Types of patients in a psychiatric intensive care unit

Objective: This paper reports the findings of a descriptive study of a patient populationover a three-month period on an eight bed psychiatric intensive care unit (PICU) in Western Australia. The report provides a quantitative insight into the profile of patients in PICUs. It provides information on patients' diagnoses, presenting signs, symptoms and/or behaviours,legal codes assigned to patients, treatment interventions and management. Method: Data were collected prospectively from August to October 1999. A total of 122 patients were admitted to the PICU during the review period. Data were entered into an Access program then exported to SPSS (Version 9 for Windows) for analysis and frequency distributions were obtained. Results: The results confirmed that the majority of patients admitted to the PICU were assessed as a high level of risk or needed containment. This finding is in line with the admission criteria developed by staff working in the PICU. It also supports the view that staffworking in these units require expertise and confidence to communicate with and manage potentially aggressive and highly aroused patients. Conclusion: This study demonstrates the importance of ongoing evaluations of patient populations in promoting best practice initiatives in psychiatric care

Challenges of caring for children with mental disorders: Experiences and views of caregivers attending the outpatient clinic at Muhimbili National Hospital, Dar es Salaam - Tanzania

It is estimated that world-wide up to 20 % of children suffer from debilitating mental illness. Mental disorders that pose a significant concern include learning disorders, hyperkinetic disorders (ADHD), depression, psychosis, pervasive development disorders, attachment disorders, anxiety disorders, conduct disorder, substance abuse and eating disorders. Living with such children can be very stressful for caregivers in the family. Therefore, determination of challenges of living with these children is important in the process of finding ways to help or support caregivers to provide proper care for their children. The purpose of this study was to explore the psychological and emotional, social, and economic challenges that parents or guardians experience when caring for mentally ill children and what they do to address or deal with them. A qualitative study design using in-depth interviews and focus group discussions was applied. The study was conducted at the psychiatric unit of Muhimbili National Hospital in Tanzania. Two focus groups discussions (FGDs) and 8 in-depth interviews were conducted with caregivers who attended the psychiatric clinic with their children. Data analysis was done using content analysis. The study revealed psychological and emotional, social, and economic challenges caregivers endure while living with mentally ill children. Psychological and emotional challenges included being stressed by caring tasks and having worries about the present and future life of their children. They had feelings of sadness, and inner pain or bitterness due to the disturbing behaviour of the children. They also experienced some communication problems with their children due to their inability to talk. Social challenges were inadequate social services for their children, stigma, burden of caring task, lack of public awareness of mental illness, lack of social support, and problems with social life. The economic challenges were poverty, child care interfering with various income generating activities in the family, and extra expenses associated with the child's illness. Caregivers of mentally ill children experience various psychological and emotional, social, and economic challenges. Professional assistance, public awareness of mental illnesses in children, social support by the government, private sector, and non-governmental organizations (NGOs) are important in addressing these challenges

The Amsterdam Studies of Acute Psychiatry - II (ASAP-II): a comparative study of psychiatric intensive care units in the Netherlands

Background The number of patients in whom mental illness progresses to stages in which acute, and often forced treatment is warranted, is on the increase across Europe. As a consequence, more patients are involuntarily admitted to Psychiatric Intensive Care Units (PICU). From several studies and reports it has become evident that important dissimilarities exist between PICU's. The current study seeks to describe organisational as well as clinical and patient related factors across ten PICU's in and outside the Amsterdam region, adjusted for or stratified by level of urbanization. Method/Design This paper describes the design of the Amsterdam Studies of Acute Psychiatry II (ASAP-II). This study is a prospective observational cohort study comparing PICU's in and outside the Amsterdam region on various patient characteristics, treatment aspects and recovery related variables. Dissimilarities were measured by means of collecting standardized forms which were filled out in the framework of care as usual, by means of questionnaires filled out by mental health care professionals and by means of extracting data from patient files for every consecutive patient admitted at participating PICU's during a specific time period. Urbanization levels for every PICU were calculated conform procedures as proposed by the Dutch Central Bureau for Statistics (CBS). Discussion The current study may provide a deeper understanding of the differences between psychiatric intensive care units that can be used to promote best practice and benchmarking procedures, and thus improve the standard of care

