The heterogeneity of clinical presentations in psychiatric emergencies creates difficulties in the response by interdisciplinary Mental Health teams. This is aggravated and difficult when the care is carried out on pu...The heterogeneity of clinical presentations in psychiatric emergencies creates difficulties in the response by interdisciplinary Mental Health teams. This is aggravated and difficult when the care is carried out on public roads or the patient’s home, that is, it is a pre-hospital context. Our Psychiatric Emergency Hospital, located in the City of Buenos Aires, provides pre-hospital care with a psychiatric ambulance, which is then referred to general hospitals or other health system providers. Not all effectors in the network have the same resources and, at the time of the emergency, the reasons for consultation such as the patient’s clinic are heterogeneous and require the greatest effectiveness in the intervention that is taken. The triage system is a resource that allows the systematization of approaches against the multiplicity of reasons for consultation and presentation of mental pathologies in the emergency room, in addition to providing greater effectiveness in interventions, homogeneity for the health system and consensus among the health effectors. Framed in the Mental Health Law, and especially in the concept of risk, a triage proposal was designed for pre-hospital interventions by the psychiatric ambulance dependent on Hospital Alvear and under current legal regulations with the aim of homogenizing care and referrals with the highest rate of effectiveness to provide quality interdisciplinary medicine.展开更多
BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major ...BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major depressive disorder(MDD)remain poorly understood.Aberrant resting-state functional connectivity(rsFC)in the amygdala,a key region implicated in emotional regulation and threat detection,is strongly implicated in depression and suicidal behavior.AIM To investigate rsFC alterations between amygdala subregions and whole-brain networks in adolescent patients with depression and suicide attempts.METHODS Resting-state functional magnetic resonance imaging data were acquired from 32 adolescents with MDD and suicide attempts(sMDD)group,33 adolescents with MDD but without suicide attempts(nsMDD)group,and 34 demographically matched healthy control(HC)group,with the lateral and medial amygdala(MeA)defined as regions of interest.The rsFC patterns of amygdala subregions were compared across the three groups,and associations between aberrant rsFC values and clinical symptom severity scores were examined.RESULTS Compared with the nsMDD group,the sMDD group exhibited reduced rsFC between the right lateral amygdala(LA)and the right inferior occipital gyrus as well as the left middle occipital gyrus.Compared with the HC group,the abnormal brain regions of rsFC in the sMDD group and nsMDD group involve the parahippocampal gyrus(PHG)and fusiform gyrus.In the sMDD group,right MeA and right temporal pole:Superior temporal gyrus rsFC value negatively correlated with the Rosenberg Self-Esteem Scale scores(r=-0.409,P=0.025),while left LA and right PHG rsFC value positively correlated with the Adolescent Self-Rating Life Events Checklist interpersonal relationship scores(r=0.372,P=0.043).CONCLUSION Aberrant rsFC changes between amygdala subregions and these brain regions provide novel insights into the underlying neural mechanisms of suicide attempts in adolescents with MDD.展开更多
Background Intimate partner violence(IPV) and sexual violence(SV) occur commonly and are a violation of basic human rights. There are limited studies to date that examine the impact of IPV, SV and mental health outcom...Background Intimate partner violence(IPV) and sexual violence(SV) occur commonly and are a violation of basic human rights. There are limited studies to date that examine the impact of IPV, SV and mental health outcomes in Thailand.Aims The objective of the present study was to estimate the prevalence of intimate partner physical violence and IPV in Thai women and the association between these forms of violence and psychiatric disorders.Methods The present study used data from a national cross-sectional, population-based, household design survey. This study analysed data from 3009 female respondents above the age of 18 who were interviewed in person using the World Mental Health-Composite International Diagnostic Interview V.3.0(WMH-CIDI 3.0). We estimated the lifetime and the 12-month period prevalence of IPV and SV, the lifetime and the past 12-month period correlation of IPV/SV with psychiatric disorders and the OR for psychiatric disorders associated with these types of violence.Results There was only 5.2 % of the weighted sample that reported experiencing some form of violence, including reported rates of intimate partner physical violence of 3.5% and IPV of 2.0%. Women who had experienced IPV have a lifetime prevalence for common psychiatric disorders of 28.9%, for suicidal behaviours of 12.2% and for substance use disorders of 8.8%. Women who had experienced SV have a lifetime diagnoses for common psychiatric disorders of 21.4%, for suicidal behaviours of 16.5% and for substance use disorders of 19.4%. There was a statistically significant association between IPV/SV and being diagnosed with a psychiatric disorder during the past year and also during one's lifetime.Conclusion The association between IPV/SV and psychiatric disorders is significant; therefore, performing a formal assessment for a history of violence in psychiatric patients is often beneficial in refining the diagnosis and treatment.展开更多
BACKGROUND The literature has discussed the relationship between environmental factors and depressive disorders;however,the results are inconsistent in different studies and regions,as are the interaction effects betw...BACKGROUND The literature has discussed the relationship between environmental factors and depressive disorders;however,the results are inconsistent in different studies and regions,as are the interaction effects between environmental factors.We hypo-thesized that meteorological factors and ambient air pollution individually affect and interact to affect depressive disorder morbidity.AIM To investigate the effects of meteorological factors and air pollution on depressive disorders,including their lagged effects and interactions.METHODS The samples were obtained from a class 3 hospital in Harbin,China.Daily hos-pital admission data for depressive disorders from January 1,2015 to December 31,2022 were obtained.Meteorological and air pollution data were also collected during the same period.Generalized additive models with quasi-Poisson regre-ssion were used for time-series modeling to measure the non-linear and delayed effects of environmental factors.We further incorporated each pair of environ-mental factors into a bivariate response surface model to examine the interaction effects on hospital admissions for depressive disorders.RESULTS Data for 2922 d were included in the study,with no missing