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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.
1

Patienter med psykossjukdom och deras upplevelse av livskvalitet

Grufman, Rose-Marie, Berg, Daniel January 2016 (has links)
SAMMANFATTNING   Bakgrund: Psykossjukdom kan beskrivas som en förändring i verklighetsuppfattning. Symtom är vanföreställningar, hallucinationer, tankestörningar, passivitet, avtrubbade affekter och känslomässiga störningar. Att drabbas av psykossjukdom innebär en stor förändring i livet för den som drabbas, med stort lidande och sänkt livskvalitet. Tidigare forskning har visat att olika bakgrundsfaktorer kan påverka livskvalitet hos patienter med psykossjukdom. Syfte: Denna studie syftar till att undersöka hur människor med psykossjukdom upplever sin livskvalitet och hur ålder, kön, hushållssituation samt utbildning och sysselsättning påverkar detta. Metod: Studiedesignen var komparativ tvärsnittsstudie medelst frågeformulär. Enkäter delades ut på en psykosöppenvårdsmottagning och en slutenvårdsavdelning på ett sjukhus i mellansverige. EQ-5D användes som instrument för att mäta livskvalitet. Deltagarna fick också besvara ett frågeformulär som undersökte deras bakgrundsfaktorer. Resultat: Sysselsättning, som arbete eller studier hade en positiv inverkan på livskvalitet.  ålder, kön, hushållssituation och utbildningsnivå hade ingen inverkan på livskvalitet. Resultatet från insamlingen på slutenvårdsavdelningen var inte möjligt att analysera på grund av bortfall. Slutsats: Denna studie hade för få deltagare som sannolikt påverkat resultatet. Framtida forskning bör vara mer omfattande. Tidigare forskning visar dock att olika bakgrundsfaktorer påverkar livskvalitet. Det är därför viktigt att sjuksköterskor oavsett var de arbetar känner till patientens enskilda bakgrundsfaktorer och utnyttjar denna kunskap för att hitta de individer som behöver mest stöd.     Nyckelord: Livskvalitet, psykossjukdom, bakgrundsfaktorer / ABSTRACT Background Psychotic disorders can be described as a change in the perceptions of reality. Symptoms include delusions, hallucinations, confused thinking, lack of motivation and emotional expressions. To suffer from psychotic disorder means a change in the life of those affected and reduced quality of life. Precious research has shown different background factors can affect the quality of life in patients with psychotic disorders. Aim The aim of this study was to measure quality of life in patients with different psychotic disorders and the impact of age, gender, occupation, household situation and level of education. Method A comparative cross-sectional design was used. In- and outpatients undergoing treatment in a Swedish psychiatric care setting was asked to participate in the study. The EQ-5D instrument was used to measure quality in life. Participants were also asked to fill in in a questioner regarding their background factors. Results Occupation had a positive outcome in quality of life. Age, gender, household situation and level of education did not impact quality of life, The group of inpatients were not included in this study due to failing filling in the questionnaires properly Conclusion The result has probably been affected by the low number of participants, making it difficult to draw any conclusions. Previous research shows different background factor does have an impact on quality of life, future research should ensure a bigger sample of participants.   Keywords: Quality of life, psychotic disorder, background factors
2

Co-occurring depression and alcohol/other drug use problems: developing effective and accessible treatment options

