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1.
Artigo em Inglês | MEDLINE | ID: mdl-38963477

RESUMO

Standard models of well-child care may not sufficiently address preventive health needs of immigrant families. To augment standard individual well-child care, we developed a virtual group-based psychoeducational intervention, designed to be delivered in Spanish as a single, stand-alone session to female caregivers of 0-6 month-olds. The intervention included a video testimonial of an individual who experienced perinatal depression followed by a facilitated discussion by the clinic social worker and an orientation to relevant community resources by a community health worker. To assess feasibility and acceptability of the intervention, we conducted an open pilot within an academic pediatric practice serving predominantly Latinx children in immigrant families. Participants included 19 female caregivers of infants attending the practice, of whom 16 completed post-intervention measures and 13 completed post-intervention semi-structured interviews. Quantitative measures of acceptability and satisfaction with the intervention were high. We found preliminary effects of the intervention on postpartum depression knowledge and stigma in the expected direction. In interviews, participants described increases in their familiarity with postpartum depression and about relevant community resources, including primary care for caregivers. Participants reported an appreciation for the opportunity to learn from other caregivers and provided suggestions for additional topics of interest. Trial registration: Registered 6/21/22 as NCT05423093.

2.
J Eval Clin Pract ; 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38979880

RESUMO

RATIONALE: Psycho-education application is effective in reducing the risk of postpartum depression (PPD) and increasing the level of social support. The quality of care increases with the implementation of Watson's Theory of Human Caring Model (WTHCM)-based care programs to reduce the risk of PPD. AIMS: This study aimed to evaluate the impact of a psycho-educational intervention based on the Watson model on pregnant women in preventing PPD. Additionally, the effect of the psycho-educational intervention on women's perceptions of social support in relation to PPD was evaluated. METHODS: A randomized-controlled pretest-posttest control group intervention study design was used. The sample consisted of 91 women (intervention:45, control:46) in their 20th to 32nd gestational week. While all women received routine care at the family health centre the intervention group was additionally applied a psycho-educational intervention based on the WTHCM. Chi-square and t-test analysis methods were performed to determine the homogeneity of the intervention and control groups. The t-test method was used to compare group scores. Multiple regression analysis was employed to compare multiple variables. RESULTS: Following the psycho-educational intervention, the total Edinburgh Postpartum Depression Scale of the intervention group was found significantly lower than that of the control group, but the total and friend subscale scores on the Multidimensional Scale of Perceived Social Support (MSPSS) were higher (p < 0.05). The regression analysis results indicate that friend and family support, which are sub-dimensions of the MSPSS, exhibited a significant decrease in both groups. Furthermore, this decline had a greater impact on reducing the PPD level in the intervention group compared to the control group. It was found that while the support of the significant other sub-dimension reduced the PPD level in the intervention group, it did not make a significant difference in the control group. CONCLUSIONS: The Watson's Theory of Human Caring Model-based psycho-educational intervention program decreased women's risk of PPD and increased their social support levels. It is recommended to use approaches that include psycho-educational intervention in postpartum midwifery care.

3.
Seizure ; 120: 15-24, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38889520

RESUMO

BACKGROUND: Cognitive behavioural therapy (CBT) and other psychological approaches have a growing evidence base for treating Non-Epileptic Seizures (NES). However, communication about the diagnosis can be difficult for clinicians and is not always well received. It is thought that Psychoeducation about NES may improve engagement with treatment such as CBT and may contribute to reductions in the frequency of seizures and improvements in health related quality of life. However, psychoeducational components of treatment are often not evaluated in isolation meaning the specific benefit to patients is not currently well understood. AIMS: The researchers aimed to examine the outcomes associated with psychoeducational interventions and the content of these programmes for NES. METHOD: A scoping review was undertaken across four databases with seventeen eligible studies identified which were charted to analyse the data. RESULTS: Findings revealed that components and modalities of interventions varied as did methods of evaluating the interventions. A number of different outcome measures were used and not all studies reported the significance of findings. Results across studies were inconsistent; however, there was a general trend across the studies of symptom reduction and improvement in mental health. CONCLUSIONS: Findings illustrate that psychoeducation has potential benefits as an intervention in its own right. However, it may be best placed as a second step in a stepped care model, between initial diagnosis and further psychological treatment. The present literature needs replication and more robust studies for more certain conclusions to be drawn.

