Lancashire Care Library and Information Service

Psychosocial model of care – The article outlines the work of a ward in a high secure hospital Merseyside

sjennings29 — Fri, 20 Nov 2009 23:02:26 +0000

Introducing cognitive rehabilitation into a psychosocial model of care, Mental Health Practice , 2009 Oct; 13(2): 29-33

Lawrence Savage - Staff nurse at Ashworth Hospital, Merseyside

Abstract:

The article outlines the work of a ward in a high secure hospital Merseyside. The ward was opened to accommodate service users with cognitive difficultures who no longer required the high-dependency care provided in the Centre for Cognitive Rehabilitation and were ready to move to a medium or low dependency area in the hospital. The ward was part of a unit that uses a psychosocial model of care. Staff had attended a five-day course introducing them to cognitive rehabilitation therapy. The intention was to combine psychosocial interventions with cognitive rehabilitation therapy.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Eating Disorders: Seminar – The Lancet

sjennings29 — Fri, 20 Nov 2009 12:20:54 +0000

Seminar: Eating Disorders, The Lancet, 2009

Prof Janet Treasure FRCPsych , Angélica M Claudino PhD, Nancy Zucker PhD

Institute of Psychiatry, King’s College London, London, UK

Abstract:

This Seminar adds to the previous Lancet Seminar about eating disorders, published in 2003, with an emphasis on the biological contributions to illness onset and maintenance. The diagnostic criteria are in the process of review, and the probable four new categories are: anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified. These categories will also be broader than they were previously, which will affect the population prevalence; the present lifetime prevalence of all eating disorders is about 5%. Eating disorders can be associated with profound and protracted physical and psychosocial morbidity. The causal factors underpinning eating disorders have been clarified by understanding about the central control of appetite. Cultural, social, and interpersonal elements can trigger onset, and changes in neural networks can sustain the illness. Overall, apart from studies reporting pharmacological treatments for binge eating disorder, advances in treatment for adults have been scarce, other than interest in new forms of treatment delivery.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Creative reminiscence program for older adults with severe mental disorders

sjennings29 — Thu, 19 Nov 2009 23:02:22 +0000

A creative reminiscence program for older adults with severe mental disorders: Results of a pilot evaluation, Aging & Mental Health, Volume 13, Issue 5 September 2009 , pages 736 – 743

Bernadette M. Willemse – Netherlands Institute of Mental Health and Addiction, Trimbos-Instituut, 3500 AS Utrecht, The Netherlands

Abstract:

Objective: Older adults with severe mental disorders experience major dissatisfaction with conditions of life that are connected with aging. To assist them in developing a coherent, meaningful life-story and to improve their life satisfaction, we conducted a pilot evaluation of a creative reminiscence program called Searching for meaning in life.

Methods: One week before and one week after the intervention 36 participants from three psychiatric hospitals and one sheltered housing program were interviewed. Life satisfaction was measured with the Manchester Short Assessment of Quality of Life (MANSA) and the Philadelphia Geriatric Center Moral Scale (PGCMS). At follow-up questions were also asked about the intervention.

Results: About 78% of the participants completed the course. Most of them were satisfied with the course (74%). The overall sample showed significantly more life satisfaction after the intervention. Participants with a psychotic disorder also improved significantly in life satisfaction but at the same time their depressive symptoms increased significantly. Participants with a moderate to high level of depressive symptoms at baseline had relatively favorable outcomes. Their life satisfaction had improved significantly and they especially had a better attitude toward their aging.

Conclusion: The program is feasible and acceptable for adults with severe mental illness and it has potential benefits for them. More research is needed to find out what explains the increase of depressive symptoms for participants with psychotic disorders.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Counting the Cost – Caring for people with Dementia

sjennings29 — Thu, 19 Nov 2009 17:18:59 +0000

Counting the cost: caring for people with dementia Alzheimers Society, 2009

Click on the title above to access the full-text of this report

Abstract:

People with dementia – who occupy a quarter of all hospital beds – are staying far longer in hospital than people without the condition who go in for the same treatment.

