Background: Few studies have considered the impact of demographic and clinical variables on help received respectively from services and relatives to satisfy needs of adults with severe mental disorders (SMD). Purpose...Background: Few studies have considered the impact of demographic and clinical variables on help received respectively from services and relatives to satisfy needs of adults with severe mental disorders (SMD). Purposes: To identify major needs receiving help and, using the Andersen’s Behavioural Model of Health Service Use, to identify and compare predisposing, enabling and need factors associated with help given respectively by services and relatives. Methods: 352 adults with SMD from Montreal (Canada) were interviewed using six standardized instruments. Clinical records were consulted. Multiple linear regression analyses were processed to measure level of help received from relatives and services. Results: Factors significantly associated with help from relatives were: higher number of perceived needs;fewer diagnoses;better community functioning;being younger, and in a conjugal relationship;living autonomously;having social support and better quality of life;and, marginally, being an immigrant. Factors significantly associated with help from services were: higher number of perceived needs, better quality of life, supervised housing, adjustment disorder and schizophrenia. Conclusions: Help overall is insufficient to meet users’ needs. Services are more helpful than relatives, in particular regarding health needs. Comparatively to help from services, help from relatives is associated with predisposing factors like age, marital status and nationality.展开更多
Introduction: Tuberculosis is a global health problem. Improving medication adherence is an important attribute concerning the outcome of tuberculosis treatment. This study investigates illness experience of patients ...Introduction: Tuberculosis is a global health problem. Improving medication adherence is an important attribute concerning the outcome of tuberculosis treatment. This study investigates illness experience of patients belonging to a low-income district within Manguinhos catchment area. Narrative studies are able to unfold features concerning patient adherence and co-occurrence of depressive symptoms. Methods: Twenty-three patients under treatment were interviewed using McGill Illness Narrative Interview (MINI-McGILL), besides depression screening with “Self-Report Questionnaire-20” (SRQ-20) and “Beck Depression Inventory” (BDI). Results: Explanatory models disregarded airborne microorganism contagion, known but not considered relevant while bohemian or deviant lifestyle was rather perceived as a causal model. Patients mentioned contiguous events suggesting pneumonia or influenza misdiagnosis before final tuberculosis diagnosis (testing or suspicion). Therapeutic pathways were erratic, suggesting low literacy level and postponed or inadequate diagnosis accuracy. Emergency units or private services usually stood for primary care units considered first choice by planners. Expressions such as “dreadful/shameful disease” or “very heavy illness” acknowledged stigma. Research data detected the importance of social network role, highlighting the family through financial and affective support. Hopelessness and depression were closely related to illness suffering and adversities. The percentage of patients for positive common mental disorder and depression approaches 30%. Conclusion: Tuberculosis remains a stigmatizing disease. Building effective health services networks, comprising treatment facilities, community and family resources are very important to improve medication adherence. Effective tuberculosis management through health teams training seems necessary. Incorporating simple screening instruments for depression assessment might promote well-being and patient adherence.展开更多
目的:探索网络正念减压疗法(MBSR)对严重精神障碍患者的照料者焦虑抑郁水平及生活质量的影响。方法:纳入2021年3月在云南省精神病医院封闭病房住院治疗的、诊断为精神分裂症或双相情感障碍患者的照料者93名作为研究对象,使用随机数字表...目的:探索网络正念减压疗法(MBSR)对严重精神障碍患者的照料者焦虑抑郁水平及生活质量的影响。方法:纳入2021年3月在云南省精神病医院封闭病房住院治疗的、诊断为精神分裂症或双相情感障碍患者的照料者93名作为研究对象,使用随机数字表法随机分为两组:对照组47名和MBSR干预组46名。对照组给予健康宣教、康复技能训练,干预组在健康宣教、康复技能训练的基础上给予8周基于网络的MBSR。分别于基线及8周后采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、SF-36健康量表(The 36-item Short Form Health Survey)进行效果评价。结果:8周后,两组共脱落13名(对照组7名,干预组6名)。对照组与干预组基线SAS、SDS分值差异无统计学意义(均P>0.05)。8周后,干预组SAS、SDS分值较基线值均降低(均P<0.01),且明显低于对照组(均P<0.01),而对照组较基线值无明显变化(均P>0.05)。对照组与干预组基线SF-36总分及各个维度分值差异均无统计学意义(均P>0.05)。8周后,干预组SF-36总分及各个维度分值较基线时均升高,除生理功能维度外,差异均有统计学意义(均P<0.05),且明显高于对照组(均P<0.01);而对照组较基线时无明显变化(均P>0.05)。结论:网络MBSR可以减轻严重精神障碍患者照料者的焦虑抑郁水平,提高生活质量。展开更多