values.The total number of depressive admissions was 83905.Medium to high correlations existed between environmental factors.Air temperature(AT)and wind speed(WS)significantly affected the number of admissions for depression.An extremely low temperature(-29.0℃)at lag 0 caused a 53%[relative risk(RR)=1.53,95%confidence interval(CI):1.23-1.89]increase in daily hospital admissions relative to the median temperature.Extremely low WSs(0.4 m/s)at lag 7 increased the number of admissions by 58%(RR=1.58,95%CI:1.07-2.31).In contrast,atmospheric pressure and relative humidity had smaller effects.Among the six air pollutants considered in the time-series model,nitrogen dioxide(NO_(2))was the only pollutant that showed significant effects over non-cumulative,cumulative,immediate,and lagged conditions.The cumulative effect of NO_(2) at lag 7 was 0.47%(RR=1.0047,95%CI:1.0024-1.0071).Interaction effects were found between AT and the five air pollutants,atmospheric temperature and the four air pollutants,WS and sulfur dioxide.CONCLUSION Meteorological factors and the air pollutant NO_(2) affect daily hospital admissions for depressive disorders,and interactions exist between meteorological factors and ambient air pollution.展开更多
BACKGROUND Previous studies found several factors associated with suicide in schizophrenic patients,such as age,sex,education level,history of suicide attempts,psychotic symptoms,social factors,and substance abuse.How...BACKGROUND Previous studies found several factors associated with suicide in schizophrenic patients,such as age,sex,education level,history of suicide attempts,psychotic symptoms,social factors,and substance abuse.However,there might be some additional factors that were not considered in previous studies but may be correlated with a greater likelihood of suicide attempts,such as medication and treatment.AIM To investigate the prevalence of suicide attempts and identify the risk of suicidality in hospitalized schizophrenia patients.METHODS This is a cross-sectional study of schizophrenic patients admitted to a psychiatric hospital who were 18 years of age or more.The outcomes and possible suicide risk factors in these patients were collated.The current suicide risk was evaluated using the mini-international neuropsychiatric interview module for suicidality and categorized as none(0 points),mild(1-8 points),moderate(9-16 points),or severe(17 or more points).This study used ordinal logistic regression to assess the association of potential risk factors with the current suicide risk in schizophrenic patients.RESULTS Of 228 hospitalized schizophrenia patients,214(93.9%)were included in this study.The majority(79.0%)of patients were males.Females appeared to have a slightly higher suicidality risk than males,with borderline significance.With regard to the current suicide risk assessed with the mini-international neuropsychiatric interview,172(80.4%)schizophrenic patients scored zero,20(9.4%)had a mild risk,8(3.7%)had a moderate risk,and 14(6.5%)had a severe risk.The total prevalence of current suicide risk in these schizophrenic patients was 19.6%.Based on multivariable ordinal logistic regression analysis with backward elimination,it was found that younger age,a current major depressive episode,receiving fluoxetine or lithium carbonate in the previous month,or a relatively higher Charlson comorbidity index score were all significantly and independently associated with a higher level of suicide risk.CONCLUSION The prevalence rate of suicide attempts in schizophrenia is high.Considering risk factors in routine clinical assessments,environmental manipulations and adequate treatment might prevent or decrease suicide in these patients.展开更多
Background Obsessive-compulsive disorder(OCD)is considered a very debilitating disorder with severe loss of quality of life and income.Aims This study estimates the quality of life and economic consequences of OCD in ...Background Obsessive-compulsive disorder(OCD)is considered a very debilitating disorder with severe loss of quality of life and income.Aims This study estimates the quality of life and economic consequences of OCD in China.Methods The research team interviewed 639 patients with OCD in 13 hospitals in 12 cities in China.The direct method was used to get the direct cost of OCD.Indirect costs associated with OCD were estimated using the human capital approach.Linear regression analysis was conducted for quality of life and generalised linear model analysis was conducted for total cost.Sensitivity analysis was used to analyse the uncertainty of total cost.Results The mean quality of life score for OCD was 52.78(20.46).The annual total cost of OCD per capita was 24503.78(95%CI:22621.53 to 26386.03)renminbi(RMB)(US$3465.88(95%CI:US$3199.65 to US$3732.11)).The annual cost of OCD in China was estimated to be 37.74 billion(95%CI:34.95 billion to 40.53 billion)RMB(equal to US$5.34 billion(95%CI:US$4.94 billion to US$5.73 billion)).Sensitivity analysis showed that the total annual cost of OCD in China was between 23.15 billion RMB(US$3.27 billion)and 370.00 billion RMB(US$52.33 billion).Worse social function status,more psychiatric symptoms and higher Yale Brown Obsessive-Compulsive Scale(Y-BOCS)score were associated with worse quality of life.The numbers of clinic visits and hospitalisations,socioeconomic status,education,Y-BOCS scores and age were found to be significantly associated with total cost.Conclusions OCD is associated with low quality of life and high costs in China.The findings call for concerted efforts to improve services for patients with OCD.Improvements may include early detection and diagnosis,the provision of evidence-based treatments and relapse prevention strategies.展开更多
Explanatory models of co-morbid traits related to dental anxiety (DA) as described in the literature were tested and relative strengths analyzed in two groups of Danish adults, one with psychiatric diagnoses (n = 108)...Explanatory models of co-morbid traits related to dental anxiety (DA) as described in the literature were tested and relative strengths analyzed in two groups of Danish adults, one with psychiatric diagnoses (n = 108) and the other healthy incoming patients at a large dental school teaching clinic (n = 151). Dental Anxiety Scale (DAS) and self-report measures representing three co-morbidity explanatory models, 1) presence of other fears;2) anxiety sensitivity and 3) feelings of vulnerability specific to dental treatment, were collected in subscales of a 53-item questionnaire. Other items identified gender, age, education, income, avoidance behavior and dental symptoms. Frequency, chi-square, odds ratio and logistic regression analyses were performed. Results: All individuals with high DA (DAS > 13) regardless of group, demonstrated significant differences in avoidance of treatment (>2 yr.) versus lower or no anxiety. Patients with psychiatric diagnoses were three times more likely to have high DA and nearly two times more likely to have avoided dental treatment >2 yr.;25.9% reported extreme DA, compared to 9.3% of controls. Models of high general fear levels, predisposing anxiety sensitivity and vulnerability all demonstrated significant and strong association with intensity of dental anxiety in bivariate analyses. Feelings of vulnerability were the strongest predictor of DAS high anxiety, according to logistic regression analyses. Conclusion: Co-morbidity explanatory models as represented in present trait measures appear not to be competitive, but rather explain different aspects of a vulnerability model in high dental anxiety. Higher incidence of DA and treatment avoidance in psychiatric patients requires special attention.展开更多