4.
BMC Psychiatry ; 24(1): 445, 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38877468

RESUMO

BACKGROUND: The purpose of this study was to examine the effects of a brief family psychoeducation (BFP) programme provided by psychiatric visiting nurses on caregiver burden of family caregivers of people with schizophrenia through a cluster randomised controlled trial (cRCT). METHODS: The study was a two-arm, parallel-group cRCT. Forty-seven psychiatric visiting nurse agencies were randomly allocated to the BFP programme group (intervention group) or treatment as usual group (TAU; control group). Caregivers of people with schizophrenia were recruited by psychiatric visiting nurses using a randomly ordered list. The primary outcome was caregiver burden, measured using the Japanese version of the Zarit Burden Interview. Outcome assessments were conducted at baseline, 1-month follow-up, and 6-month follow-up. Intention-to-treat analysis was conducted to examine the effects of the BFP programme on caregiver burden. RESULTS: Thirty-four psychiatric visiting nurse agencies and 83 family caregivers of people with schizophrenia participated in the study. The participant attrition rate was less than 20%. Adherence to the program was 100%. Compared with TAU group, the BFP programme group had decreased caregiver burden. However, this improvement was not significant at 1-month follow-up (adjusted mean difference [aMD] = 0.27, 95% CI = - 5.48 to 6.03, p = 0.93, d = 0.01) or 6-month follow-up (aMD = - 2.12, 95% CI = - 7.80 to 3.56, p = 0.45, d = 0.11). CONCLUSIONS: The BFP programme provided by psychiatric visiting nurses did not achieve significant decreases in caregiver burden. This result may be attributed to the difficulty in continuing the research due to the COVID-19 pandemic, which prevented us from achieving the targeted sample size necessary to meet the statistical power requirements, as well as to the participation of caregivers with relatively low burden. However, the program had the advantage of high adherence to treatment plan. Further studies should be conducted with a larger sample size and a more diverse sample that includes caregivers with a higher care burden. TRIAL REGISTRATION: The study protocol was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000038044) on 2019/09/18.


Assuntos
Sobrecarga do Cuidador , Cuidadores , Esquizofrenia , Humanos , Esquizofrenia/terapia , Esquizofrenia/enfermagem , Feminino , Masculino , Cuidadores/psicologia , Pessoa de Meia-Idade , Adulto , Sobrecarga do Cuidador/psicologia , Enfermeiros de Saúde Comunitária/psicologia , Enfermagem Psiquiátrica/métodos
5.
Front Public Health ; 12: 1391764, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38894989

RESUMO

Introduction: Preoperative anxiety, with its multifactorial origins, affects a wide range of surgical patients, leading to adverse physiological and psychological effects in the perioperative period. Customized, autonomous nursing interventions are needed to address individual person needs. The shift toward outpatient surgery emphasizes the need for restructured nursing approaches. Existing literature suggests that preoperative nursing consultations offer opportunities for assessing needs, providing information, and prescribing anxiety-reduction strategies. Psychoeducation, a specialized skill within mental health and psychiatric nursing, has proven effective in alleviating preoperative anxiety and reducing postoperative complications. The aim is to obtain and analyze the information reflecting nurses' understanding of the design, structure, and operationalization of a psychoeducation program to reduce preoperative anxiety in adults. Methods: A qualitative, exploratory, descriptive study was conducted. Data were collected through a 90-min focus group session held online via Zoom Meetings videoconferencing platform. Inclusion criteria for the participant's selection were established. The focus group was guided to deliberate on potential strategies for crafting effective psychoeducational interventions. Data collection ceased upon reaching theoretical saturation and gathered information was submitted for content analysis. Ethical procedures were ensured. Results: Of the participants, 10 were specialist nurses (7 working in mental health and psychiatric nursing and the remaining in medical-surgical nursing), with an average age of 41 and an average of 15 years working in surgical services. The nurses selected the target population, the structure and content of the psychoeducation sessions, and the resources and addressed the perceived importance, effectiveness, and feasibility of the designed psychoeducation program. Discussion: The study revealed the nurses' understanding of the design of a psychoeducation program potentially effective in reducing preoperative anxiety in adults, in an outpatient surgery context. This result will allow the transfer of the produced knowledge to nurses' professional practice reflecting lower levels of anxiety and promoting a better surgical recovery. This is an unprecedented study conducted in Portugal, adding substantial knowledge to the nursing discipline. However, further research into implementing psychoeducation in a surgical context is suggested aiming to consolidate the results of research already carried out internationally.