Kay-Lambkin, Frances January 2006 (has links)
Research Doctorate - Doctor of Philosphy (PhD) / A large body of population- and treatment-based evidence exists to indicate depression and alcohol/other drug (AOD) use are highly prevalent on a global scale, and co-occur with considerable frequency. Despite this evidence, significant gaps exist in treatment research and clinical services, as people with co-occurring depression and AOD use problems have typically been excluded from randomised controlled treatment trials, and also face many individual- and service-level barriers to accessing treatment. Consequently, a well-defined and adequately tested treatment strategy does not currently exist for people experiencing the complexities of concurrent depression and AOD use problems. A small body of evidence exists to suggest that co-occurring mental and AOD use disorders (“comorbidity”) leads to poorer treatment outcomes, increased risk of relapse, higher levels of problematic symptomatology, and poorer quality of life. However, little consistent information is currently available to suggest what additional impact comorbid depression and AOD misuse produces relative to the experience of a “single” condition (such as depression or AOD misuse in isolation). Studies 1 and 2 attempted to address this important gap in knowledge by examining the presenting characteristics of 246 people with AOD use problems, according to the presence of comorbid depressive symptoms. One hundred and thirty seven participants were drawn from AOD treatment services, and a further 109 were referred via mental health services and also met criteria for a psychotic disorder. Results indicated that the presence of depression was associated with a significantly higher severity of psychiatric symptoms and personality disorder, significantly decreased social and occupational functioning and significantly reduced quality of life. Current depression was also associated with a significant increase in the experience of cravings and self-reported dependence on amphetamines. These difficulties were over and above the already high rates of disability and distress reported by each sample as a whole. Furthermore, treatment for mental health problems was rare among the AOD treatment participants, as was AOD treatment among the mental health sample. This is despite the presence of moderate to severe levels of depression and AOD use reported by each sample. In particular, Studies 1 and 2 highlight the vulnerabilities for people with comorbid mental health and AOD use problems who present to treatment in the mental health or AOD use settings, and in particular how depression significantly increases the disability and other challenges experienced by these people. These results provide a strong rationale for the development of an appropriate treatment protocol for depression and AOD use comorbidity. No clear treatment model or evidence-based approach exists to suggest how depression and AOD use comorbidity is best managed. When people with this comorbidity do manage to access clinical treatment services, they typically receive treatment targeted at one aspect of their presentation (e.g. depression-focussed or AOD-focussed treatment). Yet, it is not known whether a singular focus of treatment is effective in producing sustainable change in the outcomes of people with comorbid problems, nor whether failure to treat all components of the comorbid presentation confers a worse outcome. Studies 3 and 4 reported on two randomised controlled clinical trials of psychologicaltreatment for AOD use problems among a sample of 246 people with AOD use problems, drawn from AOD treatment services (n=137) or mental health services (n=109). In doing so, these studies provide some of the first available data on these issues. Participants were categorised according to the presence of comorbid depression (as per Studies 1 and 2) and response to treatment was analysed over a six- to 12-month follow-up period. In spite of high levels of current depressive symptoms at entry to the studies, and equally hazardous use thresholds of a range of substance, people enrolled in Studies 3 and 4 reported some gains via their experiences with these single-focussed treatments. Attendance and retention rates were higher than reported in previous research, and the presence of depression did not adversely influence the motivation of project participants to change their current AOD use patterns. A treatment effect was generally not detected among the Study 3 and 4 participants, regardless of the presence of depression, with those receiving an assessment-only control treatment in both studies reporting similar patterns of change in outcome. Regardless of the magnitude of change reported by all study participants, people with depression reported significantly higher levels of depression, poly-drug use, amphetamine dependence, hazardous use of a range of substances, HIV risk taking and criminal activity and lower levels of functioning and self-concept across the follow-up assessment period. These residual symptoms were present at sufficiently high levels of severity to increase the risk of relapse to AOD use and continued morbidity. These results suggested the potential value of targeting depression in the context of comorbid AOD use problems. One previous study has examined the impact