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1.
BMJ Open ; 12(9): e059826, 2022 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-36123056

RESUMO

INTRODUCTION: Transition-age youth (16-29 years old) are disproportionately affected by the onset, impact and burden of serious mental illness (SMI; for example, depression, bipolar disorder, schizophrenia spectrum disorders). Emerging evidence has increasingly highlighted the concept of resilience in mental health promotion and treatment approaches for this population. A comprehensive synthesis of existing evidence is needed to enhance conceptual clarity in this area, identify knowledge gaps, and inform future research and practice. As such, the present scoping review is guided by the following questions: How has resilience been conceptualised and operationalised in the transition-age youth mental health literature? What factors influence resilience among transition-age youth with SMI, and what outcomes have been studied within the context of transition-age youth's mental health recovery? METHODS AND ANALYSIS: The present protocol will follow six key stages, in accordance with Arksey and O'Malley's (2005) established scoping review methodology and recent iterations of this framework, and has been registered with Open Science Framework (https://osf.io/rzfc5). The protocol and review process will be carried out by a multidisciplinary team in consultation with community stakeholders. A comprehensive search strategy will be conducted across multiple electronic databases to identify relevant empirical literature. Included sources will address the population of transition-age youth (16-29 years) diagnosed with SMI, the concept of resilience (in any context) and will report original research written in English. Data screening and extraction will be completed by at least two independent reviewers. Following meta-narrative review and qualitative content analyses, findings will be synthesised as a descriptive overview with tabular and graphical summaries. ETHICS AND DISSEMINATION: University of Toronto Health Sciences Research Ethics Board approval was obtained to complete the community stakeholder consultation stage of this review. Results will be disseminated through conference presentations, publications, and user-friendly reports and graphics.


Assuntos
Transtornos Mentais , Projetos de Pesquisa , Adolescente , Adulto , Humanos , Transtornos Mentais/terapia , Literatura de Revisão como Assunto , Adulto Jovem
2.
Artigo em Inglês | MEDLINE | ID: mdl-34831967

RESUMO

Traumatic brain injury (TBI) and mental health and/or substance use challenges (MHSU) are commonly co-occurring and prevalent in individuals experiencing homelessness; however, evidence suggests that systems of care are siloed and organized around clinical diagnoses. Research is needed to understand how housing and housing supports are provided to this complex and understudied group in the context of siloed service systems. This study aimed to describe critical characteristics of housing and housing supports for individuals with concurrent TBI and MHSU from the perspectives of service users with TBI and MHSU and housing service providers. Using basic qualitative description, in-depth interviews were conducted with 16 service users and 15 service providers. Data were analyzed using thematic analysis techniques. Themes capture core processes in finding and maintaining housing and the critical housing supports that enabled them: (1) overcoming structural barriers through service coordination, education and awareness raising, and partnerships and collaborations; and (2) enabling engagement in meaningful activity and social connection through creating opportunities, training and skills development, and design of home and neighborhood environments. Implications for practice, including the urgent need for formalized TBI and MHSU education, support for service providers, and potential interventions to further enable core housing processes are discussed.


Assuntos
Lesões Encefálicas Traumáticas , Pessoas Mal Alojadas , Transtornos Mentais , Transtornos Relacionados ao Uso de Substâncias , Lesões Encefálicas Traumáticas/epidemiologia , Habitação , Humanos , Transtornos Mentais/epidemiologia , Saúde Mental , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
3.
BMJ Open ; 10(6): e035299, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-32580984

RESUMO

INTRODUCTION: Community-dwelling older adults living with subjective cognitive decline or mild cognitive impairment may experience decreased efficiency in their overall functional performance. This decreased cognitive efficiency may result in anxiety, low mood, perceived stress and decreased emotional well-being and quality-of-life. These psychological symptoms may further exacerbate cognitive decline.Exploring non-pharmacological interventions such as mindfulness within primary care is vital in enabling individuals to develop strategies to manage cognitive impairment or psychological symptoms. Mindfulness-based stress reduction (MBSR) is an 8-week programme that is beneficial in alleviating psychological symptoms; however, its impact on perceived satisfaction on overall functional performance with this population has not been evaluated. The primary objective of this study is to explore the feasibility of conducting a randomised controlled trial of an occupational therapist-led MBSR programme within primary care. METHODS: Convergent mixed-methods, randomised control feasibility trial with 40 participants from an interprofessional primary care team in Toronto, Ontario. Participants are randomised into the 8-week MBSR group or wait-list control will be compared at baseline, postintervention and 4weeks follow-up. The primary aim is to determine the feasibility of the intervention with this population and setting. The secondary aim is to examine perceived satisfaction with functional performance as measured by the Canadian Occupational Performance Measure. Secondary clinical outcomes include psychological symptoms. ANALYSIS: Investigators will analyse the quantitative and qualitative data strands separately. Descriptive statistics, focus group and interviews will then be merged and further analysed to best understand the feasibility and preliminary clinical outcomes from the study. ETHICS AND DISSEMINATION: The study is approved by Women's College Hospital (2017-0056-E), and Queen's University, Kingston, Ontario (6026418). The study will follow Standard Protocol Items: Recommendations for Interventional Trials. The results will be published in peer-reviewed academic journals and disseminated to patient organisations and media.Trial registration numberNCT03867474; Pre-results.