Assuntos
Ansiedade , Grupos Focais , Pesquisa Qualitativa , Humanos , Ansiedade/prevenção & controle , Adulto , Feminino , Cuidados Pré-Operatórios , Masculino , Educação de Pacientes como Assunto/métodos , Pessoa de Meia-Idade , Enfermagem Psiquiátrica/educação
6.
EClinicalMedicine ; 73: 102645, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38841708

RESUMO

Background: There is uncertainty regarding how best to support patients with anorexia nervosa following inpatient or day care treatment. This study evaluated the impact of augmenting intensive treatment with a digital, guided, self-management intervention (ECHOMANTRA) for patients with anorexia nervosa and their carers. Methods: In this pragmatic multicentre randomised controlled trial and economic evaluation, patients with a diagnosis of anorexia nervosa or atypical anorexia nervosa, aged 16+ and attending one of the 31 inpatient or day-patient services in the UK were randomised with one of their carers to receive ECHOMANTRA plus treatment as usual (TAU), or TAU alone. ECHOMANTRA was hosted on a digital platform and included a workbook, recovery-oriented video-clips and online facilitated groups (patients only, carers only, joint patient-carer). Participants were randomised on a 1:1 ratio using a minimisation algorithm to stratify by site (N = 31) and severity (defined by BMI <15 and ≥ 15 kg/m2 at baseline). The primary outcome was patient depression, anxiety, and stress at 12 months. Primary and secondary outcomes were compared between trial arms on an intention-to-treat basis (ITT). This trial is registered with the ISRSTN registry, ISRCTN14644379. Findings: Between July 01, 2017 and July 20, 2020, 371 patient-carer dyads were enrolled and randomly assigned to ECHOMANTRA + TAU (N = 185) or TAU alone (N = 186). There were no significant differences between trial arms with regards to the primary outcome (completed by N = 143 patients in the TAU group, Mean = 61.7, SD = 29.4 and N = 109 patients in the ECHOMANTRA + TAU group, Mean = 58.3, SD = 26.9; estimated mean difference 0.48 points; 95% CI -5.36 to 6.33; p = 0.87). Differences on secondary outcomes were small and non-significant (standardised effect size estimates ≤0.25). Five patients died (2 from suicide and 3 from physical complications) over the course of the trial, and this was unrelated to their participation in the study. Interpretation: ECHOMANTRA added to TAU was not superior to TAU alone in reducing patient depression, anxiety, and stress symptoms. This may be explained by limited engagement with the intervention materials and changes in usual care practices since the beginning of the trial. Funding: National Institute for Health Research (NIHR), under its Health Technology Assessment Programme (HTA) Programme (Grant Reference Number 14/68/09). NIHR Maudsley Biomedical Research Centre (BRC), South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, and King's College London. NIHR Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust.

7.
Mult Scler Relat Disord ; 88: 105719, 2024 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-38909526

RESUMO

BACKGROUND: People with MS (pwMS) commonly experience a range of hidden symptoms, including cognitive impairment, anxiety and depression, fatigue, pain, and sensory difficulties. These "invisible" symptoms can significantly impact wellbeing, relationships, employment and life goals. We developed a novel bespoke online group neuropsychological intervention combining psychoeducation and cognitive rehabilitation with an Acceptance and Commitment Therapy (ACT)-informed approach for pwMS in an acute tertiary hospital. This 'Neuropsychological Intervention for Managing Invisible Symptoms' in MS (NIMIS-MS) consisted of 6 sessions, each with a psychoeducation and ACT component. The content included psychoeducation around managing cognitive difficulties, fatigue, pain, sleep and other unpleasant sensations in MS with the general approach of understanding, monitoring, and recognising patterns and potential triggers. Specific cognitive rehabilitation and fatigue management strategies were introduced. The ACT-informed component focussed on three core ACT areas of the 'Triflex' of psychological flexibility (Harris, 2019): Being Present, Opening Up, and Doing What Matters. METHODS: 118 pwMS attended the NIMIS-MS group intervention which was delivered 14 times in six-week blocks over an 18-month period. To evaluate the effectiveness and acceptability, participants completed measures of depression and anxiety (HADS), functional impairment (WSAS), Values- Progress (VQ) and Values- Obstruction (VQ), and Acceptance of MS (MSAS) pre and post NIMIs-MS group intervention. Qualitative feedback was obtained during focus groups after the final session and via online feedback questionnaires RESULTS: Pre-post analysis showed that symptoms of depression and anxiety were significantly lower and acceptance of MS was significantly higher following completion of the NIMIS-MS group. Qualitative feedback showed that participants reported that they felt more equipped to manage the "invisible" symptoms of MS following completion of the group, and benefited from using ACT-based strategies and techniques. Participants highly valued the peer support that evolved during the NIMIS-MS groups. The online format was considered more accessible than in-person groups, due to less concerns of travel time, cost, fatigue, and comfort and infection. CONCLUSION: Evaluation suggests that our novel NIMIS-MS groups is an acceptable, beneficial and feasible approach for providing neuropsychological interventions to individuals with MS.

