Factors Influencing Relapse People with Mental Health Disorders in Indonesia

A cross – sectional study was conducted to study the effects of demographic characteristics, stigma, home visit and stress of caregiver on relapse people with mental disorders in West Sumatera Province, Indonesia. Using a structured questionnaire, data were derived from 313 of caregivers from Mey until July 2013. Descriptive statistic was used to describe demographic characteristic, stigma, home visit and stress of caregivers on the relapse of people with mental disorders while the effect between these factors and relapse was determined by binary logistic regression. This study found there was no significant relationship between age and occupational of caregivers and relapse people with mental disorders. While when those factors entered in binary logistic the entire variable had statistically significant effect to relapse people with mental disorders. The strongest predictor of relapse people with mental disorders was stress of caregiver, recording an odd ratio 8.06. This indicated that caregiver whose stress were over 8 times more likely to increase relapse people with mental disorders than those with less stress. The lowest predictor were age of caregivers an odd ratio of 2.07. It is important for mental health nurse to strengthen their therapeutic relationship with patients and their caregivers. Stress of caregivers can appear because of lack of support from environment and might be because of lack of knowledge and coping skill of caregivers. Furthermore, the home visiting program needs to be improved because of the increased knowledge of nurses in caring for people with mental disorders can reduce relapse. Besides that it is a form of participation and support from social networks.

Spirituality as an internal protective factor of resilience in children after exposing flood

Background: Flooding is recognizing as a risk element that effect many difficulties to children and could impact to their academic performance. In order to buffer such risk condition, some abilities are required to overcome that situation. One of abilities is resilience. The main purpose of this study was to investigate predictor of internal factors (age, illness, gender, emotion, behaviour, spirituality and physical activity) in resilience of elementary school-aged children who exposed the major flood in Serang, Indonesia. The framework used in this study was Resilience Model proposed by Karol Kumpfer.Methods: A cross-sectional correlation design was employed to accomplishing the study. The total final samples were 162 children who were 9-12 years and who were studied in 3rd to 6th years. All of them are those who were exposed to major flood in Undar Andir, Serang, Indonesia in 2013. The instruments used were self-report questionnaires. The Connor-Davidson Resilience Scale- 10, The Daily Spiritual Experience Scale, The Strengths and Difficulties Questionnaire and The Physical Activity Questionnaire were utilized in this study after the validity and reliability test. Pearson’s correlation, point biserial and multiple regressions were employed for analysing data.Results: The results showed that there were significant correlated between behaviour (r = 0.157, p <0.05), spirituality (r = 0.261, p<0.01), physical activity (r = 0.185, p<0.05), and resilience of children. However, age, illness, gender, and emotion were not significantly correlated with resilience. In multiple regressions, spirituality showed as a predictor of resilience (Beta = 0.213, p <0.05) in children after exposing the flood.Conclusions: In conclusions, flooding is considered as a risk for children. In order to prevent the potential problems due to flood, children need protective factor. This study discovered that high spirituality increases resilience of children. Therefore, spirituality is well thought-out as an internal protective factor of resilience. This study suggested the developing of nursing intervention with religion-activities

Assessing system-based trainings for primary care teams and quality-of-life of patients with multimorbidity in Thailand: patient and provider surveys.

BACKGROUND: Strengthening primary care is considered a global strategy to address non-communicable diseases and their comorbidity. However, empirical evidence of the longer-term benefits of capacity building programmes for primary care teams contextualised for low- and middle-income countries is scanty. In Thailand, a series of system-based capacity building programmes for primary care teams have been implemented for a decade. An analysis of the relationship between these systems-based trainings in diverse settings of primary care and quantified patient outcomes was needed. METHODS: Facility-based and community-based cross-sectional surveys were used to obtain data on exposure of primary care team members to 11 existing training programmes in Thailand, and health profiles and health-related quality of life of their patients measured in EuroQol-5 Dimension (EQ-5D) scale. Using a multilevel modelling, the associations between primary care provider's training and patient's EQ-5D score were estimated by a generalized linear mixed model (GLMM). RESULTS: While exposure to training programmes varied among primary care teams nationwide, District Health Management Learning (DHML) and Contracting Unit of Primary Care (CUP) Leadership Training Programmes, which put more emphasis on bundling of competencies and contextualising of applying such competencies, were positively associated with better health-related quality of life of their multimorbid patients. CONCLUSIONS: Our report provides systematic feedback to a decade-long investment on system-based capacity building for primary care teams in Thailand, and can be considered as new evidence on the value of human resource development in primary care systems in low- and middle-income countries. Building multiple competencies helps members of primary care teams collaboratively manage district health systems and address complex health problems in different local contexts. Coupling contextualised training with ongoing programme implementation could be a key entity to the sustainable development of primary care teams in low and middle income countries which can then be a leverage for improving patients outcomes

Is adherence therapy an effective adjunct treatment for patients with schizophrenia spectrum disorders? A systematic review and meta-analysis

Background Poor adherence to medication in schizophrenia spectrum disorders leads to inadequate symptom control. Adherence therapy (AT) is an intervention that seeks to reduce patients’ psychiatric symptoms by enhancing treatment adherence. We aimed to systematically review the trial evidence of the effectiveness of AT on improving clinical outcomes in these patients. Method Systematic review and meta-analysis of published RCTs. We included studies testing AT as an adjunct intervention against treatment as usual or a comparator intervention in the general adult psychiatric population. The primary outcome of interest was improvement in psychiatric symptoms. Results We included six studies testing AT in schizophrenia spectrum disorders published since 2006. A meta-analysis showed AT significantly reduced psychiatric symptoms compared to usual treatment over a follow-up period of less than 1 year. We found no significant effects of AT on patients’ adherence and adherence attitudes. Conclusions AT is an effective adjunctive treatment for people with schizophrenia spectrum disorders

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e. a controlling message) compared to no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly-internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared to the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly-internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing: Controlled motivation was associated with more defiance and less long-term behavioral intentions to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

Adherence therapy following acute exacerbation of schizophrenia:A randomised controlled trial in Thailand

Background: Up to 50% of patients with schizophrenia are non-adherent with antipsychotic medication. Aims: To establish the efficacy of adherence therapy (AT) compared to treatment as usual (TAU) in improving clinical outcomes in patients with schizophrenia following an acute exacerbation of illness. Method: A parallel-group, single-blind, randomised controlled trial. Fieldwork was conducted in Thailand. Patients received eight weekly sessions of AT in addition to TAU. The primary outcome was improvement in psychopathology (measured using the Positive and Negative Syndrome Scale (PANSS)) at 26-week follow-up. Secondary outcomes included patient attitudes towards medication, global functioning and side-effects. Results: In total, 70 inpatients with schizophrenia were recruited to the trial. At 26-week follow-up, PANSS total scores improved in the AT compared to the TAU group by a mean of −3.94 points (effect size = 0.24). The number needed to treat (NNT) was 5. There was no significant effect on patients’ attitudes towards treatment, functioning or medication side-effects. No treatment-related adverse effects were reported. Conclusion: AT improves psychopathology in Asian patients with schizophrenia following an acute exacerbation of illness. </jats:sec

A Global Experiment on Motivating Social Distancing during the COVID-19 Pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e. a controlling message) compared to no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly-internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared to the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly-internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing: Controlled motivation was associated with more defiance and less long-term behavioral intentions to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges