Dataset Information

Long term outcome study of a salutogenic psychoeducational recovery oriented intervention (Inte.G.R.O.) in severe mental illness patients.

ABSTRACT:

Aim

Inte.G.R.O. is a standardized Salutogenic-Psychoeducational intervention designed to help people with severe mental illness manage their life-stress and achieve personal recovery goals through the improvement of social functioning. The aim of this study is to evaluate the long-term outcome of this approach, characterized by health promotion rather than correction of dysfunctional strategies.

Methods

41 people underwent an observational study with a three time-point evaluation (t0, pre- treatment; t1, 12 months; t2, 36 months). At each time point, social functioning was assessed as primary outcome by the Personal and Social Functioning scale (PSP); furthermore, psychopathological status was assessed by Brief Psychiatric Rating Scale (BPRS), stress management was measured by means of Stress-Scale and cognitive flexibility variables were assessed by Modified Five-Point Test (M-FPT).

Results

Personal and Social Functioning increased at t1 and t2 vs t0; psychopathological status improved at t2 vs t0; stress management improved at t2 vs t1; cognitive flexibility improved at t2 vs t0.

Conclusions

these results substantially confirm after a three-year follow-up the improvements in functioning, psychopathology, stress management and cognitive flexibility seen in previous studies. Furthermore, they show a complex time-dependent fashion. Overall, they confirm a remarkable and long-term impact of Inte.G.R.O. on key Recovery variables. Further studies are needed to address extent and duration of these improvements.

SUBMITTER: Veltro F

PROVIDER: S-EPMC8981821 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Publications

Long term outcome study of a salutogenic psychoeducational recovery oriented intervention (Inte.G.R.O.) in severe mental illness patients.

Veltro Franco F Latte Gianmarco G Pontarelli Irene I Pontarelli Cristina C Nicchiniello Ilenia I Zappone Lilia L

BMC psychiatry 20220405 1

<h4>Aim</h4>Inte.G.R.O. is a standardized Salutogenic-Psychoeducational intervention designed to help people with severe mental illness manage their life-stress and achieve personal recovery goals through the improvement of social functioning. The aim of this study is to evaluate the long-term outcome of this approach, characterized by health promotion rather than correction of dysfunctional strategies.<h4>Methods</h4>41 people underwent an observational study with a three time-point evaluation ...[more]

PMID: 35382789

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Project description:AimsMany people who are homeless with severe mental illnesses are high users of healthcare services and social services, without reducing widen health inequalities in this vulnerable population. This study aimed to determine whether independent housing with mental health support teams with a recovery-oriented approach (Housing First (HF) program) for people who are homeless with severe mental disorders improves hospital and emergency department use.MethodsWe did a randomised controlled trial in four French cities: Lille, Marseille, Paris and Toulouse. Participants were eligible if they were 18 years or older, being absolutely homeless or precariously housed, with a diagnosis of schizophrenia (SCZ) or bipolar disorder (BD) and were required to have a high level of needs (moderate-to-severe disability and past hospitalisations over the last 5 years or comorbid alcohol or substance use disorder). Participants were randomly assigned (1:1) to immediate access to independent housing and support from the Assertive Community Treatment team (social worker, nurse, doctor, psychiatrist and peer worker) (HF group) or treatment as usual (TAU group) namely pre-existing dedicated homeless-targeted programs and services. Participants and interviewers were unmasked to assignment. The primary outcomes were the number of emergency department (ED) visits, hospitalisation admissions and inpatient days at 24 months. Secondary outcomes were recovery (Recovery Assessment Scale), quality of life (SQOL and SF36), mental health symptoms, addiction issues, stably housed days and cost savings from a societal perspective. Intention-to-treat analysis was performed.ResultsEligible patients were randomly assigned to the HF group (n = 353) or TAU group (n = 350). No differences were found in the number of hospital admissions (relative risk (95% CI), 0.96 (0.76-1.21)) or ED visits (0.89 (0.66-1.21)). Significantly less inpatient days were found for HF v. TAU (0.62 (0.48-0.80)). The HF group exhibited higher housing stability (difference in slope, 116 (103-128)) and higher scores for sub-dimensions of S-QOL scale (psychological well-being and autonomy). No differences were found for physical composite score SF36, mental health symptoms and rates of alcohol or substance dependence. Mean difference in costs was €-217 per patient over 24 months in favour of the HF group. HF was associated with cost savings in healthcare costs (RR 0.62(0.48-0.78)) and residential costs (0.07 (0.05-0.11)).ConclusionAn immediate access to independent housing and support from a mental health team resulted in decreased inpatient days, higher housing stability and cost savings in homeless persons with SCZ or BP disorders.