8.
Front Psychiatry ; 15: 1381007, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38855639

RESUMO

Background: Family interventions (FI) are recommended as part of the treatment for psychotic disorders, but the implementation in mental health services is generally poor. Recently, The Implementation of guidelines on Family Involvement for persons with Psychotic disorders (IFIP) trial, demonstrated significant improvements in implementation outcomes at cluster-level. This sub-study aims to examine the effectiveness of the IFIP intervention on relatives' outcomes and received FI. Methods: A cluster randomized controlled trial, was conducted in 15 Norwegian Community Mental Health Center (CMHC) units that were randomized to either the IFIP intervention, including implementation interventions and clinical interventions, or treatment as usual (TAU). The clinical interventions consisted of FI: basic family involvement and support (BFIS) to all patients and family psychoeducation (FPE) to as many as possible. Patients with psychotic disorders and their closest relative were invited to fill in questionnaires at inclusion and 6 months and 12 months follow-up. Received FI was reported by both relatives and clinicians. The relatives' primary outcome was satisfaction with health service support, measured by the Carer well-being and support questionnaire part B (CWS-B). The relatives' secondary outcomes were caregiver experiences, expressed emotions and quality of life. Patients' outcomes will be reported elsewhere. Results: In total 231 patient/relative pairs from the CMHC units were included (135 intervention; 96 control).The relatives in the intervention arm received an increased level of BFIS (p=.007) and FPE (p < 0.05) compared to the relatives in the control arm, including involvement in crisis planning. The primary outcome for relatives' satisfaction with health service support, showed a non-significant improvement (Cohen's d = 0.22, p = 0.08). Relatives experienced a significant reduced level of patient dependency (Cohen's d = -0.23, p = 0.03). Conclusion: The increased support from clinicians throughout FI reduced the relatives' perceived level of patient dependency, and may have relieved the experience of responsibility and caregiver burden. The COVID-19 pandemic and the complex and pioneering study design have weakened the effectiveness of the IFIP intervention, underscoring possible potentials for further improvement in relatives' outcomes. Clinical Trial Registration: ClinicalTrials.gov, identifier NCT03869177.

9.
Cureus ; 16(5): e59491, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38826934

RESUMO

This comprehensive review examines the impact of family therapy on expressed emotions (EE) within the context of psychiatric disorders. EE, characterized by high levels of criticism, hostility, or emotional over-involvement, have been consistently linked to poorer treatment outcomes and increased severity of psychiatric symptoms. The review explores various family therapy approaches and their effectiveness in reducing high EE levels in families of psychiatric patients. It synthesizes existing literature to highlight the mechanisms underlying the changes in EE, such as modifying communication patterns and enhancing family cohesion. Additionally, the review discusses the implications for clinical practice, emphasizing the importance of integrating family therapy into psychiatric treatment plans and providing psychoeducation to empower families to manage emotions effectively. Future research directions are also outlined, including investigating the long-term sustainability of changes brought about by family therapy and exploring cultural considerations in therapeutic approaches. Overall, the review underscores the pivotal role of family therapy in addressing EE and promoting recovery and resilience in psychiatric patients and their families.

10.
BMC Psychiatry ; 24(1): 375, 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38773509

RESUMO

BACKGROUND: Obsessive slowness, a symptom of obsessive-compulsive disorder (OCD), is characterized by compulsive behavior and significant slowness of movement. Primary obsessive slowness (POS) is defined as a condition in which a series of actions are segmented, and the patient spends an unlimited amount of time performing each action while checking each action, resulting in cessation or slowness of movement. It is often difficult to treat POS with exposure and response prevention, which is considered effective in general OCD, and no treatment has been established. Here, we discuss the effectiveness of psychoeducation and modeling using video recordings in the treatment of POS. CASE PRESENTATION: We report a case of POS in a 19-year-old woman. Each action was subdivided and ordered, and the patient could not proceed to the next action without confirming that the previous step had been performed. Therefore, she could not live her daily life independently; for instance, toileting and bathing required more than 1 h, even with assistance. After more than 5 months of long-term treatment, including pharmacotherapy, psychoeducation, and modeling with video recordings, she recovered to live her daily life independently. CONCLUSION: Psychoeducation and behavioral therapy can effectively treat POS. Particularly, modeling with video recordings would be an easy-to-use option for POS treatment.


