptive coping (disengagement and effort to disconfirm stereotypes) at follow-up. The results point to the particular importance of secondary control engagement coping for helping to mitigate the impact of peer

  17. The suitability of the Hospital Anxiety and Depression Scale, Distress Thermometer and other instruments to screen for psychiatric disorders in both lung cancer patients and their partners.

    Science.gov (United States)

    Schellekens, Melanie P J; van den Hurk, Desiree G M; Prins, Judith B; Molema, Johan; van der Drift, Miep A; Speckens, Anne E M

    2016-10-01

    Lung cancer patients and their partners report high rates of distress. Although distress is of importance, psychiatric disorders might be more important in terms of prognostic value and additional psychological treatment. This study examined the suitability of the Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), Beck Depression Inventory (BDI-II) and State subscale of State Trait Anxiety Inventory (STAI-S) to screen for psychiatric disorders in lung cancer patients and partners. A consecutive sample of lung cancer patients and partners completed the screening instruments. The Structured Clinical Interview DSM-IV (SCID-I) was used to diagnose psychiatric axis I disorders. In 144 patients, overall ability of HADS total score (HADS-T) screening for patients with psychiatric disorders was good, whereas DT appeared less suitable. In 98 partners, the performance of HADS-T was good. Although no instrument was successful in identifying psychiatric disorders, HADS-T came closest with a fair performance in patients and partners. Several patients and partners declined participation because they perceived participation as too distressing. As decliners possibly have the highest rates of disorders, our findings might underestimate the prevalence of psychiatric disorders. A low prevalence negatively affects the positive predictive value and complicates efficient screening for psychiatric disorders. The HADS-T appears to be a suitable screening instrument for ruling out those lung cancer patients and partners without a psychiatric disorder. Regarding identifying those with a psychiatric disorder, HADS-T should be used to refer both patients and partners for further diagnostics and treatment to a psychiatrist/psychologist. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Does physical exercise improve ADL capacities in people over 65 years with moderate or severe dementia hospitalized in an acute psychiatric setting? A multisite randomized clinical trial.

    Science.gov (United States)

    Bürge, Elisabeth; Berchtold, André; Maupetit, Christine; Bourquin, Nathalie M-P; von Gunten, Armin; Ducraux, Daniel; Zumbach, Serge; Peeters, Anne; Kuhne, Nicolas

    2017-02-01

    Several studies on the effect of physical exercise on activities of daily living (ADL) for people with dementia exist; yet, data concerning the specific context of acute psychiatric hospitals remain scant. This study measured the effect of a physical exercise program on ADL scores in patients with moderate to severe dementia hospitalized in an acute psychiatric ward. A multicenter clinical trial was conducted in five Swiss and Belgian psychiatric hospitals. Participants were randomly allocated to either an experimental group (EG) or a control group (CG). Members of the EG received 20 physical exercise sessions (strengthening, balance, and walking) over a four-week period while members of the CG participated in social interaction sessions of equivalent duration and frequency, but without physical exercise. The effect of exercise on ADL was measured by comparing scores of the Barthel Index and the Functional Independence Measure in the EG and CG before and after the intervention, and two weeks later. Hundred and sixty patients completed the program. Characteristics of participants of both groups were similar at the inception of the study. The mean ADL score of EG decreased slightly over time, whereas that of the CG significantly decreased compared to initial scores. Overall differences between groups were not significant; however, significant differences were found for mobility-related items. ADL scores in elderly with moderate to severe dementia deteriorate during acute psychiatric hospitalization. An exercise program delays the loss of mobility but does not have a significant impact on overall ADL scores.

  19. Evaluating Psychiatric Hospital Admission Decisions for Children in Foster Care: An Optimal Classification Tree Analysis

    Science.gov (United States)

    Snowden, Jessica A.; Leon, Scott C.; Bryant, Fred B.; Lyons, John S.

    2007-01-01

    This study explored clinical and nonclinical predictors of inpatient hospital admission decisions across a sample of children in foster care over 4 years (N = 13,245). Forty-eight percent of participants were female and the mean age was 13.4 (SD = 3.5 years). Optimal data analysis (Yarnold & Soltysik, 2005) was used to construct a nonlinear…

  20. An analysis of acute admissions to a general hospital psychiatric unit

    African Journals Online (AJOL)

    QuickSilver

    with mental illness stay in a hospital for optimum benefit (and least harm) both to the patient and ... costs use around 80% of mental health resources.2 Recent emphasis on cutting the costs of .... The effectiveness of stigma coping orientations: can negative consequences of mental illness labeling be avoided? J Health Soc ...

  1. Human rights abuses at a psychiatric hospital in KwaZulu-Natal

    African Journals Online (AJOL)

    A public notice of the enquiry was posted in the local media inviting interested or affected parties to participate. The notice in the print media was complemented by announcements on local radio stations where members of the public were invited to submit personal experiences of human rights abuses at the hospital to the.

  2. The probability of readmission within 30 days of hospital discharge is positively associated with inpatient bed occupancy at discharge--a retrospective cohort study.

    Science.gov (United States)

    Blom, Mathias C; Erwander, Karin; Gustafsson, Lars; Landin-Olsson, Mona; Jonsson, Fredrik; Ivarsson, Kjell

    2015-12-14

    Previous work has suggested that given a hospital's need to admit more patients from the emergency department (ED), high inpatient bed occupancy may encourage premature hospital discharges that favor the hospital's need for beds over patients' medical interests. We argue that the effects of such action would be measurable as a greater proportion of unplanned hospital readmissions among patients discharged when the hospital was full than when not. In response, the present study tested this hypothesis by investigating the association between inpatient bed occupancy at the time of hospital discharge and the 30-day readmission rate. The sample included all inpatient admissions from the ED at a 420-bed emergency hospital in southern Sweden during 2011-2012 that resulted in discharge before 1 December 2012. The share of unplanned readmissions within 30 days was computed for levels of inpatient bed occupancy of 105% at the hour of discharge. A binary logistic regression model was constructed to adjust for age, time of discharge, and other factors that could affect the outcome. In all, 32,811 visits were included in the study, 9.9% of which resulted in an unplanned readmission within 30 days of discharge. The proportion of readmissions was 9.0% for occupancy levels of discharge, 10.2% for 95-100% occupancy, 10.8% for 100-105% occupancy, and 10.5% for >105% occupancy (p = 0.0001). Results from the multivariate models show that the OR (95% CI) of readmission was 1.11 (1.01-1.22) for patients discharged at 95-100% occupancy, 1.17 (1.06-1.29) at 100-105% occupancy, and 1.15 (0.99-1.34) at >105% occupancy. Results indicate that patients discharged from inpatient wards at times of high inpatient bed occupancy experience an increased risk of unplanned readmission within 30 days of discharge.

  3. Primary triage nurses do not divert patients away from the emergency department at times of high in-hospital bed occupancy - a retrospective cohort study.

    Science.gov (United States)

    Blom, Mathias C; Erwander, Karin; Gustafsson, Lars; Landin-Olsson, Mona; Jonsson, Fredrik; Ivarsson, Kjell

    2016-09-22

    Emergency department (ED) overcrowding is frequently described in terms of input- throughput and output. In order to reduce ED input, a concept called primary triage has been introduced in several Swedish EDs. In short, primary triage means that a nurse separately evaluates patients who present in the Emergency Department (ED) and either refers them to primary care or discharges them home, if their complaints are perceived as being of low acuity. The aim of the present study is to elucidate whether high levels of in-hospital bed occupancy are associated with decreased permeability in primary triage. The appropriateness of discharges from primary triage is assessed by 72-h revisits to the ED. The study is a retrospective cohort study on administrative data from the ED at a 420-bed hospital in southern Sweden from 2011-2012. In addition to crude comparisons of proportions experiencing each outcome across strata of in-hospital bed occupancy, multivariate models are constructed in order to adjust for age, sex and other factors. A total of 37,129 visits to primary triage were included in the study. 53.4 % of these were admitted to the ED. Among the cases referred to another level of care, 8.8 % made an unplanned revisit to the ED within 72 h. The permeability of primary triage was not decreased at higher levels of in-hospital bed occupancy. Rather, the permeability was slightly higher at occupancy of 100-105 % compared to triage at times of high in-hospital bed occupancy is reassuring, as the opposite would have implied that patients might be denied entry not only to the hospital, but also to the ED, when in-hospital beds are scarce.

  4. Exposure to Exhaled Air from a Sick Occupant in a Two-Bed Hospital Room with Mixing Ventilation: Effect of Posture of Doctor and Air Change Rate

    OpenAIRE

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Barova, Mariya

    2013-01-01

    Full-scale measurements were performed in a climate chamber set as a two-bed hospital room, ventilated at 3, 6 and 12 ACH with overhead mixing ventilation. Air temperature was kept constant at 22 °C. Two breathing thermal manikins were used to mimic a sick patient lying on one side in one of the beds and a doctor. A thermal dummy mimicked an exposed patient lying in the second bed. The doctor either stood up or sat in a chair 0.55 m facing the sick patient. The ‘sick patient’ was exhaling thr...

  5. [Treatment of eating disorders in adolescents--the view of a child and adolescence psychiatric hospital].

    Science.gov (United States)

    Pfeiffer, Ernst; Hansen, Berit; Korte, Alexander; Lehmkuhl, Ulrike

    2005-04-01

    The paper presents--in the sense of clinical guidelines--reality of clinical care in a child and adolescence university hospital specialised on eating disorders. Need of a multimodal therapeutic approach is emphasized, including normalisation of weight and eating behaviour, nursing and pedagogical measures, individual, group and family therapy, completed by body therapy, art and music therapy and in case psychopharmacotherapy. Recommendations for overcoming weak spots are made.

  6. Awareness and perceptions of electroconvulsive therapy among psychiatric patients: a cross-sectional survey from teaching hospitals in Karachi, Pakistan

    Directory of Open Access Journals (Sweden)

    Choudhary Maria

    2007-06-01

    Full Text Available Abstract Background Electroconvulsive therapy (ECT is shown to be effective in many psychiatric illnesses, but its distorted projection by the Pakistani media and its unregulated use by many physicians across the country have adversely affected its acceptability. Given this situation we aimed to assess the awareness and perceptions regarding ECT as a treatment modality among the psychiatric patients. Methods This was a questionnaire based cross-sectional study carried out at 2 tertiary care hospitals in Karachi, Pakistan. Results We interviewed 190 patients of which 140 were aware of ECT. The study showed that the level of education had a significant impact on the awareness of ECT (p = 0.009. The most common source of awareness was electronic and print media (38%, followed by relatives (24% and doctors (23%. Physical injuries (42% and neurological (12% and cognitive disturbances (11% were the commonly feared side effects. The most popular belief about ECT was that it was a treatment of last resort (56%. Thirty-nine percent thought that ECT could lead to severe mental and physical illness and 37% considered it inhumane. Patients' willingness to receive ECT was dependant on whether or not they were convinced of its safety (p = 0.001 and efficacy (p = 0.0001. Conclusion We identified a serious lack of dissemination of information regarding ECT by the psychiatrists and the mental health care providers. This may be the result of an inadequate postgraduate training in Pakistan or just a lack of concern about the mentally ill patients. The media seemed to be the major source of information for our patients. We also saw the prevalence of a variety of myths regarding ECT in our society, which we feel may be responsible for the patients' adverse attitudes. Given the widespread applicability of ECT there is a dire need to dispel these misconceptions and improve its acceptability.

  7. Sexual orientation differences in treatment expectation, alliance, and outcome among patients at risk for suicide in a public psychiatric hospital.

    Science.gov (United States)

    Plöderl, Martin; Kunrath, Sabine; Cramer, Robert J; Wang, Jen; Hauer, Larissa; Fartacek, Clemens

    2017-05-15

    Sexual minority (SM) individuals (gay, lesbian, bisexual, or otherwise nonheterosexual) are at increased risk for mental disorders and suicide and adequate mental healthcare may be life-saving. However, SM patients experience barriers in mental healthcare that have been attributed to the lack of SM-specific competencies and heterosexist attitudes and behaviors on the part of mental health professionals. Such barriers could have a negative impact on common treatment factors such as treatment expectancy or therapeutic alliance, culminating in poorer treatment outcomes for SM versus heterosexual patients. Actual empirical data from general psychiatric settings is lacking, however. Thus, comparing the treatment outcome of heterosexual and SM patients at risk for suicide was the primary aim of this study. The secondary aim was to compare treatment expectation and working alliance as two common factors. We report on 633 patients from a suicide prevention inpatient department within a public psychiatric hospital. Most patients were at risk for suicide due to a recent suicide attempt or warning signs for suicide, usually in the context of a severe psychiatric disorder. At least one indicator of SM status was reported by 21% of patients. We assessed the treatment outcome by calculating the quantitative change in suicide ideation, hopelessness, and depression. We also ran related treatment responder analyses. Treatment expectation and working alliance were the assessed common factors. Contrary to the primary hypothesis, SM and heterosexual patients were comparable in their improvement in suicide ideation, hopelessness, or depression, both quantitatively and in treatment responder analysis. Contrary to the secondary hypothesis, there were no significant sexual orientation differences in treatment expectation and working alliance. When adjusting for sociodemographics, diagnosis, and length of stay, some sexual orientation differences became significant, indicating that SM

  8. De-escalation techniques used, and reasons for seclusion and restraint, in a forensic psychiatric hospital.

    Science.gov (United States)

    Kuivalainen, Satu; Vehviläinen-Julkunen, Katri; Louheranta, Olavi; Putkonen, Anu; Repo-Tiihonen, Eila; Tiihonen, Jari

    2017-10-01

    In Finland, the Mental Health Act determines the legal basis for seclusion and restraint. Restrictive measures are implemented to manage challenging situations and should be used as a last resort in psychiatric inpatient care. In the present study, we examined the reasons for seclusion and restraint, as well as whether any de-escalation techniques were used to help patients calm down. Seclusion and restraint files from a 4-year period (1 June 2009-31 May 2013) were retrospectively investigated and analysed by content analysis. Descriptive statistics were calculated. A total of 144 episodes of seclusion and restraint were included to analyse the reasons for seclusion and restraint, and 113 episodes were analysed to examine unsuccessful de-escalation techniques. The most commonly-used techniques were one-to-one interaction with a patient (n = 74, 65.5% of n = 113) and administration of extra medication (n = 37, 32.7% of n = 113). The reasons for seclusion and restraint were threatening harmful behaviour (n = 51, 35.4% of n = 144), direct harmful behaviour (n = 43, 29.9%), indirect harmful behaviour (n = 42, 29.1%), and other behaviours (n = 8, 5.6%). In general, the same de-escalation techniques were used with most patients. Most episodes of seclusion or restraint were due to threats of violence or direct violence. Individual means of self-regulation and patient guidance on these techniques are needed. Additionally, staff should be educated on a diverse range of de-escalation techniques. Future studies should focus on examining de-escalation techniques for the prevention of seclusion. © 2017 Australian College of Mental Health Nurses Inc.

  9. Gender Differences in the Relationship Between Physical Activity and Smoking Among Psychiatrically Hospitalized Adolescents.

    Science.gov (United States)

    Bloom, Erika Litvin; Abrantes, Ana M; Fokas, Kathryn F; Ramsey, Susan E; Brown, Richard A

    2012-12-01

    Physical activity has been identified as a protective factor with regard to tobacco use, such that physically active adolescents are less likely to initiate smoking, and smokers are less physically active than non-smokers. These findings, along with the well-documented benefits of exercise on mood and well-being in adults, have stimulated interest in exercise-based smoking cessation interventions. However, little research has explored the relationship between physical activity and smoking characteristics within adolescent smokers. Also, gender differences in adolescents' motives for smoking and exercise may have implications for intervention development, especially in clinical populations. The current study explored the relationship between physical activity and smoking in a sample of adolescent smokers (N = 191) and non-smokers (N = 48) receiving inpatient psychiatric treatment (61% female, mean age 15.3 years). Results indicated that smokers were less likely to be physically active than non-smokers. Additionally, there was a consistent pattern of gender differences in the relationship between smoking and physical activity within smokers. Specifically, physically active male smokers were less nicotine dependent and less prone to withdrawal, and had a trend toward greater motivation to quit, than their non-active counterparts. In contrast, physically active female smokers did not differ in dependence or withdrawal and were less motivated to quit than non-active female smokers. Taken together, these results suggest that within clinical populations of adolescent females, smoking and exercise may be used jointly as weight control strategies. Exercise-based interventions for smoking cessation for adolescent females, especially clinical populations, should address weight and body image concerns.

  10. Problematic video game use scale: initial psychometric properties with psychiatrically hospitalized adolescents.

    Science.gov (United States)

    Topor, David R; Swenson, Lance P; Liguori, Gina M; Spirito, Anthony; Lowenhaupt, Elizabeth A; Hunt, Jeffrey I

    2011-12-01

    Excessive video game use among youth has been a growing concern in the United States and elsewhere. The aims of this study are to establish validity of a video game measure in a large adolescent inpatient sample, identify clinical factors underlying problem video game use, and identify associations with measures of psychopathology. Three hundred eighty participants admitted to an adolescent inpatient psychiatric unit between November 2007 and March 2009 were administered a battery of self-report measures, including a questionnaire developed for this study that assessed reinforcers and consequences of past-year video game use (ie, Problematic Video Game Use Scale). Factor analysis was used to identify the underlying structure of behaviors associated with problem video game use. A factor analysis of the Problematic Video Game Use Scale indicated 2 primary factors. One was associated with engaging in problem behaviors that impaired the adolescent's functioning as a result of playing video games and one reflected the reinforcing effects of playing video games. Both factors were associated with measures of psychopathology, although associations were generally stronger for impairment in functioning than for reinforcing effects. Both factors were significantly correlated with self-reported daily video game use (P video game playing: impairment in functioning and reinforcing effects. Initial evidence of the content validity of the video game measure was established. Findings highlight the importance of assessing video game use among an adolescent population, the factors associated with video game use, and associations with symptoms of psychopathology. Limitations include a common reporter for multiple measures and cross-sectional data that do not allow for causal links to be made. © Copyright 2011 Physicians Postgraduate Press, Inc.

  11. Reasons for cancellation of operation on the day of intended surgery in a multidisciplinary 500 bedded hospital

    Directory of Open Access Journals (Sweden)

    Rajender Kumar

    2012-01-01

    Full Text Available Background: Cancellation of operations in hospitals is a significant problem with far reaching consequences. This study was planned to evaluate reasons for cancellation of elective surgical operation on the day of surgery in a 500 bedded Government hospital. Materials and Methods: The medical records of all the patients, from December 2009 to November 2010, who had their operations cancelled on the day of surgery in all surgical units of the hospital, were audited prospectively. The number of operation cancelled and reasons for cancellation were documented. Results: 7272 patients were scheduled for elective surgical procedures during study period; 1286 (17.6 % of these were cancelled on the day of surgery. The highest number of cancellation occurred in the discipline of general surgery (7.1% and the least (0.35% occurred in Ear-Nose-Throat surgery. The most common cause of cancellation was the lack of availability of theater time 809 (63% and patients not turning up 244 (19% patients. 149 cancellations (11.6% were because of medical reasons; 16 (1.2% were cancelled by the surgeon due to a change in the surgical plan; 28 (2.1% were cancelled as patients were not ready for surgery; and 40 (3.1% were cancelled due to equipment failure.]. Conclusion: Most causes of cancellations of operations are preventable.

  12. Rapid Patient Discharge Contribution to Bed Surge Capacity During a Mass Casualty Incident: Findings From an Exercise With New York City Hospitals.

    Science.gov (United States)

    Jacobs-Wingo, Jasmine L; Cook, Heather A; Lang, William H

    Mass casualty incidents may increase patient volume suddenly and dramatically, requiring hospitals to expeditiously manage bed inventories to release acute care beds for disaster victims. Electronic patient tracking systems combined with unit walk-throughs can identify patients for rapid discharge. The New York City (NYC) Department of Health and Mental Hygiene's 2013 Rapid Patient Discharge Assessment (RPDA) aimed to determine the maximum number of beds NYC hospitals could make available through rapid patient discharge and to characterize discharge barriers. Unit representatives identified discharge candidates within normal operations in round 1 and additional discharge candidates during a disaster scenario in round 2. Descriptive statistics were performed. Fifty-five NYC hospitals participated in the RPDA exercise; 45 provided discharge candidate counts in both rounds. Representatives identified 4225 patients through the RPDA: among these, 1138 (26.9%) were already confirmed for discharge; 1854 (43.9%) were round 1 discharge candidates; and 1233 (29.2%) were round 2 discharge candidates. These 4225 patients represented 21.4% of total bed capacity. Frequently reported barriers included missing prescriptions for aftercare or discharge orders. The NYC hospitals could implement rapid patient discharge to clear one-fifth of occupied inpatient beds for disaster victims, given they address barriers affecting patients' safe and efficient discharge.

  13. The Development of Psychiatric Services Providing an Alternative to Full-Time Hospitalization Is Associated with Shorter Length of Stay in French Public Psychiatry.

    Science.gov (United States)

    Gandré, Coralie; Gervaix, Jeanne; Thillard, Julien; Macé, Jean-Marc; Roelandt, Jean-Luc; Chevreul, Karine

    2017-03-21

    International recommendations for mental health care have advocated for a reduction in the length of stay (LOS) in full-time hospitalization and the development of alternatives to full-time hospitalizations (AFTH) could facilitate alignment with those recommendations. Our objective was therefore to assess whether the development of AFTH in French psychiatric sectors was associated with a reduction in the LOS in full-time hospitalization. Using data from the French national discharge database of psychiatric care, we computed the LOS of patients admitted for full-time hospitalization. The level of development of AFTH was estimated by the share of human resources allocated to those alternatives in the hospital enrolling the staff of each sector. Multi-level modelling was carried out to adjust the analysis on other factors potentially associated with the LOS (patients', psychiatric sectors' and environmental characteristics). We observed considerable variations in the LOS between sectors. Although the majority of these variations resulted from patients' characteristics, a significant negative association was found between the LOS and the development of AFTH, after adjusting for other factors. Our results provide first evidence of the impact of the development of AFTH on mental health care and will provide a lever for policy makers to further develop these alternatives.

  14. Demandas de atendimento psiquiátrico em um hospital universitário Demandas de lo atendimiento psiquiátrico en un hospital universitario Demands of psychiatric care in a university hospital

    Directory of Open Access Journals (Sweden)

    Naiara Gajo Silva

    2011-09-01

    la necesidad de la interconsulta de enfermería psiquiátrica en este hospital.This is a cross-sectional study that aimed to describe the psychiatric demand in a university hospital in the city of Cuiabá, state of Mato Grosso, Brazil, and to know the current situation of the service to this demand. The data were collected from the inpatient medical records in a university hospital, from June to August, 2009, in a total of 551 records. Despite being considered by the literature as unprepared, nursing is the professional category that most identifies the psychiatric demand in this hospital. The treatment plan to this demand was restricted to medication, nine evaluations of psychology and thirteen consultation-liaison psychiatric service, without a significant involvement of nursing. The approach of emotional and/or mental aspects results in the improvement in the quality of nursing care, and there is a need for the nurses to qualify for that. To make it happen, we propose a reflection on the need for the consultation-liaison psychiatric service in this hospital.