of an adjunctive psychological treatment of depression for people hospitalised for alcohol use disorder. Results indicated that people who received the additional depression treatment reported significantly greater improvements on depression- and alcohol-related outcomes over the short-term relative to people receiving a relaxation-only control treatment. These improvements were suggested to be enhanced if treatment had integrated depression- and alcohol-related approaches into the one treatment program. In the first study of its kind, Study 5 developed and evaluated the efficacy of an integrated psychological treatment program for comorbid depression and AOD use problems. Sixty-seven participants received integrated treatment delivered by a therapist, computer-delivered integrated treatment or a brief intervention (control) treatment delivered by a therapist. Depression scores, daily use of alcohol and cannabis, hazardous use of a range of substance and poly-drug use fell significantly over a 12-month follow-up period across the integrated treatments and brief intervention (control) conditions. The small sample size of Study 5 meant that very few treatment effects were detected at a statistically significant level, however important reductions in key outcomes for depression, AOD use, quality of life and general functioning were noted for people in the integrated treatment relative to controls over a 12-month period. The magnitude of change in Study 5 across these domains was comparable with the only other study of psychological treatment of depression and alcohol-use disorders described above. The integrated treatment in Study 5 was associated with higher levels of improvement in depression, alcohol use and cannabis use (where present) than did the AOD-focussed treatment examined in Studies 3 and 4. The results further suggest that a brief intervention targeting both depression and AOD drug use problems is associated with reductions in key outcomes in the short-term, withintegrated, lengthier psychological treatment potentially associated with longer-term changes on the same outcomes. No previous study has directly compared the outcomes for people completing psychological treatment delivered via a computer program with those completing treatment with a ‘live’ clinician over an extended follow-up period of 12-months. Given the barriers people with comorbid depression and AOD use problems face in accessing available treatment services, the consideration of alternative modes of delivery of evidence-based treatment to this group is timely. Study 6 expanded on the Study 5 results by presenting further analysis of the performance of the computer-delivered version of the integrated treatment relative to the clinician-delivered equivalent, matched for content. Given the small sample size of participants, Study 6 devised a four-point criterion which, if satisfied, would suggest that the computer-delivered and clinician-delivered integrated treatments were approximately equal. Based on these criteria, the results indicated that the outcome profiles for people engaged in the computer-delivered treatment were equivalent to those reported by people involved in clinician-delivered therapy over a 12¬month follow-up period. Additionally, computer-delivered integrated treatment was associated with similar rates of improvement as the therapist-equivalent on depression scores, risky drinking patterns, hazardous use of substances, poly-drug use, levels of daily cannabis use, suicidality, treatment retention and therapeutic alliance. This result requires further replication to test these assumptions, however it is promising that a treatment requiring an average of 12-minutes face-to-face of “generic” clinician time per weekproduces a similar pattern of improvement to a treatment requiring an average of 60 minutes of face-to-face specialist psychologist input over the same time period. Studies 1-6 resulted in the development of a menu of treatment options for people with depression and AOD use comorbidity, with each treatment approach providing evidence for at least some benefit among the study participants. While encouraging, these results again raise the issue of how treatment may be incorporated into existing services (mental health, AOD use, primary care, etc.), which typically remain segregated, with little opportunity for collaboration and cross-fertilisation of skills and expertise between service settings. Chapter 7 discusses a new model of treatment for comorbid depression and AOD use problems that incorporates the results of Studies 1-6, and involves a stepped care approach to developing a treatment plan tailored to the specific needs and levels of distress experienced by people with depression and AOD use comorbidity. The stepped care model of treatment could be incorporated into existing service settings and structures, with the potential for computer-based therapy to provide access to specialised treatment for depression and AOD use comorbidity that might otherwise be unavailable. As a result, stepped care treatment could foster earlier engagement with treatment services and encourage motivation and optimism among people with comorbid depression and AOD use problems. These are important issues for service development and delivery of appropriate treatments to this underserved population.
3

