Experiences of clinicians and managers in the implementation of a family focused model in child and adult psychiatry

IntroductionThis paper describes the process of implementing a family focused model, The Family Model, in child and adolescent and adult mental health services in Sweden. Additionally, it describes a service development project carried out in both services within a defined geographical area of Region Stockholm. The Family Model is a communication tool designed to assist clinicians in both services to have family focused conversations with their patients and relatives. Internationally, the needs of individuals experiencing mental health challenges (parents, children and young people) and their close relatives are now well recognized, but barriers to family focused practice nevertheless persist. The aim of this study was to better understand clinicians` experiences in implementing The Family Model in both services.MethodsThree preplanned focus group interviews were carried out with 14 clinicians and managers across both services and the data were analyzed in accordance with methods of Naturalistic inquiry.ResultFindings suggest that The Family Model has utility in both services. The Naturalistic inquiry analyses revealed three main themes: individual, relational and organizational aspects with a total of 10 sub-themes of how the models influence the participants. Furthermore, analyses on a meta understanding level explored that participants underwent a developmental journey in learning about and using The Family Model in practice which was expressed through three themes: “Useful for burdened families”, “Influencing prevention”, and “To integrate this would be fantastic”.ConclusionsThe Family Model, when adapted for the Swedish context, is a useful tool for assisting experienced clinicians to engage in family focused practice in both child and adolescent and adult mental health services. The Family Model highlights different aspects in everyday clinical services that were of special interest for clinicians, families, and the system. Future research could explore families’ perspectives of the utility of the model

The impact of personality factors on delay in seeking treatment of acute myocardial infarction

<p>Abstract</p> <p>Background</p> <p>Early hospital arrival and rapid intervention for acute myocardial infarction is essential for a successful outcome. Several studies have been unable to identify explanatory factors that slowed decision time. The present study examines whether personality, psychosocial factors, and coping strategies might explain differences in time delay from onset of symptoms of acute myocardial infarction to arrival at a hospital emergency room.</p> <p>Methods</p> <p>Questionnaires on coping strategies, personality dimensions, and depression were completed by 323 patients ages 26 to 70 who had suffered an acute myocardial infarction. Tests measuring stress adaptation were completed by 180 of them. The patients were then categorised into three groups, based on time from onset of symptoms until arrival at hospital, and compared using logistic regression analysis and general linear models.</p> <p>Results</p> <p>No correlation could be established between personality factors (i.e., extraversion, neuroticism, openness, agreeableness, conscientiousness) or depressive symptoms and time between onset of symptoms and arrival at hospital. Nor was there any significant relationship between self-reported patient coping strategies and time delay.</p> <p>Conclusions</p> <p>We found no significant relationship between personality factors, coping strategies, or depression and time delays in seeking hospital after an acute myocardial infraction.</p

Barn som lever i familjer där någon av föräldrarna har en psykisk sjukdom

Barn som lever i familjer med förälder som har en svår psykisk sjukdom har en speciell situation. Dock framgår tydligt av befintlig forskning att alla barn i denna situation inte upplever situationen som annorlunda än andra barn. Följande kapitel försöker belysa några faktorer och aspekter som är viktiga att ta i beaktande när vi möter dessa barn, samt också aspekter som kan vara värdefulla för att stödja denna barngrupp i olika hälsorelaterade strategier

Low satisfaction with sex life among people with severe mental illness living in a community

Background/Objectives Research on sex lives of people with severe mental illness (SMI) most often focuses on dysfunction and the side-effects of medication. We wished to determine how people with SMI experience sex and assess satisfaction with it in a broader evaluation of quality of life. Methods Data was gathered using mixed methods, including a reliable psychometric quality of life instrument and in-depth interviews. Results Sex life showed the lowest rating of all quality of life domains, with men indicating lower satisfaction with sexual life than women. Low satisfaction also correlated with lower scores on the total quality of life index. Sex life for people with SMI was seen to be of secondary importance. Discussion/Conclusion The area of sex showed the lowest experienced satisfaction rating of all measured domains of quality of life. Our interview-based study verified that intimate relationships and sexual experiences are considered unattainable among those suffering from SMI. Programs to increase the possibility sustaining a sex life might need to be added to existing recommendations for people with SMI living in a community

