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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

"It's Not a Real Disorder": Attention Deficit/Hyperactivity Disorder and Paradigms of Childhood Harm

Hamiter, Amelia 01 January 2016 (has links)
Attention Deficit/Hyperactivity Disorder has garnered controversy in the United States since it became a widely diagnosed disorder in American schoolchildren in the 1970s. Both diagnosis and treatment are sites of controversy. Some believe the disorder is a contrivance of parents and teachers who do not want to deal with hardly exceptional childhood difficulties, or a contrivance of pharmaceutical companies taking advantage of such parents and teachers. Others believe that a neurobiological basis for the disorder will eventually be discovered, and thus will legitimize both the diagnosis and the practice of prescribing medication for treatment. I utilize the Science, Technology, and Society approach of actor network theory to show that these multiple understandings of ADHD can coexist, since ADHD is a complex product of external and internal agents. This will demonstrate how cultural shifts and values cause parents, teachers, and doctors to evaluate childhood in a way that frames certain behaviors as harmful. I also evaluate how cultural values of medicalization center issues in the individual rather than in external factors, and assess the values that psychiatric treatment appeals to and whether they primarily serve the needs of children. I conclude that ADHD is a heavily context-dependent disorder, but that that does not delegitimize harmful effect on children who exhibit ADHD-associated behaviors. I also conclude that the current dominant medicalized approach to ADHD is not optimal because it focuses on only a few of the total factors that make ADHD a pathological disorder for children in the contemporary United States.
22

Behandlares attityder och uppfattningar om Kultur på recept som behandlingsmetod : En kvantitativ enkätundersökning / Healthcare professionals’ attitudes and perceptions of Arts on prescription as a rehabilitation method

Lindberg, Elin, Blom, Johanna January 2017 (has links)
Syftet med detta examensarbete var att beskriva behandlares attityder och uppfattningar om Kultur på recept som rehabiliteringsmetod för patienter med lättare till medelsvår psykisk ohälsa och/eller ospecificerad långvarig smärta. Metoden var en kvantitativ enkätstudie. Enkäten distribuerades digitalt till 89 behandlare inom primärvården, med möjlighet att remittera till Kultur på recept, och besvarades av 32, vilket innebar att bortfallet bestod av 57 personer. Insamlad data bearbetades med deskriptiv och jämförande statistik med hjälp av statistikprogrammet Package for the Social Sciences [SPSS], version 21. Resultatet visade att Kultur på recept framförallt ansågs ha effekt för ökad subjektiv hälsa och symptomlindring. Respondenternas kunskapsnivå visade sig ha betydelse för hur effektiv behandlingsmetoden uppfattades och i vilken grad de föreslog denna. Resultatet visade också att kvinnor erbjöds Kultur på recept i större omfattning än män. Framförallt berodde det på, enligt respondenterna, att kvinnor är sjukskrivna i högre grad än män för framförallt psykisk ohälsa men även långvarig smärta. Några uttryckte även att intresset för kulturella aktiviteter var större hos kvinnor.  Slutsatsen är att det är viktigt att behandlare har kunskap om Kultur på recept för att uppfatta behandlingsformen som effektiv och vilja remittera till den. Det är också viktigt att föra diskussioner om genusperspektiv hos behandlare som kan påverka valet av rehabilitering, samt att vid sammansättningen av Kultur på recept ha med en variation av aktiviteter som kan tilltala olika intresseinriktningar hos både män och kvinnor. / The aim of this thesis was to describe healthcare professionals’ attitudes and perceptions of Arts on prescription as a rehabilitation method for patients with mild to moderate mental illness and/or unspecific longterm pain. The method was a quantitative survey. The survey was distributed digitally to 89 primary care professionals, able to prescribe Arts on prescription, and 32 responded. The non-response was 57 persons. The collected data were analysed using descriptive and comparative statistics using the Package for the Social Sciences [SPSS], version 21. The results showed that the method of treatment primarily had effect on increased subjective health and symptom relief. The respondents' level of knowledge also proved to be important for the perceived effectiveness of the method of treatment, and to the extent to which the respondents proposed it. The result also showed that women were offered Arts on prescription to a greater extent than men. In particular, it was reported, according to the respondents, that women were on sick-leave to a greater extent than men, especially due to mental illness, but also due to longterm pain. Some respondents also meant that women have a greater interest in cultural activities. The conclusion was that it was important for therapists have good knowledge of Arts on prescription, in order to perceive the treatment as effective, and show willingness to prescribe it. It is also important with further discussions on gender perspectives among therapists which can influence the choice of rehabilitation, and in the composition of Arts on prescription, include a variety of activities that might address different interests of both men and women.
23

Právní jednání osob stižených duševní poruchou / Legal actions of persons suffering from mental disorder

Roul, Jiří January 2016 (has links)
The aim of this thesis is to assess the Czech legislation in legal actions of persons suffering from mental disorder. The thesis is composed of five chapters. The first chapter describes the historical background of the topic. In the second chapter I describe in detail basic terms such as legal action, legal capacity and mental disorder, since these are important and essential for the thesis. The fundamental part of the thesis discusses institutes that support the legal conduct of persons suffering from mental disorder. These are preliminary statement, assist in determining, the representation of a household member, incapacitation and limitations associated with the institute guardian. The final chapter describes the fundamental international legal documents that influenced the Czech legislation.
24

Associação entre a pontuação Dieta Mind (Mediterranean - Dash Intervention for Neurodegenerative Delay) e Transtornos Mentais Comuns em idosos de São Paulo: Estudo de Base Populacional / Association between Mind Diet score (Mediterranean - Dash Intervention for Neurodegenerative Delay) and Common Mental Disorders in the elderly of São Paulo: Population Based Study

Ávila, Mariana de Oliveira 24 June 2019 (has links)
Introdução: Dentre as diferentes manifestações de saúde que acometem os idosos, pode-se destacar os Transtornos Mentais Comuns (TMC). Sugere-se que a adesão a padrões alimentares específicos, como a dieta MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay), possa atenuar ou reduzir os riscos relacionados ao envelhecimento. A Dieta MIND tem como princípio ingestão elevada de frutas vermelhas, vegetais verdes folhosos e demais vegetais, aves, peixes, oleaginosas, leguminosas, grãos integrais, azeite de oliva extra-virgem, vinho tinto, e por sua vez, uma ingestão baixa de carnes vermelhas, doces e massas, queijos, manteiga, margarina, além dos alimentos convencionalmente chamados de \"fast food\". Objetivo: este estudo tem como objetivo identificar, em idosos, a pontuação do padrão dietético MIND e investigar a associação entre essa pontuação e a presença de TMC. Métodos: a amostra para o presente estudo é derivada do Inquérito de Saúde - ISA Capital Nutrição, no período de 2015. Foram estudados, nessa amostra, 545 idosos (acima de 60 anos), de ambos os sexos. Os dados alimentares da amostra foram obtidos a partir de dois recordatórios alimentares de 24 horas, que foram corrigidos para identificação da dieta habitual, e calculados quanto à ingestão dos grupos alimentares que constituem a dieta MIND. Além disso, a pontuação à dieta MIND foi identificada a partir da mediana da ingestão dos grupos determinados. A presença de TMC foi avaliada por meio da aplicação do SRQ-20 (Self-Reported Questionnaire). Foram ainda consideradas algumas variáveis de ajuste (sexo, idade, raça, nível de atividade física de lazer, presença de doenças crônicas como hipertensão arterial sistêmica, dislipidemia e diabetes mellitus, renda familiar total, Índice de Massa Corporal e escolaridade). Resultados: os participantes avaliados eram em sua maioria mulheres, inativas, com presença de doenças crônicas. Não houve associação significativa quanto a adesão à pontuação da dieta MIND e TMC, contudo, alguns componentes da dieta, quando associados isolados, mostraram associação significativa e