Co-occurring depression and alcohol/other drug use problems: developing effective and accessible treatment options

Kay-Lambkin, Frances January 2006 (has links)
Research Doctorate - Doctor of Philosphy (PhD) / A large body of population- and treatment-based evidence exists to indicate depression and alcohol/other drug (AOD) use are highly prevalent on a global scale, and co-occur with considerable frequency. Despite this evidence, significant gaps exist in treatment research and clinical services, as people with co-occurring depression and AOD use problems have typically been excluded from randomised controlled treatment trials, and also face many individual- and service-level barriers to accessing treatment. Consequently, a well-defined and adequately tested treatment strategy does not currently exist for people experiencing the complexities of concurrent depression and AOD use problems. A small body of evidence exists to suggest that co-occurring mental and AOD use disorders (“comorbidity”) leads to poorer treatment outcomes, increased risk of relapse, higher levels of problematic symptomatology, and poorer quality of life. However, little consistent information is currently available to suggest what additional impact comorbid depression and AOD misuse produces relative to the experience of a “single” condition (such as depression or AOD misuse in isolation). Studies 1 and 2 attempted to address this important gap in knowledge by examining the presenting characteristics of 246 people with AOD use problems, according to the presence of comorbid depressive symptoms. One hundred and thirty seven participants were drawn from AOD treatment services, and a further 109 were referred via mental health services and also met criteria for a psychotic disorder. Results indicated that the presence of depression was associated with a significantly higher severity of psychiatric symptoms and personality disorder, significantly decreased social and occupational functioning and significantly reduced quality of life. Current depression was also associated with a significant increase in the experience of cravings and self-reported dependence on amphetamines. These difficulties were over and above the already high rates of disability and distress reported by each sample as a whole. Furthermore, treatment for mental health problems was rare among the AOD treatment participants, as was AOD treatment among the mental health sample. This is despite the presence of moderate to severe levels of depression and AOD use reported by each sample. In particular, Studies 1 and 2 highlight the vulnerabilities for people with comorbid mental health and AOD use problems who present to treatment in the mental health or AOD use settings, and in particular how depression significantly increases the disability and other challenges experienced by these people. These results provide a strong rationale for the development of an appropriate treatment protocol for depression and AOD use comorbidity. No clear treatment model or evidence-based approach exists to suggest how depression and AOD use comorbidity is best managed. When people with this comorbidity do manage to access clinical treatment services, they typically receive treatment targeted at one aspect of their presentation (e.g. depression-focussed or AOD-focussed treatment). Yet, it is not known whether a singular focus of treatment is effective in producing sustainable change in the outcomes of people with comorbid problems, nor whether failure to treat all components of the comorbid presentation confers a worse outcome. Studies 3 and 4 reported on two randomised controlled clinical trials of psychologicaltreatment for AOD use problems among a sample of 246 people with AOD use problems, drawn from AOD treatment services (n=137) or mental health services (n=109). In doing so, these studies provide some of the first available data on these issues. Participants were categorised according to the presence of comorbid depression (as per Studies 1 and 2) and response to treatment was analysed over a six- to 12-month follow-up period. In spite of high levels of current depressive symptoms at entry to the studies, and equally hazardous use thresholds of a range of substance, people enrolled in Studies 3 and 4 reported some gains via their experiences with these single-focussed treatments. Attendance and retention rates were higher than reported in previous research, and the presence of depression did not adversely influence the motivation of project participants to change their current AOD use patterns. A treatment effect was generally not detected among the Study 3 and 4 participants, regardless of the presence of depression, with those receiving an assessment-only control treatment in both studies reporting similar patterns of change in outcome. Regardless of the magnitude of change reported by all study participants, people with depression reported significantly higher levels of depression, poly-drug use, amphetamine dependence, hazardous use of a range of substances, HIV risk taking and criminal activity and lower levels of functioning and self-concept across the follow-up assessment period. These residual symptoms were present at sufficiently high levels of severity to increase the risk of relapse to AOD use and continued morbidity. These results suggested the potential value of targeting depression in the context of comorbid