Among all contaminants of emerging interest,drugs are the ones that give rise to the greatest concern.Any of the multiple stages of the drug's life cycle(production,consumption and waste management)is a possible e...Among all contaminants of emerging interest,drugs are the ones that give rise to the greatest concern.Any of the multiple stages of the drug's life cycle(production,consumption and waste management)is a possible entry point to the different environmental matrices.Psychiatric drugs have received special attention because of two reasons.First,their use is increasing.Second,many of them act on phylogenetically highly conserved neuroendocrine systems,so they have the potential to affect many non-target organisms.Currently,wastewater is considered the most important source of drugs to the environment.Furthermore,the currently available wastewater treatment plants are not specifically prepared to remove drugs,so they reach practically all environmental matrices,even tap water.As drugs are designed to produce pharmacological effects at low concentrations,they are capable of producing ecotoxicological effects on microorganisms,flora and fauna,even on human health.It has also been observed that certain antidepressants and antipsychotics can bioaccumulate along the food chain.Drug pollution is a complicated and diffuse problem characterized by scientific uncertainties,a large number of stakeholders with different values and interests,and enormous complexity.Possible solutions consist on acting at source,using medicines more rationally,eco-prescribing or prescribing greener drugs,designing pharmaceuticals that are more readily biodegraded,educating both health professionals and citizens,and improving coordination and collaboration between environmental and healthcare sciences.Besides,end of pipe measures like improving or developing new purification systems(biological,physical,chemical,combination)that eliminate these residues efficiently and at a sustainable cost should be a priority.Here,we describe and discuss the main aspects of drug pollution,highlighting the specific issues of psychiatric drugs.展开更多
Background: Somatic symptoms that are not attributable to organic pathology are common in general practice settings however, data in most parts of Africa including southern Nigeria are still scarce. The aim of our stu...Background: Somatic symptoms that are not attributable to organic pathology are common in general practice settings however, data in most parts of Africa including southern Nigeria are still scarce. The aim of our study was to examine such somatic symptoms reported by patients attending a primary care facility at a tertiary hospital in southern Nigeria as well as to motivate future research in this area. Method: The study was conducted at the General Out Patient Clinic (GOPC) of the University of Calabar Teaching Hospital (UCTH). It was a cross sectional study in which data were obtained from the case notes of 115 patients that presented in the clinic with somatic complaints which could not be attributed to organic pathology by their physicians. Results: While 46 of the patients were males, 69 were females. Their mean age was 37.7 (SD = 11.9). Internal heat, crawling sensation, body pains and palpitations were the most prevalent symptoms reported by the patients. When the symptoms were sorted into various groups, the “subjective abnormal bodily sensation” was the most prevalent and far outnumbered the “pseudo neurological symptoms”. Conclusion: A number of patients attending the GOPC of the UCTH seek consultations for medically unexplained somatic symptom. The most prevalent of these symptoms are internal heat and crawling sensations both of which are not stated in the criteria recognized by the International Classification of Diseases—version 10 (ICD-10) for the diagnosis of psychiatric disorders.展开更多
Acne vulgaris is a chronic inflammatory skin disorder which has a high prevalence among adolescents and young adults and can be associated with emotional and psychological burden on patients. This review aimed to expl...Acne vulgaris is a chronic inflammatory skin disorder which has a high prevalence among adolescents and young adults and can be associated with emotional and psychological burden on patients. This review aimed to explore psychological factors in patients with acne. Several forms of emotional distress and psychological complications can occur with acne. Such complications may be worse than the physical impact of the skin condition. Current literature suggests that skin changes in acne are associated with changed body image, psychological distress, anxiety, social phobia, suicidal ideation and depression. Population-based studies suggest a significant association between acne and mental distress among both male and female adolescents. Presence of psychological distress is related to severity of acne in some studies. However, other case-controlled studies suggest increased risk for psychological problems in patients with acne regardless of its severity. Stress is suspected to have a role in exacerbations of acne, and the quality of life (QoL) is affected particularly in cases with severe facial acne. Acne treatment can be associated with psychiatric side effects. Isotretinoin may be associated with depression and suicide attempts as shown in several studies but with conflicting results. On the other hand, psychotropic medications (such as antidepressants, antipsychotics and mood stabilizers) can also induce acne. The results of this review indicate the importance of vigilant psychiatric assessment for patients with acne, particularly those receiving isotretinoin, is needed for early diagnosis and treatment of the associated psychiatric co-morbidity.展开更多
The Law on Tobacco Control of the Republic of Lithuania （issued in 1996） prohibits smoking in health care facilities. The security implementation is particularly problematic in psychiatric hospitals, where patients ...The Law on Tobacco Control of the Republic of Lithuania （issued in 1996） prohibits smoking in health care facilities. The security implementation is particularly problematic in psychiatric hospitals, where patients with adaptation problems are used to smoking feeling anxiety. Meanwhile, experts and scholars do not agree on the benefits or harm of smoking for individuals suffering from mental disorder. Republican Vilnius Psychiatric Hospital undertook an investigation of the attitudes of those mostly concerned--the patients, their relatives and the staff of the hospital, also of their views on the ways and feasibility to reduce smoking in the hospital. It was concluded that the main cause of patients＇ smoking is addiction, and hospital staff recognize that mental disorders contribute to the increase in dependency. Other reasons--smoking reduces tension, facilitates adaptation to environments, enhances contacts. Most patients and their relatives believe that smoking should not be banned, while the staff believes it should be prohibited in part by a variety of increasing of constraints. The most effective means to reduce smoking in the hospital would be rich leisure activities, education and professional help.展开更多