protetora (vegetais verdes folhosos, outros vegetais não folhosos e leguminosas). Por sua vez, o consumo de carnes vermelhas mostrou correlação negativa para TMC. Conclusão: O presente estudo não encontrou associação significativa entre a pontuação 7 da dieta MIND e TMC entre os idosos, entretanto, quando se analisou os componentes do padrão dietético MIND isolados em relação a TMC, encontrou-se correlação positiva para os grupos de vegetais verdes folhosos, outros vegetais e leguminosas e correlação negativa para o grupo de carnes vermelhas. Desse modo, estratégias nutricionais voltadas à saúde da função cerebral, com foco em um maior consumo de alimentos protetores e menor consumo de alimentos não-protetores presentes na dieta MIND, podem auxiliar beneficamente a população, especialmente os idosos. / Introduction: Among the different health manifestations that affect the elderly, we can highlight Common Mental Disorders (CMD). In turn, it is suggested that adherence to specific dietary patterns, such as the Mediterranean-DASH Intervention for Neurodegenerative Delay, may attenuate or prevent mental disorders related to aging. The MIND Diet has as a principle a relatively high intake of healthy foods such as red fruits, leafy green vegetables and other vegetables, poultry, fish, oilseeds, legumes, whole grains, extra virgin olive oil, red wine, a relatively low intake of unhealthy foods such as red meats, sweets and pasta, cheeses, butter, margarine, and food conventionally called fast food. Objective: This study aims at analyzing, in the elderly, the score of the MIND dietary pattern, and to investigate the association between this score and the presence of CMD. Methods: The sample for the present study is derived from the Health Survey - ISA Capital Nutrition, in the period of 2015. In this sample, 545 elderly (over 60 years) of both sexes were studied. The dietary data of the sample were obtained from two 24-hour dietary reminders that were corrected for intrapersonal variability to identify the usual diet and calculated for the intake of the dietary groups that constitute the MIND diet. In addition, adherence to the MIND diet was identified from the median ingestion of the previously determined groups. The presence of CMD was assessed by the application of SRQ-20. Some adjustment variables (gender, age, physical activity pattern, presence of chronic diseases, income and schooling) were also considered. Results: the participants were mostly female, inactive, with chronic diseases. There was no significant association with adherence to the MIND and CMD scores, however, some dietary components, when associated alone, showed a significant and protective association (green leafy vegetables, other no-leafy vegetables and legumes). In turn, the consumption of red meat showed a significant and harmful association. Conclusion: The present study did not find a significant association between the MIND and TMC diet scores among the elderly, however, when analyzing the components of the isolated MIND dietary pattern in relation to the TMC, a positive correlation was found for the leafy green vegetable groups, other vegetables and legumes and negative correlation for the red meat group. Thus, nutritional strategies focused on brain function health, with a focus on higher consumption of protective foods and lower consumption of non-protective foods present in the MIND diet, can benefit the population, especially the elderly.
25