  15. How common are errors in the medication process in a psychiatric hospital?

    DEFF Research Database (Denmark)

    Sørensen, Ann Lykkegaard; Mainz, Jan; Lisby, Marianne

    2012-01-01

    -hospital patients (n=67), physicians prescribing drugs and ward staff (nurses and nurses assistants) dispensing and administering drugs. The study was carried out using 3 methods of investigation – an observational study, an unannounced control visit and an audit of medical records. Medication errors were evaluated...... for error. In total, 434 errors were detected in 1333 opportunities for error (33%). The rate of medication errors (with potential to harm patients) was 8% and 0.3% were considered potentially fatal. The frequency of errors was: Prescription: A) Computerized physician order entry (CPOE): 10/267 (4%), B...

  16. Family caregivers' experiences of involuntary psychiatric hospital admissions of their relatives--a qualitative study.

    Science.gov (United States)

    Jankovic, Jelena; Yeeles, Ksenija; Katsakou, Christina; Amos, Tim; Morriss, Richard; Rose, Diana; Nichol, Peter; McCabe, Rosemarie; Priebe, Stefan

    2011-01-01

    Family caregivers of people with mental disorders are frequently involved in involuntary hospital admissions of their relatives. To explore family caregivers' experience of involuntary admission of their relative. 30 in-depth interviews were conducted with family caregivers of 29 patients who had been involuntarily admitted to 12 hospitals across England. Interviews were analysed using thematic analysis. Four major themes of experiences were identified: relief and conflicting emotions in response to the relative's admission; frustration with a delay in getting help; being given the burden of care by services; and difficulties with confidentiality. Relief was a predominant emotion as a response to the relative's admission and it was accompanied by feelings of guilt and worry. Family caregivers frequently experienced difficulties in obtaining help from services prior to involuntary admission and some thought that services responded to crises rather than prevented them. Family caregivers experienced increased burden when services shifted the responsibility of caring for their mentally unwell relatives to them. Confidentiality was a delicate issue with family caregivers wanting more information and a say in decisions when they were responsible for aftercare, and being concerned about confidentiality of information they provided to services. Compulsory admission of a close relative can be a complex and stressful experience for family caregivers. In order for caregivers to be effective partners in care, a balance needs to be struck between valuing their involvement in providing care for a patient and not overburdening them.

  17. Family caregivers' experiences of involuntary psychiatric hospital admissions of their relatives--a qualitative study.

    Directory of Open Access Journals (Sweden)

    Jelena Jankovic

    Full Text Available Family caregivers of people with mental disorders are frequently involved in involuntary hospital admissions of their relatives.To explore family caregivers' experience of involuntary admission of their relative.30 in-depth interviews were conducted with family caregivers of 29 patients who had been involuntarily admitted to 12 hospitals across England. Interviews were analysed using thematic analysis.Four major themes of experiences were identified: relief and conflicting emotions in response to the relative's admission; frustration with a delay in getting help; being given the burden of care by services; and difficulties with confidentiality. Relief was a predominant emotion as a response to the relative's admission and it was accompanied by feelings of guilt and worry. Family caregivers frequently experienced difficulties in obtaining help from services prior to involuntary admission and some thought that services responded to crises rather than prevented them. Family caregivers experienced increased burden when services shifted the responsibility of caring for their mentally unwell relatives to them. Confidentiality was a delicate issue with family caregivers wanting more information and a say in decisions when they were responsible for aftercare, and being concerned about confidentiality of information they provided to services.Compulsory admission of a close relative can be a complex and stressful experience for family caregivers. In order for caregivers to be effective partners in care, a balance needs to be struck between valuing their involvement in providing care for a patient and not overburdening them.

  18. Processes of In-Hospital Psychiatric Care and Subsequent Criminal Behaviour Among Patients With Schizophrenia: A National Population-Based, Follow-Up Study

    DEFF Research Database (Denmark)

    Pedersen, C. G.; Jensen, S. O. W.; Johnsen, S. P.

    2013-01-01

    Objectives: It is unknown whether evidence-based, in-hospital processes of care may influence the risk of criminal behaviour among patients with schizophrenia. Our study aimed to examine the association between guideline recommended in-hospital psychiatric care and criminal behaviour among patients...... patients receiving the most processes of in hospital care (top quartile of received recommended care, compared with bottom quartiles, adjusted hazard ratio = 0.86, 95% CI 0.75 to 0.99). The individual processes of care associated with the lowest risk of criminal behaviour were antipsychotic treatment...

  19. Advances and challenges of psychiatric reform in Brazil 22 years after the Caracas declaration

    Directory of Open Access Journals (Sweden)

    Domingos Sávio Nascimento Alves

    2012-11-01

    Full Text Available The authors present the psychiatric reform in Brazil (PRB against the backdrop of the ideological and technical crisis of the care model previous to redemocratization and the Unified Healthcare System (SUS creation. They emphasize the leading role of Caracas Declaration in 1990 and the normative initiatives taken by the Ministry of Health. The authors place the PRB legal framework in the context of the Federal Act 10.216/2001 and its positive effects. Implementation of community services, expressive reduction in psychiatric hospital beds and financial transition for the new care model are highlighted. Also are discussed the main current challenges concerning alcohol and drug abuse policies, the insufficient availability of psychiatric beds in general hospitals and the increase of hospitalizations covered by private health insurance.

  20. Implications for the prevention of aggressive behavior within psychiatric hospitals drawn from interpersonal communication theory.

    Science.gov (United States)

    Daffern, Michael; Day, Andrew; Cookson, Amy

    2012-05-01

    Although interpersonal style is a defining feature of personality and personality disorder and is commonly identified as an important influence on aggressive behavior, treatment completion, and the development of an effective therapeutic alliance, it is rarely considered in practice guidelines for preventing, engaging, and managing patients at risk of aggression. In this article, the authors consider three potential applications of interpersonal theory to the care and management of patients at risk of aggression during hospitalization: (a) preventing aggression through theoretically grounded limit setting and de-escalation techniques, (b) developing and using interventions to alter problematic interpersonal styles, and (c) understanding therapeutic ruptures and difficulties establishing a therapeutic alliance. Interpersonal theory is proposed to offer a unifying framework that may assist development of intervention and management strategies that can help to reduce the occurrence of aggression in institutional settings.

  1. [Mental health of college students: experience of the university psychiatric outpatient clinic of Hospital de São João].

    Science.gov (United States)

    Silveira, Celeste; Norton, Andreia; Brandão, Isabel; Roma-Torres, António

    2011-12-01

    The mental health of college students has been raising major awareness, due to the increased prevalence and severity of psychiatric disorders in this population. Higher education is associated with significant stressors that contribute to the development of mental health disturbances, and most college students are in the high-risk age group for the emergence of symptoms of major psychiatric disorders. Early diagnosis and treatment of these disorders in college students are important areas of effort, since they pose a high impact at the educational, economic, and social levels. Thus, specifically planned mental health services play a major role in the management of this population, should be specialized and have easy accessibility. The purpose of this study is to describe and characterize the College Students' psychiatric outpatient clinic of the Department of Psychiatry, Hospital de São João.

  2. First-time first-trimester induced abortion and risk of readmission to a psychiatric hospital in women with a history of treated mental disorder.

    Science.gov (United States)

    Munk-Olsen, Trine; Laursen, Thomas Munk; Pedersen, Carsten B; Lidegaard, Ojvind; Mortensen, Preben Bo

    2012-02-01

    Mental health problems are associated with women's reproductive decisions and predict poor mental health outcomes after abortion and childbirth. To study whether having a first-trimester induced abortion influenced the risk of psychiatric readmission and compare findings with readmission risk in women with mental disorders giving birth. Survival analyses were performed in a population-based cohort study merging data from the Danish Civil Registration System, the Danish Psychiatric Central Register, and the Danish National Hospital Register from January 1,1994, to December 31, 2007. Denmark. All women born in Denmark between 1962 and 1992 with a record of 1 or more psychiatric admissions at least 9 months before a first-time first-trimester induced abortion or childbirth. Main Outcome Measure  Readmission at a psychiatric hospital with any type of mental disorder from 9 months before to 12 months after a first-time first-trimester induced abortion or childbirth. Relative risk (RR) for readmission risk 9 to 0 months before a first-trimester induced abortion was 0.95 (95% CI, 0.73-1.23) compared with the first year after the abortion. This contrasts with a reduced risk of readmission before childbirth (RR, 0.56; 95% CI, 0.42-0.75) compared with the first year post partum. Proximity to previous psychiatric admission in particular predicted rehospitalization risks in both the abortion and the childbirth group. Risk of readmission is similar before and after first-time first-trimester abortion, contrasting with a marked increased in risk of readmission post partum. We speculate that recent psychiatric episodes may influence women's decisions to have an induced abortion; however, this decision does not appear to influence the illness course in women with a history of treated mental disorders.

  3. Psychiatric admission and readmission in a general hospital of Porto Alegre: sociodemographic, clinic, and use of Network for Psychosocial Care characteristics.

    Science.gov (United States)

    Zanardo, Gabriela Lemos de Pinho; Silveira, Luísa Horn de Castro; Rocha, Cristianne Maria Famer; Rocha, Kátia Bones

    2017-01-01

    The revolving door phenomenon is characterized by repeated and frequent psychiatric readmissions. We aim to investigate sociodemographic, clinic, and follow-up characteristics in health services associated to psychiatric admissions and readmissions of inpatients in a general hospital of Porto Alegre. It is a cross-sectional study with a sample of 96 participants. More than half of the sample (53.1%) were female, 51% were single, and the average age was 44.3 years old. From clinic data, 36% (n = 35) of the users were in their first admission, and 36% (n = 35) met the criteria for frequent readmission. The results show that users with frequent readmissions significantly mentioned fewer people on whom they could rely. Alternatively, users in first admission lived with a significant larger number of people than the rest of the sample and had, with less frequency, bond with health services other than hospitals, using hospitals as an entrance door to mental health care. Regarding follow-up in the network, 34.4% of the sample did not visit often NPC services before admission, and only 4.1% used psychosocial rehabilitation services. We highlight the importance of hospitals as an articulation point in the network, and as strategic to connect with NPC services. In spite of international literature investigation and registration of the frequent psychiatric readmission phenomenon, we notice it is a field that needs greater investigation in Brazil.

  4. Biodegradation of pharmaceuticals from hospital wastewater in staged Moving Bed Biofilm Reactors (MBBR)

    DEFF Research Database (Denmark)

    Escola, Monica; Kumar Chhetri, Ravi; Ooi, Gordon

    2015-01-01

    conditions. In both campaigns general parameters DOC removal and nitrification mainly occurred in the first tank. In the batch campaign, first order kinetic degradation fitted the concentration of pharmaceuticals in each tank except for diclofenac, propranolol, citalopram and trimethoprim. These compounds...... the wastewater treatment. In both experiments, the first tank was observed to conduct the main part of the pharmaceuticals removal, matching the general parameters data. Overall, the MBBR was shown to treat hospital wastewater efficiently. However, for removal of recalcitrant pharmaceuticals, a polishing...... treatment such as ozonation might be needed....

  5. Two Years Experience With A Broadband Cable Network In An 1100-Bed Hospital

    Science.gov (United States)

    Cahill, Patrick T.; McCarthy, Robert H.; James, R.; Knowles, R.

    1985-09-01

    Early in 1983, a three-cable broadband network was installed in The New York Hospital-Cornell Medical Center using well-established cable-TV technology. This network was configured in a vertical tree topology. Currently, it extends over thirteen floors vertically and over two city blocks horizontally. It has now survived several major renovations on the various floors of the hospital. This survivability is a result of the siting of the main tree and of the isolation gained for the branches through the strategic placement of amplifiers. This communications system was designed in a modular fashion for later expansion and so that seven types of functions could be supported on the network without the addition of a new functional level disrupting the functions already existing on the system. Thus far, two functions (real-time image consultation and computer sharing) have been implemented, and two other functions (analog image storage and data base management) are in the prototype stage. Perhaps the most significant feature of our experience thus far has been the ease and utility of analog transmission and storage of images. This experience has lead us to postpone and even de-emphasize digital transmission and storage in our future plans.

  6. Psychiatric conditions and general practitioner attendance prior to HPV vaccination and the risk of referral to a specialized hospital setting because of suspected adverse events following HPV vaccination

    DEFF Research Database (Denmark)

    Lützen, Tina Hovgaard; Bech, Bodil Hammer; Mehlsen, Jesper

    2017-01-01

    conditions, general practitioner (GP) attendance and indicators of psychological symptoms prior to HPV vaccination and the risk of referral to an HPV center following vaccination. STUDY DESIGN AND SETTING: Register-based, matched case-control study. Cases were identified from five Danish, regional HPV...... registration. The total study population consisted of 8,976 women. RESULTS: Overall, women above 18 years who had been referred to an HPV center were more likely to have used psychiatric medication (odds ratio [OR]: 1.88 [95% CI 1.48-2.40]) or to have been hospitalized because of a psychiatric disorder within...... 5 years prior to the first vaccine registration (OR: 2.13 [95% CI 1.59-2.86]). Specifically, referred women were more likely to have used antipsychotics, antidepressants, attention deficit hyperactivity disorder (ADHD) medication or anxiolytics, and to have been hospitalized for affective disorders...

  7. Comparison of burden among family members of patients diagnosed with schizophrenia and bipolar disorder in a large acute psychiatric hospital in China

    OpenAIRE

    Zhou, Yanling; Rosenheck, Robert; Mohamed, Somaia; Ou, Yufen; Ning, Yuping; He, Hongbo

    2016-01-01

    Background The difference of burden between caregivers of acute patients with schizophrenia and bipolar disorder has not been well studied in China, a culture where family responsibility has a very high value. Our aim is to compare family burden in these two categories diagnosis and to identify predictors of family burden in a large psychiatric hospital in China. Methods Two hundred forty-three schizophrenic patients and 200 bipolar patients were enrolled in a cross-sectional study. Patients ...

  8. Policies on assisted suicide in Dutch psychiatric facilities.

    Science.gov (United States)

    Haverkate, I; van der Wal, G

    1998-01-01

    Recent jurisprudence in the Netherlands challenges psychiatric hospitals to formulate policies on how to approach requests for assisted suicide. This study examined whether such policies exist in Dutch psychiatric hospitals and general hospitals with psychiatric wards. The directors of patient care in 38 of the country's 52 psychiatric hospitals and 42 of the 59 general hospitals with psychiatric wards responded to a mail survey. Five psychiatric hospitals and six general hospitals had written policies. Almost half of the psychiatric hospitals had a verbal policy only. The majority of the hospitals with policies had a tolerant or permissive policy toward assisted suicide.

  9. Pénibilité du travail en hôpital psychiatrique Demanding work in a psychiatric hospital Dificultades del trabajo en un hospital psiquiátrico

    Directory of Open Access Journals (Sweden)

    Caroline Cintas

    2009-05-01

    Full Text Available L’objectif de cet article est de montrer que la pénibilité du travail des soignants en hôpital psychiatrique est moins due à la dangerosité des patients qu’à l’impossibilité perçue de faire un travail de qualité. Nous tentons donc à travers les discours des personnels interrogés par entretiens d’analyser les difficultés ressenties. Nous développons l’idée que cette pénibilité est liée à l’inquiétude que suscitent les changements organisationnels en cours. Cette explication de la pénibilité s’apparente davantage à un choc des cultures qui rend le décalage entre travail prescrit et réel plus prégnant. La discussion nous permet d’envisager le cadre théorique de la psychopathologie pour comprendre les résultats obtenus. Ainsi, c’est sous l’angle de l’organisation du travail que nous mettons en évidence les problèmes de pénibilité des soignants en psychiatrie. Nous formulons l’hypothèse que l’impact des changements étudiés à l’hôpital psychiatrique n’est pas spécifique à ce secteur ; ils ont, cependant, un retentissement plus fort dans des situations de travail déjà porteuses de violence. En effet, le contexte de l’hôpital psychiatrique met en évidence l’exacerbation des problèmes organisationnels généraux soulevés.The aim of this article is to show that the difficult work of nursing staff in psychiatric hospitals is less the result of the dangerousness of patients than the perceived impossibility of doing quality work. Through interviews with the staff, we attempt to analyze the difficulties felt. We develop the idea that this difficulty is related to the worry caused by current organizational changes. This explanation of the difficulty is more like a culture clash that emphasizes the difference between the prescribed work and the actual work. The discussion allows us to consider the theoretical framework of psychopathology in order to understand the results obtained

  10. Depression and suicide risk of outpatients at specialized hospitals for substance use disorder: comparison with depressive disorder patients at general psychiatric clinics.

    Science.gov (United States)

    Matsumoto, Toshihiko; Matsushita, Sachio; Okudaira, Kenichi; Naruse, Nobuya; Cho, Tetsuji; Muto, Takeo; Ashizawa, Takeshi; Konuma, Kyohei; Morita, Nobuaki; Ino, Aro

    2011-12-01

    The present study used a self-reporting questionnaire to compare suicide risk in outpatients being treated for substance use disorder at specialized hospitals to suicide risk in outpatients being treated for depressive disorder at general psychiatric clinics. Although patients in both groups exhibited an equal severity of depression, the patients with drug use disorder had a higher suicide risk than those with depressive disorder. These findings indicate that drug-abusing patients at specialized hospitals may have a severe risk of committing suicide, suggesting that carefully assessing the comorbidity of depression with drug abuse may be required for preventing suicide in drug-abusing patients.

  11. One-year risk of psychiatric hospitalization and associated treatment costs in bipolar disorder treated with atypical antipsychotics: a retrospective claims database analysis

    Directory of Open Access Journals (Sweden)

    Pikalov Andrei

    2011-01-01

    Full Text Available Abstract Background This study compared 1-year risk of psychiatric hospitalization and treatment costs in commercially insured patients with bipolar disorder, treated with aripiprazole, ziprasidone, olanzapine, quetiapine or risperidone. Methods This was a retrospective propensity score-matched cohort study using the Ingenix Lab/Rx integrated insurance claims dataset. Patients with bipolar disorder and 180 days of pre-index enrollment without antipsychotic exposure who received atypical antipsychotic agents were followed for up to 12 months following the initial antipsychotic prescription. The primary analysis used Cox proportional hazards regression to evaluate time-dependent risk of hospitalization, adjusting for age, sex and pre-index hospitalization. Generalized gamma regression compared post-index costs between treatment groups. Results Compared to aripiprazole, ziprasidone, olanzapine and quetiapine had higher risks for hospitalization (hazard ratio 1.96, 1.55 and 1.56, respectively; p Conclusions In commercially insured adults with bipolar disorder followed for 1 year after initiation of atypical antipsychotics, treatment with aripiprazole was associated with a lower risk of psychiatric hospitalization than ziprasidone, quetiapine, olanzapine and risperidone, although this did not reach significance with the latter. Aripiprazole was also associated with significantly lower total healthcare costs than quetiapine, but not the other comparators.

  12. Burden of psychiatric morbidity among attendees of a secondary level hospital in Northern India: Implications for integration of mental health care at subdistrict level.

    Science.gov (United States)

    Haldar, Partha; Sagar, Rajesh; Malhotra, Sumit; Kant, Shashi

    2017-01-01

    There is little information available on the type, pattern, trend, and demographic differentials of psychiatric cases attending a subdistrict level facility in India. Our objectives were to describe the sociodemographic profile of the patients availing the psychiatric outpatient department services and document the diagnosis. This study is based on a retrospective analysis of routinely recorded administrative data collected during psychiatry consultations that took place between January 2010 and June 2014, at the subdistrict level hospital, Ballabgarh, Faridabad district, Haryana, Northern India. The data were abstracted in Microsoft Excel, scrutinized for duplicates, and cleaned in terms of the International Classification of Diseases 10th Revision coding. Descriptive analysis was done for dependent variables and continuous variables were compared using independent t-test. A total of 2806 people (new registrations) were provided psychiatric consultations between January 2010 and June 2014. The mean age of males was 33.7 years (95% confidence interval [CI], 32.9, 34.5) and of females was 35.6 years (95% CI, 34.9, 36.3). Neurotic, stress-related, and somatoform disorders (F40-F48) comprised the major category of diagnoses with 661 cases (24%), followed by unspecified mental disorders (F99) with 528 cases (19%), mood (affective) disorders (F30-F39) with 448 cases (16%), and episodic and paroxysmal disorders (G40-G47) with 334 cases (12%). We reported an increase in level and trend in the monthly attendance of patients who required psychiatric at a secondary care hospital in Northern India. We suggest that setting up of mental health units only at district hospital might not be a sufficient health system's approach as has been envisaged under the District Mental Health Program.

  13. Silence of male child sexual abuse in India: Qualitative analysis of barriers for seeking psychiatric help in a multidisciplinary unit in a general hospital

    Science.gov (United States)

    Subramaniyan, Vyjayanthi Kanugodu Srinivasa; Reddy, Praveen; Chandra, Girish; Rao, Chandrika; Rao, T. S. Sathyanarayana

    2017-01-01

    Introduction: In 2007, Ministry of Women and Child Welfare, supported by United Nations Children's Fund, save the children and Prayas conducted a study to understand the magnitude of child abuse in India, they found that 53.22% children faced one or more forms of sexual abuse; among them, the number of boys abused was 52.94%. Aim: The aim of this study was to explore the barriers for seeking psychiatric help by qualitative analysis of stake holders of male victims of child abuse. Materials and Methods: All the statements made by the stakeholders regarding psychiatric assessment and treatment were recorded in each referral made to the psychiatrist. Semistructured interviews and in-depth interviews were conducted to explore the topic of understanding the need for psychiatric treatment to the victims. Results: Collaborative child response unit, a multidisciplinary team, to tackle child sexual abuse in a general hospital received three referrals of male child abuse among the 27 referrals in 20 months. The main theme of the barrier that was generated by interviewing the stakeholders of male child victims of abuse was the misconception of superiority of a male victim due to gender (patriarchy) an expectation that he will outgrow the experience. In-depth interviews of three cases of homosexual abuse explored the theme. Conclusion: Patriarchy is oppressing male children and acts as a barrier to seek psychiatric help in collaborative child response unit. PMID:28827868

  14. Mathari psychiatric hospital

    African Journals Online (AJOL)

    correlated with physical exhaustion, sleep disorder, substance abuse and family problems.3. Earlier studies report that risk factors for burnout included younger age, lack of role clarity, perceived inadequacy of resources, lack of personal support and workloadi5 On the other hand, hardiness, which is the individual's relative ...

  15. Mathari psychiatric hospital

    African Journals Online (AJOL)

    which includes: 1) Emotional exhaustion (feeling emotionally drained by one's contact with other people); 2). Depersonalization (negative feelings and cynical attitudes toward the recipient of one's services or care) and, 3). Reduced personal accomplishment (a tendency to negatively evaluate one's own work).1 Unlike ...

  16. Exposure to exhaled air from a sick occupant in a two-bed hospital room with mixing ventilation: effect of distance from sick occupant and air change rate

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Georgiev, Emanuil

    2011-01-01

    an exposed patient lying in the second bed. The doctor stood 0.55 m or 1.1 m facing the sick patient. The breathing mode of the “sick patient” was: exhalation mouth/inhalation nose. Tracer gas (R-134a) was mixed with the exhaled air. Important finding of this study is that airflow distribution......Full-scale measurements were performed in a climate chamber set as a two-bed hospital room, ventilated at 3, 6 and 12 h-1. Air temperature was kept constant at 22 °C. Two breathing thermal manikins were used: a sick patient lying on one side in one bed and a doctor. A thermal dummy mimicked...

