ABSTRACT
The outflow of the natural thermal Lake of Hévíz is habitat of several fish species, with conservation relevance. In the past few years, numerous thermophile (tropically originated) fishes were reported in this waterbody, from which two species Parachromis managuensis (Günther, 1867), Vieja melanurus (Günther, 1862) characterized with strong, self-sustaining population. The aim of our research was to provide basic population data and to study their individual growth. The standard length of jaguar cichlid ranged from 37 to 283 mm (mean SL = 110.21 ± 65.4 mm), the redhead cichlid standard length varied between 30 and 203 mm (mean SL = 93.91 ± 40.0 mm). Slightly positive allometry (b > 3) was found in the case of both species. The von Bertalanffy Growth Function can be described as the following Lt = 343.6[1 - e-0.196(t+0.973)] in jaguar cichlid and Lt = 298.9[1 - e-0.113(t+0.997)] in the case of redhead cichlid. The Bertalanffy growth equations show slow growth for both species. Fulton's condition factor (K) values varied between 1.376 and 2.11 (mean K = 1.701 ± 0.17) in the case of jaguar cichlid, and between 1.391 and 3.033 (mean K = 2.237 ± 0.24) for redhead cichlid. These baseline population biology data from the first known self-sustaining, temperate-zone populations of two tropical cichlids provide information e.g., for future ecological risk assessments or comparative growth analyzes.
Subject(s)
Cichlids , Ecosystem , Lakes , Animals , Cichlids/growth & development , Hungary , Introduced Species/trendsABSTRACT
Background: Buurtzorg is a pioneering healthcare organization founded in the Netherlands. Buurtzorg has established independent, self-managing teams of nurses and promises high-quality home care at a lower cost through person-centered care, continuity of care, building trusting relationships, and networks in the neighborhood. Traditional home care services are increasingly reorganized according to the Buurtzorg-principles. Objectives: This review aims to describe the experiences gathered during the implementation of the Buurtzorg-derived model outside the Netherlands. It further outlines their potential effects. Design: Scoping Review. Methods: Several electronic databases were searched for relevant articles, supplemented by hand-searching and internet searches for gray literature. Various publication types that described the implementation of the Buurtzorg model or its outcomes in countries other than the Netherlands were included. The data were analyzed using qualitative content analysis. Two authors coded the data in several cycles and created categories and subcategories. Results: The review identified 25 publications reporting the experiences or outcomes of Buurtzorg-derived models outside the Netherlands. Upon implementing elements of Buurtzorg, the home care organizations adopted a person-centered care approach, with improved communication with patients and family caregivers, and could establish new networks with other services. The main challenges were related to the self-managed working culture, the organizational framework, or national healthcare policies, which hindered the implementation process. Conclusions: The implementation of Buurtzorg-derived models is complex, challenging, and requires adaptations on several levels: upskilling of networking and staffing competencies in teams, leadership and IT requirements in the organization, and policy changes in the healthcare system. Individualized approaches and solid conceptual preparation are required for implementation. Tweetable abstract: Experiences with the implementation of Buurtzorg in home care services outside the Netherlands. A scoping review @HegeduesAnna.
ABSTRACT
BACKGROUND: To adequately describe the advanced psychiatric nursing roles and to distinguish them from the other roles of psychiatric and general nursing care, it is necessary to explore the concrete tasks and activities and the scope of practice of Psychiatric Mental Health Advanced Practice Nurses (APN). OBJECTIVE: to extract, summarize and systematize the tasks and activities of the Psychiatric Mental Health APN from the international scientific literature. DESIGN: systematic literature review reported following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement and checklist. METHODS: The database search was performed using CINAHL, PubMed/Medline, Cochrane Library and Google/Google Scholar databases. Literature sources in English and German, which reported tasks and activities of the Psychiatric Mental Health APNs were included in the analysis. No time restrictions were defined. Roles such as Community Mental Health Nurses and Public Mental Health Nurses were excluded from the analysis. Data were extracted by independent reviewers for qualitative thematic analysis. RESULTS: An extensive body of international literature on Psychiatric Mental Health APN sub-roles could be identified through a systematic literature search. Through our synthesis the main tasks and activities of Psychiatric Mental Health APNs could be identified and described. Altogether 46 items (practice dimensions) could be identified from the 20 sources and finally systematically summarized into six themes or "practice domains": (1) direct (clinical) nursing and care practice, (2) care coordination and case management, (3) psychosocial health promotion and prevention, (4) consulting, education and coaching, (5) leadership and public relations, and (6) research and practice development. CONCLUSIONS: The results of this review provide a thorough outline of the tasks and activities of the Psychiatric Mental Health APN. Thus, the results reported here form the basis for a further differentiation of the tasks and activities of the Psychiatric Mental Health APNs from the basic nursing activities as well as tasks and activities of the generalist APNs. In this context, however, an attempt should be made to increase the specificity of the settings by including the tasks and activities of the community and public mental health nurses.