Objective:To evaluate the knowledge,compliance,and influencing factors of hand hygiene among psychiatric healthcare workers.Methods:68 healthcare workers who worked in the Department of Psychiatry between September 20...Objective:To evaluate the knowledge,compliance,and influencing factors of hand hygiene among psychiatric healthcare workers.Methods:68 healthcare workers who worked in the Department of Psychiatry between September 2023 and May 2024 were selected to assess their knowledge of hand hygiene and compliance by questionnaire as well as to analyze their influencing factors.Results:Knowledge of hand hygiene among healthcare workers was less than 90%,and doctors’knowledge was lower than that of nurses(P<0.05).The healthcare workers’compliance with hand hygiene was lower than 80%,and the adherence of doctors was lower than that of nurses(P<0.05).Analysis of influencing factors reveals that skepticism about the effectiveness of rapid disinfectants/hand washing,skin irritation from disinfectants/cleaning agents,and busy work schedules with time constraints are the main factors affecting healthcare workers’compliance with hand hygiene,with P<0.05 compared with the same group.Conclusion:Psychiatric healthcare workers’knowledge of hand hygiene as well as compliance with it is low,and there are various factors affecting it,so targeted training is required to strengthen their hand hygiene implementation.展开更多
Objective: to explore the effect of continuous improvement of nursing quality by using sensitive indicators of nursing quality in the nursing process of psychiatric patients. Methods: from January 2017 to June 2018, 5...Objective: to explore the effect of continuous improvement of nursing quality by using sensitive indicators of nursing quality in the nursing process of psychiatric patients. Methods: from January 2017 to June 2018, 56 patients in the psychiatric department of our hospital were selected by random number table method for retrospective analysis as the control group. Since July 2018, our hospital has applied nursing quality sensitive indicators, and 61 patients were selected by random number table method as the study group. Analyze the clinical nursing quality, BPRS score and IPROS score. Results: the quality of clinical nursing in the control group was inferior to that in the study group (P < 0.05), indicating that the difference was statistically significant;the BPRS score of the study group was better than that of the control group (P < 0.05), indicating that the difference was statistically significant;the IPROS score of the study group was better than that of the control group (P < 0.05), indicating that the difference was statistically significant. Conclusion: in the continuous improvement of psychiatric nursing quality, the application of nursing quality sensitive indicators is helpful to improve the quality of nursing and alleviate the mental illness of patients.展开更多
Objective:To study the application effect of the plan-do-check-act(PDCA)cycle management in the hand hygiene management of psychiatric medical staff.Methods:One hundred and twenty medical staff from a psychiatric hosp...Objective:To study the application effect of the plan-do-check-act(PDCA)cycle management in the hand hygiene management of psychiatric medical staff.Methods:One hundred and twenty medical staff from a psychiatric hospital from May 2023 to December 2023 were selected and divided into two groups.The control group(May 2023 to August 2023)applied the conventional management model,and the observation group(September 2023 to December 2023)applied the PDCA cycle management.The hand hygiene compliance,hand hygiene knowledge,and hygiene qualifications were compared,including the amount of hand sanitizer used.Results:The proportion of medical staff’s hand hygiene compliance and hand hygiene knowledge mastery scores in the observation group were higher than those in the control group(P<0.05);the hand hygiene passing rate in the observation group was higher than that of the control group(P<0.05);the daily amount of hand sanitizer per patient bed and the amount of hand sanitizer used was higher than that of the control group(P<0.05).Conclusion:The PDCA cycle management model for psychiatric medical staff promoted the improvement of hand hygiene compliance and increased their hand hygiene qualifications.It is suitable for further popularization and application in future clinical practice.展开更多
Objective: to analyze the methods to improve the nursing quality in psychiatric department. Methods: A number of psychiatric patients in our hospital were randomly divided into humanistic management group and control ...Objective: to analyze the methods to improve the nursing quality in psychiatric department. Methods: A number of psychiatric patients in our hospital were randomly divided into humanistic management group and control group with 31 cases in each group. The improvement of mental status of the two groups was compared. Results: the anxiety score of the humanized management group after intervention was (37.52±4.33) points, as compared with (50.30±5.41) points of the control group (P < 0.05). Conclusion: humanistic management is beneficial to improve the mental state of patients with mental diseases and promote their physical and mental rehabilitation, with significant nursing effect.展开更多
At present, social development is rapidly, the economic level is constantly improving, people's life pressure is gradually enhanced, various mental diseases appear in people's vision. In recent years, the term...At present, social development is rapidly, the economic level is constantly improving, people's life pressure is gradually enhanced, various mental diseases appear in people's vision. In recent years, the term depression and anxiety disorder has been greatly mentioned, and people will gradually pay attention to it. Depression and anxiety have a great impact on physical and mental effects, which will seriously hinder the normal life of patients and reduce the quality of life. The disease factors and treatment methods of depression and anxiety disease have also been intensified in recent years. How to inhibit depression and anxiety disease research and clinical treatment are urgent problems to be solved at the current stage.展开更多