  17. Exposure to Exhaled Air from a Sick Occupant in a Two-Bed Hospital Room with Mixing Ventilation: Effect of Posture of Doctor and Air Change Rate

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Barova, Mariya

    2013-01-01

    Full-scale measurements were performed in a climate chamber set as a two-bed hospital room, ventilated at 3, 6 and 12 ACH with overhead mixing ventilation. Air temperature was kept constant at 22 °C. Two breathing thermal manikins were used to mimic a sick patient lying on one side in one...... of the beds and a doctor. A thermal dummy mimicked an exposed patient lying in the second bed. The doctor either stood up or sat in a chair 0.55 m facing the sick patient. The ‘sick patient’ was exhaling through the mouth and inhaling from the nose. Tracer gas (R 134A) was mixed with the exhaled air to mimic...

  18. [Notes on the abandoned construction project for the provincial psychiatric hospital in Istria in the second half of the nineteenth century].

    Science.gov (United States)

    Cergna, Sandro

    2013-01-01

    Records about the need for a psychiatric hospital in Istria date back to the early 19th century). This article presents the views on the issue expressed by advisors of the National Council of Istria more than half a century later. It starts with the session held on 15 March 1864 and follows the development of views the National Council held, from the motion to build a new mental hospital in at the feet of Monte Ghiro to the actual construction of the "Santorio Santorio" Provincial Hospital (still existing) at the hill of St Mihovil in Pula. The paper also investigates the reasons why the Council advisors abandoned the project of building the psychiatric hospital in Istria in favour of a home for the mentally ill in Trieste, where many Istrian patients were provided accommodation from as early as the end of the eighteenth century until the end of World War II. During the rule of the Habsburg Monarchy, many other cities of the Empire hospitalised mental patients from Istria, whose pitiful condition was reported by Matteo Campitelli at the session of the Istrian Provincial Parliament in 1886.

  19. A decentralised model of psychiatric care: Profile, length of stay and outcome of mental healthcare users admitted to a district-level public hospital in the Western Cape

    Directory of Open Access Journals (Sweden)

    Eileen Thomas

    2015-02-01

    Full Text Available Background. There is a lack of studies assessing the profile and outcome of psychiatric patients at entry-level public hospitals that are prescribed by the Mental Health Care Act to provide a decentralised model of psychiatric care. Objective. To assess the demographic and clinical profile as well as length of stay and outcomes of mental healthcare users admitted to a district-level public hospital in the Western Cape.  Method. Demographic data, clinical diagnosis, length of stay, referral profile and outcomes of patients (N=487 admitted to Helderberg Hospital during the period 1 January 2011 - 31 December 2011 were collected.  Results. Psychotic disorders were the most prevalent (n=287, 59% diagnoses, while 228 (47% of admission episodes had comorbid/secondary diagnoses. Substance use disorders were present in 184 (38% of admission episodes, 37 (57% of readmissions and 19 (61% of abscondments. Most admission episodes (n=372, 76% were discharged without referral to specialist/tertiary care.  Conclusion. Methamphetamine use places a significant burden on the provision of mental healthcare services at entry-level care. Recommendations for improving service delivery at this district-level public hospital are provided.

  20. A nurse-physician co-leadership model in psychiatric hospitals: results of a survey among leading staff members in three sites.

    Science.gov (United States)

    Steinert, Tilman; Goebel, Rita; Rieger, Wolfgang

    2006-12-01

    In three psychiatric hospitals in Baden-Wuerttemberg, Germany, a physician-nurse shared leadership model was implemented in 1997 by the hospital management. The whole hospital, departments, and single wards are led each by a leadership team consisting of a physician, psychologist or social worker and a nurse, being responsible for organization, staff, and budgets. The consequences for staff opinion in leadership positions were evaluated. All 165 leading staff members of all professional groups were anonymously interviewed with a questionnaire containing 45 items regarding their satisfaction with this new leadership model. The response rate was 79.4%. Overall, the leading staff members were satisfied with the shared leadership model both in their own clinical practice and in general. Non-medical staff members were significantly more in favour of several aspects of shared leadership than physicians, but even the latter reported to be generally satisfied. However, both professional groups estimated leading positions to be only modestly attractive. The results yield some evidence that the change from traditional leadership models to the physician-nurse shared leadership model may have advantages in the management of psychiatric hospitals.

  1. Suicídio de internos em um hospital de custódia e tratamento Suicide among inmates hospitalized in a Forensic Psychiatric Hospital

    Directory of Open Access Journals (Sweden)

    Elizabete Rodrigues Coelho

    2009-01-01

    Full Text Available OBJETIVO: Descrever o perfil dos internos suicidas do Instituto Psiquiátrico Forense (IPF de Porto Alegre em duas décadas. MÉTODO: Foi realizado um estudo retrospectivo dos registros dos internos com óbito por suicídio. Os dados foram analisados por meio da estatística descritiva. RESULTADOS: Dos 20 casos de suicídio, 70% cumpriam medida de segurança, 70% eram réus primários, 80% dos crimes era contra a pessoa; a maioria (45% dos suicídios foi cometida durante a madrugada e 40% dos casos ocorreram com internos que estavam de 1 a 9 anos na instituição; 90% eram do sexo masculino, 55% tinham idade entre 20 e 39 anos, 70% eram solteiros, 60% não tinham filhos, 85% eram naturais do interior do RS, 25% não tinham profissão, 84,2% tinham até o Ensino Fundamental; 55% dos casos tinham diagnóstico de esquizofrenia. Em 75% dos casos a morte ocorreu por enforcamento. CONCLUSÕES: Os dados apontam para o seguinte perfil: homem, solteiro, sem filhos, do interior do Estado, com baixa qualificação profissional e pouca escolaridade. Os fatores psicossociais encontrados foram transtorno mental grave, uso de drogas e/ou álcool, baixo suporte social e familiar e tentativas anteriores de suicídio.OBJECTIVE: To describe the profile of suicides inmates at a Forensic Psychiatric Institute in Porto Alegre from two decades. METHOD: It was a retrospective study of the inmates records with a history of death by suicide. The data were analyzed through descriptive statistics. RESULTS: There was a total of 20 cases of suicide, 70% were involuntary commitment, 70% were primary defendants, 80% of crimes against persons, the majority (45% of suicides were committed in the daybreak period and 40% of the cases occurred in inmates that were from 1 to 9 years in the institution. They also had the following characteristics: 90% were male, 55% were between 20 and 39 years old, 70% single, 60% childless man, 85% of the subjects were originally from small towns

  2. Economic cost and quality of life of family caregivers of schizophrenic patients attending psychiatric hospitals in Ghana.

    Science.gov (United States)

    Opoku-Boateng, Yaw Nyarko; Kretchy, Irene A; Aryeetey, Genevieve Cecilia; Dwomoh, Duah; Decker, Sybil; Agyemang, Samuel Agyei; Tozan, Yesim; Aikins, Moses; Nonvignon, Justice

    2017-12-04

    Low and middle income countries face many challenges in meeting their populations' mental health care needs. Though family caregiving is crucial to the management of severe mental health disabilities, such as schizophrenia, the economic costs borne by family caregivers often go unnoticed. In this study, we estimated the household economic costs of schizophrenia and quality of life of family caregivers in Ghana. We used a cost of illness analysis approach. Quality of life (QoL) was assessed using the abridged WHO Quality of Life (WHOQOL-BREF) tool. Cross-sectional data were collected from 442 caregivers of patients diagnosed with schizophrenia at least six months prior to the study and who received consultation in any of the three psychiatric hospitals in Ghana. Economic costs were categorized as direct costs (including medical and non-medical costs of seeking care), indirect costs (productivity losses to caregivers) and intangible costs (non-monetary costs such as stigma and pain). Direct costs included costs of medical supplies, consultations, and travel. Indirect costs were estimated as value of productive time lost (in hours) to primary caregivers. Intangible costs were assessed using the Zarit Burden Interview (ZBI). We employed multiple regression models to assess the covariates of costs, caregiver burden, and QoL. Total monthly cost to caregivers was US$ 273.28, on average. Key drivers of direct costs were medications (50%) and transportation (27%). Direct costs per caregiver represented 31% of the reported monthly earnings. Mean caregiver burden (measured by the ZBI) was 16.95 on a scale of 0-48, with 49% of caregivers reporting high burden. Mean QoL of caregivers was 28.2 (range: 19.6-34.8) out of 100. Better educated caregivers reported lower indirect costs and better QoL. Caregivers with higher severity of depression, anxiety and stress reported higher caregiver burden and lower QoL. Males reported better QoL. These findings highlight the high household

  3. Psychiatric inpatient care at a county hospital before and after the inception of a university-affiliated psychiatry residency program.

    Science.gov (United States)

    Woo, Benjamin K P; Ma, Albert Y

    2007-09-01

    The University of California, Los Angeles (UCLA), along with Kern Medical Center (KMC) and Kern County Mental Health (KCMH), established a new psychiatry residency program in 2004. In this study, we compared psychiatric care at a county psychiatric facility serving a population of 760,000 inhabitants before and after the initiation of this psychiatry residency program. Medical charts for all patients admitted to the psychiatric inpatient service during the year before the inception of the psychiatry residency program (2003-2004) and during the first year in which there was full implementation of residents after inception of the psychiatry residency program (2005-2006) were reviewed. Baseline characteristics, demographics, and various outcomes of the two groups were compared. After the residency program was established, the mean length of stay increased from 8.8 to 9.8 days (p psychiatric inpatient setting. More research is needed to identify strategies, such as guidelines to eliminate over-utilization of resources and methods to improve residents' competency, that may successfully enhance the quality of care provided by residents to psychiatric inpatients.

  4. Effects of two hospital bed design features on physical demands and usability during brake engagement and patient transportation: a repeated measures experimental study.

    Science.gov (United States)

    Kim, Sunwook; Barker, Linsey M; Jia, Bochen; Agnew, Michael J; Nussbaum, Maury A

    2009-03-01

    Work-related musculoskeletal disorders (WMSDs) are prevalent among healthcare workers worldwide. While existing research has focused on patient-handling techniques during activities which require direct patient contact (e.g., patient transfer), nursing tasks also involve other patient-handling activities, such as engaging bed brakes and transporting patients in beds, which could render healthcare workers at risk of developing WMSDs. Effectiveness of hospital bed design features (brake pedal location and steering-assistance) was evaluated in terms of physical demands and usability during brake engagement and patient transportation tasks. Two laboratory-based studies were conducted. In simulated brake engagement tasks, three brake pedal locations (head-end vs. foot-end vs. side of a bed) and two hands conditions (hands-free vs. hands-occupied) were manipulated. Additionally, both in-room and corridor patient transportation tasks were simulated, in which activation of steering-assistance features (5th wheel and/or front wheel caster lock) and two patient masses were manipulated. Nine novice participants were recruited from the local student population and community for each study. During brake engagement, trunk flexion angle, task completion time, and questionnaires were used to quantify postural comfort and usability. For patient transportation, dependent measures were hand forces and questionnaire responses. Brake pedal locations and steering-assistance features in hospital beds had significant effects on physical demands and usability during brake engagement and patient transportation tasks. Specifically, a brake pedal at the head-end of a bed increased trunk flexion by 74-224% and completion time by 53-74%, compared to other pedal locations. Participants reported greater overall perceived difficulty and less postural comfort with the brake pedal at the head-end. During in-room transportation, participants generally reported "Neither Low nor High" physical demands

  5. The importance of relationships in mental health care: A qualitative study of service users' experiences of psychiatric hospital admission in the UK

    Directory of Open Access Journals (Sweden)

    Slade Mike

    2008-04-01

    Full Text Available Abstract Background While a number of studies have looked at life on service users' experiences of life on psychiatric wards, no research exists that have approached these experiences from the user perspective since the introduction of community care. Methods This user-led study uses a participatory approach to develop an understanding of the processes and themes which define the user experience of hospitalisation. Nineteen service users who had all had inpatient stays in psychiatric hospitals in London were interviewed in the community. Results Relationships formed the core of service users' experiences. Three further codes, treatment, freedom and environment defined the role of hospital and its physical aspects. Themes of communication, safety, trust, coercion, and cultural competency contributed to the concept of relationships. Conclusion Relationships with an individual which comprised effective communication, cultural sensitivity, and the absence of coercion resulted in that person being attributed with a sense of trust. This resulted in the patient experiencing the hospital as a place of safety in terms of risk from other patients and staff. Barriers to positive relationships included ineffective and negative communication, a lack of trust, a lack of safety in terms of staff as ineffective in preventing violence, and as perpetrators themselves, and the use of coercion by staff. This unique perspective both acts as a source of triangulation with previous studies and highlights the importance of the therapeutic relationship in providing a safe and therapeutic milieu for the treatment of people with acute mental health problems.

  6. A recusa à desospitalização psiquiátrica: um estudo qualitativo Refusal of psychiatric de-hospitalization: a qualitative study

    Directory of Open Access Journals (Sweden)

    Vanessa Machado

    2005-10-01

    Full Text Available O presente trabalho justifica-se à medida que se constata o número elevado de pessoas internadas em hospital psiquiátrico, embora exista a atual proposta de desospitalização. Este estudo objetivou analisar os fatores envolvidos na recusa da desospitalização a partir do relato de pacientes internos, em um hospital psiquiátrico, com diagnóstico de esquizofrenia e capacidade verbal preservada. Segundo escolha aleatória, foi realizada uma entrevista semi-estruturada com seis pacientes. As entrevistas, posteriormente, foram submetidas à análise de conteúdo temática. Após leitura das transcrições, foram extraídos os seguintes núcleos temáticos: a sensação de liberdade ainda que internado, a proteção concreta e subjetiva que o hospital oferece, o modo de vida asilar incorporado pelos pacientes. Os achados podem contribuir para a elaboração de políticas públicas em saúde mental e para a compreensão da dinâmica subjetiva dessa população.This study is justified based on the large number of individuals currently institutionalized in psychiatric hospitals in Brazil, despite the current proposal for de-hospitalization. The study focused on factors involved in the refusal of de-hospitalization, based on reports by patients in a psychiatric hospital with a diagnosis of schizophrenia and preserved verbal capacity. Based on a random selection, six patients answered a semi-structured interview. The interviews were later submitted to thematic content analysis. After reading the transcriptions, the following key thematic contents were extracted: a feeling of freedom even while hospitalized, the material and subjective protection provided by the hospital, and the way institutionalized hospital life is incorporated by patients. The findings can contribute to the drafting of public policies in mental health and to the understanding of this population's subjective dynamics.

  7. Changing pattern of clinical profile of first-contact patients attending outpatient services at a general hospital psychiatric unit in India over the last 50 years

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    Mamta Sood

    2017-01-01

    Full Text Available Introduction: Over the last five decades, general hospital psychiatric units (GHPUs have become important mental health service setups in India. The present study reports on the changing clinical profile of the patients attending the GHPUs over the last five decades. Methodology: A total of 500 subjects, attending a GHPU were recruited prospectively for the study. The subjects were assessed using a semistructured proforma. A comparison was made with similar studies conducted in GHPU settings over the last five decades. Results: In the present study, neurotic, stress-related and somatoform disorders formed the commonest diagnostic group (33% followed by psychotic disorders (17% and mood disorders (15%. The diagnostic distribution is broadly similar to the studies done at different times in the last 5 decades, though there were lesser number of patients with mental retardation and organic brain syndrome. About 15% of the subjects did not have a psychiatric diagnosis. Conclusion: GHPUs in India attend to a broad range of patients with psychiatric disorders.

  8. Job Stress and Self-Efficacy among Psychiatric Nursing Working in Mental Health Hospitals at Cairo, Egypt

    Science.gov (United States)

    Zaki, Rania. A.

    2016-01-01

    Nursing stress is considered a problem that affects the practice worldwide. Job stress is a harmful response physically and emotionally when the nurses' skills, resources, and needs could not fulfill the requirement of the job. This study was aimed to assess job stress and self-efficacy among psychiatric nursing working in mental health hospitals…

  9. Prevalence of Attention Deficit Hyperactivity among Children Attending Outpatient Clinic in Psychiatric Teaching Hospital in Erbil City

    Science.gov (United States)

    Shakir, Lana Nabeel; Sulaiman, Karwan Hawez

    2016-01-01

    Background and objectives: Attention deficit hyperactivity disorder is one of the common psychiatric disorder in childhood and it affects on children socially and academically. The aim of this study is to find out the prevalence of Attention deficit hyperactivity disorder among the studied population, describe its association with certain…

  10. Changes in Inpatient and Postdischarge Suicide Rates in a Nationwide Cohort of Danish Psychiatric Inpatients, 1998-2005

    DEFF Research Database (Denmark)

    Madsen, Trine; Nordentoft, Merete

    2013-01-01

    A reduction in the number of inpatient beds as well as shorter admissions have aroused concern that tendencies to deinstitutionalize may increase the suicide rate for psychiatric patients who have been hospitalized. One study indicates that a decreasing inpatient suicide rate may actually reflect...... a transfer to an increasing postdischarge suicide rate; however, uncertainties exist about this transfer, since it is not well studied. The objectives of this study were to estimate adjusted changes over time in suicide rates among psychiatric inpatients and recently discharged psychiatric patients...

  11. The virtual institution: cross-sectional length of stay in general adult and forensic psychiatry beds.

    Science.gov (United States)

    Sharma, Anand; Dunn, Warren; O'Toole, Clare; Kennedy, Harry G

    2015-01-01

    Length of stay in psychiatric hospitals interests health service planners, economists and clinicians. At a systems level it is preferable to study general adult and forensic psychiatric beds together since these are likely to be inter-dependent. We examined whether patients were placed according to specialist need or according to their cross-sectional length of stay. A one night census of all registered mental nursing home (RMNH) beds was carried out for a defined catchment area of 1.2 m population in north London in November 1999. This included all public sector psychiatric hospital beds, independent sector and forensic beds in and outside the catchment area. Cross-sectional length of stay was defined as time since the date of admission from the community. Log rank (Mantel-Cox) Chi squared was used to test for differences between groups and hierarchical logistic regression for statistical modelling. There were 1,085 occupied psychiatric beds. Cross-sectional LOS was greater than 365 days in 43.5%. Forensic beds had longer cross-sectional LOS than general beds. LOS increased with the level of therapeutic security from open through low, medium and high secure. Cross-sectional LOS was shorter for open hospital beds than community RMNH beds, shorter for informal patients than those detained under civil mental health law, and longest for forensic detentions. Longest cross-sectional LOS were for patients placed in RMNHs in the community, 10.7% of whom were 'forensic' as were 25.4% of low secure patients. Designated length of stay (acute, rehab/medium term and long term) was also associated with increasing cross-sectional LOS. In regression analysis only three variables contributed to a model of cross-sectional LOS, commissioning status (general or forensic), designated length of stay and designated level of therapeutic security. Studying cross-sectional LOS for whole systems (all psychiatric beds) is essential for operational health service management. At the time of

  12. Use of the Suicide Status Form-II to investigate correlates of suicide risk factors in psychiatrically hospitalized children and adolescents

    Science.gov (United States)

    Romanowicz, Magdalena; O’Connor, Stephen S.; Schak, Kathryn M.; Swintak, Cosima C.; Lineberry, Timothy W.

    2013-01-01

    Background Suicide is the third leading cause of death in the United States for youth 12–17 years or age. Acute psychiatric hospitalization represents a clear worst point clinically and acute suicide risk is the most common reason for psychiatric admission. We sought to determine factors associated with differences in individual suicide risk assessment for children and adolescents during acute psychiatric admission. Methods Study participants were 1,153 youth consecutively admitted to an inpatient psychiatry unit who completed a self-administered Suicide Status Form (SSF) within 24 hours of admission. Additional information on suicide risk factors was obtained through medical chart abstraction. Results Females reported significantly greater psychological pain, stress, hopelessness, and self-hate on the SSF and were significantly more likely to have made a suicide attempt just prior to the index hospital admission (OR = 1.59, SE = .29; CI = 1.12–2.26), report a family history of suicide (OR = 2.02, SE = .33; CI = 1.47–2.78), and had experienced a greater number of inpatient psychiatry admissions related to suicidal ideation (RR = 1.33, SE = .13; CI = 1.10–1.61). High school aged youth and those with a primary diagnosis of depression displayed consistently elevated SSF scores and risk factors for suicide compared to comparison groups. Limitations Diagnosis was determined through chart abstraction. Responses to access to firearm question had missing data for 46% of the total sample. Conclusions Systematic administration of a suicide-specific measure at admission may help clinicians improve identification of suicide risk factors in youth in inpatient psychiatry settings. PMID:23856283

  13. Development of Hiccup in Male Patients Hospitalized in a Psychiatric Ward: Is it Specifically Related to the Aripiprazole-Benzodiazepine Combination?

    Science.gov (United States)

    Caloro, Matteo; Pucci, Daniela; Calabrò, Giuseppa; de Pisa, Eleonora; Mancinelli, Iginia; Rosini, Enrico; Montebovi, Franco; De Filippis, Sergio; Telesforo, Carla Ludovica; Cuomo, Ilaria; Kotzalidis, Georgios D; Girardi, Paolo

    2016-01-01

    The aim of this study was to identify hiccup cases among patients hospitalized in a psychiatric ward and focus on their treatment, so to establish intervention risk. We reviewed records of 354 consecutively admitted patients during the year 2013 to identify hiccup cases. Hiccup occurred in 7 patients on both aripiprazole and benzodiazepines and in one on delorazepam. No patient on aripiprazole alone developed hiccup. No patient on drugs other than aripiprazole or benzodiazepines developed hiccup. The symptom subsided in 3 cases upon discontinuing aripiprazole and in 5 cases after discontinuing the benzodiazepine (including the case on delorazepam alone); in 2 cases of persistent hiccup, the symptom resolved after adding the calcium channel blocker, pregabalin. All patients developing hiccup were male. There was a 70-fold increase in the risk for developing hiccup in the aripiprazole/benzodiazepine intake condition versus all other conditions, and it further increased if limiting to the male sex. The retrospective nature of the study was its limitation. Hospitalized psychiatric patients on both aripiprazole and benzodiazepines may be at significant risk of hiccup. This clinical awareness could lead to antipsychotic and/or benzodiazepine discontinuation or switch or to the addition of calcium channel blocker inhibitors.

  14. Who’s Boarding in the Psychiatric Emergency Service?

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    Scott A. Simpson

    2014-09-01

    Full Text Available Introduction: When a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a “boarder.” The psychiatric emergency service (PES has been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics of adult PES boarders have not been described. Methods: We electronically extracted electronic medical records for adult patients presenting to the PES in an urban county safety-net hospital over 12 months. Correlative analyses included Student’s t-tests and multivariate regression. Results: 521 of 5363 patient encounters (9.7% resulted in boarding. Compared to non-boarding encounters, boarding patient encounters were associated with diagnoses of a primary psychotic, anxiety, or personality disorder, or a bipolar manic/mixed episode. Boarders were also more likely to be referred by family, friends or providers than self-referred; arrive in restraints; experience restraint/ seclusion in the PES; or be referred for involuntary hospitalization. Boarders were more likely to present to the PES on the weekend. Substance use was common, but only tobacco use was more likely associated with boarding status in multivariate analysis. Conclusion: Boarding is common in the PES, and boarders have substantial psychiatric morbidity requiring treatment during extended PES stays. We question the appropriateness of PES boarding for seriously ill psychiatric patients. [West J Emerg Med. 2014;15(6:669-674

  15. Narratives of change and reform processes: global and local transactions in French psychiatric hospital reform after the Second World War.