AOD use problems. One previous study has examined the impact of an adjunctive psychological treatment of depression for people hospitalised for alcohol use disorder. Results indicated that people who received the additional depression treatment reported significantly greater improvements on depression- and alcohol-related outcomes over the short-term relative to people receiving a relaxation-only control treatment. These improvements were suggested to be enhanced if treatment had integrated depression- and alcohol-related approaches into the one treatment program. In the first study of its kind, Study 5 developed and evaluated the efficacy of an integrated psychological treatment program for comorbid depression and AOD use problems. Sixty-seven participants received integrated treatment delivered by a therapist, computer-delivered integrated treatment or a brief intervention (control) treatment delivered by a therapist. Depression scores, daily use of alcohol and cannabis, hazardous use of a range of substance and poly-drug use fell significantly over a 12-month follow-up period across the integrated treatments and brief intervention (control) conditions. The small sample size of Study 5 meant that very few treatment effects were detected at a statistically significant level, however important reductions in key outcomes for depression, AOD use, quality of life and general functioning were noted for people in the integrated treatment relative to controls over a 12-month period. The magnitude of change in Study 5 across these domains was comparable with the only other study of psychological treatment of depression and alcohol-use disorders described above. The integrated treatment in Study 5 was associated with higher levels of improvement in depression, alcohol use and cannabis use (where present) than did the AOD-focussed treatment examined in Studies 3 and 4. The results further suggest that a brief intervention targeting both depression and AOD drug use problems is associated with reductions in key outcomes in the short-term, withintegrated, lengthier psychological treatment potentially associated with longer-term changes on the same outcomes. No previous study has directly compared the outcomes for people completing psychological treatment delivered via a computer program with those completing treatment with a ‘live’ clinician over an extended follow-up period of 12-months. Given the barriers people with comorbid depression and AOD use problems face in accessing available treatment services, the consideration of alternative modes of delivery of evidence-based treatment to this group is timely. Study 6 expanded on the Study 5 results by presenting further analysis of the performance of the computer-delivered version of the integrated treatment relative to the clinician-delivered equivalent, matched for content. Given the small sample size of participants, Study 6 devised a four-point criterion which, if satisfied, would suggest that the computer-delivered and clinician-delivered integrated treatments were approximately equal. Based on these criteria, the results indicated that the outcome profiles for people engaged in the computer-delivered treatment were equivalent to those reported by people involved in clinician-delivered therapy over a 12¬month follow-up period. Additionally, computer-delivered integrated treatment was associated with similar rates of improvement as the therapist-equivalent on depression scores, risky drinking patterns, hazardous use of substances, poly-drug use, levels of daily cannabis use, suicidality, treatment retention and therapeutic alliance. This result requires further replication to test these assumptions, however it is promising that a treatment requiring an average of 12-minutes face-to-face of “generic” clinician time per weekproduces a similar pattern of improvement to a treatment requiring an average of 60 minutes of face-to-face specialist psychologist input over the same time period. Studies 1-6 resulted in the development of a menu of treatment options for people with depression and AOD use comorbidity, with each treatment approach providing evidence for at least some benefit among the study participants. While encouraging, these results again raise the issue of how treatment may be incorporated into existing services (mental health, AOD use, primary care, etc.), which typically remain segregated, with little opportunity for collaboration and cross-fertilisation of skills and expertise between service settings. Chapter 7 discusses a new model of treatment for comorbid depression and AOD use problems that incorporates the results of Studies 1-6, and involves a stepped care approach to developing a treatment plan tailored to the specific needs and levels of distress experienced by people with depression and AOD use comorbidity. The stepped care model of treatment could be incorporated into existing service settings and structures, with the potential for computer-based therapy to provide access to specialised treatment for depression and AOD use comorbidity that might otherwise be unavailable. As a result, stepped care treatment could foster earlier engagement with treatment services and encourage motivation and optimism among people with comorbid depression and AOD use problems. These are important issues for service development and delivery of appropriate treatments to this underserved population.
4