Objective: to explore the effect of applying high-quality nursing combined with psychotherapy in psychiatric schizophrenia nursing. Methods: from January 2020 to December 2021 in our hospital, 46 female patients with ...Objective: to explore the effect of applying high-quality nursing combined with psychotherapy in psychiatric schizophrenia nursing. Methods: from January 2020 to December 2021 in our hospital, 46 female patients with schizophrenia in the psychiatric department of our hospital were selected as the research objects, and the satisfaction degree of patients disease education, environment arrangement, personnel attitude, nursing operation, humanistic care, cognition degree of schizophrenia disease knowledge and compliance of schizophrenia treatment were observed and analyzed. Results: through the questionnaire survey, it was found that after the treatment, the patients satisfaction of disease education, environment arrangement, personnel attitude, nursing operation and humanistic care were 91.2%, 90.6%, 94.1%, 96.2% and 93.6% respectively. The satisfaction of the patients and their families was at a high level. Before treatment, the cognition degree of schizophrenia disease knowledge and the compliance of schizophrenia treatment were 83.12±12.36 and 84.23±12.45, and after treatment, the cognition degree of schizophrenia disease knowledge and the compliance of schizophrenia treatment were 89.12±12.55 and 91.12±13.49, the difference was statistically significant. After a period of treatment, 26 cases (56.52%) were effectively improved, 10 cases (21.74%) were improved, and the effective rate was 78.26%. Conclusion: the combination of high-quality nursing and psychotherapy can effectively improve patients cognitive level, enhance patients treatment compliance, improve patients and family members satisfaction with nursing, and effectively improve patients disease status.展开更多
Objective: to explore the effect of humanistic nursing in the nursing of psychiatric patients. Methods: 86 inpatients in the psychiatric department of our hospital from July 2019 to August 2021 were selected and divid...Objective: to explore the effect of humanistic nursing in the nursing of psychiatric patients. Methods: 86 inpatients in the psychiatric department of our hospital from July 2019 to August 2021 were selected and divided into the observation group (43 cases) and the control group (43 cases) according to the random number table method. The nursing satisfaction, SAS and SDS scores of the patients in the two groups were observed and analyzed. Results: the SAS and SDS scores of the observation group after nursing were 40.98 ± 4.69 and 41.21 ± 5.01 respectively, which were significantly lower than those of the control group 46.98 ± 4.88 and 47.36 ± 4.97, and the difference was statistically significant (P 0.05);The satisfaction rate of the observation group was 95.35%, which was significantly higher than that of the control group (74.42%), and the difference was statistically significant (P 0.05). Conclusion: humanized nursing can improve the nursing satisfaction of psychiatric patients, enhance the treatment compliance of patients, relieve the anxiety of patients, provide better treatment environment for patients, and promote the recovery of patients.展开更多
Introduction: Mechanical or physical restraint is an exceptional therapeutic resource to immobilize a subject and thus guarantee the safety of the patient and/or third parties in the face of high-risk behaviors, but i...Introduction: Mechanical or physical restraint is an exceptional therapeutic resource to immobilize a subject and thus guarantee the safety of the patient and/or third parties in the face of high-risk behaviors, but it entails multiple crossings (bioethical, philosophical, medical, psychological, legal). Framed in the so-called “safety culture” developed by the WHO, based on the Protocol for its implementation of the CABA and attentive to its frequent use in CABA by different hospital services (medical clinic, geriatrics, intensive care and medical guards) we consider it necessary its study in terms of compliance with the risks it entails and its management. Objectives: Identify regulatory compliance with the GCABA Mechanical restraint (MR) Protocol from a patient safety perspective, as well as describe the clinical and medicolegal aspects, and propose the usefulness of a tool for its management and control. Methodology: Observational, descriptive, transversal and prospective work through the analysis of Clinical Records with indication of MR using a rubric-type form. 177 cases were analyzed between September-November 2023 from three hospitals of the Government of the City of Buenos Aires, statistical parameters were applied and graphs were made. Results: Only 12.99% complied with the Protocol. In the mental health specialized hospital compliance was almost 5 times greater than in the general one, and in the emergency services compliance was 12 times greater than in Inpatient services. We found that the start or end time of MR was not recorded and only 43% described the causes/justifications for the indication (mostly in Emergency and Specialized hospitals), with the MR average time being shorter in Emergency. Conclusions: Only 1.3 out of 10 patients reliably completed the Protocol and it was mostly in the mental health specialized hospital and the emergency services. The results show non-compliance behavior in the application and management of the risk that the use of mechanical restraints entails, being causes for criminal litigation. We consider that the checklists are useful to complete the Protocol and thus provide security to patients and professionals.展开更多
文摘The heterogeneity of clinical presentations in psychiatric emergencies creates difficulties in the response by interdisciplinary Mental Health teams. This is aggravated and difficult when the care is carried out on public roads or the patient’s home, that is, it is a pre-hospital context. Our Psychiatric Emergency Hospital, located in the City of Buenos Aires, provides pre-hospital care with a psychiatric ambulance, which is then referred to general hospitals or other health system providers. Not all effectors in the network have the same resources and, at the time of the emergency, the reasons for consultation such as the patient’s clinic are heterogeneous and require the greatest effectiveness in the intervention that is taken. The triage system is a resource that allows the systematization of approaches against the multiplicity of reasons for consultation and presentation of mental pathologies in the emergency room, in addition to providing greater effectiveness in interventions, homogeneity for the health system and consensus among the health effectors. Framed in the Mental Health Law, and especially in the concept of risk, a triage proposal was designed for pre-hospital interventions by the psychiatric ambulance dependent on Hospital Alvear and under current legal regulations with the aim of homogenizing care and referrals with the highest rate of effectiveness to provide quality interdisciplinary medicine.
基金Supported by Suzhou Clinical Medical Center for Mood Disorders,No.Szlcyxzx202109Suzhou Key Laboratory,No.SZS2024016Multicenter Clinical Research on Major Diseases in Suzhou,No.DZXYJ202413.