    Science.gov (United States)

    Henckes, Nicolas

    2009-02-01

    As with the rest of biomedicine, psychiatry has, since the Second World War, developed under the strong influence of the transnational accumulation of a whole series of practices and knowledge. Anthropology has taught us to pay attention to the transactions between local-level actors and those operating at the global level in the construction of this new world of medicine. This article examines the role played by the recommendations of the WHO Expert Committee of Mental Health in the reform of the French mental health system during the 1950s. Rooted in the experience of practitioners and administrators participating in the process of reforming local psychiatric systems, the recommendations of the WHO Expert Committee developed a new vision of regulating psychiatry, based on professionalism and an idea of a normativity of the doctor-patient relation. This article shows how, by mobilizing the WHO reports' recommendations, French administrators and doctors succeeded in creating a typically French object: "the psychiatric sector", founded on elaborating a new mandate for the psychiatric profession. The article thus questions the deinstitutionalization model as an explanation of transformations of the structure of the French psychiatry system in the post-war period.

  16. Banho No Leito: o Discurso do Sujeito Coletivo de Pacientes Hospitalizados / Bath In Bed: the Collective Subject Discourse of Hospitalized Patients

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    Bruna Coelho Nepomuceno

    2014-03-01

    Full Text Available Objetivo: conhecer os significados e os sentimentos dos pacientes quanto ao fato de tomar banho no leito. Materiais e métodos: estudo de abordagem qualitativa e exploratória, tendo sido entrevistados 20 pacientes hospitalizados. Para a coleta de dados utilizou-se um roteiro de entrevista semiestruturada, gravada e transcrita na íntegra. Foi utilizado o método do Discurso do Sujeito Coletivo para análise dos dados. Resultados: para os pacientes hospitalizados, banho no leito significa “impossibilidade de locomover” e “seguro”. Os sentimentos dos pacientes hospitalizados variaram entre “vergonha” e “incapacidade”. Conclusão: os discursos encontrados podem cooperar para a melhoria da abordagem da equipe de enfermagem ao realizar um cuidado cotidiano e básico da vida diária. Objective: to identify the meanings and feelings of patients considering the action of to take a bath in bed. Materials and methods: qualitative and exploratory study, 20 patients hospitalized were interviewed. To collect data, we used semi-structured interviews, recorded and transcribed in full. We used the method of the Collective Subject Discourse for data analysis. Results: for hospitalized patients, bathing in bed means "inability to move" and "safe". The feelings of hospitalized patients ranged from "shame" and "disability." Conclusion: the discourses found can cooperate to improve the approach of the nursing staff by performing a basic daily care and daily life.

  17. Hospital-at-home Integrated Care Programme for the management of disabling health crises in older patients: comparison with bed-based Intermediate Care.

    Science.gov (United States)

    Mas, Miquel À; Inzitari, Marco; Sabaté, Sergi; Santaeugènia, Sebastià J; Miralles, Ramón

    2017-11-01

    to analyse the clinical impact of a home-based Intermediate Care model in the Catalan health system, comparing it with usual bed-based care. quasi-experimental longitudinal study. hospital Municipal de Badalona and El Carme Intermediate Care Hospital, Badalona, Catalonia, Spain. we included older patients with medical and orthopaedic disabling health crises in need of Comprehensive Geriatric Assessment (CGA) and rehabilitation. a CGA-based hospital-at-home Integrated Care Programme (acute care and rehabilitation) was compared with a propensity score matched cohort of contemporary patients attended by usual inpatient hospital care (acute care plus intermediate care hospitalisation), for the management of medical and orthopaedics processes. Main outcomes measures were: (a) Health crisis resolution (referral to primary care at the end of the intervention); (b) functional resolution: relative functional gain (functional gain/functional loss) ≥ 0.35; and (c) favourable crisis resolution (health + functional) = a + b. We compared between-groups outcomes using uni/multivariable logistic regression models. clinical characteristics were similar between home-based and bed-based groups. Acute stay was shorter in home group: 6.1 (5.3-6.9) versus 11.2 (10.5-11.9) days, P home-based scheme showed better results on functional resolution 79.1% (versus 75.2%), OR 1.62 (1.09-2.41) and on favourable crisis resolution 73.8% (versus 69.6%), OR 1.54 (1.06-2.22), with shorter length of intervention, with a reduction of -5.72 (-9.75 and -1.69) days. in our study, the extended CGA-based hospital-at-home programme was associated with shorter stay and favourable clinical outcomes. Future studies might test this intervention to the whole Catalan integrated care system.

  18. Serviço de Emergência Psiquiátrica em hospital geral: estudo retrospectivo Servicio de emergencia psiquiátrica en hospital general: estudio retrospectivo Emergency psychiatric service in general hospitals: a retrospective study

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    Fernando Sérgio Pereira de Sousa

    2010-09-01

    SEPHG, 43,45% de tales pacientes fueron derivados al CAPS-ad. Se desprende de los resultados cuán imprescindibles son los servicios de salud mental.The Emergency Psychiatric Service in General Hospitals (SEPHG, acronym in Portuguese is a service included in the psychiatric reform movement. The purpose of the present study was to characterize patients with psychological distress treated at the Dr. Estevam SEPHG, located in Sobral, Ceará state. This exploratory study was performed using documental analyses with a quantitative approach, and involved 191 clients treated at the referred SEPHG from January to December 2007. Data collection was performed using a client register book, which contained information obtained from the patients' medical record. There was a predominance of male patients (70.15%, aged 30-49 years (48.71% and single (74.86%. Most patients were from the city of Sobral (69.64%. In 42.40% of cases, the diagnosis was of alcohol use/abuse. Most clients (66.50% sought the service voluntarily. After being evaluated at the SEPHG, 43.45% of patients were referred to the local Center for Psychosocial Care -Alcohol and other Drugs. The results emphasize the importance of mental health.

  19. Snapshot of the supports of communication used by patients at a French psychiatric hospital: a digital or social division?

    Science.gov (United States)

    Girard, Murielle; Nubukpo, Philippe; Malauzat, Dominique

    2017-02-01

    The role of information and communications technology is becoming increasingly prevalent in daily life and in the organization of medical care: are some people being left out? To evaluate access to and the uses of communication resources by psychiatric patients, focusing on the means of communication (e.g. mobile phones and computers), access and frequency of internet use. A questionnaire was distributed, over a period of 1 week, to inpatients or day hospitalised patients aged over 12 years in all care units. Access to and the uses of modern communication resources were lower than in the general population. Among places and means of internet consultation, the personal computer was most often cited, but only by 34%, and the use of mobile phones is still not widespread. Finally, day hospitalised subjects, the elderly, or subjects being treated in the psychosis care sector use internet and technology the least. Some differences exist between this population with mental illness and the general population on the use of new communication technologies. The possibility of integrating these techniques in individualized psychiatric care requires prior equipment and/or updates.

  20. Mental disorders in early adulthood and later psychiatric hospital admissions in relation to mortality in a cohort study of a million men

    Science.gov (United States)

    Gale, Catharine R; Batty, G David; Osborn, David P J; Tynelius, Per; Whitley, Elise; Rasmussen, Finn

    2014-01-01

    Context Mental disorders have been associated with increased mortality, but the evidence is primarily based on hospital admissions for psychoses. The underlying mechanisms are unclear. Objective To investigate whether the risks of death associated with mental disorders diagnosed in young men are similar to those associated with admission for these disorders, and to examine the role of confounding or mediating factors. Design Prospective cohort study in which mental disorders were assessed by psychiatric interview during a medical examination on conscription for military service at a mean age of 18.3 years and data on psychiatric hospital admissions and mortality during a mean 22.6 years of follow-up were obtained from national registers. Setting Sweden. Participants 1,095,338 men conscripted between 1969 and 1994. Main outcome measure All-cause mortality according to diagnoses of schizophrenia, other non-affective psychoses, bipolar or depressive disorders, neurotic/adjustment disorders, personality disorders, alcohol-related or other substance use disorders at conscription and on hospital admission. Results Diagnosis of mental disorder at conscription or on hospital admission was associated with increased mortality. Age-adjusted hazard ratios (95% confidence intervals) according to diagnoses at conscription ranged from 1.81 (1.54, 2.10) (depressive disorders) to 5.55 (1.79, 17.2) (bipolar disorders). The equivalent figures according to hospital diagnoses ranged from 5.46 (5.06, 5.89) (neurotic/adjustment disorders) to 11.2 (10.4, 12.0) (other substance use disorders) in men born 1951-8 and increased in men born later. Adjustment for early-life socioeconomic status, body mass index and blood pressure had little effect on these associations, but they were partially attenuated by adjustment for smoking, alcohol intake, intelligence, education and late-life socioeconomic position. These associations were not primarily due to deaths from suicide. Conclusions The

  1. Bed-integrated local exhaust ventilation system combined with local air cleaning for improved IAQ in hospital patient rooms

    DEFF Research Database (Denmark)

    Bivolarova, Mariya Petrova; Melikov, Arsen Krikor; Mizutani, Chiyomi

    2016-01-01

    micro-environment was exhausted. Two modes of operation were studied: 1) the exhausted polluted air was discharged out of the room and 2) the polluted air was cleaned by the ACF material installed inside the mattress and recirculated back into the room. Both modes of operation efficiently reduced......The performance of a ventilated mattress (VM) used as a bed-integrated local exhaust ventilation system combined with air cleaning fabric (acid-treated activated carbon fibre (ACF) fabric) was developed and studied. The separate and combined effect of the VM and the local air cleaning for reducing....... The patient's body was covered with either a cotton sheet or with the ACF material used as a blanket. Ammonia gas released from the patient's groins simulated the body generated bio-effluents. At the location of the groins the surface area of the VM was perforated through which the contaminated air of the bed...

  2. [Changes of the psychogeriatric inpatient care at the University Psychiatric Hospitals in Basel following the constitution of an outpatient care service for the elderly].

    Science.gov (United States)

    Eren, Gökhan; Hiss, Barbara; Maeck, Lienhard; Stoppe, Gabriela

    2014-05-01

    10-year follow-up of the psychogeriatric inpatient care at the University Psychiatric Hospitals Basel following the establishment of an outpatient care service for the elderly (ADA). Standardized chart review of a random sample of psychogeriatric cases (≥ 65 y) of the years 1997 and 2007 (n = 100 each) in terms of socio-demographic, diagnostic, therapeutic und administrative data. The number of patients with contact to both inpatient and outpatient services prior to admission increased. There was no change regarding the amount of unvoluntary admissions. As expected more complex cases were treated. The case management showed changes towards greater guideline conformity. The 10-year follow-up shows a better outpatient treatment and the provision of inpatient facilities for complex multimorbid and emergency patients. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Evaluation of an open-rota system in a Danish psychiatric hospital: a mechanism for improving job satisfaction and work-life balance.

    Science.gov (United States)

    Pryce, Joanna; Albertsen, Karen; Nielsen, Karina

    2006-05-01

    To evaluate the impact of an open-rota scheduling system on the health, work-life balance and job satisfaction of nurses working in a psychiatric ward in Denmark. The effects of shift rotation and scheduling are well known; however, little is known about the wider benefits of open-rota systems. Method A structured questionnaire was distributed to control and intervention groups preintervention and postintervention (20 months). Nurses within the intervention group trialed an open-rota system in which nurses designed their own work-rest schedules. Nurses in the intervention group reported that they were more satisfied with their work hours, less likely to swap their shift when working within the open-rota system and reported significant increases in work-life balance, job satisfaction, social support and community spirit when compared with nurses in the control groups. The ownership and choice over work-rest schedules has benefits for nurses, and potentially the hospital.

  4. [Special observation on psychiatric patients on acute inpatient wards at the Division of Psychiatry, Landspítali-University Hospital in Iceland, attitudes of patients and staff].

    Science.gov (United States)

    Snorrason, Jón; Grímsdóttir, Gudrún Ulfhildur; Sigurdsson, Jón Fridrik

    2007-12-01

    Special observation (constant observation) of patients is common on psychiatric wards, both in Iceland and abroad, but very few studies have been conducted on their therapeutic value. The objective was to investigate the extent and nature of special observation on emergency wards at the division of psychiatry at the Landspitali-University Hospital in Iceland as well as the attitudes of patients and staff toward special observation. Information about patients on special observation was recorded over a three months period. Patients were interviewed with a standardised eleven questions interview shortly after the observation finished in order to investigate their attitudes toward the observation. Also, members of staff from each ward were asked to answer eight questions about their attitudes toward special observation in general. The Ethics Committee of Landspitali - University Hospital gave its permission for the study. During the research period observation was used for 157 patients, which is 31% of the total number of patients admitted during that period. Most of the patients (83%) were on 5-15 minutes observation, 25 per cent on close observation and 11 percent on suicide or constant observation. The majority of the patients claimed that security was the most important aspect of being on special observation, independent of which type of observation they were, and only one fifth felt that the company of staff was most important. The staff members on the other hand claimed that concern for the patient, respect and companionship were most important for the patients, independent of the type of observation used. The extent, nature and process of observation on acute inpatient wards in Iceland seems to be comparable to other studies from abroad. In view of the importance of special observations in psychiatric emergency care and their influence on patients' private life it is important to develop and implement clinical guidelines about their use.

  5. A família e a internação psiquiátrica em hospital geral La familia y la internación psiquiátrica en hospital general Patient's relatives and the psychiatric hospitalization in a general hospital

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    Rita Mello de Mello

    2011-06-01

    profesionales de la salud mental reflexionen sobre sus acciones y sobre el involucramiento de la familia en una unidad de internación psiquiátrica en un hospital general.Qualitative study based upon Alfred Schutz' phenomenological sociology approach aims at identifying the reasons for psychiatric hospitalization in a general hospital by patients' relatives. Fourteen relatives having one of the family members hospitalized in a general hospital psychiatric unit from August through October 2009 were interviewed. The guiding question of phenomenological interview was "What do you expect from the psychiatric admittance in a general hospital?" The phenomenological sociology grounds were used to analyze the statements, from which three defined categories have arisen leading to reasons for: treatment guidelines and continuity; betterment perspectives; projection on normality. This research allows identifying the experiences of such relatives, contributing with mental care professionals so as they could think about their actions and family involvement in a general hospital psychiatric unit.

  6. Hospital psiquiátrico: (reafirmação da exclusão Psychiatric hospital: (reaffirmation of the exclusion

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    Osvaldo Gradella Junior

    2002-06-01

    Full Text Available Nosso objetivo é compreender a situação da instituição psiquiátrica hoje, quanto ao perfil da população internada e quais as suas perspectivas face aos questionamentos e propostas do movimento de reforma psiquiátrica e luta antimanicomial. O projeto foi desenvolvido em uma instituição de Bauru/SP, com a população feminina ali internada. Foi realizada a caracterização da amostra, a partir dos dados constantes do sistema de registro utilizado pela instituição, anotando-se as seguintes variáveis: idade, estado civil, escolaridade, naturalidade, ocupação, local de moradia e diagnóstico. Foi feita a análise quantitativa e qualitativa dos dados coletados. Constatou-se que a função principal da instituição psiquiátrica continua sendo a exclusão. A necessidade de construção dos modelos substitutivos em saúde mental que valorizem a integridade e promovam a cidadania, torna-se a única possibilidade de resistência do movimento antimanicomial.The aim of this study is to understand the situation of the psychiatric institution today, with respect to the profile of the interned population and its perspectives face to the questions and proposals of the psychiatric reform and anti-asylums' movement. The project was developed in an institution at Bauru/SP, with interned women. The characterization of the sample was realized from the data of the registration system used by the institution, enrolling the following variables: age, civil status, education, naturalness, occupation, local of dwelling and diagnosis. It was made a quantitative and a qualitative analysis of the collected data. It was verified that the principal function of the psychiatric institution continues to be exclusion. The single possibility of resistance of the anti-asylums' movement becomes the necessity of construction of substitutive mental health's models that value people integrity and promote citizenship.

  7. General hospital costs in England of medical and psychiatric care for patients who self-harm: a retrospective analysis.

    Science.gov (United States)

    Tsiachristas, Apostolos; McDaid, David; Casey, Deborah; Brand, Fiona; Leal, Jose; Park, A-La; Geulayov, Galit; Hawton, Keith

    2017-10-01

    Self-harm is an extremely common reason for hospital presentation. However, few estimates have been made of the hospital costs of assessing and treating self-harm. Such information is essential for planning services and to help strengthen the case for investment in actions to reduce the frequency and effects of self-harm. In this study, we aimed to calculate the costs of hospital medical care associated with a self-harm episode and the costs of psychosocial assessment, together with identification of the key drivers of these costs. In a retrospective analysis, we estimated hospital resource use and care costs for all presentations for self-harm to the John Radcliffe Hospital (Oxford, UK), between April 1, 2013, and March 31, 2014. Episode-related data were provided by the Oxford Monitoring System for Self-harm and we linked these with financial hospital records to quantify costs. We assessed time and resources allocated to psychosocial assessments through discussion with clinical and managerial staff. We then used generalised linear models to investigate the associations between hospital costs and methods of self-harm. Between April 1, 2013, and March 31, 2014, 1647 self-harm presentations by 1153 patients were recorded. Of these, 1623 (99%) presentations by 1140 patients could be linked with hospital finance records. 179 (16%) patients were younger than 18 years. 1150 (70%) presentations were for self-poisoning alone, 367 (22%) for self-injury alone, and 130 (8%) for a combination of methods. Psychosocial assessments were made in 75% (1234) of all episodes. The overall mean hospital cost per episode of self-harm was £809. Costs differed significantly between different types of self-harm: self-injury alone £753 (SD 2061), self-poisoning alone £806 (SD 1568), self-poisoning and self-injury £987 (SD 1823; pFoundation Trust, and Department of Health. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4

  8. Sleep Problems and Their Relationship to Maladaptive Behavior Severity in Psychiatrically Hospitalized Children with Autism Spectrum Disorder (ASD).

    Science.gov (United States)

    Sannar, Elise M; Palka, Tamara; Beresford, Carol; Peura, Christine; Kaplan, Desmond; Verdi, Mary; Siegel, Matthew; Kaplan, Shir; Grados, Marco

    2017-10-30

    We examined the relationship between sleep duration and awakenings to Aberrant Behavior Checklist-Community (ABC-C) and Autism Diagnostic Observation Schedule (ADOS-2) scores in hospitalized youth with ASD and behavioral disturbance. Participants included 106 patients with a stay of at least 10 nights. Sleep in the hospital was recorded by staff observation. Higher scores on the ABC-C (irritability, stereotypy, and hyperactivity subscales) at admission were significantly associated with fewer minutes slept during the last five nights of hospitalization. There was no association between total awakenings and ABC-C scores or ADOS-2 comparison scores. Improved understanding of the relationship between sleep quality and maladaptive behavior in this challenging cohort of patients with ASD is vital to the definition and design of future effective interventions.

  9. Tempo médio de hospitalização e categorias diagnósticas em hospital psiquiátrico Mean hospitalization time and diagnostic categories in a psychiatric hospital

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    José Carlos Souza

    2008-01-01

    Full Text Available OBJETIVO: Avaliar o tempo médio de hospitalização (TMH e os diagnósticos dos pacientes. MÉTODOS: Fez-se um levantamento documental dos registros de 2.247 prontuários de pacientes internados de janeiro a dezembro de 2004 em um hospital psiquiátrico. Foram investigados TMH, idade, sexo, procedência e grupos diagnósticos. Usaram-se medidas de tendência central e de dispersão, testes t de Student, de Kruskal-Wallis ou análise da variância, qui-quadrado e de Pearson. Adotou-se o nível de significância de 5%. RESULTADOS: Eram procedentes de Campo Grande (MS 59,8% dos pacientes, 65,5% eram do sexo masculino (p = 0,000 e 43,3% apresentavam diagnóstico de esquizofrenia; não houve diferença significativa na idade entre os dois sexos (p = 0,080. O TMH foi de 27,66 dias por paciente. Houve diferença significativa do TMH em função das características diagnósticas (p = 0,001 entre os três grupos de procedência (p = 0,045, ficando as cidades a mais de 200 km de Campo Grande com média maior de dias de hospitalização (29,1 dias. Também foram encontradas diferenças estatísticas na distribuição das categorias diagnósticas em função do número de hospitalizações (p = 0,000, na distribuição das principais categorias diagnósticas (p = 0,000 e também nas distribuições em relação à procedência (p = 0,000. CONCLUSÃO: O TMH está dentro da média recomendada pelo Ministério da Saúde brasileiro.OBJECTIVE: The objective of this study was to evaluate mean hospitalization time (MHT and patient diagnosis. METHODS: Records of 2,247 patients admitted to a psychiatric hospital from January to December 2004 were reviewed to retrieve MHT, age, sex, origin and diagnostic categories. Measures of central tendency and dispersion, Student's t, Kruskal-Wallis or analysis of variance, chi-square and Pearson tests were used for statistical analyses at a 5% level of significance. RESULTS: Of all patients, 59.8% were from Campo Grande (MS

  10. [Forensic psychiatric patients in Denmark].

    Science.gov (United States)

    Larsen, Tina Gram; Valbak, Lone; Perto, Gurli; Reinert, Kjeld

    2006-06-05

    In Denmark the number of forensic psychiatric patients is increasing. The objective of this study was to explore whether the increased number of forensic psychiatric patients has been reflected in the use of psychiatric inpatient facilities. Furthermore, we wanted to investigate differences in the treatment of various diagnostic groups of forensic patients and of forensic and non-forensic patients with schizophrenia. Information about admissions and outpatient contact was extracted from the Danish Psychiatric Central Research Register for all Danish patients sentenced to psychiatric treatment in the period 1994-2003. Furthermore, a group of first-admission forensic patients suffering from schizophrenia was compared to a control group of first-admission non-forensic patients with schizophrenia, matched for sex, age and time of admission. The number of forensic psychiatric patients increased markedly in the period 1994-2003; at the same time, the use of inpatient facilities for this group of patients did not increase to a similar degree but actually decreased. Forensic patients in the group F20-F29 spent more time in hospital than did forensic patients with affective disorders and personality disorders. Forensic psychiatric patients with schizophrenia had significantly longer periods of hospitalization than did non-forensic patients with schizophrenia. Forensic psychiatric patients' use of psychiatric inpatient facilities during the last 10 years did not increase to the extent expected relative to the increasing number of forensic psychiatric patients. This raises the question of whether these patients are receiving necessary and sufficient treatment.

  11. First World War and Mental Health: a retrospective comparative study of veterans admitted to a psychiatric hospital between 1915 and 1918.

    Science.gov (United States)

    Lagonia, Paolo; Aloi, Matteo; Magliocco, Fabio; Cerminara, Gregorio; Segura-Garcia, Cristina; Del Vecchio, Valeria; Luciano, Mario; Fiorillo, Andrea; De Fazio, Pasquale

    2017-01-01

    The association between mental illness and war has been repeatedly investigated. Higher levels of depressive symptoms and an increased suicidal risk have been found in veterans. In this study we investigated the mental health conditions among Italian soldiers during the “Great War”, who were hospitalized in a mental health hospital in Italy. The study sample consists of 498 soldiers who were admitted during the World War I between 1915 and 1918, and 498 civilian patients admitted in two different periods (1898-1914, 1919- 1932). Psychiatric diagnoses have been recorded retrospectively by a detailed examination of clinical records. Socio-demographic informations, diagnosis at first admission, number of admissions, and deployment in war zones were collected. A logistic regression analysis was performed, the diagnosis of depression was considered as dependent variable while clinical and demographic variables as independent predictors. Soldiers deployed in war zones were more likely to have a diagnosis of depression compared to those not serving on the frontline. The logistic regression analysis showed that the diagnosis of depression is predicted by being a soldier and being deployed in a war area. Our data confirm that soldiers engaged in war are at higher risk of developing depression compared to non-deployed soldiers.

  12. International study on antidepressant prescription pattern at 40 major psychiatric institutions and hospitals in Asia: A 10-year comparison study.