文摘Background: Few studies have considered the impact of demographic and clinical variables on help received respectively from services and relatives to satisfy needs of adults with severe mental disorders (SMD). Purposes: To identify major needs receiving help and, using the Andersen’s Behavioural Model of Health Service Use, to identify and compare predisposing, enabling and need factors associated with help given respectively by services and relatives. Methods: 352 adults with SMD from Montreal (Canada) were interviewed using six standardized instruments. Clinical records were consulted. Multiple linear regression analyses were processed to measure level of help received from relatives and services. Results: Factors significantly associated with help from relatives were: higher number of perceived needs;fewer diagnoses;better community functioning;being younger, and in a conjugal relationship;living autonomously;having social support and better quality of life;and, marginally, being an immigrant. Factors significantly associated with help from services were: higher number of perceived needs, better quality of life, supervised housing, adjustment disorder and schizophrenia. Conclusions: Help overall is insufficient to meet users’ needs. Services are more helpful than relatives, in particular regarding health needs. Comparatively to help from services, help from relatives is associated with predisposing factors like age, marital status and nationality.
文摘Introduction: Tuberculosis is a global health problem. Improving medication adherence is an important attribute concerning the outcome of tuberculosis treatment. This study investigates illness experience of patients belonging to a low-income district within Manguinhos catchment area. Narrative studies are able to unfold features concerning patient adherence and co-occurrence of depressive symptoms. Methods: Twenty-three patients under treatment were interviewed using McGill Illness Narrative Interview (MINI-McGILL), besides depression screening with “Self-Report Questionnaire-20” (SRQ-20) and “Beck Depression Inventory” (BDI). Results: Explanatory models disregarded airborne microorganism contagion, known but not considered relevant while bohemian or deviant lifestyle was rather perceived as a causal model. Patients mentioned contiguous events suggesting pneumonia or influenza misdiagnosis before final tuberculosis diagnosis (testing or suspicion). Therapeutic pathways were erratic, suggesting low literacy level and postponed or inadequate diagnosis accuracy. Emergency units or private services usually stood for primary care units considered first choice by planners. Expressions such as “dreadful/shameful disease” or “very heavy illness” acknowledged stigma. Research data detected the importance of social network role, highlighting the family through financial and affective support. Hopelessness and depression were closely related to illness suffering and adversities. The percentage of patients for positive common mental disorder and depression approaches 30%. Conclusion: Tuberculosis remains a stigmatizing disease. Building effective health services networks, comprising treatment facilities, community and family resources are very important to improve medication adherence. Effective tuberculosis management through health teams training seems necessary. Incorporating simple screening instruments for depression assessment might promote well-being and patient adherence.
文摘目的:探索网络正念减压疗法(MBSR)对严重精神障碍患者的照料者焦虑抑郁水平及生活质量的影响。方法:纳入2021年3月在云南省精神病医院封闭病房住院治疗的、诊断为精神分裂症或双相情感障碍患者的照料者93名作为研究对象,使用随机数字表法随机分为两组:对照组47名和MBSR干预组46名。对照组给予健康宣教、康复技能训练,干预组在健康宣教、康复技能训练的基础上给予8周基于网络的MBSR。分别于基线及8周后采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、SF-36健康量表(The 36-item Short Form Health Survey)进行效果评价。结果:8周后,两组共脱落13名(对照组7名,干预组6名)。对照组与干预组基线SAS、SDS分值差异无统计学意义(均P>0.05)。8周后,干预组SAS、SDS分值较基线值均降低(均P<0.01),且明显低于对照组(均P<0.01),而对照组较基线值无明显变化(均P>0.05)。对照组与干预组基线SF-36总分及各个维度分值差异均无统计学意义(均P>0.05)。8周后,干预组SF-36总分及各个维度分值较基线时均升高,除生理功能维度外,差异均有统计学意义(均P<0.05),且明显高于对照组(均P<0.01);而对照组较基线时无明显变化(均P>0.05)。结论:网络MBSR可以减轻严重精神障碍患者照料者的焦虑抑郁水平,提高生活质量。