Atitudes de familiares de portadores de transtornos mentais frente aos transtornos mentais: a influência do grupo de autoajuda / Attitudes of mental disorder patients\' relatives towards the mental disorders: the influence of a self-help group

Machado, Angelina Moda 09 August 2011 (has links)
Diferentes pessoas podem ter atitudes diferentes frente a um mesmo objeto, mas esta diversidade de posicionamento não deve ser encarada como características idiossincráticas ou estáveis, não nascem num vazio social, são fruto de interação social, de processo de comparação, identificação e diferenciação social que permite situar uma posição frente a outras em um determinado momento. A família, enquanto grupo, atravessa os tempos passando por inúmeras transformações e críticas, sem se afastar da responsabilidade e das exigências dos papéis socialmente atribuídos a ela. O transtorno mental permanece ainda obscuro, não existindo uma causa que o explique como tão estigmatizante, mas, o adoecer psíquico, é facilmente percebido, pois, os indivíduos que adoecem, apresentam comportamentos diferentes daqueles normalmente aceitos pela sociedade. Os grupos de autoajuda são homogêneos, seus participantes passam pelo mesmo sofrimento, são de apoio mútuo e educacional, a liderança vem do interior do grupo, reporta-se somente a um único evento desestruturador de vida, os membros participam voluntariamente, sem fins lucrativos, objetivam o crescimento pessoal dos integrantes e tem caráter anônimo e confidencial. Partindo-se do princípio de que as atitudes frente aos transtornos mentais e seus portadores são passíveis de serem trabalhadas e modificadas, mesmo sendo necessário um trabalho ao longo de um grande período de tempo, pois envolve aspectos formadores da personalidade, este estudo teve como objetivo mostrar as atitudes frente aos transtornos mentais de familiares de portadores de transtornos mentais que participam de grupo de autoajuda, de familiares que não participam de grupos desta natureza e estudar comparativamente as atitudes destes dois grupos. Para isso, 20 familiares de portadores de transtornos mentais, sendo 10 familiares que participam de um grupo de autoajuda e 10 familiares que nunca participaram de grupo de autoajuda, responderam a um questionário com uma parte sobre os seus dados pessoais e a outra parte com perguntas abertas sobre sua proximidade com o seu parente portador de transtorno mental e a escala de atitudes \"Opiniões Sobre os Transtornos Mentais\" (OTM). Os resultados mostraram que em ambos os grupos a faixa etária dos familiares está acima dos 50 anos, a maioria são mães, casadas, católicas, com tempo de convívio com o parente portador de transtorno mental acima de 5 anos, a esquizofrenia é o transtorno mais frequente, sendo melhor a situação econômica dos familiares participantes do grupo de autoajuda. Os resultados da OTM, analisados de forma estatística utilizando-se o teste de Mann-Whitney U mostraram uma influência positiva do grupo de autoajuda nas atitudes de familiares de portadores de transtornos mentais frente aos transtornos mentais e seus parentes portadores desses transtornos, mas essa influência mostrou-se relativa, pois, os dois grupos, revelaram ainda atitudes autoritárias, restritivas e discriminadoras, levando à conclusão de que o grupo de autoajuda é extremamente importante e uma expressiva ferramenta de apoio, mas para uma real mudança de atitudes nos aspectos considerados, são necessárias modalidades terapêuticas mais específicas e que utilizam intervenções mais focadas. / Different people may have different attitudes towards a same object, but this range of positions should not be seen as idiosyncratic or stable characteristics. They are not born in a social void, but are the fruit of social interaction, of a comparison, identification and social distinction process that permits situating one position towards others at a given time. As a group, the family evolves going through countless transformations and criticism, without distancing itself from the responsibility and requirements of the roles it is socially attributed. Mental disorder is still obscure, without a cause to explain the extent of its stigma, but psychic illness is easily perceived, as the people who get ill display behaviors different from what society normally accepts. Self-help groups are homogeneous. Their participants go through the same suffering. The groups provide mutual support and are educational. Leadership comes from within the group, which only refers to a single deconstructive event in life. Members participate voluntarily, without aiming for profit. The groups aim for their members\' personal growth and are anonymous and confidential. Departing from the principle that attitudes towards mental disorders and their patients can be addressed and modified, although demanding long-term work, as it involves personality-building aspects, this study aimed to show the attitudes towards mental disorders of family members of mental disorder patients who participate in a self-help group, of family members who do not participate in this kind of groups, and to comparatively study these two groups\' attitudes. Thus, 20 relatives of mental disorder patients, ten of whom participate in a self-help group and ten who had never participated in a self-help group, answered a questionnaire. One part referred to their personal data, while the other part contained open questions on their proximity with their relative suffering from a mental disorder, as well as the attitude scale \"Opinions on Mental Disorders\" (OMD). The results showed that, in both groups, the relatives\' age range is over 50 years, most are mothers, married, Catholic, have lived with the relative suffering from the mental disorder for more than five years, schizophrenia is the most frequent disorder and the relatives who participate in the self-help group display a better socio-economic situation. Statistical analysis of the OMD results, using Mann-Whitney\'s U-test, showed a positive influence of the self-help group on the attitudes of mental disorder patients\' relatives towards the mental disorders and their relatives suffering from these disorders. This influence revealed to be relative though, as the two groups also revealed authoritarian, restrictive and discriminatory attitudes, leading to the conclusion that the self-help group is extremely important and a meaningful support tool. To achieve an actual change in attitudes towards the aspects under analysis though, more specific therapeutic modes are needed, which use more focused interventions.
26

Reabilitação psicossocial de pessoas com transtorno mental no contexto da reforma psiquiátrica brasileira: representações das famílias / The families representation of the psychosocial rehabilitation of those with mental disorder in the context of the brazilian psychiatric reform