    Science.gov (United States)

    Chee, Kok-Yoon; Tripathi, Adarsh; Avasthi, Ajit; Chong, Mian-Yoon; Sim, Kang; Yang, Shu-Yu; Glover, Sandeep; Xiang, Yu-Tao; Si, Tian-Mei; Kanba, Shigenobu; He, Yan-Ling; Lee, Min-Soo; Chiu, Helen Fung-Kum; Kuga, Hironori; Mahendran, Rathi; Udormatn, Pichet; Kallivayalil, Roy A; Tanra, Andi J; Maramis, Margarita; Shinfuku, Naotaka; Shen, Winston W; Tan, Chay-Hoon; Sartorius, Norman

    2015-12-01

    Research in prescription pattern of antidepressants in Asia is lacking. This study aims to compare the antidepressants prescription pattern in Asia in 2003-2004 and 2013. The Research in East Asia Psychotropic Prescription Pattern on Antidepressants (REAP-AD) had worked collaboratively in 2003-2004 (REAP-AD 2003/2004) and 2013 (REAP-AD 2013) to study the prescription pattern of antidepressants in Asia. The REAP-AD 2013 study was conducted in China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Singapore, Taiwan, and Thailand using a unified research protocol and questionnaire. Forty psychiatric centers participated in REAP-AD 2013 and a total of 2,319 patients receive antidepressants were analyzed. In 2013, 39.6% of the antidepressant prescriptions were for diagnoses other thandepressive disorder compared with 38.4% in REAP-AD 2003/2004. Out of all the antidepressants listed in the Anatomical Therapeutic Chemical Classification index by the World Health Organization Collaborating Center for Drug Statistics Methodology (Oslo), only 38% antidepressants were prescribed in participating centers in 2013 compared with 46% in REAP-AD 2003/2004. The selective serotonin reuptake inhibitors were the most common antidepressant prescribed in the participating centers, which was similar to the 2003-2004 survey. Prescription of newer generation antidepressants had increased in 2013 survey; on the contrary, prescription of tricyclic antidepressants had reduced. This study has contributed significantly in relation to the changing patterns of antidepressant use in all the participating Asian centers in the last 10 years. The findings are important in shaping optimal antidepressant prescription and future policy making. © 2015 Wiley Publishing Asia Pty Ltd.

  13. Exposure to coughed airborne pathogens in a double bed hospital patient room with overhead mixing ventilation: impact of posture of coughing patient and location of doctor

    DEFF Research Database (Denmark)

    Kierat, W.; Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor

    2010-01-01

    The exposure of a doctor and a patient to air coughed by a second infected patient was studied in a mock-up of two-bed hospital infectious ward with mixing ventilation at 22oC (71.6 F) room air temperature. The effect of posture of the coughing patient lying sideways or on back), position...... of the doctor (either facing the coughing patient or standing sideways) at three ventilation rates (3 h-1, 6 h-1 and 12 h-1) was examined. Thermal manikin with realistic body shape and surface temperature distribution was used to resemble the doctor. The coughing patient was simulated by a heated dummy...... with a cough generator. Another heated dummy was used to simulate the second patient in the second bed. The cough consisted of 100% CO2. The Peak Cough Time was 4 s, when the doctor was close to coughing patient and increased more than twice for the exposed patient. The level of exposure (Peak Concentration...

  14. Prevalence of physical violence in a forensic psychiatric hospital system during 2011-2013: Patient assaults, staff assaults, and repeatedly violent patients.

    Science.gov (United States)

    Broderick, Charles; Azizian, Allen; Kornbluh, Rebecca; Warburton, Katherine

    2015-06-01

    Introduction We examined physical violence in a large, multihospital state psychiatric system during 2011-2013, and associated demographic and clinical characteristics of violent patients to better understand issues of patient and staff safety. Acts of physical violence committed by patients against other patients (n=10,958) or against staff (n=8429) during 2011-2013 were collected and analyzed for all hospitalized patients during the same time period to derive prevalence rates and associated odds ratios. Overall, 31.4% of patients committed at least 1 violent assault during their hospitalization. Differential risk factor patterns were noted across patient and staff assault. Younger age was associated with a higher prevalence of both patient and staff assault, as was nonforensic legal status. Females had a higher prevalence of staff assault than patient assault. Ethnic groups varied on rates of patient assault, but had no significant differences for staff assault. Schizoaffective disorder was associated with higher prevalence and odds of patient (OR 1.244, 95% CI 1.131 to 1.370) and staff (OR 1.346, 95% CI 1.202 to 1.507) assault when compared to patients diagnosed with schizophrenia. Most personality disorder diagnoses also had a higher prevalence and odds of physical violence. One percent of patients accounted for 28.7% of all assaults. Additionally, violent patients had a significantly longer length of hospitalization. Discussion Implications of these findings to enhance patient safety and inform future violence reduction efforts, including the need for new treatments in conjunction with the use of violence risk assessments, are discussed.

  15. Relationship between healthcare worker surface contacts, care type and hand hygiene: an observational study in a single-bed hospital ward.

    Science.gov (United States)

    King, M-F; Noakes, C J; Sleigh, P A; Bale, S; Waters, L

    2016-09-01

    This study quantifies the relationship between hand hygiene and the frequency with which healthcare workers (HCWs) touch surfaces in patient rooms. Surface contacts and hand hygiene were recorded in a single-bed UK hospital ward for six care types. Surface contacts often formed non-random patterns, but hygiene before or after patient contact depends significantly on care type (P=0.001). The likelihood of hygiene correlated with the number of surface contacts (95% confidence interval 1.1-5.8, P=0.002), but not with time spent in the room. This highlights that a potential subconscious need for hand hygiene may have developed in HCWs, which may support and help focus future hygiene education programmes. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. How can a change in the operating system of the mental health review board promote the discharge of long-term hospitalized psychiatric patients? A case study of Seoul city

    OpenAIRE

    Lee, Myung-Soo; Lim, Hee-Young; Kim, Youngki; Lee, Yong-Suk

    2014-01-01

    Background One of the most typical and chronic problem in Korean mental health system is the prolonged length of hospital stay. In contrast to there are many components which leads to long length of stay of psychiatric patients in Korean situation such as low and fixed medical fee for psychiatric inpatient treatment, shortage of community resources, lack of care-givers’ awareness and so on, there are just few mechanisms to handle this issue such as Mental Health Review Board (MHRB) which is b...

  17. Effects of a humor-centered activity on disruptive behavior in patients in a general hospital psychiatric ward

    OpenAIRE

    Antonio Higueras; Hugo Carretero-Dios; José P. Muñoz; Esther Idini; Ana Ortiz; Francisco Rincón; David Prieto-Merino; María M. Rodríguez del Águila

    2006-01-01

    El objetivo de este estudio cuasi-experimental es analizar lo efectos de una actividad centrada en el humor sobre las conductas disruptivas de pacientes hospitalizados en un servicio de Psiquiatría. Se han comparado, teniendo en cuenta dos grupos homogéneos de pacientes hospitalizados en un servicio de Psiquiatría de hospital general (unidad de agudos), dos periodos temporales de 83 días cada uno, siendo el período 1 el de línea base, y el período 2, el de intervención. Para am...

  18. Rate of Nonadherence to Antipsychotic Medications and Factors Leading to Nonadherence among Psychiatric Patients in Gondar University Hospital, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Abyot Endale Gurmu

    2014-01-01

    Full Text Available Objective. The main aim of this study was to assess the rate of medication nonadherence among psychiatry patients at University of Gondar Hospital. Materials and Methods. Cross-sectional, descriptive method was conducted over a period of one month in May, 2013, at University of Gondar Hospital. Rate of nonadherence was computed using Medication Adherence Rating Scale questionnaire and self-reporting via a structured patient interview. Chi-square was used to determine the statistical significance of the association of variables with adherence. Result. Out of 209 respondents, 105 (50.2% were found to be nonadherent. Patients who were forced to take their medication against their will (P<0.001, those who did not believe they require medication (P=0.026, and those who discontinued their medication without consulting their prescriber (P<0.001 had significant association with nonadherence. Adherence among schizophrenia was 75.7%; psychotic was 46.7%; bipolar disorder was 37.5%; and psychosis with depression was 52.6%. Reasons for nonadherence included recovery from the illness (26.7%, seeking alternative therapy and unavailability of drugs (18.1% each, adverse drug reaction (12.7%, forgetfulness (10.6%, and being busy (8.6%. Conclusion. The observed rate of antipsychotic medication nonadherence in this study was high. Interventions to increase adherence are therefore crucial.

  19. From psychiatric ward to the streets and shelters.

    Science.gov (United States)

    Forchuk, C; Russell, G; Kingston-Macclure, S; Turner, K; Dill, S

    2006-06-01

    The issue of discharge from hospital ward to the streets is seldom explored in the literature, but all too commonly experienced by individuals experiencing psychiatric disorders. The Community University Research Alliance on Housing and Mental Health sought to determine how frequently people were discharged from psychiatric wards to shelters or the street in London, Ontario, Canada. A number of data sources were accessed to determine instances of discharges to shelters or the street. Data were analysed to determine the number of moves occurring between hospital and shelter or no fixed address. All datasets revealed the problem of discharge to shelters or the street occurred regularly. All data sources used have the difficulty of likely underestimating the extent of the problem. This type of discharge occurred at least 194 times in 2002 in London, Ontario, Canada. Policies that contribute to this problem include income-support policies, the reduction in psychiatric hospital beds and the lack of community supports. Without recognition, this problem is at risk of remaining invisible with no further improvements to the situation.

  20. A comprehensive psychiatric service

    DEFF Research Database (Denmark)

    Wang, A G

    1984-01-01

    A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service......, and an outpatient service. The number of chronic patients has not decreased, due to an influx of unruly senile patients. The close proximity of the service to the community has increased the pressure with regard to the care of such patients. Other services, such as outpatient treatment of alcoholics and neurotics...

  1. A comprehensive psychiatric service

    DEFF Research Database (Denmark)

    Wang, A G

    1984-01-01

    , and an outpatient service. The number of chronic patients has not decreased, due to an influx of unruly senile patients. The close proximity of the service to the community has increased the pressure with regard to the care of such patients. Other services, such as outpatient treatment of alcoholics and neurotics......A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service...

  2. A reforma e os hospitais psiquiátricos: histórias da desinstitucionalização Reform and psychiatric hospitals: histories of deinstitutionalization

    Directory of Open Access Journals (Sweden)

    Maria Stella Brandão Goulart

    2010-04-01

    Full Text Available Esta pesquisa investigou como o processo de Reforma da Política de saúde mental repercutiu no mais antigo hospital psiquiátrico público de Belo Horizonte, o Instituto Raul Soares, resultando em iniciativas institucionais que procuravam responder à crítica aos asilos e à cultura manicomial que emergiu desde os anos 60 (século XX, em Minas Gerais. Trata-se de um esforço historiográfico, realizado em 2007, que trabalhou com fontes documentais e orais (entrevistas com psiquiatras, psicólogos, enfermeiros e outros, recuperando informações sobre as décadas de 60, 70 e 80. O referencial teórico foi o da Análise Institucional. Foram enfocadas iniciativas instituintes que tomaram a forma de projetos assistenciais e de formação que objetivavam a reestruturação do hospital: o Ambulatório Central Roberto Resende; a Residência em Psiquiatria, o Projeto Guimarães Rosa e o Hospital Dia. São evidenciados os paradigmas de referência e o contraditório processo de desinstitucionalização.The aim of the present research is to determine how the mental health Policy Reform affected the Raul Soares Institute, the first public psychiatric hospital (asylum in Belo Horizonte, tracing institutional initiatives that aimed to respond to criticisms on the mental houses and their set of procedures in usage since the 1960s, in the state of Minas Gerais. The research became a historiographic effort, carried out in 2007, dealing with oral and documental sources (interviews with psychiatrists, psychologists, nurses and others and collecting information about facts that occurred in the 1960s, 1970s and 1980s. Institutional analysis was taken as the theoretical support. The present study focused on initiatives that assumed the format of assisting and constitutional projects that aimed to remodel the Raul Soares Institute. In addition, paradigms of references and the contradiction-marked process of deinstitutionalization were made evident.

  3. "When you're in the hospital, you're in a sort of bubble." Understanding the high risk of self-harm and suicide following psychiatric discharge: a qualitative study.

    Science.gov (United States)

    Owen-Smith, Amanda; Bennewith, Olive; Donovan, Jenny; Evans, Jonathan; Hawton, Keith; Kapur, Nav; O'Connor, Susan; Gunnell, David

    2014-01-01

    Individuals are at a greatly increased risk of suicide and self-harm in the months following discharge from psychiatric hospital, yet little is known about the reasons for this. To investigate the lived experience of psychiatric discharge and explore service users' experiences following discharge. In-depth interviews were undertaken with recently discharged service users (n = 10) in the UK to explore attitudes to discharge and experiences since leaving hospital. Informants had mixed attitudes to discharge, and those who had not felt adequately involved in discharge decisions, or disagreed with them, had experienced urges to self-harm since being discharged. Accounts revealed a number of factors that made the postdischarge period difficult; these included both the reemergence of stressors that existed prior to hospitalization and a number of stressors that were prompted or exacerbated by hospitalization. Although inferences that can be drawn from the study are limited by the small sample size, the results draw attention to a number of factors that could be investigated further to help explain the high risk of suicide and self-harm following psychiatric discharge. Findings emphasize the importance of adequate preparation for discharge and the maintenance of ongoing relationships with known service providers where possible.

  4. Prediction of changes in self-stigma among veterans participating in partial psychiatric hospitalization: The role of disability status and military cohort.

    Science.gov (United States)

    Harris, J Irene; Farchmin, Leah; Stull, Laura; Boyd, Jennifer; Schumacher, Marianne; Drapalski, Amy L

    2015-06-01

    Interventions addressing internalized stigma are a new area of research, and it is important to identify the types of clientele who derive benefit from existing interventions. Information was provided by 235 veterans attending a partial psychiatric hospitalization program, regarding their levels of internalized stigma on admission and discharge from a 3-week program that included interventions targeting internalized stigma. Upon discharge, veterans receiving disability benefits demonstrated less reduction in internalized stigma than those not receiving disability benefits. Time of service moderated the relationship between disability status and change in internalized stigma, such that veterans serving in the more recent Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) cohort who received disability benefits had a more difficult time resolving internalized stigma. Further analyses suggested that OEF/OIF/OND cohort veterans receiving disability benefits have more difficulty developing effective stigma resistance, and more difficulty resolving stigma-related alienation, than other veterans. Based on this research, particular attention should be devoted to internalized stigma among OEF/OIF/OND veterans. (c) 2015 APA, all rights reserved).

  5. Early intervention programme for patients with psychotic disorders in "Sveti Ivan" Psychiatric hospital (RIPEPP) - sociodemographic and baseline characteristics of the participants.

    Science.gov (United States)

    Restek-Petrović, Branka; Majdančić, Ana; Molnar, Sven; Grah, Majda; Ivezić, Ena; Filipčić, Igor; Bogović, Anamarija; Grošić, Vladimir; Mayer, Nina; Kezić, Slobodanka; Pavlović, Irena

    2017-06-01

    Psychiatric hospital "Sveti Ivan" in Zagreb, Croatia, offers an outpatient Early intervention programme for patients with psychotic disorders (RIPEPP), consisting of psychoeducational workshops and group psychodynamic psychotherapy. The aim of this study was to describe sociodemographic and baseline characteristics of the participants, in order to provide better understanding of this population, and to assist with the development of more effective therapeutic approaches. Since 2008, a total of 245 patients with first episodes of psychosis and their family members participated in the programme. They filled out several questionnaires within the framework of the programme evaluation, but for the purposes of this study, only data collected on sociodemographic questionnaire and the Health of the Nation Outcome Scales (HoNOS) are presented. Majority of the participants were male (66%), at the average age of 28 (SD=6.6), living with their parents (73.5%). Most of them finished secondary school (45.7%) but almost a quarter of the sample (23.7%) is currently studying at university. The average duration of untreated period was 101.60 days, with a median of 30 days. According to results of HONOS questionnaire, upon entry into the programme, the patients most often listed cognitive functioning (attention, concentration, memory) and professional issues (performance of work tasks and activities tied to work) as the most problematic areas. The findings of this study provide more detailed description of the beneficiaries of the RIPEPP programme, which can contribute to forming future programmes for the prevention of psychotic disorders.

  6. Comparison of burden among family members of patients diagnosed with schizophrenia and bipolar disorder in a large acute psychiatric hospital in China.

    Science.gov (United States)

    Zhou, Yanling; Rosenheck, Robert; Mohamed, Somaia; Ou, Yufen; Ning, Yuping; He, Hongbo

    2016-08-11

    The difference of burden between caregivers of acute patients with schizophrenia and bipolar disorder has not been well studied in China, a culture where family responsibility has a very high value. Our aim is to compare family burden in these two categories diagnosis and to identify predictors of family burden in a large psychiatric hospital in China. Two hundred forty-three schizophrenic patients and 200 bipolar patients were enrolled in a cross-sectional study. Patients were independently evaluated on symptoms, insight, attitudes toward medication, quality of life during the first week of their admissions. The prime caregiver for each patient was also evaluated with a standard measure of family burden within 1 week of patients' admission. Caregiver perceptions of violent behavior and suicidal risk among patients with bipolar disorder were significantly greater than among families of those with schizophrenia. Hierarchical regression analyses demonstrated differential correlates of burden for all predictive factors with R(2) values ranging from 0.14 to 0.27 in the five burden factors in schizophrenia families; and from 0.12 to 0.24 in bipolar disorder families. Symptoms severity explained the greatest proportion of variance, whereas patient and caregiver demographic variables explained much less variance. Family burden, especially the caregiver perceptions of violent and suicidal behaviors were greater in care givers of acute bipolar disorder patients than among caregivers of schizophrenia patients in the present sample. However, in families of patients with both disorders clinical features were the strongest predictor of caregiver burden.

  7. Effects of a humor-centered activity on disruptive behavior in patients in a general hospital psychiatric ward

    Directory of Open Access Journals (Sweden)

    Antonio Higueras

    2006-01-01

    Full Text Available El objetivo de este estudio cuasi-experimental es analizar lo efectos de una actividad centrada en el humor sobre las conductas disruptivas de pacientes hospitalizados en un servicio de Psiquiatría. Se han comparado, teniendo en cuenta dos grupos homogéneos de pacientes hospitalizados en un servicio de Psiquiatría de hospital general (unidad de agudos, dos periodos temporales de 83 días cada uno, siendo el período 1 el de línea base, y el período 2, el de intervención. Para ambos periodos, se codificaron y registraron un total de diez conductas disruptivas. En los 83 días del periodo de intervención, y con una frecuencia de dos días semanales, dos actores profesionales llevaban a cabo las actividades centradas en el humor. Se calculó un Indice de Disrupción Global (IGD, teniendo en cuenta conjuntamente todas las conductas disruptivas, al igual que un Indice de Disrupción Específico (IDE para cada una de las conductas disruptivas. Usando para las comparaciones la corrección de Bonferroni, los resultados indican que el IGD descendió significativamente durante el periodo de intervención, siendo tres las conductas disruptivas que mostraron un descenso significativo (intentos de fuga, autolesiones y peleas.

  8. [Standard treatment of schizophrenia and legality of personnel equipment in psychiatric hospitals (German Psych-PV): possibilities and limitations].

    Science.gov (United States)

    Wölfle, M; Onnen, V; Vollmer, E; Steinert, T

    1999-09-01

    Comprehensive insight regarding better treatment and social reintegration of patients with schizophrenia has been gained over the past decade. Implementation of this knowledge into everyday's practice should be a major aim prior to the research on new variants of rehabilitative measures. To which extent this takes place has been poorly discussed until now. Our comprehensive treatment program includes psychoeducation for patients and relatives, cognitive training, social skills training, additional psychoeducation for patients with dual diagnosis and a variety of a traditional group therapies like work therapy. An intensive cooperation is practised with complementary psycho-social services. In n = 89 consecutive admissions lasting at least 2 weeks we examined which patients were reached by these treatment offers. 84% of the patients participated in group therapies, where they passed 6.9 hours weekly on average. Most patients were reached by occupation therapy (62%), followed by physical therapy (54%), unspecific conversation group (54%), psychoeducation (35%), cognitive training (30%), work therapy (26%) and social skills training (7%). The PANSS Positive Scale at admission was negatively correlated with participation in group therapies. The implementation of a variety of psychotherapeutic offers for psychotic patients adequate to the state of the art can be achieved under conditions of standard hospital care in Germany (Psych-PV-law). Required organizational measures therefore are programs offered for patients of several wards in union and participation of employees in education. However, even by such efforts a considerable part of patients is not reached. Strategies to improve treatment results should consider these problems.

  9. Reducing seclusion and restraint use in inpatient settings: a phenomenological study of state psychiatric hospital leader and staff experiences.

    Science.gov (United States)

    Huckshorn, Kevin Ann

    2014-11-01

    The current study explored and described the experiences of individuals who either directed or participated in successfully reducing the use of restraint and seclusion (R/S) in two inpatient public mental health hospitals. A phenomenological methodology was used to capture the lived experiences of 21 study participants, including senior leaders, middle managers, and direct care staff, who were interviewed as key informants. Thirty-two themes were extracted and subsequently synthesized into five "meaning themes." The five meaning themes yielded six significant findings: (a) critical roles of leadership and staff in successful R/S reduction projects; (b) ability of leaders and staff to change their beliefs and behaviors; (c) ability of leaders and staff to build a shared vision that was critical to the reduction of R/S use in in-patient settings; (d) identification and resolution of key challenges staff and leaders experienced in reduction efforts; (e) use of a solid performance improvement lens to direct changes in practices; and (f) important lessons learned. Copyright 2014, SLACK Incorporated.

  10. Knowledge of nurses at a psychiatric hospitalization unit of a teaching hospital Saberes de los enfermeros en una unidad de internación psiquiátrica en un hospital universitario Saberes dos enfermeiros em uma unidade de internação psiquiátrica de um hospital universitário

    Directory of Open Access Journals (Sweden)

    Agnes Olschowsky

    2007-08-01

    Full Text Available This study aims to identify the knowledge of the nurses in a psychiatric hospitalization unit at a university hospital. It is an exploratory, descriptive research with a qualitative approach, utilizing semistructured interviews. The nurses refer to a change in the assisting care, starting from their experience in the asylum mode and making references to the concepts of the psychosocial mode: integrality, welcoming, interdisciplinarity and interpersonal relationship. Integral and individual care, knowledge of the psychiatric syndromes and their treatment as well as the consideration of the subjectivity of the subject under psychiatric suffering are part of the knowledge that guides nursing actions in mental health.Este estudio tiene por objetivo identificar los saberes de los enfermeros en una unidad de internación psiquiátrica en un hospital universitario. Se trata de una investigación exploratoria, descriptiva, con aproximación cualitativa, utilizando la entrevista semi-estructurada. Los enfermeros refieren una transformación en el cuidado asistencial a partir de su experiencia en el modo asilar, haciendo referencias a las concepciones del modo psicosocial: integralidad, acogida, interdisciplinaridad y relación interpersonal. El cuidado integral e individual, el conocimiento de los síndromes psiquiátricos y su tratamiento y la consideración de la subjetividad del individuo bajo sufrimiento psíquico son formas del saber que orientan las acciones de la enfermería en salud mental.Este estudo tem o objetivo de identificar os saberes dos enfermeiros em uma unidade de internação psiquiátrica em um hospital universitário. Trata-se de pesquisa exploratório-descritiva, com abordagem qualitativa, utilizando a entrevista semi-estruturada. Os enfermeiros relatam transformação no cuidado assistencial a partir de sua experiência no modo asilar, fazendo referências às concepções do modo psicossocial: integralidade, acolhimento

  11. Nosocomial infection in long-term care facilities. A survey in a Brazilian psychiatric hospital Infecção hospitalar em instituições de longa permanência. Pesquisa em hospital psiquiátrico brasileiro

    Directory of Open Access Journals (Sweden)

    Regina Capanema de ALMEIDA

    1999-11-01

    Full Text Available Nosocomial infection among male patients in a public psychiatric hospital was studied and the definitions for use in long-term care facilities were employed for diagnosis. The overall nosocomial infection rate was 6.7 per 1,000 day inpatients; 55.6% of these infections were identified in the respiratory tract, 50% of them being respiratory viral diseases; 38.9% of the nosocomial infections involved the eyes, ears, nose, throat and mouth, and 5.6% involved the skin and soft tissues. The epidemiological characteristics and the main clinical alterations of these inpatients were also identified.Foi estudada a Infecção Hospitalar (IH em pacientes masculinos internados em hospital psiquiátrico público e as definições sugeridas para uso em instituições de longa permanência (ILPs/Long-Term Care Facilities-LTCFs foram utilizadas para diagnóstico das IH. A taxa global de IH foi de 6,7 por 1000 pacientes-dia, 55,6% das infecções foram identificadas no trato respiratório, sendo que 50% dessas eram viroses respiratórias; 38,9% das IH relacionavam-se aos olhos, ouvidos, nariz, garganta e boca e 5,6% a pele e partes moles. As características epidemiológicas e as principais alterações clínicas desses pacientes também foram identificadas.