文摘BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major depressive disorder(MDD)remain poorly understood.Aberrant resting-state functional connectivity(rsFC)in the amygdala,a key region implicated in emotional regulation and threat detection,is strongly implicated in depression and suicidal behavior.AIM To investigate rsFC alterations between amygdala subregions and whole-brain networks in adolescent patients with depression and suicide attempts.METHODS Resting-state functional magnetic resonance imaging data were acquired from 32 adolescents with MDD and suicide attempts(sMDD)group,33 adolescents with MDD but without suicide attempts(nsMDD)group,and 34 demographically matched healthy control(HC)group,with the lateral and medial amygdala(MeA)defined as regions of interest.The rsFC patterns of amygdala subregions were compared across the three groups,and associations between aberrant rsFC values and clinical symptom severity scores were examined.RESULTS Compared with the nsMDD group,the sMDD group exhibited reduced rsFC between the right lateral amygdala(LA)and the right inferior occipital gyrus as well as the left middle occipital gyrus.Compared with the HC group,the abnormal brain regions of rsFC in the sMDD group and nsMDD group involve the parahippocampal gyrus(PHG)and fusiform gyrus.In the sMDD group,right MeA and right temporal pole:Superior temporal gyrus rsFC value negatively correlated with the Rosenberg Self-Esteem Scale scores(r=-0.409,P=0.025),while left LA and right PHG rsFC value positively correlated with the Adolescent Self-Rating Life Events Checklist interpersonal relationship scores(r=0.372,P=0.043).CONCLUSION Aberrant rsFC changes between amygdala subregions and these brain regions provide novel insights into the underlying neural mechanisms of suicide attempts in adolescents with MDD.
基金funded by the Department of Mental Health,Ministry of Public Health
文摘Background Intimate partner violence(IPV) and sexual violence(SV) occur commonly and are a violation of basic human rights. There are limited studies to date that examine the impact of IPV, SV and mental health outcomes in Thailand.Aims The objective of the present study was to estimate the prevalence of intimate partner physical violence and IPV in Thai women and the association between these forms of violence and psychiatric disorders.Methods The present study used data from a national cross-sectional, population-based, household design survey. This study analysed data from 3009 female respondents above the age of 18 who were interviewed in person using the World Mental Health-Composite International Diagnostic Interview V.3.0(WMH-CIDI 3.0). We estimated the lifetime and the 12-month period prevalence of IPV and SV, the lifetime and the past 12-month period correlation of IPV/SV with psychiatric disorders and the OR for psychiatric disorders associated with these types of violence.Results There was only 5.2 % of the weighted sample that reported experiencing some form of violence, including reported rates of intimate partner physical violence of 3.5% and IPV of 2.0%. Women who had experienced IPV have a lifetime prevalence for common psychiatric disorders of 28.9%, for suicidal behaviours of 12.2% and for substance use disorders of 8.8%. Women who had experienced SV have a lifetime diagnoses for common psychiatric disorders of 21.4%, for suicidal behaviours of 16.5% and for substance use disorders of 19.4%. There was a statistically significant association between IPV/SV and being diagnosed with a psychiatric disorder during the past year and also during one's lifetime.Conclusion The association between IPV/SV and psychiatric disorders is significant; therefore, performing a formal assessment for a history of violence in psychiatric patients is often beneficial in refining the diagnosis and treatment.
基金This study was reviewed and approved by the Ethics Committee of The First Psychiatric Hospital of Harbin.
文摘BACKGROUND The literature has discussed the relationship between environmental factors and depressive disorders;however,the results are inconsistent in different studies and regions,as are the interaction effects between environmental factors.We hypo-thesized that meteorological factors and ambient air pollution individually affect and interact to affect depressive disorder morbidity.AIM To investigate the effects of meteorological factors and air pollution on depressive disorders,including their lagged effects and interactions.METHODS The samples were obtained from a class 3 hospital in Harbin,China.Daily hos-pital admission data for depressive disorders from January 1,2015 to December 31,2022 were obtained.Meteorological and air pollution data were also collected during the same period.Generalized additive models with quasi-Poisson regre-ssion were used for time-series modeling to measure the non-linear and delayed effects of environmental factors.We further incorporated each pair of environ-mental factors into a bivariate response surface model to examine the interaction effects on hospital admissions for depressive disorders.RESULTS Data for 2922 d were included in the study,with no missing values.The total number of depressive admissions was 83905.Medium to high correlations existed between environmental factors.Air temperature(AT)and wind speed(WS)significantly affected the number of admissions for depression.An extremely low temperature(-29.0℃)at lag 0 caused a 53%[relative risk(RR)=1.53,95%confidence interval(CI):1.23-1.89]increase in daily hospital admissions relative to the median temperature.Extremely low WSs(0.4 m/s)at lag 7 increased the number of admissions by 58%(RR=1.58,95%CI:1.07-2.31).In contrast,atmospheric pressure and relative humidity had smaller effects.Among the six air pollutants considered in the time-series model,nitrogen dioxide(NO_(2))was the only pollutant that showed significant effects over non-cumulative,cumulative,immediate,and lagged conditions.The cumulative effect of NO_(2) at lag 7 was 0.47%(RR=1.0047,95%CI:1.0024-1.0071).Interaction effects were found between AT and the five air pollutants,atmospheric temperature and the four air pollutants,WS and sulfur dioxide.CONCLUSION Meteorological factors and the air pollutant NO_(2) affect daily hospital admissions for depressive disorders,and interactions exist between meteorological factors and ambient air pollution.