Insight in psychosis : a systematic review : the constructs of insight in psychosis and their measurement, &, An exploration of current practices in the assessment and intervention of insight in psychosis within Scotland's Forensic Mental Health Services : clinical psychologists' perspective

Slack, Tom Gavin Hume January 2015 (has links)
Poor insight has clinical significance as a predictor of non-adherence to treatment, increased number of relapses, hospitalisations, recovery and risk of violence. Empirical research has led to advances in the redefinition, knowledge and understanding of insight in psychosis. However, the use of a wide range of definitions and measures has created difficulties in interpreting research findings, without clarifying the concepts being measured and evaluating the quality of their associated assessment tool. Therefore, the aim of the first piece of work, a Systematic Review (SR), was to identify and describe the constructs of insight in psychosis and their assessment tools and briefly evaluate their psychometric properties. Insight in psychosis is particularly relevant to Forensic Mental Health Services, given its link with offending behaviour and risk to others. However, outside of those provided by risk appraisal tools, there are no current guidelines that specifically target the assessment, or intervention, of insight. Therefore, the second piece of work, a research project (RP), aimed to explore current practices, as described by experienced clinicians. The SR identified twelve assessment tools and fourteen papers for detailed analysis. Twelve theoretical constructs were identified, the most prominent being awareness of mental illness and awareness of the need for treatment. Other prominent theoretical constructs included awareness of negative consequences of illness and awareness of generic or specific symptoms. However, few of the subscales associated with each theoretical construct were supported by empirical evidence. Further work to clarify aspects of insight that are important areas for intervention, along with the provision of data to support these, should continue to be a focus for on-going research. The RP was a qualitative design using Thematic Analysis. Data was collected by semi-structured interviews from 11 qualified Clinical Psychologists working in Forensic Mental Health Services across Scotland. The RP identified three overarching themes. The first “risk related” illustrated the influence of risk to other when assessing and treating patients. The second “holistic approach” illustrated that insight or mental illness was rarely looked at in isolation. The third theme “no specific or satisfactory unified approach” illustrated the diversity of the conceptualising, assessment and treatment of insight. Opportunities exist to develop a more uniformed approach and to introduce or develop outcome measures for interventions.
5

"Som alla andra" : Sjuksköterskors erfarenheter av att vårda personer med psykossjukdom inom somatiskvård / "Like everyone else" : The experiences of nurses caring for patients with psychosis undergoing somatic treatment

Björk, Teres, Wahlström, Emelie January 2016 (has links)
Induktiv intervjustudie med syfte att beskriva vilka erfarenheter sjuksköterskor verksamma inom somatisk vård har av att vårda personer med psykossjukdom. Resultatet visar att sjuksköterskor inom den somatiska vården har relativt mycket erfarenhet av att vårda personer med psykossjukdom. Den specifika psykiatriska kompetensen uppfattades otilräcklig och vårdandet innebar ofta känslosamma möten.
6

Sjuksköterskors upplevelser av att möta patienter med psykossjukdom inom den somatiska vården : En beskrivande litteraturstudie

Öhman, Michaela, Östergrens, Lisa January 2019 (has links)
Bakgrund: Ungefär 2000 personer i Sverige insjuknar varje år i någon form av psykos. Psykossjukdom förknippas ofta med fördomar och stigmatisering. Forskning har visat att ju mer stigmatisering psykossjuka patienter förväntar sig från omgivningen, desto mer ökar deras stigmatisering av sig själva, vilket i sin tur påverkar deras återhämtning negativt. Personer med psykossjukdom har också beskrivit att de ej fått fullgod somatisk vård på grund av sin psykiska sjukdom. Syfte: Syftet med föreliggande litteraturstudie var att beskriva sjuksköterskors upplevelser av att möta patienter med psykossjukdom inom den somatiska vården. Metod: En beskrivande litteraturstudie baserat på 5 kvalitativa och 5 kvantitativa vetenskapliga artiklar. PubMed och Cinahl var de databaser som användes i sökningarna till de inkluderade artiklarna. Huvudresultat: Okunskapen kring psykossjukdomar beskrevs vara stor inom den somatiska vården. Sjuksköterskor upplevde ofta känslor som rädsla, anspänning och osäkerhet, vilket gjorde mötet med dessa patienter problematiskt. Begränsningar som tidsbrist i den somatiska vårdmiljön beskrevs bidra till ogynnsamma förutsättningar i mötet med psykossjuka patienter. Slutsats: Stigmatisering, okunskap och brister i vårdmiljön kan leda till att omvårdnaden för patienter med psykossjukdom blir bristfällig, och att de inte får vård på lika villkor som andra. Det är därför viktigt att sjuksköterskor blir medvetna om sina egna attityder och fördomar, och att de somatiska verksamheterna erbjuder sjuksköterskor mer kunskap om ämnet. De somatiska verksamheterna bör även se över möjligheter till förbättring i vårdmiljön. / Background: Every year approximately 2000 people in Sweden fall ill to some kind of psychotic disorder. Psychotic disorders are often associated with prejudice and stigma. Research has shown a connection between the expected external stigma, internal stigma and the recovery of patients with a psychotic disorder. It has also been described that patients with a psychotic disorder has received insufficient care due to their psychiatric illness.     Aim: The aim of this study was to describe how nurses experience the encounter with patients that are suffering from a psychotic disorder within the somatic inpatient and outpatient care. Method: A descriptive literature study based on 5 qualitative and 5 quantitative scientific articles. The databases that was used to obtain articles was PubMed and Cinahl.    Main result: It appeared that there is a substantial lack of knowledge regarding psychotic disorders within the somatic care. Nurses often experienced feelings of fear, tension and insecurity, which made the encounter with these patients problematic. Limitations such as time constraints contributed to unfavourable conditions in the care of patients with a psychotic disorder.    Conclusion: Stigma, lack of knowledge and deficiencies in the care environment could make the care that patients with a psychotic disorder receive inadequate. Therefore, it is important that nurses in the somatic inpatient and outpatient care become aware of their own preconceptions and attitudes towards these patients, and that nurses get access to additional knowledge on this topic. The somatic units should also try to make improvements in the care environment.
7