  12. [Determination in blood and urine of the recent non-therapeutic consumption of psychotropic substances in patients being admitted to the psychiatric unit of a general hospital in Valencia].

    Science.gov (United States)

    Bertolín Guillén, J M; Pretel Piqueras, J; Sánchez Hernández, A; Acebal Gómez, I

    1996-01-01

    An increasing trend in the consumption of psychoactive substances has been observed in psychiatric patients who are hospitalised. The aim of this research is to establish the prevalence and the characteristics of the recent and non-therapeutic consumption of these substances, by detecting their presence in the blood and urine of psychiatric patients admitted to hospital, the influence of such consumption on the clinical manifestations of the mental disorders and to recommend criteria for such a phenomenon. Detection of cannabis, amphetamines, opiates and cocaine, using the ADX system, and in blood through the REA system for alcohol detection, in patients admitted to the Psychiatric Unit of the General University Hospital in Valencia, during the first six months of 1995. The diagnoses were based on the CIE-10 in its research version, and the influence of the consumption of substances detected in the clinical manifestations of the disorders was determined by the majority decision taken be three experienced psychiatrists. the prevalence detected in the consumption of psychotropic substances is high (almost one third of those admitted), and consumption played a part in the admission of most of these patients (nearly 89%), aggravating the mental disorder problem when they were admitted. The variables that were most often associated with the consumption detected, where males hospitalised as a result of a brush with the law. A routine determining of the presence or absence of substances liable to abuse is recommended in patients admitted to psychiatric institutions.

  13. The Impact of Cannabis Use on the Dosage of Antipsychotic Drugs in Patients Admitted on the Psychiatric Ward at the University Hospital of the West Indies

    Directory of Open Access Journals (Sweden)

    P Thomas

    2015-03-01

    Full Text Available Objective: To assess the impact of cannabis use on the efficacy of antipsychotic drugs in male subjects presenting to the University Hospital of the West Indies (UHWI with psychotic episodes. Methods: Male subjects, 18–40 years old, admitted to the psychiatric ward of the UHWI between February 2013 and May 2013, diagnosed with schizophrenia, schizophreniform disorder and who tested positive for ∆9-tetrahydrocannabinol were recruited for the study. On day one, consenting subjects were assessed using the Brief Psychiatric Rating Scale (BPRS. Patients were prescribed seven days of an oral antipsychotic medication (haloperidol, chlorpromazine, risperidone, quetiapine, olanzapine. Medicated subjects were then reassessed using the BPRS on days three and seven. Statistical analysis involved the use of Student’s t-test and repeated measure analysis of variance. Results: In total, 20 subjects were recruited (mean age = 26.00 ± 5.96 years. Subjects were grouped based on the daily chlorpromazine equivalent (CPZE dose given on day one into CPZE1 (CPZE dose of 100–300mg; n = 8 and CPZE2 (CPZE dose of 400–1250 mg; n = 12. There was no significant difference in the total BPRS score between the groups on day one (CPZE1 = 41.38 ± 16.47 versus CPZE2 = 49.42 ± 25.58; p = 0.44; similar findings were obtained for the positive (26.75 ± 9.27 versus 31.83 ± 17.30; p = 0.46 and negative (14.63 ± 7.73 versus 17.58 ± 9.74; p = 0.48 symptom component on the BPRS. For subjects in CPZE1, there was no significant decrease in total BPRS score [F(2,21 = 0.07, p = 0.93] over the study period. For CPZE2, significant reduction in total BPRS scores was achieved [F(2,33 =7.12, p = 0.01], contributed by significant decrease in the positive [F(2,33 = 5.64, p = 0.02 and negative [F(2,33 = 7.53, p = 0.01 symptom components of the BPRS. Conclusion: The findings of this study purport that male cannabis users presenting with psychotic disorders may not achieve optimal

  14. Establishment of a local psychiatric service

    DEFF Research Database (Denmark)

    Wang, A G

    1981-01-01

    of senile psychoses. The total increase amounts to 2.4 times the admission rates of psychiatric cases to the General Hospital and 4.4 times the admission rates to the Psychiatric Hospital in Nykøbing in the last years prior to the start of the local service. The outpatient department has grown steadily...

  15. Patterns and determinants of acute psychiatric readmissions

    Directory of Open Access Journals (Sweden)

    Graham Michael Behr

    2002-12-01

    Full Text Available Objectives . Deinstitutionalisation and shortage of psychiatric beds worldwide has led to extensive research into the risk fac- tors and interventions associated with rapid and recurrent admission to hospital. Little research of this nature has taken place in South Africa, particularly with regard to acute hospital admissions. This study attempted primarily to assess the effect of length of stay and administration of depot antipsychotics in hospital on time to readmission. Design. A retrospective cohort of 180 admissions was fol- lowed up for 12 months, after an index discharge, by means of multiple hospital and community-based record reviews. Each readmission was analysed as an event using a survival analysis model. Setting. Chris Hani Baragwanath Hospital, Gauteng. Subjects. A random sample of patients admitted during a 6-month period in 1996. Outcome measures. Time to readmission. Results. Two hundred and eighty-four admissions were analysed. The only factor that provided a significant protective effect was being married or cohabiting ( P = 0.015. Clinic attendance showed a slight protective effect early on but con- ferred a significantly higher risk of readmission on those who had been out of hospital for a long period ( P = 0.001. Only 21% of discharged patients ever attended a clinic. The overall risk of readmission was significantly higher in the first 90 days post discharge. Conclusions. The lack of impact of length of hospital stay and use of depot neuroleptics on time to readmission may indicate that patients are being kept for appropriate duration and that the most ill patients are receiving depot medication. Several sampling and statistical artefacts may explain some of our findings. These results confirm the worldwide difficulty in finding consistent and accurate predictors of readmission. Low rates of successful referral to community aftercare need to be addressed before their effectiveness can be reasonably assessed. The inherent

  16. Ocorrência de tuberculose em um hospital psiquiátrico do interior de Goiás Tuberculosis in a Psychiatric Hospital in the state of Goiás, Brazil

    Directory of Open Access Journals (Sweden)

    Hindenburg Cruvinel Guimarães da Costa

    2006-12-01

    Full Text Available OBJETIVO: Investigar a prevalência de infecção, doença e eventual surto institucional de tuberculose em um hospital psiquiátrico empregando teste tuberculínico, pesquisa de micobactéria em material da árvore respiratória e técnica de rastreamento molecular baseada na seqüência IS6110. MÉTODOS: Durante o período de fevereiro a agosto de 2002, foi realizado teste tuberculínico entre os 74 internos e os 31 funcionários de um hospital psiquiátrico na Cidade de Rio Verde (GO, pesquisa de Mycobacterium tuberculosis em material da árvore respiratória dos pacientes e estudo do perfil genético pelo método restriction fragment length polymorphism - IS6110. RESULTADOS: Micobactérias foram isoladas de 5 pacientes analisados (6,8 %, sendo em quatro M. tuberculosis e em um M. chelonae. Os isolados de M. tuberculosis foram sensíveis a isoniazida e rifampicina e, através da técnica restriction fragment length polymorphism - IS6110, apresentaram perfis genéticos únicos, totalmente distintos uns dos outros, indicando que os casos de tuberculose encontrados eram decorrentes de reativação endógena, não sendo possível caracterizá-los como um surto institucional. Através da realização do teste tuberculínico em dois passos nos pacientes, verificaram-se taxas de infecção de 23% e 31%. Entre os funcionários a taxa foi de 42%, não tendo sido realizada entre estes a repetição do teste. CONCLUSÃO: Os resultados indicaram uma incidência considerável de tuberculose infecção entre os pacientes e funcionários, sendo também elevada a ocorrência de tuberculose doença entre os pacientes.OBJECTIVE: To investigate the prevalence of infection, disease and eventual institutional outbreak of tuberculosis in a psychiatric hospital using the PPD test, as well as testing for mycobacteria in material collected from the respiratory tree and using molecular tracking technique based on insertion sequence 6110 (IS6110. METHODS: Between

  17. Hipertensão arterial sistêmica e morbidade psiquiátrica em ambulatório de hospital terciário Hypertension and psychiatric morbidity: a tertiary care setting experience

    Directory of Open Access Journals (Sweden)

    ISABELA M. BENSEÑOR

    1998-09-01

    Full Text Available A hipertensão arterial sistêmica representa um dos principais fatores de risco para as doenças cardiovasculares que são a principal causa de morte em nosso meio. Hipertensos que frequentam hospital terciário apresentam elevada co-morbidade incluindo distúrbios psiquiátricos. O objetivo deste estudo é avaliar a morbidade psiquiátrica em hipertensos graves. Este estudo foi realizado em ambulatório geral de hospital terciário: 41 pacientes (26 mulheres e 15 homens foram submetidos a consulta médica com aplicação do PRIME-MD, um questionário específico para diagnóstico de alterações psiquiátricas a ser realizado pelo clínico. A frequência de distúrbios psiquiátricos diferiu em homens e mulheres: 63,4% das mulheres na pesquisa apresentavam algum tipo de distúrbio contra 36,6% dos homens (p=0,012. A maior parte dos diagnósticos foi de distúrbios do humor representados pela depressão associada ou não a distúrbios ansiosos. A média de idade dos pacientes com distúrbio psiquiátrico foi 47,1 anos contra 59,3 anos dos pacientes sem distúrbio psiquiátrico (p=0,0049, mostrando a presença dos distúrbios psiquiátricos em pacientes mais jovens. Outros fatores pesquisados, como a pressão arterial sistólica, a pressão arterial diastólica e índice de massa corpórea não apresentaram diferenças em função dos distúrbios psiquiátricos apresentados. Concluímos que há grande co-morbidade psiquiátrica em hipertensos que frequentam ambulatórios de hospital terciário e que esses distúrbios são mais frequentes em mulheres e em pacientes jovens.Arterial hypertension is one of the most important risk factor for cardiovascular disease, the main cause of death in Brazil. Hypertensive patients that have treated in tertiary care hospitals have shown elevated co-morbidity including psychiatric disturbances. Our objective is to study psychiatric co-morbidity among severe hypertensive patients. This study was performed in an

  18. Dyspepsia in chronic psychiatric patients

    NARCIS (Netherlands)

    Mookhoek, E.J.; Meijs, V.M.M.; Loonen, A.J.M.; Leufkens, H.G.M.

    2005-01-01

    Introduction: We report on dyspeptic complaints among patients hospitalized in the long-stay ward of a general psychiatric hospital. Methods: A representative sample of the patients was interviewed using a structured questionnaire. Results: Eighty percent of the patients reported one or more

  19. [Initial experiences in psychiatric emergency service. Comments on the prevention or indication of compulsory hospitalization in accordance with the Hamburg Law on Aid and Protective Measures in Mental Diseases (author's transl)].

    Science.gov (United States)

    Spengler, A; Strege, W; Dörner, K; Hagenah, R; Meyberg, U

    1981-02-01

    On the basis of the rules of the Hamburg Law on Aid and Protective Measures in Mental Diseases, a psychiatric emergency service operates at night and on weekends. This emergency service is called upon to decide on the need for compulsory hospitalization and to prevent the same, if possible, via therapeutic alternatives. The article illustrates by documents an initial phase of the activities of this public service. Within the framework of a preliminary study, 63 recorded incidents of service by four physicians are presented who collected data on the situation encountered by them at the time of examination, on the social and anamnestic background of the patients, on their psychiatric evaluation and on the indication for compulsory hospitalization or alternative treatment methods. 22% of the patients were subjected to compulsory hospitalization. Provisional hypotheses on the conditions under which compulsory hospitalization becomes more probable, are developed from the recorded data. The concept of the risk situation is specially reflected upon. The therapeutic possibilities in connection with institutional factors are discussed with a view to promote further development of crisis intervention in the sense of preventing compulsory hospitalization.

  20. [The link between aggressive behavior and depression in adolescence. A cross-sectional study conducted in the psychiatric emergency unit at the Sainte-Anne hospital].

    Science.gov (United States)

    Benarous, X; Guedj, M J; Braitman, A; Gallois, E; Lana, P

    2014-12-01

    The link between depression and aggressive behavior in adults has been found in many studies. In adolescents, this relationship is still controversial. Several studies point out that irritability is a key symptom in adolescent depressed. Few studies have analyzed precisely the kind of aggressive behavior. This study sets out to assess the relationship between aggressive behavior and depressive affects in adolescents. We also pay attention in this population to hopelessness feelings, anxiety, global functioning and the type of aggressive behavior. This is a descriptive and observational cross-sectional study. Data was collected from 49 successive adolescents admitted for a 24-hour evaluation in the emergency department of the Sainte-Anne psychiatric hospital. The inclusion period was from February to April 2012, with age limits between 15 and 18. For each patient, the clinician completed with the parents or other caregivers the Modified Overt Aggressive Scale (MOAS) searching for existence of aggressive behavior in the week prior to the consultation. The population was divided into two groups: P- group when the MOAS score was Aggression Questionnaire (QA), the Beck Hopelessness scale and the Adolescent Depression Rating Scale for patients (ADRSp). Forty-nine adolescents with a median age of 16 years and 4 months participated. The first reason for consultation was depressive symptoms, followed by disruptive behavior. The analysis was conducted on 39 questionnaires. The demographic profile of the two groups was similar. We did not find any significant difference between the groups P+ and P- on ADRSc scores and secondary criteria. However, we found higher scores in the QA in the more depressed patient, especially a higher hostility score in this sample. In the subgroup analysis: as expected self-aggressive behavior was associated with a higher depression score, more hospitalization and a poor global functioning score. Surprisingly, the patients who showed physical

  1. College Student Utilization of a Comprehensive Psychiatric Emergency Program

    Science.gov (United States)

    Mitchell, Sharon L.; Kader, Mahrin; Haggerty, Melinda Z.; Bakhai, Yogesh D.; Warren, Calvert G.

    2013-01-01

    The authors sought to identify college students at risk for experiencing a mental health crisis that warranted a psychiatric evaluation at a hospital and/or a psychiatric hospitalization. A retrospective chart review of college students evaluated at a comprehensive psychiatric emergency program during a 1-year period was conducted. Demographic…

  2. Psychiatric Genomics

    DEFF Research Database (Denmark)

    Sullivan, Patrick F; Agrawal, Arpana; Bulik, Cynthia M

    2018-01-01

    into biologically, clinically, and therapeutically meaningful insights. The emerging findings suggest that we are entering a phase of accelerated genetic discovery for multiple psychiatric disorders. These findings are likely to elucidate the genetic portions of these truly complex traits, and this knowledge can...... then be mined for its relevance for improved therapeutics and its impact on psychiatric practice within a precision medicine framework. [AJP at 175: Remembering Our Past As We Envision Our Future November 1946: The Genetic Theory of Schizophrenia Franz Kallmann's influential twin study of schizophrenia in 691...

  3. Impact of social-psychiatric services and psychiatric clinics on involuntary admissions.

    Science.gov (United States)

    Emons, Barbara; Haussleiter, Ida Sybille; Kalthoff, Jörg; Schramm, Anja; Hoffmann, Knut; Jendreyschak, Jasmin; Schaub, Markus; Armgart, Carina; Juckel, Georg; Illes, Franciska

    2014-11-01

    Germany provides a wide range of highly developed mental health care to its citizens. The aim of this study was to identify factors influencing the voluntariness of admissions to psychiatric hospitals. Especially the impact of demographic factors of the region, characteristics of the psychiatric hospitals and characteristics of the psychosocial services was analyzed. A retrospective analysis of hospital admission registers from 13 German adult psychiatric hospitals in 2009 was conducted. Public data on the regional psychiatric accommodation and demographic situation were added. Hospitals were dichotomously divided according to their index of involuntary admissions. Group comparisons were performed between the clinics with low and high involuntary admission indices. Analysis was conducted with clinical, psychiatric provision and demographic data related to inpatients in the Landschaftsverbands Westfalen-Lippe (LWL)-PsychiatryNetwork. Especially the range of services provided by the social-psychiatric services in the region such as number of supervised patients and home visits had an influence on the proportion of involuntary admissions to a psychiatric hospital. Some demographic characteristics of the region such as discretionary income showed further influence. Contrary to our expectations, the characteristics of the individual hospital seem to have no influence on the admission rate. Social-psychiatric services show a preventive impact on involuntary acute psychiatry interventions. Sociodemographic factors and patient variables play a role with regard to the number of involuntary hospitalizations, whereas characteristics of hospitals seemed to play no role. © The Author(s) 2013.

  4. Stigmatization of psychiatric symptoms and psychiatric service use: a vignette-based representative population survey.

    Science.gov (United States)

    Sowislo, Julia F; Lange, Claudia; Euler, Sebastian; Hachtel, Henning; Walter, Marc; Borgwardt, Stefan; Lang, Undine E; Huber, Christian G

    2017-06-01

    Background There is evidence for two different types and/or sources of mental illness stigma, namely the display of psychiatric symptoms and the use of psychiatric service institutions. However, no current study has compared the two. Furthermore, gaps exist in our knowledge of both types of stigma. Little is known about the perceived stigma of specific psychiatric service treatment environments, for instance forensic settings. In addition, systematic research on stigma attached to symptoms of personality disorders in the general population is scarce, and for borderline personality disorder, nonexistent. Methods We conducted a representative survey of the general population (N = 2207) in the canton of Basel-Stadt, Switzerland. Participants were asked to read a vignette depicting either the psychiatric symptoms of a fictitious character or a psychiatric service institution to which the character had been admitted, and indicate desired social distance (an indicator for stigma). Type of symptoms, type of psychiatric service, dangerousness, and gender were systematically varied between vignettes. Findings Desired social distance was significantly lower in relation to psychiatric service use than to psychiatric symptoms. Overall, symptoms of alcohol dependency, behavior endangering others, and the fictitious character's being male tend to increase stigmatization. Interestingly, the character's being hospitalized in a psychiatric unit at a general hospital and also respondent familiarity with psychiatric services tend to decrease stigmatization. Interpretation Familiarity of the general population with psychiatric patients should be increased. Furthermore, treatment in psychiatric units located within general hospitals should be promoted, as such treatment is associated with decreased stigma.

  5. The Impact of Psychiatric Patient Boarding in Emergency Departments

    Directory of Open Access Journals (Sweden)

    B. A. Nicks

    2012-01-01

    Full Text Available Objectives. Studies have demonstrated the adverse effects of emergency department (ED boarding. This study examines the impact of resource utilization, throughput, and financial impact for psychiatric patients awaiting inpatient placement. Methods. The authors retrospectively studied all psychiatric and non-psychiatric adult admissions in an Academic Medical Center ED (>68,000 adult visits from January 2007-2008. The main outcomes were ED length of stay (LOS and associated reimbursement. Results. 1,438 patients were consulted to psychiatry with 505 (35.1% requiring inpatient psychiatric care management. The mean psychiatric patient age was 42.5 years (SD 13.1 years, with 2.7 times more women than men. ED LOS was significantly longer for psychiatric admissions (1089 min, CI (1039–1140 versus 340 min, CI (304–375; <0.001 when compared to non-psychiatric admissions. The financial impact of psychiatric boarding accounted for a direct loss of ($1,198 compared to non-psychiatric admissions. Factoring the loss of bed turnover for waiting patients and opportunity cost due to loss of those patients, psychiatric patient boarding cost the department $2,264 per patient. Conclusions. Psychiatric patients awaiting inpatient placement remain in the ED 3.2 times longer than non-psychiatric patients, preventing 2.2 bed turnovers (additional patients per psychiatric patient, and decreasing financial revenue.

  6. How can a change in the operating system of the mental health review board promote the discharge of long-term hospitalized psychiatric patients? A case study of Seoul city.

    Science.gov (United States)

    Lee, Myung-Soo; Lim, Hee-Young; Kim, Youngki; Lee, Yong-Suk

    2014-01-01

    One of the most typical and chronic problem in Korean mental health system is the prolonged length of hospital stay. In contrast to there are many components which leads to long length of stay of psychiatric patients in Korean situation such as low and fixed medical fee for psychiatric inpatient treatment, shortage of community resources, lack of care-givers' awareness and so on, there are just few mechanisms to handle this issue such as Mental Health Review Board (MHRB) which is based on Mental Health Act since 1995. However, the discharge order rate was very low and there community care system after discharge order is still very weak. The Korean government has revised the Mental Health Act in 2008 and changed the operating principals of the MHRB from a regional level to a local level to strengthen the function of MHRB. However, the discharge order rate versus the whole evaluation requests still remains at a very low level or less than 5%. And it is still very difficult to execute a discharge order against a patient whose symptoms and conditions become psychiatrically stabilized enough for discharge, due to a shortage of community care facilities and a lack of social support system. These results are exactly same with former studies. Any policies to promote psychiatric discharge including MHRB are needed to take the comprehensive factors into consideration, such as payment program, community infrastructure, increasing care-givers' acceptance and so on. Despite of the political trial of Korean government to reduce length of stay of chronic psychiatric patients, it was not successful. Still it had failed to propose a detailed policy measure in terms of the above-mentioned prerequisites. Therefore, new system and program developments including reform of payment system which reflect prior studies' recommendations are essential.