Assuntos
Disfunção Cognitiva/terapia , Atenção Plena/métodos , Terapeutas Ocupacionais , Estresse Psicológico/terapia , Idoso , Disfunção Cognitiva/psicologia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Atenção Primária à Saúde/métodos , Escalas de Graduação Psiquiátrica , Ensaios Clínicos Controlados Aleatórios como Assunto
4.
BMC Health Serv Res ; 20(1): 170, 2020 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-32131826

RESUMO

BACKGROUND: Bridging involves improving knowledge sharing and collaboration across different fields, such as aging and disability. The objectives of this review were to describe: 1) the contexts where bridging has occurred in relation to delivery of health services for adults aging with neurological or developmental conditions; and 2) characterize and map bridging tasks, stakeholders involved, and outcomes discussed in peer-reviewed literature. METHODS: Seven databases were searched around the core concepts of "bridging," "aging," and "disability." In total, 10,819 articles were screened with 49 meeting the inclusion criteria of discussing aging with developmental or neurological disability, explicitly describing bridging tasks, published in English and a peer-reviewed publication. Bibliographic information, sample characteristics, and data on bridging was extracted and included in the qualitative synthesis. RESULTS: Intellectual and/or Developmental disabilities were the most studied population (76% of articles), and most articles were published in the United States (57%). Twenty-two bridging tasks were identified, and categorized into three domains: health and social service delivery (e.g., care coordination tasks), policy (e.g., policy change), and research and training (e.g., mentoring). Stakeholders involved ranged from health care professionals to policy makers and organizations in aging and disability services. CONCLUSIONS: The resulting matrix will assist in the specification of bridging in research and practice. Future work should evaluate specific models of bridging and their effects on health service delivery.


Assuntos
Envelhecimento , Pessoas com Deficiência , Humanos
5.
BMJ Open ; 7(10): e016741, 2017 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-29074511

RESUMO

INTRODUCTION: Bridging is a term used to describe activities, or tasks, used to promote collaboration and knowledge exchange across fields. This paper reports the protocol for a scoping review which aims to identify and characterise peer reviewed evidence describing bridging activities, between the ageing and disability fields. The purpose is to clarify the concepts underpinning bridging to inform the development of a taxonomy, and identify research strengths and gaps. METHODS: A scoping review will be conducted. We will search Medline, Cumulative Index to Nursing and Allied Health Literature, Embase, PsycInfo, Sociological Abstracts and the Cochrane Library, to identify peer reviewed publications (reviews, experimental, observational, qualitative designs and expert commentaries) describing bridging activities. Grey literature, and articles not published in English will be excluded. Two investigators will independently complete article selection and data abstraction to minimise bias. A data extraction form will be iteratively developed and information from each publication will be extracted: (1) bibliographic, (2) methodological, (3) demographic, and (4) bridging information. Qualitative content analysis will be used to describe key concepts related to bridging. CONCLUSIONS: To our knowledge, this will be the first scoping review to describe bridging of ageing and disability knowledge, services and policies. The findings will inform the development of a taxonomy to define models of bridging that can be implemented and further evaluated to enable integrated care and improve systems and services for those ageing with disability. ETHICS AND DISSEMINATION: Ethics is not required because this is a scoping review of published literature. Findings will be disseminated through stakeholder meetings, conference presentations and peer reviewed publication.


Assuntos
Envelhecimento , Pessoas com Deficiência , Conhecimentos, Atitudes e Prática em Saúde , Políticas , Humanos , Projetos de Pesquisa
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