Assuntos
Transtorno Obsessivo-Compulsivo , Gravação em Vídeo , Feminino , Humanos , Adulto Jovem , Hospitalização , Transtorno Obsessivo-Compulsivo/terapia , Educação de Pacientes como Assunto/métodos , Resultado do Tratamento
11.
Front Psychiatry ; 15: 1374540, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38784162

RESUMO

Background: Caring for a relative with a severe mental disorder (SMD) is associated with high levels of burden and poor physical and mental health. There is a dire need for family psychoeducational programs that can be provided as early as possible. This manuscript describes the pilot testing of "Leo" a motivational-based psychoeducational program for caregivers of individuals with a SMD. The Leo program aims to provide caregivers with skills to best support their relative and to adopt self-care behaviors. Methods: We retrospectively analyzed medical records of caregivers who enrolled in a short, multi-family, skill-based psychoeducational program, consisting of eight 3-hour sessions over 8 weeks. Outcomes of interest included: i) adherence to the program, ii) satisfaction and perceived usefulness, and iii) pre-post changes in self-reported levels of depression (CES-D), burden (ZBI), and skills (10 Likert-scaled items). A network analysis was used to investigate the relationships between pre-post changes in self-evaluated skills and pre-post changes in burden and depression levels. Results: Over the 91 enrolled participants, 87 (95.6%) completed the program attending at least 5/8 sessions, 80.5% attending all sessions. Seventy-six caregivers fulfilled the questionnaires at baseline and after the program, and were included in the analysis. Although there was no evidence for significant change in self-reported depression levels (Cohen's d=0.19, p=0.210), burden scores and all evaluated skills were improved post-intervention, with medium to strong effect size (Cohen's ds from 0.47 to 0.87; p<0.001). Network output indicated that increased self-evaluated competence in 5 skills were associated with a global improvement in caregivers' burden and/or depression scores. Post-intervention, 89.7% of caregivers were "very satisfied" and 82.1% found the program "extremely useful". Conclusion: This pilot retrospective study shows high levels of satisfaction, perceived usefulness, and adherence to "Leo", a short, multi-family, skill-based psychoeducational program with promising results in improving caregivers' burden, self-evaluated competence in coping with caregiving demands and in self-care behaviors. This study provides preliminary insights into the mechanisms by which family psychoeducation might alleviate burden of care. A larger-scaled, controlled, randomized study with follow-up assessments is warranted to determine how burden, depression, and skills, as well as their inter-relationships, evolve over time.

12.
Nurse Educ Today ; 139: 106230, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38703533

RESUMO

BACKGROUND: The clinical adaptation psychoeducation program grounded psychological flexibility model (PFMCAP) is consisting of six areas, fills a large gap in the literature regarding the effect of nursing students on perceived stress and coping behaviors in the clinical process. OBJECTIVES: To determine the effect of PFMCAP on perceived stress and coping behaviors of nursing students. DESIGN: This was a simple randomized controlled experimental pre-posttest design. SETTING: This study was conducted with 66 first-year students studying in the nursing department of a university in Türkiye. METHODS: A simple randomization method (computer-generated random number table) was used. Data were collected with "Sociodemographic Data Form", "Perceived Stress Scale for Nursing Students (PSSNS)" and "Stress-Coping Behaviors Scale for Nursing Students (SCBNS)". PFMCAP was conducted online with first-year nursing students, consisting of a total of six sessions, each lasting 90 min. Data were analyzed using percentiles and frequency distributions, and two-way mixed ANOVA one week after the completion of the PFMCAP. RESULTS: There was no significant difference between the groups of descriptive characteristics (p > 0.05). Post-test measurements of students in the experimental group's PSSNS total and sub-dimension scores had a significant decrease compared to the control group (p < 0.001). There was no significant difference between the groups in the post-test SCBNS total scores of the students (p > 0.05). However, there was a significant increase in the post-test SCBNS-Staying Optimistic sub-dimension scores in the experimental group (p < 0.001). CONCLUSION: The impact of PFMCAP on nursing students' perceived stress levels was not limited to only reducing stress levels; it also contributed to an increase in the students' levels of optimism. These findings demonstrate the potential of PFMCAP in supporting nursing students during the clinical adaptation process. It is observed that the integration of PFMCAP into nursing education could assist nursing students in better adapting to clinical practices and effectively managing stress.


Assuntos
Adaptação Psicológica , Estresse Psicológico , Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Estudantes de Enfermagem/estatística & dados numéricos , Feminino , Masculino , Estresse Psicológico/psicologia , Turquia , Adulto Jovem , Inquéritos e Questionários , Bacharelado em Enfermagem/métodos , Adulto , Modelos Psicológicos , Percepção , Capacidades de Enfrentamento
13.
JPGN Rep ; 5(2): 110-118, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38756111

RESUMO

Objectives: The goal of this longitudinal study was to reduce anxiety and pain in children with chronic conditions from the gastrointestinal tract during venipuncture. These children undergo regular venipuncture as part of their medical management and the procedure is often accompanied with anxiety and pain. In addition, children as well as their parents and health care professionals (HCPs) often suffer "compassionate pain" because of emotional interference. Method: In a realistic clinical setting, different psychological and medical interventions were examined: (1) Psychoeducational brochures and (2) four different medical-technical interventions during venipuncture. In a large hospital in Germany, 169 children, their parents, and HCPs were asked to rate anxiety and pain during venipuncture before and after the intervention. Results: Children showed a clear preference for some of the medical-technical interventions. Using Linear Mixed Models anxiety and pain rated by the children themselves showed no significant reduction. However, parents and HCPs reported a significant reduction. Age, gender, and status of liver transplantation were associated with a reduction in anxiety and pain in most of the analyses. Conclusion: Both psychoeducational brochures and medical-technical interventions had a positive impact on anxiety and pain. However, effectivity for the medical-technical interventions was lower than in previous studies utilizing individual interventions. Reasons for this difference as well as possibilities to improve the intervention are discussed. In addition, this study provides practical day-to-day information about the implementation of interventions for the work in pediatric units such as when and how to provide psychoeducational materials.

14.
Artigo em Inglês | MEDLINE | ID: mdl-38709329

RESUMO

PURPOSE: Postpartum depression (PPD) and anxiety (PPA) affect nearly one-quarter (23%) of women in Canada. eHealth is a promising solution for increasing access to postpartum mental healthcare. However, a user-centered approach is not routinely taken in the development of web-enabled resources, leaving postpartum women out of critical decision-making processes. This study aimed to evaluate the effectiveness, usability, and user satisfaction of PostpartumCare.ca, a web-enabled psychoeducational resource for PPD and PPA, created in partnership with postpartum women in British Columbia. METHODS: Participants were randomized to either an intervention group (n = 52) receiving access to PostpartumCare.ca for four weeks, or to a waitlist control group (n = 51). Measures evaluating PPD (Edinburgh Postnatal Depression Scale) and PPA symptoms (Perinatal Anxiety Screening Scale) were completed at baseline, after four weeks, and after a two-week follow-up. User ratings of website usability and satisfaction and website metrics were also collected. RESULTS: PPD and PPA symptoms were significantly reduced for the intervention group only after four weeks, with improvements maintained after a two-week follow-up, corresponding with small-to-medium effect sizes (PPD: partial η2 = 0.03; PPA: partial η2 = 0.04). Intervention participants were also more likely than waitlist controls to recover from clinical levels of PPD symptoms (χ 2 (1, n = 63) = 4.58, p = .032) and PostpartumCare.ca's usability and satisfaction were rated favourably overall. CONCLUSION: Findings suggest that a web-enabled psychoeducational resource, created in collaboration with patient partners, can effectively reduce PPD and PPA symptoms, supporting its potential use as a low-barrier option for postpartum women. TRIAL REGISTRATION: Protocol for this trial was preregistered on NIH U.S. National Library of Medicine, ClinicalTrials.gov as of May 2022 (ID No. NCT05382884).

15.
Alcohol Clin Exp Res (Hoboken) ; 48(7): 1383-1394, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38811340

RESUMO

BACKGROUND: Psychoeducation constitutes a routine therapeutic practice in most treatment settings for severe alcohol use disorder (sAUD). This technique is considered an efficient way to help patients to learn more about their disease and achieve therapeutic objectives. However, this approach capitalizes on three untested assumptions: namely, that (1) patients with sAUD possess insufficient knowledge about sAUD at treatment entry; (2) patients with sAUD have the cognitive resources to learn new information and benefit from psychoeducation; and (3) psychoeducation positively impacts clinical outcomes. METHODS: We tested these assumptions in two experimental studies. In the first experiment in 66 recently detoxified patients with sAUD and 102 matched healthy controls, we measured baseline knowledge on sAUD through self-reported questionnaires, determined whether an up-to-date psychoeducation program can improve this knowledge, explored the role of cognitive abilities in such learning, and established the impact of psychoeducation on relapse rates. In a second experiment in 23 patients and 17 healthy controls, we examined whether the increased knowledge following psychoeducation is alcohol specific, and whether the motivation to change influences the relation between psychoeducation and clinical outcomes. RESULTS: At treatment entry, patients with sAUD presented with more sAUD-related knowledge than healthy controls, and were able to increase this knowledge following psychoeducation, independently of their cognitive status. However, psychoeducation did not impact either the motivation to change or relapse rates. CONCLUSIONS: Psychoeducation can increase patients' knowledge about sAUD, but it does not increase the likelihood of abstinence or controlled low consumption after discharge. Thus, clinicians should question whether psychoeducation should occupy a central position in the therapeutic programs and reconsider what can be expected from psychoeducation in terms of achieving therapeutic objectives.