  7. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  8. Intensidade de ruído em hospital de 222 leitos na 18ª Regional de Saúde - PR Noise level in a 222 bed hospital in the 18th health region - PR

    Directory of Open Access Journals (Sweden)

    Marcelo Henrique Otenio

    2007-04-01

    Full Text Available A poluição sonora ambiental torna-se hoje onipresente e beira o intolerável. Nos hospitais, os avanços tecnológicos trazem, como conseqüência, níveis de ruído potencialmente danosos. Muito do ruído no hospital provém mais de dentro, do que de fora desse ambiente, sendo as principais causas de ruído em Unidade de Terapia Intensiva, por exemplo, os equipamentos e a conversação entre a equipe hospitalar. O objetivo deste trabalho foi avaliar o nível de ruído nos diversos ambientes hospitalares, em Hospital de 222 leitos na 18ª RS de Saúde - PR. MATERIAIS E MÉTODOS: Conduziu-se, em março de 2005 no período de 24 horas, em dez setores. Forma de Estudo: Aferição do nível de ruído ambiental utilizando um Decibelímetro modelo 1350. RESULTADOS: O nível de ruído encontrado em nosso estudo apresentou média total de 63,7 dB(A, que excede os valores máximos permitidos de 45 dB recomendados pela Associação Brasileira de Normas Técnicas (1987. CONCLUSÃO: Nos setores analisados, o nível de ruído encontrado neste está consideravelmente acima do recomendado. A equipe hospitalar deve estar consciente do ruído e dos efeitos deste, para que possa atuar de maneira mais efetiva na redução da poluição sonora, beneficiando assim a função laborativa dos profissionais e recuperação dos pacientes.Environment noise pollution is common place today, at intolerable levels. In hospitals, technological developments have, as a consequence, potentially harmful noise levels. Much of the hospital noise comes from inside, rather than outside, and the major source of such noise is the Intensive Care Unit, for example equipment and hospital staff talk. Our goal with the present study was to investigate the noise level present in the different hospital environments, within a 222 bed hospital located at the 18th health zone, PR. MATERIALS AND METHODS: The study was carried out in March, 2005, during a period of 24 hours, in tem different

  9. The importance of the patients deemed not guilty by reason of insanity for the psychiatric reform.

    Science.gov (United States)

    Douzenis, Athanasios

    2016-01-01

    According to the Greek Penal Law if someone "because of a morbid disturbance of his mental functioning" (article 34) is acquitted of a crime or misdemeanour that the law punishes with more than 6 months imprisonment, then the court orders that this individual should be kept in a public psychiatric institution if the court reaches the conclusion that this person poses a threat to public safety.1 Individuals who have broken the law and deemed "not guilty by reason of insanity" are treated in psychiatric units of Psychiatric Hospitals according to the article 69 of the Penal Code. In Athens, in the Psychiatric Hospital of Athens and the Dromokaiteion Psychiatric Hospital, and in Thessaloniki in the Unit for "Not guilty by reason of insanity (NGRI)". The person who is deemed not guilty by reason of insanity following a crime is facing double stigmatisation and marginalisation from both the legal and the health system. He/she is usually treated initially with fear and later since there is no therapeutic aim but only the court instruction for "guardianship", with indifference. The patient who is committed by the courts in a psychiatric unit for being "NGRI" is facing a unique legal and psychiatric status.2 In this respect he/she is disadvantaged when compared to either convicted criminals or psychiatric inpatients. If the patient was not found "NGRI" (ie innocent as far as sentencing is concerned) he would have been punished with loss of liberty for a certain (specific) amount of time, and like all individuals convicted in court he/she would have the right to appeal and reduce his/her sentence in a higher court and maybe released from prison earlier for good behaviour etc. In this respect the individual found to be "NGRI" is disadvantaged when compared to a convicted felon since he/she is kept for an undefined period of time. Additionally, he/she will be allowed to leave the psychiatric unit following a subjective assessment of a judge with no psychiatric knowledge who

  10. Prevalencia de trastornos psiquiátricos en pacientes ingresados por el Servicio de Psiquiatría en el Módulo Penitenciario del H.U.M.S. Prevalence of psychiatric disorders on patients admissed by the psychiatric service in the security area of H.U.M.S. (University Hospital "Miguel Servet"

    Directory of Open Access Journals (Sweden)

    P. Calvo Estopiñán

    2008-02-01

    Full Text Available Introducción: Estudios epidemiológicos recientes destacan el aumento de prevalencia de trastornos psiquiátricos en presos. El objetivo del presente estudio es determinar los trastornos psiquiátricos principales y secundarios más prevalentes, datos sociodemográficos y estancia media, de los pacientes ingresados en el Módulo Penitenciario de un hospital general a cargo del Servicio de Psiquiatría. Material y método: Estudio descriptivo transversal retrospectivo. La muestra está compuesta por los pacientes ingresados en el Módulo Penitenciario a cargo de Psiquiatría durante 5 años, siendo n=136. Resultados: El 90,4% fueron hombres y el 9,6% mujeres. La edad media fue de 34,18 años. Los diagnósticos psiquiátricos principales más prevalentes fueron: Tr. Personalidad 22%, Tr. Esquizofrénicos 16,3%. Como diagnósticos psiquiátricos secundarios más prevalentes encontramos: Tr. Personalidad 11,9%, Abuso de drogas 10,7%. Conclusiones: El diagnóstico psiquiátrico principal y secundario más prevalente fue el trastorno de personalidad. Se documentó la existencia de una alta comorbilidad con el abuso-dependencia de tóxicos. Actualmente las prisiones carecen de equipos multidisciplinares en Salud Mental, con lo que en muchas ocasiones se hace necesario el traslado del preso al hospital con la carga asistencial y el incremento de costes que esto supone.Introduction: recent epidemiological studies highlight an increase in the prevalence of psychiatric disorders amongst prison inmates. The objective of this study to determine the most prevalent primary and secondary psychiatric disorders, socio-demographic data and average stay period amongst patients admitted to the Prison Unit of a general hospital as charges of the Psychiatric Service. Materials and Methods: retrospective cross-sectional descriptive study. The sample group consisted of a number of patients admitted into the Prison Unit as charges of the Psychiatric Service during a

  11. Viabilidade de unidades psiquiátricas em hospitais gerais no Brasil Viabilidad de unidades psiquiátricas en hospitales generales en Brasil Feasibility of general hospitals psychiatric units in Brazil

    Directory of Open Access Journals (Sweden)

    Maurício Lucchesi

    2009-02-01

    Taubate (Sureste de Brasil, 2005-2006. Las evidencias fueron obtenidas por medio de entrevistas, observación participante y palestras sobre el proyecto de la unidad psiquiátrica para el cuerpo clínico del hospital. RESULTADOS: La inversión del órgano gestor posibilitó que las concepciones estigmatizantes presentes en la cultura del hospital estudiado (violencia, debilidad moral e intratabilidad fueran resignificadas por medio de discusiones clínicas y sanitarias, viabilizando la implantación de la unidad psiquiátrica. El análisis mostró que esas concepciones eran reactualizadas por el contexto asistencial, en el cual el acceso de los portadores de trastornos mentales era restringido. CONCLUSIONES: La postura asumida por el órgano gestor, que decidió por el financiamiento adecuado de la unidad psiquiátrica y ejerció su ascendencia sobre el hospital prestador, fue decisiva para el desenlace del caso. La principal dificultad para la implantación de las unidades psiquiátricas no es el estigma presente en la cultura de los hospitales generales, pero una limitación de orden estratégica: la falta de una política afirmativa para esas unidades.OBJECTIVE: To comprehend the stigma against people with mental disorders still persists in the culture of general hospitals and acts as a limiting factor in the implementation of psychiatric units in general hospitals in Brazil. METHODOLOGICAL PROCEDURES: A qualitative social survey was outlined based on action research strategy as of the agreement to adopt a psychiatric unit in a general hospital in Taubaté, Southeastern Brazil. Data was obtained through interviews, participant observation and talks on the psychiatric unit project given to the hospital's clinical staff. RESULTS: The investment made by the healthcare authority enabled the stigmatizing conceptions (violence, moral weakness and untreatability present in the hospital culture in question to be resignified by means of clinical and sanitary discussions, which

  12. 77 FR 47223 - Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal...

    Science.gov (United States)

    2012-08-07

    ... resource use and costs among psychiatric hospitals and psychiatric units. Section 405(g)(2) of the Medicare... differences in patient resource use and costs among psychiatric hospitals and psychiatric units. Section 405(g...(s)(3)(B)) for RYs 2013 and 2014 that reduces the update to the IPF PPS base rate for the FY...

  13. Naturalistic evaluation of inpatient treatment of mania in a private Brazilian psychiatric hospital Avaliação naturalística do tratamento da mania em um hospital psiquiátrico particular

    Directory of Open Access Journals (Sweden)

    Fernando Madalena Volpe

    2003-06-01

    Full Text Available OBJECTIVE: To describe the clinical practices on the treatment of mania in a Brazilian hospital, and to compare them to other international similar reports and practice guidelines. METHODS: Chart revision of 425 consecutive admissions (269 patients for the treatment of manic or mixed episodes (ICD-10 criteria in a private psychiatric hospital of Belo Horizonte, Brazil, from 1996 to 2000. The rates of utilization of each antimanic medication and ECT were compared to those reported in similar international observational studies (X², bicaudate, alpha =0.05. RESULTS: The observed frequencies of use of each treatment modality were: lithium (71.5%; carbamazepine (34.8%; valproate (9.4%; antipsychotics (83.3%; benzodiazepines (62.4%; antidepressants (7.5% and ECT (33.2%. The differences detected between local practice and international guidelines were: lower rate of valproate and higher rate of carbamazepine prescription; the use of sine wave devices for ECT; frequent concomitant use of ECT with lithium (72.3%, benzodiazepines (46.8% and/or carbamazepine (31.2%. CONCLUSION: These results suggest the need to develop national practice guidelines for the treatment of mania and for the use of ECT, and to promote their propagation through specific medical educational programs, aiming at the standardization of practices based on the available scientific evidence.OBJETIVO: Descrever as práticas clínicas no tratamento da mania em um hospital brasileiro e compará-las com aquelas descritas e recomendadas nas publicações internacionais. MÉTODOS: Revisão dos prontuários de 425 internações consecutivas (269 pacientes para episódios maníacos ou mistos (CID-10 em um hospital psiquiátrico privado de Belo Horizonte (MG, de 1996 a 2000. As freqüências de utilização dos diversos medicamentos e de ECT foram comparadas com as descritas em estudos observacionais estrangeiros (X², bicaudado, alfa =0,05. RESULTADOS: As freqüências observadas de uso de

  14. PSYCHIATRIC MORBIDITY IN A CHILDREN'S HOME1

    Science.gov (United States)

    Chaturvedi, P. K.; Agarwal, A. K; Gupta, S. C.

    1980-01-01

    SUMMARY Sixty-two inmates of a children's home were examined by using a symptom check list and Hindi adaptation of Stanford Binet Intelligence Scale—Form LM (1960). A high proportion (69.4%) of the inmates had one or other psychiatric problem. Mild mental retardation (I. Q. 50—70) was most common (40.3%), 11.3% were diagnosed as having unsocialized disturbance of conduct. Four most common psychiatric symptoms were stealing, quarrelsome behaviour, destructive behaviour and bed wetting. No significant correlation was found between psychiatric illnesses and present age, duration of stay and age at entry into the home. PMID:22058478

  15. Condição microbiológica dos leitos hospitalares antes e depois de sua limpeza Microbiological condition of hospital beds before and after terminal cleaning

    Directory of Open Access Journals (Sweden)

    Denise de Andrade

    2000-04-01

    Full Text Available INTRODUÇÃO: O meio ambiente hospitalar guarda uma íntima relação com as infecções hospitalares, podendo proporcionar focos de contato e de transmissão. Como a higiene representa uma das formas de controlar a contaminação ambiental, realizou-se estudo para avaliar as condições microbiológicas dos colchões hospitalares antes e depois de sua limpeza. MÉTODOS: Utilizaram-se, para a colheita dos espécimes, placas de contato -- Rodac-plate ¾ preparadas com meio de cultura ágar-sangue. Selecionaram-se os leitos de acordo com critérios previamente estabelecidos, e os locais de colheita sob o colchão foram escolhidos por sorteio aleatório. Aplicou-se o teste estatístico de Goodman para o estudo das alterações numéricas quanto a positividade das placas. RESULTADOS: Foram investigados 52 colchões, totalizando 520 placas, das quais 514 (98,8% resultaram em culturas positivas, sendo que 259 corresponderam ao período anterior à limpeza e 255 ao período posterior ao procedimento. Houve redução de culturas positivas em apenas 4 placas. CONCLUSÕES: Os resultados obtidos sugerem que a limpeza, da forma como vem sendo conduzida, provoca o deslocamento da carga microbiana para outros pontos do colchão em vez de diminuí-la, resultando na manutenção da quantidade de microorganismos que existia anteriormente à limpeza.INTRODUCTION: The hospital's environment keeps a close relationship with hospital infection, which may promote focus of contact and transmission. The terminal cleaning of patient unit represents one way to control microbiological environmental contamination. The study has as its main objective to evaluate the microbiological conditions of hospital mattresses before and after cleaning. METHODS: Rodac plates were utilized for specimen collection with culture medium - blood agar plate. The patients beds were chosen by criteria established before hand and the places for specimen collection in the mattress were chosen by

  16. The direct and interactive effects of physical abuse severity and negative affectivity on length of psychiatric hospitalization: evidence of differential reactivity to adverse environments in psychiatrically high-risk youth.

    Science.gov (United States)

    Comas, Michelle; Valentino, Kristin; Bridgett, David J; Hayden, Lisa C

    2014-01-01

    The current study examined the interactive influence of multiple factors (i.e., physical abuse severity and negative affectivity) in predicting youth's inpatient psychiatric length of stay (LOS), extending previous research focused on identification of only single LOS predictors. Elevated physical abuse severity was hypothesized to predict longer youth LOS, and negative affectivity was anticipated to exacerbate this relationship. This study included 42 youth. Clinicians rated youth temperament, whereas physical abuse severity and LOS were coded from youth medical records. Controlling for other previously determined predictors of LOS (i.e., age, gender, and GAF), moderation analyses confirmed hypotheses, revealing a temperament by environment interaction. Specifically, physical abuse severity was positively associated with LOS only in the context of high negative affectivity. Findings highlighted the importance of disentangling the interactive effects of multiple factors in predicting LOS. Moreover, critical clinical implications involving prioritized trauma assessment and treatment for inpatient youth are discussed.

  17. Religião e transtornos mentais em pacientes internados em um hospital geral universitário Religion and psychiatric disorders in patients admitted to a university general hospital

    Directory of Open Access Journals (Sweden)

    Rachel Esteves Soeiro

    2008-04-01

    Full Text Available A fim de determinar a prevalência de transtornos mentais em uma amostra de pacientes de um hospital geral e sua relação com a denominação religiosa e religiosidade, foram investigados 253 pacientes internados no Hospital das Clínicas da Universidade Estadual de Campinas por intermédio de um questionário sócio-demográfico e um instrumento para diagnóstico psiquiátrico (MINI-Plus. A maioria dos pacientes era católica (63,2%; n = 177; seguidos dos evangélicos pentecostais (20,4%; n = 57; dos "sem-religião" (7,5%; n = 21; espíritas (4,3%; n = 12 e protestantes históricos (2,3%; n = 8. Consideraram-se muito religiosos 43,2% (n = 116, religiosos 46,9% (n = 129, pouco religiosos 9,8% (n = 27, não religiosos 1,1% (n = 3. A filiação religiosa evangélica e maior freqüência a cultos relacionaram-se à menor freqüência de problemas com álcool. É possível que a filiação religiosa evangélica exerça uma ação inibidora na ocorrência de transtornos relacionados ao álcool. Indivíduos muito religiosos ou pouco/nada religiosos apresentaram maior prevalência de transtorno bipolar. A dimensão intensidade da religiosidade revelou-se modestamente associada à prevalência geral dos transtornos, especialmente ao transtorno bipolar. É razoável que situações extremas (de muito ou reduzido envolvimento relacionem-se a tal achado, relacionando tanto a busca exacerbada ou o afastamento da religiosidade com estados mentais alterados.In order to evaluate the prevalence of psychiatric disorders in a Brazilian general hospital and their association with religious denomination and religiosity, 253 inpatients were interviewed. A socio-demographic questionnaire and an instrument for diagnosis of mental disorders (MINI-Plus were applied. Distribution of religious denominations was: Catholic 63.2% (n = 177, Evangelical Protestant 20.4% (n = 57, Spiritist 4.3% (n = 12, traditional Protestant 2.3% (n = 8, and "no religion" 7.5% (n = 21. Degree

  18. Patterns and determinants of acute psychiatric readmissions | Behr ...

    African Journals Online (AJOL)

    Patterns and determinants of acute psychiatric readmissions. Graham Michael Behr, Cathy Christie, Neil Soderlund, Tennyson Lee. Abstract. Objectives. Deinstitutionalisation and shortage of psychiatric beds worldwide has led to extensive research into the risk factors and interventions associated with rapid and recurrent ...

  19. Dissociative Experiences in Psychiatric Inpatients

    OpenAIRE

    Ali Firoozabadi; Nooshin Reza Alizadeh

    2016-01-01

    Dissociative disorders are conditions that involve disruptions of memory, awareness, identity, or perception. Data collected in diverse geographic locations underline the consistency in clinical symptoms of dissociative disorders. In this cross-sectional descriptive study, prevalence of dissociative experiences has been screened in hospitalized patients in psychiatric wards of Shiraz University of Medical Sciences in Iran. One hundred and sixty patients in two hospitals entered the study. Our...

  20. Predictors of psychiatric readmissions to

    African Journals Online (AJOL)

    identification of early symptoms of relapse, application of immediate and appropriate measures, and adequate record-keeping by health institutions are ... hospitalization, resulting from the policy of de-institutionalization in. Nigeria has led to ..... adolescent psychiatric care Aust N Z ] Psychiatry 2005; 39: 600-606. 3. vaett C.

  1. Animal-assisted therapy with chronic psychiatric inpatients: equine-assisted psychotherapy and aggressive behavior.

    Science.gov (United States)

    Nurenberg, Jeffry R; Schleifer, Steven J; Shaffer, Thomas M; Yellin, Mary; Desai, Prital J; Amin, Ruchi; Bouchard, Axel; Montalvo, Cristina

    2015-01-01

    Animal-assisted therapy (AAT), most frequently used with dogs, is being used increasingly as an adjunctive alternative treatment for psychiatric patients. AAT with larger animals, such as horses, may have unique benefits. In this randomized controlled study, equine and canine forms of AAT were compared with standard treatments for hospitalized psychiatric patients to determine AAT effects on violent behavior and related measures. The study included 90 patients with recent in-hospital violent behavior or highly regressed behavior. Hospitalization at the 500-bed state psychiatric hospital was two months or longer (mean 5.4 years). Participants were randomly selected to receive ten weekly group therapy sessions of standardized equine-assisted psychotherapy (EAP), canine-assisted psychotherapy (CAP), enhanced social skills psychotherapy, or regular hospital care. Participants' mean age was 44, 37% were female, 76% had diagnoses of schizophrenia or schizoaffective disorder, and 56% had been committed involuntarily for civil or forensic reasons. Violence-related incident reports filed by staff in the three months after study intake were compared with reports two months preintake. Interventions were well tolerated. Analyses revealed an intervention group effect (F=3.00, df=3 and 86, p=.035); post hoc tests showed specific benefits of EAP (p<.05). Similar AAT effects were found for the incidence of 1:1 clinical observation (F=2.70, df=3 and 86, p=.051); post hoc tests suggested benefits of CAP (p=.058) as well as EAP (p=.082). Covariance analyses indicated that staff can predict which patients are likely to benefit from EAP (p=.01). AAT, and perhaps EAP uniquely, may be an effective therapeutic modality for long-term psychiatric patients at risk of violence.

  2. The new asylums in the community: severely ill psychiatric patients living in psychiatric supported housing facilities. A Danish register-based study of prognostic factors, use of psychiatric services, and mortality

    DEFF Research Database (Denmark)

    Nordentoft, Merete; Pedersen, Marianne G; Pedersen, Carsten B

    2012-01-01

    INTRODUCTION: Reorganization of psychiatric treatment in Denmark involved a declining number of psychiatric long-stay beds and an increasing number of psychiatric supported housing facilities in the community. Very few studies have focused on the population in such facilities. METHODS: Information...... was generated combining addresses of supported psychiatric housing facilities with information from the Danish Civil Registration System to create a case register of persons living in supported psychiatric housing facilities. Through linkage with the Danish Psychiatric Central Register, we examined predictors...... of becoming a resident in a psychiatric housing facility, use of psychiatric services around the time of entrance to a supported psychiatric housing facility, and mortality rates for residents in a psychiatric housing facility compared to non-residents and to persons in the general population who never...

  3. The effect of psychiatric rehabilitation on the activity and participation level of clients with long-term psychiatric disabilities

    NARCIS (Netherlands)

    Wel, T.F. van; Felling, A.J.A.; Persoon, J.M.G.

    2003-01-01

    During the last decades of the 20th century, many psychiatric hospitals changed the living environments of their clients with long-term psychiatric disabilities. We investigated the effect of this environmental psychiatric rehabilitation and normalization process on the activity and participation

  4. The Effect of Psychiatric Rehabilitation on the Activity and Participation Level of Clients with Long-Term Psychiatric Disabilities

    NARCIS (Netherlands)

    Wel, Tom van; Felling, Albert; Persoon, Jean

    2003-01-01

    During the last decades of the 20th century, many psychiatric hospitals changed the living environments of their clients with long-term psychiatric disabilities. We investigated the effect of this environmental psychiatric rehabilitation and normalization process on the activity and participation

  5. 21 CFR 880.6060 - Medical disposable bedding.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Miscellaneous Devices § 880.6060 Medical disposable bedding. (a) Identification. Medical disposable bedding is a device... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical disposable bedding. 880.6060 Section 880...

  6. [Knowledge about previous psychiatric care: is it a guaranty for therapeutic investment or a curse in psychiatric emergencies].

    Science.gov (United States)

    De Clercq, M; Hoyois, P

    1990-04-01

    A sample of 755 psychiatric emergencies taken in charge in the emergency service of the St-Luc Hospital, Brussels, was divided into two groups: patients without psychiatric background (498) and patients having received previous psychiatric care (238). A background of psychiatric follow-up strongly influence the taking on and therapeutic decisions to be made by psychiatrists: its absence protects the patient and is seen as the guaranty of a good investment from the therapist while the existence of previous psychiatric treatment rather leads to hospital in lieu of crisis intervention, even when the crisis mechanisms are not significantly different in both samples.

  7. A SHOCKING REQUIREMENT IN THE LAW ON NEGLIGENCE LIABILITY FOR PSYCHIATRIC ILLNESS: LIVERPOOL WOMEN'S HOSPITAL NHS FOUNDATION TRUST V RONAYNE [2015] EWCA CIV 588.

    Science.gov (United States)

    Burrows, Andrew S; Burrows, John H

    2016-01-01

    The Ronayne case concerned a husband who suffered a psychiatric illness, described as an adjustment disorder, in seeing the condition of his wife who was the primary victim of admitted medical negligence. His claim for compensation, as a 'secondary victim', failed because he could not satisfy the legal requirement that there must be a sudden shocking event. This commentary criticises that requirement which appears to make no medical sense. © The Author 2016. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Hospital

    African Journals Online (AJOL)

    treatment modality. Design: It is a retrospective study of all confirmed. Burkitt's lymphoma of the head and neck region seen at the Obafemi Awolowo University Teaching Hospital Ile. Ife (OAUTHC) between 1986 and 2002. Patients and methods: The medical records of all the patients with the histopathologically confirmed ...

  9. Exploring the perceptions of psychiatric patients regarding marijuana use

    OpenAIRE

    Belinda Scrooby; Emmerentia du Plessis; Leepile A. Sehularo

    2012-01-01

    There is limited understanding on marijuana use by psychiatric patients, specifically with regard as to why they continue to smoke marijuana despite the negative consequences, such as readmittance to psychiatric hospitals following marijuana-induced psychosis. It is, therefore, important to understand why psychiatric patients continue to use marijuana, despite experiencing its negative effects. The purpose of this study was to explore and describe the perceptions of psychiatric patients with ...