Project description:Interventions: We are assessing the impact of the National Bowel Cancer Screening Program (NBCSP) by comparing participation rates of people with and without Severe Mental Illness (SMI) and looking at health outcomes. We will be using data collected from Aug 2006 - latest available. We are linking data using Commonwealth data (NBCSP, Medicare Benefits Schedule, Pharmaceutical Benefits Scheme, Australian Cancer Database & the National Death Index) to compare bowel cancer screening participation in people with SMI to those from the general population. We will additionally link these to the NSW cancer registry and hospital data to examine care pathways from diagnosis through treatment and end-of-life care. We will also conduct a consultation with people with experience of SMI and Colorectal cancer and people with SMI in peer support roles who can provide their perspective on the barriers faced by people with SMI to gaining timely screening, diagnosis and optimal care. These participants will be recruited from New South Wales consumer organisations and organisations with a strong focus on provision of peer support and advocacy. We will use a semi structured group interview schedule to facilitate discussion of a single focus group of 15 people. The group will consist of both people with lived experience who have direct experience of bowel cancer (n=10), as well as other people with lived experience who have supported people in this situation – as peer support workers or in other consumer advocacy/support roles (n=5). We will use this qualitative arm of the study to further develop our understanding of the quantitative findings. The consultation will also develop ideas on how to improve access to care. Primary outcome(s): Participation rates in the National Bowel Cancer Screening Program assessed using data from the NBCSP.[Person-years will be calculated from entry into the study (2006) (the date of commencement of the NBCSP) or from the year that people become eligible for screening (i.e. age 50), whichever occurs later.. This is a retrospective cohort study, so all of the outcomes have already occurred and were recorded in the administrative data. This will be assessed when we receive the data.];Colonoscopy rates assessed using data from the NBCSP [Person-years will be calculated from entry into the study (2006 the date of commencement of the NBCSP), or from the year that people become eligible for screening (i.e. age 50), whichever occurs later, until colonoscopy. This is a retrospective cohort study, so all of the outcomes have already occurred and have been recorded in the administrative data.];Cancer diagnosis using data from the Australian Cancer Database[Person-years will be calculated from entry into the study (2006 the date of commencement of the NBCSP), or from the year that people become eligible for screening (i.e. age 50), whichever occurs later, until cancer diagnosis. This is a retrospective cohort study, so all of the outcomes have already occurred and have been recorded in the administrative data.] Study Design: Purpose: Screening;Duration: Longitudinal;Selection: Case control;Timing: Both

Project description:BackgroundMental health policies outline the need for codesign of services and quality improvement in partnership with service users and staff (and sometimes carers), and yet, evidence of systematic implementation and the impacts on healthcare outcomes is limited.ObjectiveThe aim of this study was to test whether an adapted mental health experience codesign intervention to improve recovery-orientation of services led to greater psychosocial recovery outcomes for service users.DesignA stepped wedge cluster randomized-controlled trial was conducted.Setting and participantsFour Mental Health Community Support Services providers, 287 people living with severe mental illnesses, 61 carers and 120 staff were recruited across Victoria, Australia.Main outcome measuresThe 24-item Revised Recovery Assessment Scale (RAS-R) measured individual psychosocial recovery.ResultsA total of 841 observations were completed with 287 service users. The intention-to-treat analysis found RAS-R scores to be similar between the intervention (mean = 84.7, SD= 15.6) and control (mean = 86.5, SD= 15.3) phases; the adjusted estimated difference in the mean RAS-R score was -1.70 (95% confidence interval: -3.81 to 0.40; p = .11).DiscussionThis first trial of an adapted mental health experience codesign intervention for psychosocial recovery outcomes found no difference between the intervention and control arms.ConclusionsMore attention to the conditions that are required for eight essential mechanisms of change to support codesign processes and implementation is needed.Patient and public involvementThe State consumer (Victorian Mental Illness Awareness Council) and carer peak bodies (Tandem representing mental health carers) codeveloped the intervention. The adapted intervention was facilitated by coinvestigators with lived-experiences who were coauthors for the trial and process evaluation protocols, the engagement model and explanatory model of change for the trial.