Randemark, Norma Faustino Rocha 14 April 2009 (has links)
Esse estudo elegeu como objeto de investigação a reabilitação psicossocial das pessoas com transtorno mental no contexto da reforma psiquiátrica brasileira. Para aproximação dessa realidade, analisamos as representações dos familiares produzidas a partir da experiência cotidiana nos serviços substitutivos de saúde mental e no domicilio junto ao parente com transtorno mental, explicitando os conflitos e contradições existentes e suas implicações na prática de cuidado da saúde e reabilitação psicossocial. Os sujeitos foram os familiares cuidadores de pessoas com transtorno mental severo e persistente, partícipes do grupo terapêutico de família dos Centros de Reabilitação Psicossocial (CAPS), na cidade de São Paulo (SP) - Brasil. Os achados foram coletados mediante entrevista semi-estruturada, observação e diário de campo e submetidos à Análise do Discurso com esteio no materialismo histórico-dialético mediante a qual foram extraídas as categorias temáticas. Constatamos que as concepções dos familiares acerca do transtorno mental, ainda, fortemente associadas aos signos estigmatizantes, determinam o modo como as famílias organizam o seu cotidiano, influenciando as atividades as relações interpessoais no âmbito familiar e social, os sentimentos, atitudes com relação ao sujeito acometido pelo transtorno, expectativas e perspectivas futuras no que refere à melhoria na qualidade de vida e inclusão social do sujeito acometido pelo transtorno mental e sua família. A maior parte dessas concepções é carregada de adjetivações negativas e adquirem conotação positiva, apenas, quando está presente a possibilidade de ganho secundário e a cura do transtorno mental é representada pela expectativa de retorno a normalidade e adaptação social / The focus of this study is the psychosocial rehabilitation of persons with mental disorders in the context of the Brazilian psychiatric reform. In order to gain insight into this reality, the study sought to perceive the familys representations which were produced from their daily experiences, dealing with substitutive services in mental health, and from the family member with the mental disorder, in the home, making explicit the existing conflicts and contradictions along with their implications in the practical care of psychosocial rehabilitation and health. The subjects were the care givers, being relatives, of those with severe, persistent mental disorder, who participated in the family therapeutic group of the Centers of Psycho-social Rehabilitation (CPR), in the city of Sao Paulo, SP, Brazil. The findings were collected through semi-structured interviews and diary field observation. The findings underwent discourse analysis with support in historical-dialectic materialism through which the thematic categories were extracted. We found that the families conceptions concerning mental disorder, still strongly associated with stigmatic signs, determined the manner in which they organized their daily life. These conceptions influenced the activities, the interpersonal relationships in the social, family context. They influenced the feelings and attitudes regarding the subject who carries the illness, as well as future expectations and perspectives regarding the improvement of the quality of life and the social inclusion of the individual suffering from the mental disorder, as well as of the family. The majority of these conceptions are latent with negative adjectives and acquire positive connotations only when there is a possibility of some secondary gain and when the cure of the mental disorder is represented by the return to normality and social adaptation
27

Atitudes de familiares de portadores de transtornos mentais frente aos transtornos mentais: a influência do grupo de autoajuda / Attitudes of mental disorder patients\' relatives towards the mental disorders: the influence of a self-help group