This is costing hundreds of millions of pounds to the NHS, an Alzheimer’s Society report found today (Tuesday, 17 November 2009). Based on research involving 2,400 people,Counting the Cost: caring for people with dementia on hospital wards reveals large, costly variations in the quality of care for people with dementia. (alzheimers.org.uk/countingthecost)

Poor hospital care also had a negative impact on the people’s dementia and physical health. The majority of people with dementia leave hospital worse than when they arrive and a third enter a care home, unable to return home.

Alzheimer’s Society is calling for all hospitals to reduce the average length of stay for a person with dementia by at least a week. The charity is also supporting calls from nurses to be equipped with the right training and tools to do the job.

Nurses told Alzheimer’s Society that they want more access to specialist advice and help. 97 per cent of nurses work with people with dementia yet 80 per cent do not receive any or enough dementia training. 89 per cent of nurses said they found working with people with dementia very or quite challenging.

fdAlzheimer’s Society is calling for cost savings gained to be reinvested in workforce development and more appropriate care in the community.

Lancashire Care staff can request the full-text of this report, email: susan.jennings@lancashirecare.nhs.uk

Walk a mile in my shoes – Dignity & Respect for the Elderly

sjennings29 — Thu, 19 Nov 2009 16:11:01 +0000

Walk a mile in my shoes: scrutiny of dignity and respect for individuals in health and social care services: a guide 2009

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Abstract:

This guide will assist Overview and Scrutiny Committees (OSCs) to raise awareness and understanding of dignity and respect for individuals who are receiving health and social care services. Using the guide, OSCs should be in a position to:

review local leadership and partnerships to judge whether services respect the dignity of service users
promote dignity and respect for individuals and the role of the OSC
help ensure local health and care services are commissioned and delivered with dignity as a central aspect of care
gather local intelligence and provide evidence which can be reflected in local reviews of services.

Dignity is an important issue for all users of all public services and, as such, should be part of local authority overview and scrutiny in many different areas, including housing services, transport and travel, leisure and cultural services, as well as scrutiny of health and social care services or issues relating to older people.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Assertive outreach in the context of the care programme approach – Emma Jones – Lancashire Care NHS Foundation Trust – Guild

sjennings29 — Thu, 19 Nov 2009 13:51:16 +0000

Assertive outreach in the context of the care programme approach, Mental Health Practice, 2009 Apr; 12(7): 24-9

Emma Jones – Deputy Leader, Guild Lodge, Goosnarch, Lancashire

Abstract:

Assertive outreach, originally developed in the United States, has been adopted in the UK and is endorsed and financially supported by the government. Yet the role of care co-ordinator required by the care programme approach, which is the key policy underpinning mental health services in England, poses difficulties for assertive outreach. This article looks at the two systems and argues that, although both are advocated by the govemment, they appear to be founded on different principles. It considers whether the two approaches can work together and, if so, how success can be measured.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Psychosocial interventions to prevent relapse: a case study.

sjennings29 — Thu, 19 Nov 2009 10:00:01 +0000

Psychosocial interventions to prevent relapse: a case study, Mental Health Practice, 2009 Sep; 13(1): 28-33

Katherine Lloyd is an early intervention practitioner at the Liverpool South Early Intervention Team

Abstract:

Katherine Lloyd used relapse prevention strategies to help a client to understand the factors that trigger bipolar episodes. This enabled himto modify his behaviours and pre-empt a deterioration in his condition,

A client with bipolar illness who did not want to be on long-term medication for his condition was offered psychosocial interventions to help prevent a relapse. The client was able to make informed choices about his drug-taking behaviour and its effect on his condition.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Mindfulness-based pain management programme: effects on well-being and multiple measures of mindfulness

sjennings29 — Wed, 18 Nov 2009 23:02:34 +0000

Evaluation of the breathworks mindfulness-based pain management programme: effects on well-being and multiple measures of mindfulness, Clinical Psychology & Psychotherapy, 2009

Bryany Cusens, Geoffrey B. Duggan, Kirsty Thorne, Vidyamala Burch

Anaesthetics, Theatres and Pain Services Directorate, Derriford Hospital, Plymouth, UK, University of Bath, Bath, UK
Manchester Buddhist Centre, Manchester, UK

Abstract:

Two studies of a mindfulness training programme are presented. Study 1 reports on a pilot investigation of the impact on well-being of the Breathworks mindfulness-based pain management programme. Significant positive change was found on self-report measures of depression, outlook, catastrophizing and pain self-efficacy in the Intervention Group, but not the Comparison Group. Particularly large effects were found for pain acceptance. These results support the short-term efficacy of the Breathworks programme and reinforce the importance of acceptance for positive outcome with chronic pain patients. Study 2 investigated alterations in mindfulness following participation in the Breathworks programme. Subjective and non-subjective measures of mindfulness were used. Scores on the Mindful Attention Awareness Scale were significantly higher at Time 2 in the Intervention Group, but not in the Comparison Group. There was no change on a measure of sustained attention. Results from an Implicit Association Test provided some support for an increased awareness of positive stimuli, following the intervention. These results are discussed with reference to the mechanisms of mindfulness.

Key Practitioner Message:

	Evidence supporting the efficacy of Breathworks for well-being.
	Mindful Attention Awareness Scale scores improved following mindfulness training.
	Mindfulness may increase awareness of pleasant affect.
	No change found on a measure of attention.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Psychotherapy for adult depression are overestimated: a meta-analysis of study quality and effect size

sjennings29 — Wed, 18 Nov 2009 15:16:06 +0000

The effects of psychotherapy for adult depression are overestimated: a meta-analysis of study quality and effect size, Psychological Medicine, 2009

P. Cuijpers, A. van Straten, E. Bohlmeijer, S. D. Hollon and G. Andersson

Department of Clinical Psychology, VU University Amsterdam, The Netherlands

Abstract:

Background No meta-analytical study has examined whether the quality of the studies examining psychotherapy for adult depression is associated with the effect sizes found. This study assesses this association.

Method We used a database of 115 randomized controlled trials in which 178 psychotherapies for adult depression were compared to a control condition. Eight quality criteria were assessed by two independent coders: participants met diagnostic criteria for a depressive disorder, a treatment manual was used, the therapists were trained, treatment integrity was checked, intention-to-treat analyses were used, N50, randomization was conducted by an independent party, and assessors of outcome were blinded.

Results Only 11 studies (16 comparisons) met the eight quality criteria. The standardized mean effect size found for the high-quality studies (d=0.22) was significantly smaller than in the other studies (d=0.74, p<0.001), even after restricting the sample to the subset of other studies that used the kind of care-as-usual or non-specific controls that tended to be used in the high-quality studies. Heterogeneity was zero in the group of high-quality studies. The numbers needed to be treated in the high-quality studies was 8, while it was 2 in the lower-quality studies.

Conclusions We found strong evidence that the effects of psychotherapy for adult depression have been overestimated in meta-analytical studies. Although the effects of psychotherapy are significant, they are much smaller than was assumed until now, even after controlling for the type of control condition used.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Simulated presence therapy for individuals with dementia: A systematic review and meta-analysis

sjennings29 — Wed, 18 Nov 2009 10:50:33 +0000

Effectiveness of simulated presence therapy for individuals with dementia: A systematic review and meta-analysis, Aging & Mental Health, Volume 12, Issue 6 November 2008 , pages 779 – 785

Jessica Zetteler – Cardiff and Vale NHS Trust and Cardiff University, Cardiff, UK

Abstract:

Objectives: To formally assess the strength of evidence for the efficacy of simulated presence therapy for challenging behaviours in dementia (playing an audio or videotape to an individual, personalized by a carer and containing positive experiences from the client’s life and shared memories involving family and friends) using meta-analytic techniques.

Method: Systematic review and meta-analysis of k = 4 studies of simulated presence therapy for challenging behaviours in dementia.

Results: Meta-analysis indicated a significance effect (d = 0.70, 95% CI = 0.38-1.02), although this was reduced when the first published study was removed from the analysis.

Conclusion: These findings provide limited support for the use of simulated presence therapy with this population and stress the importance of assessing participants’ suitability for such an approach and monitoring their responses closely. Future adequately powered studies are necessary to confirm the efficacy of simulated presence therapy.

Lancashire Care staff can request the full-text of this article, email: susan.jennings@lancashirecare.nhs.uk