Skillnader i psykiskt välmående beroende av fysisk aktivitet hos personer med psykossjukdom

Gillsäter, Linn, Pellas, Lina January 2012 (has links)
Bakgrund: Fysisk aktivitet har i studier kopplats till lindring av psykiska symtom som depression, oro, ångest samt en ökning av självupplevd livskvalitet. Vid insjuknande i psykossjukdom är det vanligt att drabbas av just ångest och depression. Dessa symtom i kombination med biverkningar från läkemedel ökar risken för en mindre hälsosam livsstil och fysisk inaktivitet, vilket kan leda till en ond cirkel och allt sämre fysisk och psykisk hälsa.Syfte: Syftet med föreliggande studie var att undersöka om det finns några skillnader mellan fysiskt hög- och lågaktiva personer med psykossjukdom avseende livskvalitet samt förekomst av depression och ångest. Syftet med studien var även att undersöka hur deltagarnas motionsvanor ser ut när det befinner sig på en sluten psykiatrisk vårdavdelning.Metod: Föreliggande studie är en kvantitativ tvärsnittsstudie. En enkät bestående av demografiska frågor, två skalor om fysisk aktivitet, en fråga om motionsform, en ångest- och depressionsskala samt en skala om livskvalitet, delades ut. I studien ingick 19 deltagare och svarsfrekvensen var 86 %. Data analyserades med det icke-parametriska testet Mann Whitney U-test. Signifikansnivån för samtliga statistiska test sattes till .05.Resultat: I analyser med skattningsskalan som mätte aktivitetsnivå överlag sågs signifikanta skillnader mellan låg- och högaktiva beträffande livskvalitet, ångest och depression (p=0.012, p=0.046, p=0.048). I analyser med skalan som mätte fysisk aktivitet de senaste två veckorna sågs inga signifikanta skillnader.Slutsatser: Personer med psykossjukdom som är högaktiva skattar sin livskvalitet högre än de som inte är det, och de skattar också lägre avseende förekomst av symtom på depression och ångest. / Background: Physical activity affects the hormonal system by alleviating psychological symptoms. There is support that physical activity also has effect on the self-perceived quality of life. Depression and anxiety are common among people with psychotic disorder, and combined with side effects from medication the risk of a less healthy lifestyle and inactivity increases.Aim: The aim of this study was to investigate whether there are any differences between those who are more and those who are less physically active when it comes to quality of life, depressive symptoms and anxiety symptoms among people with psychosis in a Swedish hospital. The aim was also to investigate what the patients’ exercise habits looked like while being admitted to the psychiatric inpatient care.Methods: This study is a quantitative cross-sectional survey performed in a psychiatric ward, specializing in psychosis. The study included 19 participants and the response rate was 86%. Data were analyzed using a non-parametric test, Mann Whitney U test. The significance levels for all statistical tests were set to .05.Results: On the scale measuring physical activity level in general there were significant differences between low-and high-level physically active participants regarding quality of life, anxiety and depression (p=0.012, p=0.046, p=0.048). On the scale, that measured the level of physical activity in the last two weeks, there were no significant differences.Conclusions: People with psychotic disorders that are high-level physically active, rate their quality of life higher and their symptom levels lower than those who score in the low-level regarding physical activity.
8