  10. in a Nigerian teaching hospital

    African Journals Online (AJOL)

    The study was conducted at the University of llorin. Teaching Hospital (U1TH) llorin between May and June 2002. The Hospital is a second generation Teaching Hospital es- tablished on 2nd May, 1980. Currently, the hospital has a total bed space of 515 distributed as follows: i. General Hospital Wing, llorin with 304 beds;.

  11. [Crisis unit at the general hospital: Determinants of further hospitalization].

    Science.gov (United States)

    Norotte, C; Omnès, C; Crozier, C; Verlyck, C; Romanos, M

    2017-10-01

    The availability of short-stay beds for brief admission (less than 72hours) of crisis patients presenting to the emergency room is a model that has gained a growing interest because it allows time for developing alternatives to psychiatric hospitalization and favors a maintained functioning in the community. Still, the determinants influencing the disposition decision at discharge after crisis intervention remain largely unexplored. The primary objective of this study was to determine the factors predicting aftercare dispositions at crisis unit discharge: transfer for further hospitalization or return to the community. Secondary objectives included the description of clinical and socio-demographic characteristics of patients admitted to the crisis unit upon presentation to the emergency room. All patients (n=255) admitted to the short-stay unit of the emergency department of Rambouillet General Hospital during a one-year period were included in the study. Patient characteristics were collected in a retrospective manner from medical records: patterns of referral, acute stressors, presenting symptoms, initial patient demand, Diagnostic and Statistical Manual, 5th edition (DSM-5) disorders, psychiatric history, and socio-demographic characteristics were inferred. Logistic regression analysis was used to determine the factors associated with hospitalization decision upon crisis intervention at discharge. Following crisis intervention at the short-stay unit, 100 patients (39.2%) required further hospitalization and were transferred. Statistically significant factors associated with a higher probability of hospitalization (P<0.05) included the patient's initial wish to be hospitalized (OR=4.28), the presence of a comorbid disorder (OR=3.43), a referral by family or friends (OR=2.89), a history of psychiatric hospitalization (OR=2.71) and suicidal ideation on arrival in the emergency room (OR=2.26). Conversely, significant factors associated with a lower probability of

  12. Oppositional defiant disorder symptoms in relation to psychopathic traits and aggression among psychiatrically hospitalized children: ADHD symptoms as a potential moderator.

    Science.gov (United States)

    Becker, Stephen P; Luebbe, Aaron M; Fite, Paula J; Greening, Leilani; Stoppelbein, Laura

    2013-01-01

    Oppositional defiant disorder (ODD) is associated with elevated rates of psychopathic traits and aggression. However, it remains unclear if attention-deficit/hyperactivity disorder (ADHD) symptoms exacerbate these relations, particularly in samples of children who are severely clinically distressed. The purpose of the present study was to test ADHD symptoms as a potential moderator of the relations of ODD symptoms to psychopathic traits (i.e., callous-unemotional [CU] traits, narcissism) and to aggressive subtypes (i.e., proactive, reactive aggression) in a large sample of children in an acute psychiatric inpatient facility (n = 699; ages 6-12). Multiple regression analyses indicated that, after controlling for child demographic variables, ADHD symptoms marginally exacerbated the relation between ODD symptoms and CU traits. Both ODD and ADHD symptoms had an additive, but not a multiplicative effect, in predicting narcissism. In addition, for a subset of the full sample for whom data were available (n =351), ADHD symptoms exacerbated the relation between ODD symptoms and both reactive and proactive aggression. These results suggest that ADHD symptoms tend to have a negative effect on the relation between ODD symptoms and markers of antisociality among children receiving acute psychiatric care. © 2013 Wiley Periodicals, Inc.

  13. Comparing Efficacy of Implementing Two Teaching Methods Contract Learning and Traditional Instruction on Clinical Skills of Nursing Students in Psychiatric Wards of Hospitals of Tehran

    Directory of Open Access Journals (Sweden)

    Jamileh Mohtashami

    2009-06-01

    Full Text Available Background and purpose: A learning contract is defined as a written agreement between teacher and student which makes explicit what a learner will do to achieve specified learning outcomes.Learning contracts have been used as a teaching and learning strategy for both undergraduate and graduate nursing students in many countries.Methods : This research is a quasi-experimental study that compares effect of two different teaching methods , Contract learning and traditional on clinical skills for a group of nursing students who were in fourth year of study in a pre-registration bachelor of nursing degree program in Tehran . A learning contract was implemented as a learning tool in the students clinical placement in psychiatric nursing .Data were connected from questionnaires , interviews and clinical evaluation papers with students .Results : The results showed that students agreed that there was an increase in students autonomy and motivation in learning with the use of learning contract . It also increased the sharing between students and clinical instructors.Conclusion : According to the findings of this study , contract learning is considered beneficial to students learning and has the potential to be used in clinical learning .Key words : NURSING STUDENTS, LEARNING CONTRACTS , TRADITIONAL METHOD , MOTIVATION , AUTONOMY, PSYCHIATRIC WARDS .

  14. [Personality disorders and "psychopathy" in sex offenders imprisoned in forensic-psychiatric hospitals--SKID-II- and PCL-R-results in patients with impulse control disorder and paraphilia].

    Science.gov (United States)

    Borchard, Bernd; Gnoth, Annika; Schulz, Wolfgang

    2003-04-01

    In order to clarify differential-diagnostic questions 47 mentally ill sex offenders (with impulse control disorder and paraphilia) were assessed with regard to comorbidity of personality disorders and "psychopathy". For this examination the SKID-II for personality disorders and the Psychopathy Checklist (PCL-R) were used. 72 % of the sex offenders showed at least one personality disorder. The highest prevalence was found for cluster-B disorders, first of all the antisocial personality disorder. Using a PCL-R cut off score of 25 (for Europe) 10 of the 47 subjects (21 %) were diagnosed as "psychopaths", whereas being a "psychopath" is associated with a number of different personality disorders. The importance of structured diagnostic with regard to comorbidity of personality disorders in sex offenders imprisoned in maximum security psychiatric hospitals is stressed, and furthermore there is evidence that the PCL-R is a valid instrument for prognosis, but not a psychological-psychiatric instrument for the assessment of personality disorders.

  15. [Promoting "successful aging" in community psychiatric care].

    Science.gov (United States)

    Niimura, Hidehito; Nemoto, Takahiro; Sakuma, Kei; Mizuno, Masafumi

    2011-01-01

    Recently, patients with schizophrenia have been progressively aging in a way similar to that of the general population. In Japan, community mental health care has become more active in the context of the policy of promoting the discharge of patients from psychiatric hospitals. Patients with chronic schizophrenia who have been discharged are already approaching old age. "Successful aging" may be a key concept in their community-based psychiatric care. Successful aging does not emphasize a loss of youth, but focuses on gains and growth achieved with aging. In the Sasagawa Project, 78 patients with schizophrenia were gradually transferred from a psychiatric hospital to a community dwelling. Eight years have passed since the project began. Elder patients (>60 years old) showed stable psychiatric symptoms and were rarely readmitted to the psychiatric ward. They were, however, more often readmitted to hospital due to physical disease (for example, lifestyle-related disease or fracture) than were middle -aged patients (aging, but they are not sufficiently prepared for old age. In the mental health care of aging psychiatric patients, it is necessary to not only control psychiatric symptoms, but also promote and improve their quality of life by maintaining their ability to continue living in the community (for example, by supporting their preparations for old age).

  16. [Social integration and contacts to reference persons of the normal social environment in inpatient treatment in the psychiatric hospital. A prospective catamnestic study of patients admitted for the first time with schizophrenic and cyclothymic psychoses].

    Science.gov (United States)

    Böcker, F M

    1984-01-01

    Fifty first-admission inpatients (27 women, 23 men; mean age 35.1 years) with schizophrenia (n = 35) or affective disorders (n = 15) participated in a standardized, half-open interview about contact with people outside the hospital. The frequency of contact was compared with outcome, as based on a 1-year follow-up. Nearly all patients (48 of 50) had "direct" contact with relatives and friends during the week (means = 3/week): 45 patients had visitors, 13 went home on weekends. Thirty-five patients had contact with the outside by telephone, and 21 by letter; only 12 patients indicated no "indirect" contact. The frequency of contact had no relationship to sex, age or diagnosis. The significant factors were: structure of the patient's family, his/her educational and occupational level, social network, means of admission, conditions of hospitalization, and length of stay. The distance between the patient's residence and the hospital markedly influenced the frequency of visits and weekend holidays. The importance of frequent interaction with the usual social environment was verified by follow-up: 11 patients with rare or only average contact had unfavorable results (readmission or suicide by 1 year after discharge or long-term hospitalization); on the other hand, none of the patients with frequent direct contact outside the hospital showed poor results. There is no reason for indiscriminate criticism of the relatives of psychiatric inpatients according to etiological hypotheses of "family research"; above all, patients without relationships with a family or friends have to be regarded as at risk.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Reducing the Use of Seclusion and Restraint in Psychiatric Emergency and Adult Inpatient Services— Improving Patient-Centered Care

    Science.gov (United States)

    Wale, Joyce B; Belkin, Gary S; Moon, Robert

    2011-01-01

    The reduction of seclusion and restraint (S/R) use has been given national priority by the US government, The Joint Commission, and patient advocacy groups. It is associated with high rates of patient and staff injuries and is a coercive and potentially traumatizing intervention. The New York City Health and Hospitals Corporation (HHC) is the largest municipal health care system in the country, with 11 HHC facilities operating psychiatric emergency services and inpatient psychiatric services. HHC operates 1117 adult inpatient psychiatric beds with an average length of stay of 22.2 days that generated over 19,000 discharges in 2009. In 2009, there were over 36,000 psychiatric emergency services visits. HHC's Office of Behavioral Health provides strategic leadership, planning, and support for the operations and quality objectives of these services. In January 2007, the corporate office initiated the Seclusion and Restraint Reduction Initiative, with a sequenced, intensive series of interventions and strategies to help focus the behavioral health leadership and staff on the need for continued culture change toward a more patient-centered and safe system of psychiatric emergency and adult inpatient care. From 2007 to 2009, there was a substantial decline in HHC's overall rate of S/R incidents in inpatient units. The more substantial impact was in the reduced overall time spent in S/R; the reduced frequency of use of S/R; and the reduced likelihood of patient injury from S/R use. PMID:21841927

  18. Reducing the use of seclusion and restraint in psychiatric emergency and adult inpatient services- improving patient-centered care.

    Science.gov (United States)

    Wale, Joyce B; Belkin, Gary S; Moon, Robert

    2011-01-01

    The reduction of seclusion and restraint (S/R) use has been given national priority by the US government, The Joint Commission, and patient advocacy groups. It is associated with high rates of patient and staff injuries and is a coercive and potentially traumatizing intervention. The New York City Health and Hospitals Corporation (HHC) is the largest municipal health care system in the country, with 11 HHC facilities operating psychiatric emergency services and inpatient psychiatric services. HHC operates 1117 adult inpatient psychiatric beds with an average length of stay of 22.2 days that generated over 19,000 discharges in 2009. In 2009, there were over 36,000 psychiatric emergency services visits. HHC's Office of Behavioral Health provides strategic leadership, planning, and support for the operations and quality objectives of these services. In January 2007, the corporate office initiated the Seclusion and Restraint Reduction Initiative, with a sequenced, intensive series of interventions and strategies to help focus the behavioral health leadership and staff on the need for continued culture change toward a more patient-centered and safe system of psychiatric emergency and adult inpatient care. From 2007 to 2009, there was a substantial decline in HHC's overall rate of S/R incidents in inpatient units. The more substantial impact was in the reduced overall time spent in S/R; the reduced frequency of use of S/R; and the reduced likelihood of patient injury from S/R use.

  19. Model-based testing for space-time interaction using point processes: An application to psychiatric hospital admissions in an urban area

    CERN Document Server

    Meyer, Sebastian; Rössler, Wulf; Held, Leonhard

    2015-01-01

    Spatio-temporal interaction is inherent to cases of infectious diseases and occurrences of earthquakes, whereas the spread of other events, such as cancer or crime, is less evident. Statistical significance tests of space-time clustering usually assess the correlation between the spatial and temporal (transformed) distances of the events. Although appealing through simplicity, these classical tests do not adjust for the underlying population nor can they account for a distance decay of interaction. We propose to use the framework of an endemic-epidemic point process model to jointly estimate a background event rate explained by seasonal and areal characteristics, as well as a superposed epidemic component representing the hypothesis of interest. We illustrate this new model-based test for space-time interaction by analysing psychiatric inpatient admissions in Zurich, Switzerland (2007-2012). Several socio-economic factors were found to be associated with the admission rate, but there was no evidence of genera...

  20. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    . Documentation exists in; well-being of patients and staff, sleep disorders, pain distraction, confidentiality and privacy, levels of errors in hospitals. Art and the use of color: Art can be context related so one should be aware whether it is in a private ward or the foyer and related to the experience...... in treating disease can be supported by architecture which is sensitive to the contextual conditions of healing in health facilities. It is not the intention to supplant technology, but a question of supplementing the incredible advances that have been made in medicine in recent decades. The central premise......- sick-leave and work-related injuries....

  1. Co-occurrence of binge eating disorder with psychiatric and medical disorders.

    Science.gov (United States)

    Javaras, Kristin N; Pope, Harrison G; Lalonde, Justine K; Roberts, Jacqueline L; Nillni, Yael I; Laird, Nan M; Bulik, Cynthia M; Crow, Scott J; McElroy, Susan L; Walsh, B Timothy; Tsuang, Ming T; Rosenthal, Norman R; Hudson, James I

    2008-02-01

    Prior studies suggest that certain psychiatric and medical disorders co-occur with binge eating disorder (BED). However, there has been no large, community-based study with diagnoses made by clinician interviewers. We used data from that type of study to assess the co-occurrence of various psychiatric and medical disorders with DSM-IV BED and with subthreshold BED. From October 2002 to July 2004, we interviewed 150 probands with BED, 150 probands without BED, and 888 of their first-degree relatives (135 of whom had BED, and 54 of whom met specific partial criteria for BED that we defined as subthreshold BED). Study participants were interviewed using the Structured Clinical Interview for DSM-IV to assess BED and other psychiatric disorders and a supplemental structured interview to assess certain medical disorders; participants also completed a self-report questionnaire, the Bad Things Scale. For each psychiatric and medical disorder, we calculated the age- and sex-adjusted co-occurrence odds ratio: the odds of having that disorder in one's lifetime among individuals with (full or subthreshold) lifetime BED compared to individuals without lifetime BED. We also used subjects' responses to the Bad Things Scale to adjust for adversity over-reporting, a type of response bias that could result in spurious findings of co-occurrence. Full BED co-occurred significantly with bipolar disorder, major depressive disorder, bulimia nervosa but not anorexia nervosa, most anxiety disorders, substance use disorders, body dysmorphic disorder, kleptomania, irritable bowel syndrome, and fibromyalgia. These results changed little after correcting for adversity over-reporting. Subthreshold BED co-occurred significantly with many, but not all, of the significantly co-occurring disorders for full BED. BED and, to a lesser degree, subthreshold BED exhibit substantial lifetime co-occurrence with psychiatric and medical disorders.

  2. Treatment Adherence in Psychiatric Disorders

    Directory of Open Access Journals (Sweden)

    Mehmet Emin Demirkol

    2016-03-01

    Full Text Available Despite developments in treatment options there is no significant increase in treatment adherence ratios. Inadherence in psychiatric disorders is higher than the other diseases. Loss of insight, drugs' side effects, sociodemographic features, personality traits are major factors affecting the treatment adherence. Determining and overcoming these factors for each disorder will help to improve adherence and reduce the treatment costs and hospitalization. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(1: 85-93

  3. How can a change in the operating system of the mental health review board promote the discharge of long-term hospitalized psychiatric patients? A case study of Seoul city

    National Research Council Canada - National Science Library

    Lee, Myung-Soo; Lim, Hee-Young; Kim, Youngki; Lee, Yong-Suk

    2014-01-01

    .... In contrast to there are many components which leads to long length of stay of psychiatric patients in Korean situation such as low and fixed medical fee for psychiatric inpatient treatment, shortage...

  4. Niveles de dependencia y utilización de servicios en los hospitales psiquiátricos de Aragón Dependency levels and health care services' utilization in psychiatric hospitals in Aragon (Spain

    Directory of Open Access Journals (Sweden)

    Marcos de Miguel

    2004-06-01

    Full Text Available Objetivos: Conocer las características de los pacientes ingresados en hospitales psiquiátricos de la Comunidad Autónoma de Aragón; valorar sus niveles de dependencia y analizar el grado de utilización de servicios. Métodos: Se realizó un estudio transversal mediante encuesta entre el 1 de julio y el 31 de noviembre de 2001. El cuestionario utilizado es el Resident Assesment Instrument (RAI para pacientes con trastornos psiquiátricos (RAI-MH. Se estudió una muestra de 437 pacientes ingresados en los hospitales psiquiátricos del Servicio Aragonés de Salud que atienden a enfermos crónicos o en rehabilitación. Se utilizó el Resource Utilization Group (RUG-I para clasificar a los pacientes en función de su nivel de dependencia para las actividades de la vida diaria (AVD. Resultados: De los 437 pacientes, 259 (59,3% eran varones con una media de edad de 62,2 años. El 82,1% de los pacientes pertenecía al grupo 1 del RUG-I. La mayor parte de los servicios de atención formal se concentra en los grupos menos dependientes. El 25,3% de los pacientes del grupo 1 del RUG-I y el 15,2% del grupo 2 requirieron al menos una visita del psiquiatra, frente a ninguna del resto de los grupos. Las intervenciones de enfermería son requeridas con más frecuencia por los pacientes dependientes. El 100% de los grupos 2-8 requiere asistencia física diaria para las AVD frente al 26,3% del grupo 1. En el análisis multivariante las variables predictoras fueron el hospital y el tipo de unidad. Conclusiones: Hay una gran variabilidad en la utilización de servicios por parte de los pacientes de hospitales psiquiátricos en función de los niveles de dependencia. Una gran parte de los pacientes no requiere asistencia formal. Es preciso realizar la valoración de las necesidades de cada paciente para proporcionar el tipo de asistencia que realmente requiere.Objectives: To determine the characteristics of patients living in psychiatric hospitals in Aragon, to

  5. Low blood pressure in psychiatric inpatients.

    OpenAIRE

    Masterton, G; Main, C J; Lever, A F; Lever, R S

    1981-01-01

    Blood pressure recordings in 116 female psychiatric inpatients were analysed. Sixty-nine women had schizophrenia, the remainder a variety of psychiatric conditions. All had been in hospital continuously for more than one year, the average for 19 years continuously. An average of seven recordings of blood pressure per patient had been made during that time. The latest of these compared well with measurements made independently using a sphygmomanometer free from observer bias. On admission to h...

  6. Memórias de idosos aposentados de um hospital psiquiátrico catarinense (1951-1971 Memorias del trabajo de ancianos jubilados de un hospital psiquiátrico (1951-1971 Memoirs of work retirees elderly from a psychiatric hospital (1951-1971

    Directory of Open Access Journals (Sweden)

    Ana Maria Espíndola Koerich

    2010-12-01

    ía, hoy ancianos, tuvieron un papel fundamental en la asistencia de enfermería prestada a la clientela internada.This is a qualitative study of socio-historical approach that aimed to historicize the daily lives of nursing workers, elderly nowadays, in a psychiatric hospital in Santa Catarina state in the period between 1951 and 1971. Data were collected through semistructured interviews with six nursing staff using the method of oral history. The memory was used as the theoretical framework and the data were categorized on content analysis. The results showed the knowledge and practices of nursing staff, working conditions and relationships between professionals in the health care team. The results showed that the situation experienced by workers in this institution was congruent with the situation of Brazilian nursing, especially in psychiatric hospitals asylums. Moreover, these nursing workers, elderly people today, had a key role in nursing care to patients admitted.

  7. Clozapine use reduced psychiatric hospitalization and emergency room visits in patients with bipolar disorder independent of improved treatment regularity in a three-year follow-up period.

    Science.gov (United States)

    Wu, Chi-Shin; Wang, Sheng-Chang; Liu, Shi-Kai

    2015-06-01

    The efficacy of clozapine in bipolar disorder remains to be systemically examined. In the current study, we sought to disentangle the effect of clozapine from that of improved treatment regularity and to compare the effect of clozapine with the effect of regular treatment for bipolar disorder by exploring the complete 10-year clozapine prescription data from a Taiwanese total population health claims database. In the period between 2000 and 2009, 3,874 (3.3%) out of the 117,785 patients identified as having bipolar disorder in a Taiwanese total population health claims database were ever prescribed clozapine. Among them, 920 patients with bipolar disorder who had good pre-clozapine medication compliance and received at least two clozapine prescriptions were further categorized according to their clozapine medication possession ratio (MPR) as regular users (MPR ≥ 0.8; n = 476) and irregular users (MPR clozapine mirror periods with a follow-up time of up to three years, controlling for time-variant course confounders. The patterns of change in outcome indices from the pre-clozapine period to the post-clozapine period differed significantly between the two clozapine-user groups. Clinical outcome indices improved only in regular users, while they deteriorated in irregular users. Over the three-year follow-up period, the irregular users consistently had a higher adjusted risk for increased numbers of ER visits [odds ratio (OR): 2.06-2.43], hospitalizations (OR: 2.52-3.22), and total hospital days (OR: 2.42-2.91) when compared to the regular users. Thus, effects of clozapine were consistently demonstrated in one- to three-year mirror comparison periods. Clozapine, when used with high treatment regularity (MPR > 0.8), was effective in reducing the numbers of ER visits, hospitalizations, and total hospital days in patients with bipolar disorder with previous frequent hospitalizations and ER visits despite regular pre-clozapine treatment for bipolar disorder. However

  8. Critical Access Hospitals (CAH)

    Science.gov (United States)

    ... Distance Requirements and Critical Access Hospital (CAH) Recertification Checklist for Evaluation of Compliance with the Location and ... purchase new equipment such as hospital beds and office machines. Visit the funding section of this guide ...

  9. A period prevalence study of being a parent in a secure psychiatric hospital and a description of the parents, the children and the impact of admission on parent-child contact.

    Science.gov (United States)

    Argent, Sarah Elizabeth; Riddleston, Laura; Warr, Jodie; Tippetts, Hannah; Meredith, Zoe; Taylor, Pamela Jane

    2017-07-14

    Most secure psychiatric hospital patients are of childbearing age, but their parental status is minimally researched. The aim of the study is to describe the parent patients in one regional secure hospital and explore post-admission child-parent contact. A 9-year records survey of a complete secure hospital admissions cohort was conducted. Nearly half of the cohort of 165 patients (46%) were parents. Parent patients were less likely than childless patients to have diagnostic co-morbidity or to have received childhood mental health care but were more likely to have committed a homicide/life-threatening index offence with family or friend victims. Men, whether fathers or not, and childless women were unlikely ever to have harmed a child, but it was more likely than not that mother patients had. Records indicated minimal discussion about childlessness. Ninety-four (60%) of the 157 children involved were under 18 years on parental admission. Adult children who had been living with the parent patient before the parent's admission invariably maintained contact with them afterwards, but nearly half (48%) of such under 18-year-olds lost all contact. The only characteristic related to such loss was the index offence victim having been a nuclear family member. As the discrepancy in whether or not parent patients and their children continued contact with each other after the parent's admission seemed to depend mainly on the child's age and his or her resultant freedom to choose, acquisition of accurate data about affected children's perspective on visiting seems essential. Given that parent patients had experienced relative stability in interpersonal relationships and had rarely had childhood disorders, parenting support in conjunction with treatment seems appropriate. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John W