16.
Cureus ; 16(4): e59347, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38817471

RESUMO

Background Depression is an important public health issue that affects many university students worldwide. It causes a wide range of physiological impairments, resulting in high mortality and morbidity rates. Regardless of the severity of the situation, the lack of knowledge about depression prevents them from seeking help. Furthermore, many individuals mistakenly believe that supernatural powers cause mental illnesses, which leads them to seek treatment from traditional healers instead of medical professionals. Therefore, video is a suitable instrument for disseminating information about depression because it corresponds to the younger generations' preferred method of accessing information. However, there is a scarcity of research on the development of psychoeducational videos aimed at improving depression literacy among university students in Malaysia. Hence, this study was conducted to address this research gap. Methods The study was conducted from October 2022 to October 2023, following the guidelines of video production and the principles of psychoeducation. During the preproduction phase, the script was written based on medical reference books and medically reviewed websites. The script's consistency, relevance, representativeness, and clarity were validated by five subject-matter experts. Subsequently, it was translated into Malay, which is the national language of Malaysia, to create subtitles. This was followed by script breakdown, storyboard and shot list creation, location scouting, blocking, shooting schedule, preparing call sheets, and recruiting talents. The production phase included the activities of voiceover recordings and filming, followed by the post-production phase, which consisted of video editing. Nine subject matter experts and 30 end-users validated the video by assessing its functionality, usability, efficiency, audio-visual style, and setting. Results The video script scored an overall item-level content validity index (I-CVI) and scale-level content validity index based on the average method (S-CVI/Ave) value of 1 for the domains of consistency, relevancy, representativeness, and clarity. On the other hand, the video's I-CVI and S-CVI/Ave scores indicated that it met the minimum acceptable value of 0.78 (with a range of 0.78 to 1) and 0.9 (with a range of 0.92 to 0.98) in the domains of functionality, usability, efficacy, audiovisual technique, and setting. Similarly, the video's item-level face validity index (I-FVI) achieved a minimal value of 0.80 (with a range of 0.87 to 1) across all domains following validation by 30 end-users. The video's scale-level face validity index based on the average method (S-FVI/Ave) scored 0.91, 0.96, and 0.97 for functionality, usability, and consistency domains, while the audiovisual technique and setting domains scored 0.94 and 0.98, respectively. The feedback from participants included reducing the video speed to increase subtitle readability, replacing gloomy background music with a more vibrant composition and tempo, and substituting stock videos with footage depicting Asian settings. Conclusion The psychoeducational video, titled "Educating University Students About Depression: A Short Documentary," serves as a valid instrument for disseminating information pertaining to depression. The practical application of this video has the potential to improve depression literacy and mitigate the adverse consequences of depression among university students.

17.
Soins Psychiatr ; 45(352): 13-16, 2024.
Artigo em Francês | MEDLINE | ID: mdl-38719353

RESUMO

A group-based online psycho-education program for adults with attention deficit hyperactivity disorder (ADHD) and their families has been set up by a multi-professional psychiatric team. Feedback from users has mainly shown benefits in terms of improving self-esteem, destigmatization and accessibility to care. This suggests a real interest in developing this care offer in the pathway of ADHD adults.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Educação de Pacientes como Assunto , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/enfermagem , Adulto , Autoimagem , Psicoterapia de Grupo/métodos , França , Masculino , Feminino , Criatividade , Instrução por Computador , Comunicação Interdisciplinar , Equipe de Assistência ao Paciente , Estigma Social , Colaboração Intersetorial , Internet , Acessibilidade aos Serviços de Saúde , Comportamento Cooperativo
18.
Rural Remote Health ; 24(2): 8213, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38772697

RESUMO

INTRODUCTION: The activity of podcasting has increased exponentially but little is known about the qualitative listener experiences of podcasts related to mental health. The aim of this study was to understand what listeners of mental health podcasts obtain from this medium. Participants were asked questions relating to mental health literacy, stigma and help-seeking behaviour. METHODS: The study gathered data, via an online survey (n=722). This article reports on the responses to open-ended questions: 'What do you take away from listening to mental health-related podcasts? What do you learn about yourself (or a loved one)? What do you find most useful about listening to mental health-related podcasts?' Inductive thematic analysis was utilised. RESULTS: Thematic analysis produced five core themes: accessibility, mental health literacy, potential pitfalls, reassurance and lived experiences. Accessibility of material and discussions featuring professionals and people with lived experience were reported key highlights. CONCLUSION: Results indicate that podcasts influence the development of mental health literacy, reduce stigma and increase help-seeking. Given the challenges with service access in underserved populations, there is a potential role for the use of podcasts in rural regions.