Familjeinterventioner

När någon familjemedlem får en svår psykisk sjukdom påverkar detta både relationen mellan den sjuke personen och hans/hennes familjemedlemmar och relationerna inom familjen som system och det omgivande samhället. Förklaringsmodeller för uppkomst av psykiska sjukdomar har skiftat genom tiderna, och därmed också synen på anhörigas roll. Under vissa tider har anhöriga setts som en medverkande part i sjukdomsutvecklingen, medan man under andra perioder och då särskilt de senaste decennierna, har sett anhöriga som en viktig grupp som ger ett värdefullt bidrag i vården av den sjuke. Studier har visat att merparten av vuxna personer som för första gången insjuknar i en schizofrenisjukdom återvänder till sin familj efter avslutad vård och att detsamma gäller patienter utskrivna från en psykiatrisk vårdavdelning. Detta kapitel kommer att belysa den börda som det innebär att ha en vuxen person med psykisk sjukdom i familjen och vad detta innebär för övriga familjemedlemmar. Vidare kommer också familjens delaktighet i vårdsituationen och familjemedlemmarnas behov av stöd att belysas. Inledningsvis bör poängteras att forskningen relaterande till situationen för de anhöriga till personer med psykisk sjukdom utgått från situationen när någon familjemedlem har en svår psykos- eller depressionssjukdom och inte specifikt belyser situationen vid psykisk funktionsnedsättning

Low satisfaction with sex life in persons with severe mental illness living in the community

Research on the sex lives of people with severe mental illness (SMI) most often focuses on dysfunction and the side-effects of medication. We wished to determine how people with SMI experience sex and assess satisfaction with it in a broader evaluation of quality of life. Data was gathered using mixed methods, including a reliable psychometric quality of life instrument, and in-depth interviews. Sex life showed the lowest rating of all quality of life domains, with men indicating lower satisfaction in this area than women. Low satisfaction also correlated with lower scores on the total quality of life index. Sexuality and intimate relations were generally experienced as out of reach or something of secondary importance that had to be controlled, according to many of those suffering from SMI. Programs such as patient disorder-specific or partner assisted interventions, to increase the possibility of sustaining a sex life might need to be added to existing recommendations for people with SMI living in a community

Familjens situation

När någon familjemedlem får en svår psykisk sjukdom påverkar detta både relationen mellan den sjuke personen och hans/hennes familjemedlemmar och relationerna inom familjen som system och det omgivande samhället. Förklaringsmodeller för uppkomst av psykiska sjukdomar har skiftat genom tiderna, och därmed också synen på anhörigas roll. Under vissa tider har anhöriga setts som en medverkande part i sjukdomsutvecklingen, medan man under andra perioder och då särskilt de senaste decennierna, har sett anhöriga som en viktig grupp som ger ett värdefullt bidrag i vården av den sjuke. Studier har visat att merparten av vuxna personer som för första gången insjuknar i en schizofrenisjukdom återvänder till sin familj efter avslutad vård och att detsamma gäller patienter utskrivna från en psykiatrisk vårdavdelning. Detta kapitel kommer att belysa den börda som det innebär att ha en vuxen person med psykisk sjukdom i familjen och vad detta innebär för övriga familjemedlemmar. Vidare kommer också familjens delaktighet i vårdsituationen och familjemedlemmarnas behov av stöd att belysas. Inledningsvis bör poängteras att forskningen relaterande till situationen för de anhöriga till personer med psykisk sjukdom utgått från situationen när någon familjemedlem har en svår psykos- eller depressionssjukdom och inte specifikt belyser situationen vid psykisk funktionsnedsättning