基金Supported by the Faculty of Medicine,Chiang Mai University,No.046/2557Chiang Mai University,No.04/2562
文摘BACKGROUND Previous studies found several factors associated with suicide in schizophrenic patients,such as age,sex,education level,history of suicide attempts,psychotic symptoms,social factors,and substance abuse.However,there might be some additional factors that were not considered in previous studies but may be correlated with a greater likelihood of suicide attempts,such as medication and treatment.AIM To investigate the prevalence of suicide attempts and identify the risk of suicidality in hospitalized schizophrenia patients.METHODS This is a cross-sectional study of schizophrenic patients admitted to a psychiatric hospital who were 18 years of age or more.The outcomes and possible suicide risk factors in these patients were collated.The current suicide risk was evaluated using the mini-international neuropsychiatric interview module for suicidality and categorized as none(0 points),mild(1-8 points),moderate(9-16 points),or severe(17 or more points).This study used ordinal logistic regression to assess the association of potential risk factors with the current suicide risk in schizophrenic patients.RESULTS Of 228 hospitalized schizophrenia patients,214(93.9%)were included in this study.The majority(79.0%)of patients were males.Females appeared to have a slightly higher suicidality risk than males,with borderline significance.With regard to the current suicide risk assessed with the mini-international neuropsychiatric interview,172(80.4%)schizophrenic patients scored zero,20(9.4%)had a mild risk,8(3.7%)had a moderate risk,and 14(6.5%)had a severe risk.The total prevalence of current suicide risk in these schizophrenic patients was 19.6%.Based on multivariable ordinal logistic regression analysis with backward elimination,it was found that younger age,a current major depressive episode,receiving fluoxetine or lithium carbonate in the previous month,or a relatively higher Charlson comorbidity index score were all significantly and independently associated with a higher level of suicide risk.CONCLUSION The prevalence rate of suicide attempts in schizophrenia is high.Considering risk factors in routine clinical assessments,environmental manipulations and adequate treatment might prevent or decrease suicide in these patients.
基金This research was supported by grants from the Shanghai Municipal Health Commission(SMHC)(2019ZB0201)Shanghai Clinical Research Center for Mental Health(19MC1911100)SMHC Clinical Research Center(CRC2018ZD03).
文摘Background Obsessive-compulsive disorder(OCD)is considered a very debilitating disorder with severe loss of quality of life and income.Aims This study estimates the quality of life and economic consequences of OCD in China.Methods The research team interviewed 639 patients with OCD in 13 hospitals in 12 cities in China.The direct method was used to get the direct cost of OCD.Indirect costs associated with OCD were estimated using the human capital approach.Linear regression analysis was conducted for quality of life and generalised linear model analysis was conducted for total cost.Sensitivity analysis was used to analyse the uncertainty of total cost.Results The mean quality of life score for OCD was 52.78(20.46).The annual total cost of OCD per capita was 24503.78(95%CI:22621.53 to 26386.03)renminbi(RMB)(US$3465.88(95%CI:US$3199.65 to US$3732.11)).The annual cost of OCD in China was estimated to be 37.74 billion(95%CI:34.95 billion to 40.53 billion)RMB(equal to US$5.34 billion(95%CI:US$4.94 billion to US$5.73 billion)).Sensitivity analysis showed that the total annual cost of OCD in China was between 23.15 billion RMB(US$3.27 billion)and 370.00 billion RMB(US$52.33 billion).Worse social function status,more psychiatric symptoms and higher Yale Brown Obsessive-Compulsive Scale(Y-BOCS)score were associated with worse quality of life.The numbers of clinic visits and hospitalisations,socioeconomic status,education,Y-BOCS scores and age were found to be significantly associated with total cost.Conclusions OCD is associated with low quality of life and high costs in China.The findings call for concerted efforts to improve services for patients with OCD.Improvements may include early detection and diagnosis,the provision of evidence-based treatments and relapse prevention strategies.
文摘Explanatory models of co-morbid traits related to dental anxiety (DA) as described in the literature were tested and relative strengths analyzed in two groups of Danish adults, one with psychiatric diagnoses (n = 108) and the other healthy incoming patients at a large dental school teaching clinic (n = 151). Dental Anxiety Scale (DAS) and self-report measures representing three co-morbidity explanatory models, 1) presence of other fears;2) anxiety sensitivity and 3) feelings of vulnerability specific to dental treatment, were collected in subscales of a 53-item questionnaire. Other items identified gender, age, education, income, avoidance behavior and dental symptoms. Frequency, chi-square, odds ratio and logistic regression analyses were performed. Results: All individuals with high DA (DAS > 13) regardless of group, demonstrated significant differences in avoidance of treatment (>2 yr.) versus lower or no anxiety. Patients with psychiatric diagnoses were three times more likely to have high DA and nearly two times more likely to have avoided dental treatment >2 yr.;25.9% reported extreme DA, compared to 9.3% of controls. Models of high general fear levels, predisposing anxiety sensitivity and vulnerability all demonstrated significant and strong association with intensity of dental anxiety in bivariate analyses. Feelings of vulnerability were the strongest predictor of DAS high anxiety, according to logistic regression analyses. Conclusion: Co-morbidity explanatory models as represented in present trait measures appear not to be competitive, but rather explain different aspects of a vulnerability model in high dental anxiety. Higher incidence of DA and treatment avoidance in psychiatric patients requires special attention.
文摘Among all contaminants of emerging interest,drugs are the ones that give rise to the greatest concern.Any of the multiple stages of the drug's life cycle(production,consumption and waste management)is a possible entry point to the different environmental matrices.Psychiatric drugs have received special attention because of two reasons.First,their use is increasing.Second,many of them act on phylogenetically highly conserved neuroendocrine systems,so they have the potential to affect many non-target organisms.Currently,wastewater is considered the most important source of drugs to the environment.Furthermore,the currently available wastewater treatment plants are not specifically prepared to remove drugs,so they reach practically all environmental matrices,even tap water.As drugs are designed to produce pharmacological effects at low concentrations,they are capable of producing ecotoxicological effects on microorganisms,flora and fauna,even on human health.It has also been observed that certain antidepressants and antipsychotics can bioaccumulate along the food chain.Drug pollution is a complicated and diffuse problem characterized by scientific uncertainties,a large number of stakeholders with different values and interests,and enormous complexity.Possible solutions consist on acting at source,using medicines more rationally,eco-prescribing or prescribing greener drugs,designing pharmaceuticals that are more readily biodegraded,educating both health professionals and citizens,and improving coordination and collaboration between environmental and healthcare sciences.Besides,end of pipe measures like improving or developing new purification systems(biological,physical,chemical,combination)that eliminate these residues efficiently and at a sustainable cost should be a priority.Here,we describe and discuss the main aspects of drug pollution,highlighting the specific issues of psychiatric drugs.
