Patient education to support self-management of patients with mental illness

This study explores areas which need to be improved to develop the quality of patient education to support self-management of patients with mental illness in psychiatric hospitals. The study was conducted in five phases during the period 2000 – 2007. First, patients‘ (n = 313) satisfaction with patient education were investigated. Second, patients' (n = 51) experiences of patient education were explored. Third, a national survey was conducted to investigate realisation of patient education from the staff (n = 55) viewpoint. Fourth, outcomes of patient education were investigated by evaluating the impacts of different patient education methods on patients‘ (n = 311) attitudes towards medication, knowledge level and importance of information. Fifth, patients‘ (n = 16) perceptions of different patient education methods were explored. Patients reported poor satisfaction with patient education (Phase I), and they have considerable need to receive information during their hospital stay (Phase II). Described by staff, the content of patient education covered almost all informational areas investigated. However, discrepancies related to the realisation of patient education were found. (Phase III.) Evaluation of different patient education methods indicate that patients derived benefits from structured patient education with supportive methods (Phase IV) and patients also perceived that these methods supported their information receiving (Phase V). In order to improve the quality of patient education to support self-management of patients with mental illness patient education should be systematically and individually provided to all patients by using different educational methods. Realisation of this should be ensured by providing written instructions, improving nurses‘ knowledge and skills as well ensuring operating conditions.Siirretty Doriast

An analysis of online health information on schizophrenia or related conditions: a cross-sectional survey

Background: Around 20% of those who seek health information online, search specifically for mental health. However, little is known about the nature of the online health information offered by two European countries, Finland and Greece, which are characterized by markedly differing levels of Internet access and online health information seeking. This study aims to assess, describe and compare websites, written in two European, non-English languages (Finnish and Greek) that appear first after performing an online search concerning schizophrenia or related conditions. Methods: The first 20 results from four search terms (searched in Finnish and Greek) in the Web search engine ‘Google’ were screened. A total of 160 websites were retrieved (80 Finnish, 80 Greek) and evaluated using a preformulated coding system which consisted of websites’ indicators, such as: types, characteristics, accountability, interactivity, aesthetics and content. Differences between websites were evaluated with Chi-Square or Fisher’s Exact tests for categorical data and independent t-tests for parametric data. Results: Twenty-four Finnish and thirty-four Greek websites (36% in total) were included. Almost two-thirds (62%, n=36) were owned by an organization, compared to 17% (n=10) by an individual. In both countries, aesthetics had the highest score (possible range 0–4, mean = 2.6, SD = .62), while interactivity the lowest (range 0–5, mean = 1.79, SD = .87). There were no statistically significant differences among the accountability, interactivity and aesthetics scores of the Finnish and Greek websites. Conclusions: All assessed indicators suggest there is a need to improve Finnish and Greek online information about schizophrenia or related conditions. The poor website interactivity is of particular concern given the challenges faced by the target group. The findings can be used to guide the development and dissemination of online mental health information aimed at Finnish and Greek online health-seekers

Connectivity to computers and the Internet among patients with schizophrenia spectrum disorders: a cross-sectional study

PurposeInformation and communication technologies have been developed for a variety of health care applications and user groups in the field of health care. This study examined the connectivity to computers and the Internet among patients with schizophrenia spectrum disorders (SSDs).Patients and methodsA cross-sectional survey design was used to study 311 adults with SSDs from the inpatient units of two psychiatric hospitals in Finland. The data collection lasted for 20 months and was done through patients’ medical records and a self-reported, structured questionnaire. Data analysis included descriptive statistics.ResultsIn total, 297 patients were included in this study (response rate =96%). More than half of them (n=156; 55%) had a computer and less than half of them (n=127; 44%) had the Internet at home. Of those who generally had access to computers and the Internet, more than one-fourth (n=85; 29%) used computers daily, and >30% (n=96; 33%) never accessed the Internet. In total, approximately one-fourth of them (n=134; 25%) learned to use computers, and less than one-third of them (n=143; 31%) were known to use the Internet by themselves. Older people (aged 45–65 years) and those with less years of education (primary school) tended not to use the computers and the Internet at all (PConclusionPatients had quite good access to use computers and the Internet, and they mainly used the Internet to seek information. Social, occupational, and psychological functioning (which were evaluated with Global Assessment of Functioning) were not associated with access to and frequency of computer and the Internet use. The results support the use of computers and the Internet as part of clinical work in mental health care.</p

Short text messages to encourage adherence to medication and follow-up for people with psychosis (Mobile.Net): randomized controlled trial in Finland

