ABSTRACT
BACKGROUND: Newly arrived immigrant patients who frequently use primary health care resources have difficulties in verbal communication. Also, they have a system of beliefs related to health and disease that makes difficult for health care professionals to comprehend their reasons for consultation, especially when consulting for somatic manifestations. Consequently, this is an important barrier to achieve optimum care to these groups. The current project has two main objectives: 1. To define the different stressors, the level of distress perceived, and its impact in terms of discomfort and somatisation affecting the main communities of immigrants in our area, and 2. To identify the characteristics of cross-cultural competence of primary health care professionals to best approach these reasons for consultation. METHODS/DESIGN: It will be a transversal, observational, multicentre, qualitative-quantitative study in a sample of 980 people from the five main non-European Union immigrant communities residing in Catalonia: Maghrebis, Sub-Saharans, Andean South Americans, Hindustanis, and Chinese. Sociodemographic data, level of distress, information on the different stressors and their somatic manifestations will be collected in specific questionnaires. Through a semi-structured interview and qualitative methodology, it will be studied the relation between somatic manifestations and particular beliefs of each group and how these are associated with the processes of disease and seeking for care. A qualitative methodology based on individual interviews centred on critical incidents, focal groups and in situ questionnaires will be used to study the cross-cultural competences of the professionals. DISCUSSION: It is expected a high level of chronic stress associated with the level of somatisations in the different non-European Union immigrant communities. The results will provide better knowledge of these populations and will improve the comprehension and the efficacy of the health care providers in prevention, communication, care management and management of resources.
Subject(s)
Cultural Competency , Depressive Disorder/epidemiology , Emigrants and Immigrants/psychology , Health Knowledge, Attitudes, Practice , Primary Health Care/standards , Somatoform Disorders/epidemiology , Stress, Psychological/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Clinical Competence , Cross-Cultural Comparison , Cultural Competency/psychology , Emigrants and Immigrants/statistics & numerical data , Female , Focus Groups , Humans , Interviews as Topic , Male , Middle Aged , Patient Acceptance of Health Care/ethnology , Pilot Projects , Qualitative Research , Socioeconomic Factors , Spain/epidemiology , Surveys and Questionnaires , Workforce , Young AdultABSTRACT
Background and Objectives: The aim of this study is to investigate the relative effectiveness of routine care (RC) in addition to a specific early intervention program (PIPE) compared to routine care alone.Methods: A total of 34 participants in the initial phase of schizophrenia took part in randomized, single-blind controlled trial. Participants were randomized to receive either routine care (RC; n = 13) or routine integrated with Cognitive-Motivational Therapy(PIPE; n = 21). PIPE comprised individual and family Cognitive-Motivational therapyplus routine care for 12 months. In this paper we present preliminary results at 6 months after the beginning of the intervention. Clinical assessments were carried out at pre-treatment,and in this manuscript the results at 3 and 6 months after starting the intervention by external raters are presented, using the Positive and Negative Syndrome Scale, Brief Psychiatry Rating Scale, the Clinical Global Impression Scale, the Global Assessment of Functioning scale, and relapses. Mann-Whitney test and MANOVAs analysis for variance effects were used for the statistical analysis Results: Significant greater clinical effects were observed in those patients treated inRC+PIPE at three months from baseline assessment and at six months in PANSS scale(Mann-Whitney test; p < 0.000). Other benefits of the program included increase in globalactivity, reduced relapse rates, and reduction of the pharmacological treatment.Conclusions: These findings show the effectiveness of a program of routine care integratedwith cognitive-motivational interventions (individual and family therapy) over routine psychiatric care alone for patients who are in the initial phase of schizophrenia (AU)
Subject(s)
Humans , Schizophrenia/therapy , Psychotherapy/methods , Randomized Controlled Trials as Topic/methods , Motivation , Family TherapyABSTRACT
Este trabajo evalúa los cambios de una intervención psicoterapéutica grupal para pacientes con trastornos de ansiedad generalizada, trastorno de pánico con o sin agorafobia y trastorno adaptativo con sintomatología ansiosa o depresiva asociada. Un total de 107 pacientes participaron en el estudio, de los cuales 73,8% eran mujeres y el 26,2% hombres con edades comprendidas entre los 21 y 62 años, provenientes de un Centro de Salud Mental y un Centro de Atención Primaria del Consorci Sanitari del Maresme (Barcelona). El tratamiento cognitivo-conductual se compuso de 20 sesiones con periodicidad semanal de 90 minutos de duración. Los participantes completaron a través de una entrevista semiestructurada medidas clínicas de ansiedad, depresión, somatización, inteligencia emocional percibida y medidas protectoras de salud tales como autoestima y satisfacción vital. Los resultados obtenidos muestran mejoras significativas en términos de reducción sintomática, además de un incremento de la autoestima y la satisfacción general con la vida para todos los grupos diagnósticos (AU)
The aim of the current study is to assess the outcome of a group psychotherapy intervention in patients with generalized anxiety disorder, panic disorder with or without agoraphobia and adjustment disorder with anxious or depressive symptoms. A total of 107 patients were included in the study, 73,8% were women and 26,2% men, aged form 21 and 62, form a Mental Health Center and a Primary Care Center, both of which are part of the Maresme Sanitary Consortium (Barcelona). The cognitive-behavioral therapy consisted of twenty 90 minute weekly sessions. The participants completed a semistructures interview that included clinical measures of anxiety, depression, somatization, perceived emotional intelligence and other measures related with health (self-esteem and life satisfaction). The results showed significant improvements in symptom reduction, as well as an increase in self-esteem and perceived quality of life (p<0.01) for all diagnostic groups (AU)