Assuntos
Letramento em Saúde , Webcasts como Assunto , Humanos , Feminino , Masculino , Adulto , Letramento em Saúde/estatística & dados numéricos , Pessoa de Meia-Idade , Estigma Social , Saúde Mental , Inquéritos e Questionários , Pesquisa Qualitativa , Adulto Jovem , Acessibilidade aos Serviços de Saúde , Idoso
19.
Front Psychiatry ; 15: 1349476, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38585479

RESUMO

Background: Evidence shows that there is a high prevalence of mental health challenges including depression and anxiety, among Chinese university students. Providing mental health care providers with professional training is crucial to implementing effective mental health promotion initiatives in university settings. Globally, the focus of the mental health system is shifting to recovery and the importance of empowerment is increasingly being emphasized. There is a call to integrate empowerment education into professional training programs for health service providers with the goal of mobilizing them to become mental health champions capable of advancing mental health care. Method: The ACE-LYNX (Acceptance and Commitment to Empowerment-Linking Youth and Xin i.e., "heart(s)" in Chinese) intervention took place at six universities in Jinan, Shandong Province, China. It aimed to promote mental health literacy and build capacity among mental health service providers (MHSPs) to enable them to become mental health champions at their universities and beyond. A total of 139 university MHSPs participated. We collected pre-, immediate post- and three-month-post-surveys. In addition, we recruited forty-five participants to take part in three-month- post-intervention focus group interviews to explore their experiences taking part in ACE-LYNX and applying the knowledge, skills, and insights they gained from the intervention. Result: This paper reports on the effects of empowerment education, which is a key component of ACE-LYNX, on the MHSPs. Four themes were identified: 1) conscious awareness and behavioral change through psychological empowerment users; 2) professional insights and motivation for organizational empowerment; 3) non-self in the continuum of collective empowerment; and 4) interdisciplinary challenges and divergences in empowerment action. Discussion: We found that it is critical to integrate empowerment education into professional training. The process of MHSPs developing their empowerment practice is characterized by their moving from individual to collective empowerment along a continuum, with organizational and collective empowerment taking place in a longer time frame. Experiential learning, empathy education, and critical reflection accelerated the continuous iterative transformative process of empowerment practices. To advance the integration of empowerment into mental health care, the engagement of organizational decision-makers and policy makers in empowerment training is critical to ensure alignment of empowerment values and competence at all levels of service provision.

20.
Internet Interv ; 36: 100739, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38623084

RESUMO

Background: No web-based interventions addressing sexual problems are available for young adult survivors of childhood cancer. Aim: This study aimed to test the efficacy of a web-based psychoeducational intervention, Fex-Can Sex, to alleviate sexual problems in young adults treated for cancer during childhood. Method: This randomized controlled trial tested the effects of a 12-week, self-help, web-based intervention. Young adults (aged 19-40) reporting sexual dysfunction were drawn from a population-based national cohort of childhood cancer survivors and randomized to either an intervention group (IG, n = 142) or a wait-list control group (CG, n = 136). The primary outcome was 'Satisfaction with sex life' assessed by the PROMIS® SexFS v 2.0. Secondary outcomes included other SexFS domains, body image (BIS), emotional distress (HADS), health-related quality of life (EORTC QLQ-C30), and sex-related self-efficacy. Surveys were completed at baseline (T0), directly after the intervention (T1), and three months later (T2). The effects of the intervention were tested using t-test and linear mixed models, including intention-to-treat (ITT) and subgroups analysis. Adherence was based on log data extracted from the website system. The intervention included an open-ended question about perceived sexual problems. Results: No effect of the intervention was found in the primary outcome. Regarding secondary outcomes, the IG reported less vaginal dryness (Lubrication subscale) than the CG at T1 (p = 0.048) and T2 (p = 0.023). Furthermore, at T1, the IG reported less emotional distress than the CG (p = 0.047). Subgroup analyses showed that those with greater sexual problems at T0 improved over time (T1 and T2), regardless of group allocation. Overall, adherence to the intervention was low and participants' activity levels did not change the results. Additionally, some members of the IG reported increased understanding and acceptance of their sexual problems. Conclusion: The Fex-Can Sex intervention shows potential to improve sexual function, especially among those with greater dysfunction. To increase adherence and effect, we recommend the intervention to be further developed including more tailored content. Clinical trial registration: ISRCTN Registry, trial number: 33081791 (registered on November 27, 2019).

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