Background: A text messaging service (short message service [SMS]) has the potential to target large groups of people with long-term illnesses such as serious mental disorders, who may have difficulty with treatment adherence. Robust research on the impact of mobile technology interventions for these patients remains scarce. Objective: The main objective of our study was to investigate the impact of individually tailored short text messages on the rate of psychiatric hospital readmissions, health care service use, and clinical outcomes. In addition, we analyzed treatment costs. Methods: Between September 2011 and November 2012, we randomly assigned 1139 people to a tailored text message intervention (n=569) or usual care (n=570). Participants received semiautomated text messages for up to 12 months or usual care. The primary outcome, based on routinely collected health register data, was patient readmission into a psychiatric hospital during a 12-month follow-up period. Secondary outcomes were related to other service use, coercion, medication, adverse events, satisfaction, social functioning, quality of life, and economic factors (cost analysis). Results: There was 98.24% (1119/1139) follow-up at 12 months. Tailored mobile telephone text messages did not reduce the rate of hospital admissions (242/563, 43.0% of the SMS group vs 216/556, 38.8% of the control group; relative risk 1.11; 95% CI 0.92-1.33; P=.28), time between hospitalizations (mean difference 7.0 days 95% CI –8.0 to 24.0; P=.37), time spent in a psychiatric hospital during the year (mean difference 2.0 days 95% CI –2.0 to 7.0; P=.35), or other service outcomes. People who received text messages were less disabled, based on Global Assessment Scale scores at the time of their readmission, than those who did not receive text messages (odds ratio 0.68; 95% CI 0.47-0.97; P=.04). The costs of treatment were higher for people in the SMS group than in the control group (mean €10,103 vs €9210, respectively, P<.001). Conclusions: High-grade routinely collected data can provide clear outcomes for pragmatic randomized trials. SMS messaging tailored with the input of each individual patient did not decrease the rate of psychiatric hospital visits after the 12 months of follow-up. Although there may have been other, more subtle effects, the results of these were not evident in outcomes of agreed importance to clinicians, policymakers, and patients and their families

Tiedonsaanti psykiatrisessa sairaalassa - mielenterveyspotilaan näkökulma

Hakutermit: potilaan tiedonsaanti, mielenterveyspotilas Tämän tutkimuksen tarkoituksena oli kuvata psykiatrisessa sairaalahoidossa olevan potilaan tärkeänä pitämiä tiedon alueita, tiedonsaannin toteutumista sekä potilaan taustatekijöiden yhteyttä potilaan tiedonsaantiin. Lisäksi selvitettiin, millä tavoin potilaat haluaisivat saada tietoa, tiedonsaannin ongelmia potilaiden kuvaamina ja potilaiden näkemyksiä tiedonsaannin kehittämiseksi. Tutkimus toteutettiin eräässä eteläsuomalaisessa psykiatrisessa sairaalassa. Tutkimukseen otettiin mukaan tutkimuskriteerit täyttäneet ja vapaaehtoisen suostumuksen antaneet potilaat uloskirjoitusjärjestyksessä. Aineisto kerättiin haastattelemalla 51 potilasta puolistrukturoidun haastattelun avulla. Mittari oli kehitetty tätä tutkimusta varten. Kvantitatiivinen aineisto analysoitiin kuvailevin tilastolisin menetelmin (Mann Whitney U-testi, t-testi). Kvalitatiivinen aineisto analysoitiin induktiivisella sisällön analyysillä. Tutkimus osoitti, että psykiatrisessa sairaalahoidossa olevat potilaat pitivät tärkeänä saada tietoa sairaudesta ja hoidosta, eri tukimuodoista sekä potilaan oikeuksista. Potilaat eivät kuitenkaan koe saavansa riittävästi tietoa näiltä alueilta. Suurin osa vastaajista toivoi saavansa tietoa keskustellen henkilökunnan kanssa. Keskustelujen lisäksi he toivoivat saavansa tietoa usealla eri tavalla rinnakkain sekä mahdollisuuksia itsenäiseen tiedon hankintaan. Tiedonsaannin ongelmat potilaiden kuvaamina olivat rajoitettu tiedon antaminen, potilaan kohtaamiseen liittyvät ongelmat sekä henkilökunnan ja potilaan omien tiedollisten edellytysten vajavuudet. Tiedonsaannin kehittämisalueita potilaiden kuvausten mukaan olivat tiedonvälittämistapojen kehittäminen, potilaan huomioimisen kehittäminen sekä henkilökunnan riittävän tiedon varmistaminen. Mielenterveyspotilaan hoitotyötä tulee kehittää, jotta potilaiden tiedonsaantia voidaan tukea aiempaa paremmin. Käytäntöön tarvitaan strukturoituja, potilaan yksilölliset tarpeet huomioivia menetelmiä, jotka mahdollistavat potilaiden tiedonsaannin usealla tavalla rinnakkain sekä tukevat itsenäistä tiedon etsintää. Myös uuden teknologian hyödyntäminen mielenterveystyössä on ajankohtaista. Mielenterveystyössä toimiva hoitohenkilökunta tarvitsee tukea, kuten työnohjausta ja koulutusta, kyetäkseen vastaamaan potilaiden tarpeisiin ja tarjoamaan laadukasta hoitoa muuttuneessa palvelujärjestelmässä. Tulevaisuudessa tarvitaan lisää tutkittua tietoa eri tiedonvälittämismenetelmien vaikuttavuudesta, jotta voidaan edelleen kehittää tehokkaaksi havaittuja menetelmiä