Project description:BackgroundPeople with severe mental illness who reside in supported housing (SH) and need a high level of assistance are at risk of an everyday life with little meaning and low community participation. Interventions to counteract that seem warranted, which was the rationale for this study. The aim was to investigate how residents and staff perceived an intervention designed to enhance meaningful everyday activity and personal recovery.MethodsThe intervention, termed Active in My Home (AiMH), was led by an occupational therapist. It consisted of five individual and three group sessions, and AiMH staff acted as supporters. Twenty-nine AiMH participants and 43 staff members were included in this un-controlled study with three measurement points - before (T1), at completion (T2), and 6-9 months after completion of AiMH (T3). The data collection was based on self-report questionnaires addressing perceptions of satisfaction, meaningfulness, and recovery-oriented support.ResultsThe residents' satisfaction with the SH per se was rated high (at 75% of the maximum score) and did not change over the study period from T1 to T3 (p = 0.544); nor did the participants' perceived recovery-oriented support from the AiMH supporter (p = 0.235). Satisfaction with AiMH was rated by both participants and staff at T2. Their scores differed regarding general satisfaction (p = 0.008), staff scoring higher, but no differences were found regarding satisfaction with group sessions, individual sessions, or support of activity (p-values 0.062-0.836). The staff rated the SH unit's provision of meaningful activities higher than the AIMH participants at T2 (p = 0.029) but not at T1 (p = 0.226) or T3 (p = 0.499).ConclusionThis study has offered some glimpses of how AiMH participants and staff perceived the AiMH intervention. It has also generated some ideas for better support for meaningful activity and recovery-oriented support in SH for people with mental illness, such as assisting SH residents in identifying activity opportunities and making activity choices when providing support for meaningful activity in the SH context.Trial registrationRegistered at ClinicalTrials.gov ID: NCT05157854.

Project description:BACKGROUND:An advance directive is a document specifying a person's preferences for treatment, should he or she lose capacity to make such decisions in the future. They have been used in end-of-life settings to direct care but should be well suited to the mental health setting. OBJECTIVES:To examine the effects of advance treatment directives for people with severe mental illness. SEARCH STRATEGY:We searched the Cochrane Schizophrenia Group's Register (February 2008), the Cochrane Library (Issue 1 2008), BIOSIS (1985 to February 2008), CINAHL (1982 to February 2008), EMBASE (1980 to February 2008), MEDLINE (1966 to February 2008), PsycINFO (1872 to February 2008), as well as SCISEARCH and Google - Internet search engine (February 2008). We inspected relevant references and contacted first authors of included studies. SELECTION CRITERIA:We included all randomised controlled trials (RCTs), involving adults with severe mental illness, comparing any form of advance directive with standard care for health service and clinical outcomes. DATA COLLECTION AND ANALYSIS:We extracted data independently. For homogenous dichotomous data we calculated fixed-effect relative risk (RR) and 95% confidence intervals (CI) on an intention-to-treat basis. For continuous data, we calculated weighted mean differences (WMD) and their 95% confidence interval again using a fixed-effect model. MAIN RESULTS:We were able to include two trials involving 321 people with severe mental illnesses. There was no significant difference in hospital admission (n=160, 1 RCT, RR 0.69 0.5 to 1.0), or number of psychiatric outpatient attendances between participants given advanced treatment directives or usual care. Similarly, no significant differences were found for compliance with treatment, self harm or number of arrests. Participants given advanced treatment directives needed less use of social workers time (n=160, 1 RCT, WMD -106.00 CI -156.2 to -55.8) than the usual care group, and violent acts were also lower in the advanced directives group (n=160, 1 RCT, RR 0.27 CI 0.1 to 0.9, NNT 8 CI 6 to 92). The number of people leaving the study early were not different between groups (n=321, 2 RCTs, RR 0.92 CI 0.6 to 1.6). AUTHORS' CONCLUSIONS:There are too few data available to make definitive recommendations. More intensive forms of advance directive appear to show promise, but currently practice must be guided by evidence other than that derived from randomised trials. More trials are indicated to determine whether higher intensity interventions, such as joint crisis planning, have an effect on outcomes of clinical relevance.

Dataset Information

Long term outcome study of a salutogenic psychoeducational recovery oriented intervention (Inte.G.R.O.) in severe mental illness patients.

Aim

Methods

Results

Conclusions

Publications

Long term outcome study of a salutogenic psychoeducational recovery oriented intervention (Inte.G.R.O.) in severe mental illness patients.

Similar Datasets

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