Angelina Moda Machado 09 August 2011 (has links)
Diferentes pessoas podem ter atitudes diferentes frente a um mesmo objeto, mas esta diversidade de posicionamento não deve ser encarada como características idiossincráticas ou estáveis, não nascem num vazio social, são fruto de interação social, de processo de comparação, identificação e diferenciação social que permite situar uma posição frente a outras em um determinado momento. A família, enquanto grupo, atravessa os tempos passando por inúmeras transformações e críticas, sem se afastar da responsabilidade e das exigências dos papéis socialmente atribuídos a ela. O transtorno mental permanece ainda obscuro, não existindo uma causa que o explique como tão estigmatizante, mas, o adoecer psíquico, é facilmente percebido, pois, os indivíduos que adoecem, apresentam comportamentos diferentes daqueles normalmente aceitos pela sociedade. Os grupos de autoajuda são homogêneos, seus participantes passam pelo mesmo sofrimento, são de apoio mútuo e educacional, a liderança vem do interior do grupo, reporta-se somente a um único evento desestruturador de vida, os membros participam voluntariamente, sem fins lucrativos, objetivam o crescimento pessoal dos integrantes e tem caráter anônimo e confidencial. Partindo-se do princípio de que as atitudes frente aos transtornos mentais e seus portadores são passíveis de serem trabalhadas e modificadas, mesmo sendo necessário um trabalho ao longo de um grande período de tempo, pois envolve aspectos formadores da personalidade, este estudo teve como objetivo mostrar as atitudes frente aos transtornos mentais de familiares de portadores de transtornos mentais que participam de grupo de autoajuda, de familiares que não participam de grupos desta natureza e estudar comparativamente as atitudes destes dois grupos. Para isso, 20 familiares de portadores de transtornos mentais, sendo 10 familiares que participam de um grupo de autoajuda e 10 familiares que nunca participaram de grupo de autoajuda, responderam a um questionário com uma parte sobre os seus dados pessoais e a outra parte com perguntas abertas sobre sua proximidade com o seu parente portador de transtorno mental e a escala de atitudes \"Opiniões Sobre os Transtornos Mentais\" (OTM). Os resultados mostraram que em ambos os grupos a faixa etária dos familiares está acima dos 50 anos, a maioria são mães, casadas, católicas, com tempo de convívio com o parente portador de transtorno mental acima de 5 anos, a esquizofrenia é o transtorno mais frequente, sendo melhor a situação econômica dos familiares participantes do grupo de autoajuda. Os resultados da OTM, analisados de forma estatística utilizando-se o teste de Mann-Whitney U mostraram uma influência positiva do grupo de autoajuda nas atitudes de familiares de portadores de transtornos mentais frente aos transtornos mentais e seus parentes portadores desses transtornos, mas essa influência mostrou-se relativa, pois, os dois grupos, revelaram ainda atitudes autoritárias, restritivas e discriminadoras, levando à conclusão de que o grupo de autoajuda é extremamente importante e uma expressiva ferramenta de apoio, mas para uma real mudança de atitudes nos aspectos considerados, são necessárias modalidades terapêuticas mais específicas e que utilizam intervenções mais focadas. / Different people may have different attitudes towards a same object, but this range of positions should not be seen as idiosyncratic or stable characteristics. They are not born in a social void, but are the fruit of social interaction, of a comparison, identification and social distinction process that permits situating one position towards others at a given time. As a group, the family evolves going through countless transformations and criticism, without distancing itself from the responsibility and requirements of the roles it is socially attributed. Mental disorder is still obscure, without a cause to explain the extent of its stigma, but psychic illness is easily perceived, as the people who get ill display behaviors different from what society normally accepts. Self-help groups are homogeneous. Their participants go through the same suffering. The groups provide mutual support and are educational. Leadership comes from within the group, which only refers to a single deconstructive event in life. Members participate voluntarily, without aiming for profit. The groups aim for their members\' personal growth and are anonymous and confidential. Departing from the principle that attitudes towards mental disorders and their patients can be addressed and modified, although demanding long-term work, as it involves personality-building aspects, this study aimed to show the attitudes towards mental disorders of family members of mental disorder patients who participate in a self-help group, of family members who do not participate in this kind of groups, and to comparatively study these two groups\' attitudes. Thus, 20 relatives of mental disorder patients, ten of whom participate in a self-help group and ten who had never participated in a self-help group, answered a questionnaire. One part referred to their personal data, while the other part contained open questions on their proximity with their relative suffering from a mental disorder, as well as the attitude scale \"Opinions on Mental Disorders\" (OMD). The results showed that, in both groups, the relatives\' age range is over 50 years, most are mothers, married, Catholic, have lived with the relative suffering from the mental disorder for more than five years, schizophrenia is the most frequent disorder and the relatives who participate in the self-help group display a better socio-economic situation. Statistical analysis of the OMD results, using Mann-Whitney\'s U-test, showed a positive influence of the self-help group on the attitudes of mental disorder patients\' relatives towards the mental disorders and their relatives suffering from these disorders. This influence revealed to be relative though, as the two groups also revealed authoritarian, restrictive and discriminatory attitudes, leading to the conclusion that the self-help group is extremely important and a meaningful support tool. To achieve an actual change in attitudes towards the aspects under analysis though, more specific therapeutic modes are needed, which use more focused interventions.
28

Quality Improvement Through Evidence-Based Education: Advancing Obesity Awareness and Clinical Management Strategies for People Living with Mental Disorders

Opusunju, Ellis Ehizele 01 January 2017 (has links)
People living with mental disorders (PLWMDs) are at an increased risk for developing obesity due to poor diet, physical inactivity, and antipsychotic medications. In the United States, the general-population obesity rate is 36% compared to more than 50% for PLWMDs. Mental health professionals (MHPs), focused on addressing psychiatric conditions, seldom recognize and clinically manage obesity. Furthermore, this population is socioeconomically disadvantaged with poor dietary habits while consuming psychiatric medications that stimulate hunger, further exacerbating the risk for obesity. The Promoting Action on Research Implementation in Healthcare Services (PARISHS) framework guided this quality improvement project to improve obesity awareness and management for PLWMD at a large state psychiatric hospital. An evidence-based education intervention was implemented to positively impact obesity awareness and clinical management or MHPs. The evaluation used a validated instrument with a pre- and posttest design. Paired t test was used to analyze multiple constructs from the MHP participants (N = 50). Overall, the pretest indicated 76% of MHPs were not involved in helping obese PLWMDs manage their weight; however, the posttest data (at 90-days) revealed that 90% were involved in this activity. This represents a positive shift in obesity perceptions and management knowledge. Future research needs to evaluate the impact of the perceptions on process measures and clinical outcomes. This project led to positive social change as MHPs are more likely to address obesity in PLWMD due to their increased awareness and knowledge. This project has broader implications as the program can be duplicated in other psychiatric hospitals.
29

Managing the contradictions : Recovery from severe mental disorders

Topor, Alain January 2001 (has links)
One of the assumptions made when mental problems are defined as a medical problem is that certain problems, certain diagnoses, are chronic. Nevertheless, a substantial number of follow-up studies have shown that the course of development in patients with these diagnoses is neither uniform nor chronic. The aim of this dissertation is to summarise the state of the art in the knowledge about recovery from severe mental disorders and to examine in depth which factors people who have recovered regard as having helped them in their recovery, and in which ways. These two aims have resulted in two separate but complementary presentations of results. The review of the state of the art, which focuses on the diagnosis schizophrenia, shows that some two-thirds of the patients who received this diagnosis have recovered, either totally or socially. The variation in the percentage of persons who have recovered is explained in the study by such factors as fluctuations in national and local unemployment rates, in definitions of the diagnoses and in access to psychiatric care. On the other hand, the introduction of various treatment interventions seems to have had no noticeable effect on the recovery rate, although it has affected the relapse frequency. There is still a long way to go towards understanding the recovery process and how it can be facilitated. The interview study with persons who have been treated for severe mental disorders and recovered show the patients themselves to be a crucial factor in their own recovery. Throughout the whole course of the disorder, they struggle to find ways to manage both their symptoms and the factors that cause them. What appears to others as symptoms might instead be theperson’s unsuccessful attempts to manage existential problems. Entering into and maintaining relationships with other people is another crucial factor in recovery work. Professionals from a variety of backgrounds as well as family members and other laypersons can contribute to recovery, first and foremost in that they represent continuity between diverse facets of the person’s life; they engage with the person in his/her full complexity, not as someone reduced to a diagnosis and a given patient role, nor by denying the fact of the person’s suffering. Still another factor in recovery work is material conditions which impact on the person’s possibility to regain an identity as a full member of the community. Lastly, the descriptions that the respondents give of their recovery practice have certain constructed meanings in common. These meanings can be categorised as medical, therapeutic, spiritual and interactional. In many of the life stories collected in this study, several of these categories of meaning appear in unison, co-existing in one and the same life story. There is a recurrent theme running through these practice stories of recovery: that people in their everyday lives are not reducible to their problems, but at the same time these problems must not be denied. That people have both weaknesses and strengths, sometimes existing within the same spheres of life and occurring simultaneously; but that in relationships with other people they are given scope to manage and live with these contradictions is of central importance for recovery practice.
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Continued Needs for Epidemiological Studies of Mental Disorders in the Community

Wittchen, Hans-Ulrich 29 November 2012 (has links) (PDF)
Introduction: Faravelli et al. [1, 2] present findings on the lifetime, point and 1-year prevalence of mental disorders from their recent Sesto Fiorentino community survey in Italy. The publication of these study findings occurs at a time where some researchers and journal editors seem to have come to the conclusion that there is currently no further need for such cross-sectional studies on the prevalence of mental disorders. In fact, there have been pleas for a pause of such studies [3]. Highlighting several noteworthy features and findings from the survey of Faravelli et al. [1, 2], this editorial will challenge this attitude. The status, past and recent progress in the field of epidemiology of mental disorders will be critically discussed, in an attempt to underline the continued core role of descriptive epidemiological studies for our field and to identify future research needs.

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