Subject(s)
Advanced Practice Nursing , Nurses , Psychiatric Nursing , Humans , Leadership , Mental HealthABSTRACT
The 'Experienced Involvement' (EX-IN) training programme prepares and certifies individuals who have experienced mental health problems to work as peer support workers and to support others challenged by similar conditions. We aimed to assess the impact of the EX-IN training on hope, self-efficacy, introspection, stigma resistance, personal recovery, health-related quality of life and employment in participants. Data was collected using standardized assessment instruments before the training started (t1) and upon course completion (t2). Data from 103 participants who participated in both measurement times were included into data analysis. Participants significantly improved their recovery, stigma resistance and introspection during the EX-IN training. In addition, a significant higher proportion of participants were employed at t2. Participants whose last inpatient stay was 0-1 year before the start of the EX-IN training showed significantly lower levels of stigma resistance, and self-efficacy at t1 than participants with two or more years since the last inpatient stay. There were no significant changes in mean values over time, or in the mean values at t2 between the two groups. EX-IN training has a positive influence on the handling of stigma, on one's recovery path and introspection. This indicates that EX-IN training has a therapeutic effect on the participants. EX-IN training seems to meet the challenges of peer support work. Therefore, the training can be recommended as preparation for working as a peer support worker as well as an intervention to improve one´s recovery process.
Subject(s)
Mental Disorders , Quality of Life , Germany , Humans , Mental Disorders/therapy , Peer Group , SwitzerlandABSTRACT
OBJECTIVES: Informative and insightful overview of the concept of Advanced Nursing Practice (ANP) and its specific facets with a focus on the psychiatric and mental health care context. METHODS: Systematic literature search in specific electronic databases (PubMed, CINAHL, Google and GoogleScholar) and synthesis of identified sources based on Mayring's structuring content analysis. RESULTS: In the psychiatric and mental health context, the Clinical Nurse Specialist and Nurse Practitioner are the classic roles of Advanced Nursing Practice. Their educational training, tasks and activities as well as their field of work show many similarities. In addition to the core elements of the ANP roles, there are strong individual characteristics depending on the work setting and patient population. CONCLUSIONS: It is important that the international experience of role development and implementation as well as the specific fields of action are integrated into the German-speaking area. This will allow specialized, expanded and advanced psychiatric care to be established effectively and on a long-term basis in German-speaking countries.
Subject(s)
Advanced Practice Nursing , Mental Health , Psychiatric Nursing , Germany , Humans , Nurse's RoleABSTRACT
Background: The transition from psychiatric hospital to community is often hindered by challenges that influence community adjustment and continuity of care. Transitional interventions with bridging components are provided prior to discharge and continue beyond inpatient care. They provide continuity of care and may be effective in preventing readmission. We aimed to assess the effectiveness of transitional interventions with predischarge and postdischarge components in reducing readmissions and improving health-related or social outcomes of patients discharged from psychiatric hospitals. Methods: We conducted a systematic review by searching electronic databases (MEDLINE, Embase, Cochrane Library, CINAHL, PsycINFO, and Psyndex) and included randomized, nonrandomized, and one-group study designs. A random effects meta-analysis was conducted with randomized controlled trials (RCTs) reporting data on readmission rates. Other study designs were synthesized qualitatively. Results: After screening 2,673 publications, 16 studies (10 RCTs, three quasi-experimental, and three cohort studies) were included and nine RCTs were included in the meta-analysis. The tested interventions included components from case management, psychoeducation, cognitive behavioral therapy, and peer support. All studies with significant improvements in at least one outcome provided elements of case management, most frequently in combination with cognitive behavioral therapy and psychoeducation. Readmission rates during follow-up ranged between 13% and 63% in intervention groups and 19% and 69% in control groups. Overall, we found an odds ratio of 0.76 (95% confidence interval = 0.55-1.05) for readmission due to transitional interventions. Heterogeneity was low at only 31% (p = 0.17) and the funnel plot indicated no obvious publication biases. Conclusions: We observed that transitional interventions with bridging components were no more effective in reducing readmission than treatment as usual; however, these results are based on limited evidence. Therefore, additional high-quality research is required to conclude the effectiveness of transitional interventions. Nevertheless, transitional interventions with bridging components are preferred by service users and could be an alternative to strategies regularly employed.