Designing mental health service delivery in partnership with Aboriginal people

There is a paucity of information on which to draw pertaining to the provision of culturally sensitive mental health services to Aboriginal people. Mental health service delivery is undertaken within a mainstream context. Research clearly illustrates that Aboriginal people seek culturally relevant services which facilitate access to treatment from both Indigenous and western domains. Culturally sensitive service provision increases uptake and provides a platform for health promotion, outreach and support while reducing stigma attached to mental health issues. The Curtin School of Nursing and Midwifery has a history of improved health outcomes with Aboriginal people. As part of the school's commitment to improved Aboriginal mental health services a research project was designed in partnership with Indigenous people to examine needs, attitudes, beliefs, practices and preferred outcomes. This paper will explore methodological and relationship building techniques which are premised on a long term sustainable and transparent connection between the Aboriginal community, health practitioners and researchers

Designing mental health service delivery in partnership with Aboriginal people

There is a paucity of information on which to draw pertaining to the provision of culturally sensitive mental health services to Aboriginal people. Mental health service delivery is undertaken within a mainstream context. Research clearly illustrates that Aboriginal people seek culturally relevant services which facilitate access to treatment from both Indigenous and western domains. Culturally sensitive service provision increases uptake and provides a platform for health promotion, outreach and support while reducing stigma attached to mental health issues. The Curtin School of Nursing and Midwifery has a history of improved health outcomes with Aboriginal people. As part of the school's commitment to improved Aboriginal mental health services a research project was designed in partnership with Indigenous people to examine needs, attitudes, beliefs, practices and preferred outcomes. This paper will explore methodological and relationship building techniques which are premised on a long term sustainable and transparent connection between the Aboriginal community, health practitioners and researchers

Open Borders

Borderline personality disorder is characterised by emotional instability, intense and unstable relationships and fear of abandonment..

Identifying mental health nursing research priorities: A Delphi study

Engaging in research and using evidence based practice are essential for mental health nurses to provide quality nursing care to consumers and families. This paper reports on a Delphi study that identified the top ten mental health nursing research priorities at one area health service in Australia servicing a population of 840,000 people. Initially 390 research questions were identified by nurses and these were then reduced to 56 broader questions. Finally, the top ten questions were ranked in order of importance. The priority questions were clinically and professionally focused and included research into the delivery and organisation of mental health services and the need to design and evaluate new practice paradigms for nurses in the primary care setting. The mental health knowledge and skill set of graduates from Australian comprehensive nursing programs along with improved recruitment and retention of graduates in mental health were also identified priority areas for research

Using the Edinburgh Postnatal Depression Scale to achieve best practice standards

The present paper reports the findings of a quantitative descriptive study that evaluated the use of the Edinburgh Postnatal Depression Scale (EPDS) as a screening tool in the child health context. Two hundred and sixty-one women who attended child health clinics in one metropolitan health region of Western Australia over a designated 4-week period for a 6 8 week or 7 9 month health scheduled infant screening assessment agreed to participate. The study aimed to (i) identify the proportion of women in the study who scored 13 or greater on the EPDS; (ii) evaluate current practice outcomes from the use of the EPDS by child health nurses and; (iii) report demographic variables associated with scores obtained from participants. Findings showed that the EPDS is a useful screening tool to identify women who may be at risk of developing depression during the postpartum period. However, the study also identified a weakness in clinical practice protocols, with some child health nurses not referring women who reported symptoms of depression on the self-report scale. Therefore, to ensure best practice standards more education regarding clinical practice protocols needs to be implemented with child health nurses in order to facilitate optimal outcomes for women using the self-report scal

Adherence to Antipsychotic Drug Measured by an Arabic Version of Morisky Scale

2016 Copyright © Taylor & Francis Group, LLCA cross-sectional study (n = 108) was conducted to assess medication adherence levels among people with mental illness in Jordan using the Arabic version of Morisky Medication Adherence Scale. The findings showed a significant negative correlation between patients’ level of adherence, frequency of admissions, and relapses per year and a negative correlation between adherence level and frequency of follow up appointments per month. Nonadherence to antipsychotic medication in Jordan is very high and the reasons for this need to be further explored as nonadherence negatively effects the global burden of disease associated with mental illness, particularly in developing countries