Evidence that the outcome of developmental expression of psychosis is worse for adolescents growing up in an urban environment

Spauwen, Janneke, Krabbendam, Lydia, Lieb, Roselind, Wittchen, Hans-Ulrich, Van Os, Jim 29 January 2013 (has links) (PDF)
Background. The urban environment may increase the risk for psychotic disorder in interaction with pre-existing risk for psychosis, but direct confirmation has been lacking. The hypothesis was examined that the outcome of subclinical expression of psychosis during adolescence, as an indicator of psychosis-proneness, would be worse for those growing up in an urban environment, in terms of having a greater probability of psychosis persistence over a 3·5-year period. Method. A cohort of 918 adolescents from the Early Developmental Stages of Psychopathology Study (EDSP), aged 14–17 years (mean 15·1 years), growing up in contrasting urban and non-urban environments, completed a self-report measure of psychotic symptoms at baseline (Baseline Psychosis) and at first follow-up around 1 year post-baseline (T1). They were again interviewed by trained psychologists for the presence of psychotic symptoms at the second follow-up on average 3·5 years post-baseline (T2). Results. The rate of T2 psychotic symptoms was 14·2% in those exposed to neither Baseline Psychosis nor Urbanicity, 12·1% in those exposed to Urbanicity alone, 14·9% in those exposed to Baseline Psychosis alone and 29·0% in those exposed to both Baseline Psychosis and Urbanicity. The odds ratio (OR) for the combined exposure was 2·46 [95% confidence interval (CI) 1·46–4·14], significantly greater than that expected if Urbanicity and Baseline Psychosis acted independently. Conclusion. These findings support the suggestion that the outcome of the developmental expression of psychosis is worse in urban environments. The environment may impact on risk for psychotic disorder by causing an abnormal persistence of a developmentally common expression of psychotic experiences.
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Sjuksköterskans upplevelser av patienter med psykossjukdom och deras delaktighet i den psykiatriska öppenvården / Nurses experiences of patients suffering from psychotic disorders and theirs participation in psychiatric outpatient care

Kimby, Louise January 2012 (has links)
Several studies show that the clinical reality in psychiatric care does not correspond to the demand of consumer participation from a variety of policy documents that has been produced recently. Studies also show that there is a lot to do in improving, patients with sever mental illness, becoming more involved in their own care. The nurse has a central role in this work. The Norwegian nursing theorist Jan-Kåre Hummelvolls holistic, existentialistic model for psychiatric nursing were used as theoretical ground. The aim of this study was to examine how nurses in psychiatric outpatient units, caring for patients with psychotic disorders, experiences consumer participation. Qualitative phenomenological method was used. Semi-structured interviews with six nurses caring for patients suffering from psychotic disorders in outpatient units were conducted. The interviews were recorded and transcript by the author and then analyzed using qualitative content analyze. Two themes were identified: To follow the road chosen by the patient and When consumer participation risks failing. The result of this study shows that there are several factors that influences nurses job to involve patients in their care. The interviews also showed that there were areas where consumer participation was more problematic. To share a decision with the patient is a way to improve consumer participation. Shared decision making is a complicated process where the nurse needs support to succeed. In pharmacological issues nurses must continue working with consumer participation.
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Strategie zvládání stresu u lidí s psychotickým onemocněním / The stress coping strategies used by people with psychotic disorder

HALO, Dagmar January 2015 (has links)
The aim of the thesis is to specify the stress coping strategies used by people with psychotic disorder and afterwards to find out the way of using these strategies is affected psychiatric rehabilitation. The thesis is structured in two parts. The theoretical part is particularly devoted to the theme of stress, coping strategies, psychotic disorder and psychiatric rehabilitation. In the practical part, there are mediated the answers to hypotheses and research questions with the assistance of the analysis of the data. The methods of research are the questionnaire SVF 78 and the semi-structured interview. The research group was formed by clients of Fokus civil association in South Bohemian region and the leader social worker.

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