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J Nerv Ment Dis ; 209(8): 543-546, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1234178


ABSTRACT: Social distancing due to COVID-19 may adversely impact treatment of adults with serious mental illness, especially those receiving intensive forms of community-based care, in part through weakening of the therapeutic alliance. Veterans and staff at a Veterans Affair (VA) medical center were surveyed 3 months after social distancing disrupted usual service delivery in intensive community-based treatment programs. Veterans (n = 105) and staff (n = 112) gave similar multi-item ratings of service delivery after social distancing, which involved far less face-to-face contact and more telephone contact than usual and rated their therapeutic alliances and clinical status similarly as "not as good" on average than before social distancing. Self-reported decline in therapeutic alliance was associated with parallel decline in clinical status indicators. Both veterans and staff indicated clear preference for return to face-to-face service delivery after the pandemic with some telehealth included.

Attitude of Health Personnel , COVID-19 , Case Management/standards , Community Mental Health Services/standards , Delivery of Health Care/standards , Patient Preference , Physical Distancing , Telemedicine/standards , Therapeutic Alliance , Adult , COVID-19/prevention & control , Female , Humans , Male , Middle Aged , United States , United States Department of Veterans Affairs , Veterans
QJM ; 113(10): 731-738, 2020 Oct 01.
Article in English | MEDLINE | ID: covidwho-851879


BACKGROUND: The 2019 coronavirus diseases (COVID-19) led out the mental health crisis. AIM: To determine the psychological status and post-traumatic stress symptoms (PTSD) among general population (except confirmed and suspected cases, and close contacts) and their association with the coping strategy types during the COVID-19 outbreak. DESIGN: A cross-sectional study. METHODS: Participants were recruited from the community through snowball sampling with anonymous online questionnaires, using 28-item General Health Questionnaire, 22-item Impact of Events Scale-Revised and 28-item Brief Coping Inventory to measure their psychiatric disorders, PTSD level and coping strategies. RESULTS: Of the total 1109 participants, 42.65% and 67.09% self-reported psychiatric disorders and high PTSD level, respectively. Age, occupation and education level were significantly association with psychological status. The status of psychiatric disorders was also significantly related to high PTSD level. Using both emotion and problem coping was better for psychiatric status [adjusted odds ratio (aOR) = 0.72, 95% confidence interval (CI): 0.54-0.98], and problem-focused coping was significantly associated with high PTSD level (aOR = 2.09, 95% CI: 1.25-3.51). CONCLUSION: Negative psychological outcomes were common among the general people during the COVID-19 outbreak, and the findings may provide references for intervention guidelines of mental health for the community population.

Adaptation, Psychological , Coronavirus Infections , Mental Health , Pandemics , Pneumonia, Viral , Psychological Distress , Stress Disorders, Post-Traumatic , Adult , Betacoronavirus , COVID-19 , China/epidemiology , Community Mental Health Services/standards , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Cross-Sectional Studies , Female , Health Services Needs and Demand , Humans , Male , Mental Health/statistics & numerical data , Mental Health/trends , Middle Aged , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Psychiatric Status Rating Scales , Qualitative Research , SARS-CoV-2 , Socioeconomic Factors , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/prevention & control , Stress Disorders, Post-Traumatic/psychology