ABSTRACT
Discharge from psychiatric inpatient care is frequently described as chaotic, stressful, and emotionally charged. Following discharge, service users are vulnerable to becoming overwhelmed by the challenges involved in readapting to their home environments, which could result in serious problems and lead to readmission. The short transitional intervention in psychiatry (STeP) is a bridging intervention that includes pre- and post-discharge sections. It aims to prepare patients for specific situations in the period immediately following discharge from a psychiatric hospital. We conducted a quasi-experimental pilot study to determine the feasibility of the intervention, and gain insight into the effects of the STeP. Two inpatient wards at a Swiss psychiatric hospital participated in the study, and represented the intervention and control arms. Patient recruitment and baseline assessment were performed 2 weeks prior to discharge. Follow-up data were collected 1 week subsequent to discharge. Questionnaires measured coping, admission and health-care usage, self-efficacy, working alliance, experience of transition, and the number of difficulties experienced following discharge. Fourteen and 15 patients completed the follow-up assessment in the control and intervention groups, respectively. The STeP did not affect primary or secondary outcomes; however, it was shown to be feasible, and patients' feedback highlighted the importance of post-discharge contact sessions. Further research is required to improve understanding of the discharge experience, identify relevant patient outcomes, and assess the effectiveness of the intervention in an adequately-powered randomized, controlled trial.
Subject(s)
Inpatients/psychology , Mental Disorders/therapy , Patient Discharge , Psychotherapy, Brief/methods , Adult , Feasibility Studies , Female , Humans , Male , Pilot ProjectsABSTRACT
BACKGROUND: Peer support workers (PSWs) are an emerging workforce within the Swiss mental health system. The 'Experienced Involvement' (EX-IN) training programmes prepare and certify individuals who have experienced mental health problems to work as PSWs. AIMS: This study examined the influence of EX-IN training on participants' employment status and their experiences in the year after training. METHOD: We employed quantitative and qualitative methods. Quantitative data were collected at baseline, immediately after completion and at 1 year post-training. Additionally, individual narrative interviews were conducted with 10 participants at 1 year post-training. RESULTS: At 1 year of completion, the majority of participants were in paid employment. Difficulties included unclear PSW roles. The qualitative analyses revealed the following categories: 'Evolving from the patient role despite experiencing effects or consequences of mental illness', 'Feeling welcome and being confronted with conflicting expectations', 'Helping others while being needy at the same time' and 'Doing something worthwhile and the fear of failure'. CONCLUSION: Clear role descriptions, well-defined expectations, team preparation, acknowledgement of vulnerabilities and institution-level support PSWs are important to safeguard both PSWs and service users by minimising the destabilisation risk. Future EX-IN training graduates can benefit from the establishment of remunerated PSW roles in psychiatric services.
Subject(s)
Employment , Mental Disorders/rehabilitation , Mental Health Services , Peer Group , Social Support , Adult , Female , Humans , Male , Mental Health/education , Middle Aged , Surveys and Questionnaires , SwitzerlandABSTRACT
Non-adherence to medication is highly prevalent in patients with schizophrenia. Adherence therapy aims to improve medication adherence of these patients by applying techniques of cognitive behavioural therapy, psycho-education, and motivational interviewing. Even though adherence therapy is frequently discussed and researched, its effectiveness is still uncertain. This paper aims to review the effectiveness of adherence therapy on the medication adherence of patients with schizophrenia. To this end, six electronic databases were systematically searched for randomized, controlled trials on adherence therapy from January 2002 to March 2013. Four trials met the inclusion criteria and were incorporated into the review. The findings suggest that adherence therapy does not improve patients' medication adherence in comparison to treatment as usual or a control intervention. However, all the studies reviewed showed high-adherence ratings at baseline. Thus, further well-designed studies that target adherence therapy to patients who are non-adherent to their medication are needed for a more profound understanding of its effectiveness. In addition, if adherence therapy is aimed not only at improving medication adherence, but also to reach an agreement whereby the patient's decision not to take his medication is accepted, the shared decision-making process needs to be assessed as well.
Subject(s)
Antipsychotic Agents/therapeutic use , Cognitive Behavioral Therapy , Medication Adherence , Schizophrenia/drug therapy , Humans , Medication Adherence/psychology , Medication Adherence/statistics & numerical data , Schizophrenic PsychologyABSTRACT
OBJECTIVE: To assess needs for care rated by clients and their community mental health nurses and their agreement on needs. METHODS: 47 randomly selected clients and their care professionals completed the Camberwell Assessment of Need. RESULTS: Psychiatric nurses indicate a higher number of total and met need than their clients. Unmet need was rated most highly in the domains of psychological distress, company of others and intimate relationships. Professionals underrated their clients' needs in the areas physical health, information about condition and treatment and psychological distress and indicated a higher level of need than their clients in the domains of daily activities and psychological distress. CONCLUSIONS: Care planning and care targeting should respond to the unmet needs of the clients in order to prevent care deficiencies. Differences in the evaluations indicate the importance to include client's viewpoints into the needs assessment.