文摘Background: Somatic symptoms that are not attributable to organic pathology are common in general practice settings however, data in most parts of Africa including southern Nigeria are still scarce. The aim of our study was to examine such somatic symptoms reported by patients attending a primary care facility at a tertiary hospital in southern Nigeria as well as to motivate future research in this area. Method: The study was conducted at the General Out Patient Clinic (GOPC) of the University of Calabar Teaching Hospital (UCTH). It was a cross sectional study in which data were obtained from the case notes of 115 patients that presented in the clinic with somatic complaints which could not be attributed to organic pathology by their physicians. Results: While 46 of the patients were males, 69 were females. Their mean age was 37.7 (SD = 11.9). Internal heat, crawling sensation, body pains and palpitations were the most prevalent symptoms reported by the patients. When the symptoms were sorted into various groups, the “subjective abnormal bodily sensation” was the most prevalent and far outnumbered the “pseudo neurological symptoms”. Conclusion: A number of patients attending the GOPC of the UCTH seek consultations for medically unexplained somatic symptom. The most prevalent of these symptoms are internal heat and crawling sensations both of which are not stated in the criteria recognized by the International Classification of Diseases—version 10 (ICD-10) for the diagnosis of psychiatric disorders.
文摘Acne vulgaris is a chronic inflammatory skin disorder which has a high prevalence among adolescents and young adults and can be associated with emotional and psychological burden on patients. This review aimed to explore psychological factors in patients with acne. Several forms of emotional distress and psychological complications can occur with acne. Such complications may be worse than the physical impact of the skin condition. Current literature suggests that skin changes in acne are associated with changed body image, psychological distress, anxiety, social phobia, suicidal ideation and depression. Population-based studies suggest a significant association between acne and mental distress among both male and female adolescents. Presence of psychological distress is related to severity of acne in some studies. However, other case-controlled studies suggest increased risk for psychological problems in patients with acne regardless of its severity. Stress is suspected to have a role in exacerbations of acne, and the quality of life (QoL) is affected particularly in cases with severe facial acne. Acne treatment can be associated with psychiatric side effects. Isotretinoin may be associated with depression and suicide attempts as shown in several studies but with conflicting results. On the other hand, psychotropic medications (such as antidepressants, antipsychotics and mood stabilizers) can also induce acne. The results of this review indicate the importance of vigilant psychiatric assessment for patients with acne, particularly those receiving isotretinoin, is needed for early diagnosis and treatment of the associated psychiatric co-morbidity.
文摘The Law on Tobacco Control of the Republic of Lithuania （issued in 1996） prohibits smoking in health care facilities. The security implementation is particularly problematic in psychiatric hospitals, where patients with adaptation problems are used to smoking feeling anxiety. Meanwhile, experts and scholars do not agree on the benefits or harm of smoking for individuals suffering from mental disorder. Republican Vilnius Psychiatric Hospital undertook an investigation of the attitudes of those mostly concerned--the patients, their relatives and the staff of the hospital, also of their views on the ways and feasibility to reduce smoking in the hospital. It was concluded that the main cause of patients＇ smoking is addiction, and hospital staff recognize that mental disorders contribute to the increase in dependency. Other reasons--smoking reduces tension, facilitates adaptation to environments, enhances contacts. Most patients and their relatives believe that smoking should not be banned, while the staff believes it should be prohibited in part by a variety of increasing of constraints. The most effective means to reduce smoking in the hospital would be rich leisure activities, education and professional help.
基金2023 Guangzhou Kangning Hospital Faculty Research Project(Project number:KN2023-008)。
文摘Objective:To evaluate the knowledge,compliance,and influencing factors of hand hygiene among psychiatric healthcare workers.Methods:68 healthcare workers who worked in the Department of Psychiatry between September 2023 and May 2024 were selected to assess their knowledge of hand hygiene and compliance by questionnaire as well as to analyze their influencing factors.Results:Knowledge of hand hygiene among healthcare workers was less than 90%,and doctors’knowledge was lower than that of nurses(P<0.05).The healthcare workers’compliance with hand hygiene was lower than 80%,and the adherence of doctors was lower than that of nurses(P<0.05).Analysis of influencing factors reveals that skepticism about the effectiveness of rapid disinfectants/hand washing,skin irritation from disinfectants/cleaning agents,and busy work schedules with time constraints are the main factors affecting healthcare workers’compliance with hand hygiene,with P<0.05 compared with the same group.Conclusion:Psychiatric healthcare workers’knowledge of hand hygiene as well as compliance with it is low,and there are various factors affecting it,so targeted training is required to strengthen their hand hygiene implementation.
文摘Objective: to explore the effect of continuous improvement of nursing quality by using sensitive indicators of nursing quality in the nursing process of psychiatric patients. Methods: from January 2017 to June 2018, 56 patients in the psychiatric department of our hospital were selected by random number table method for retrospective analysis as the control group. Since July 2018, our hospital has applied nursing quality sensitive indicators, and 61 patients were selected by random number table method as the study group. Analyze the clinical nursing quality, BPRS score and IPROS score. Results: the quality of clinical nursing in the control group was inferior to that in the study group (P < 0.05), indicating that the difference was statistically significant;the BPRS score of the study group was better than that of the control group (P < 0.05), indicating that the difference was statistically significant;the IPROS score of the study group was better than that of the control group (P < 0.05), indicating that the difference was statistically significant. Conclusion: in the continuous improvement of psychiatric nursing quality, the application of nursing quality sensitive indicators is helpful to improve the quality of nursing and alleviate the mental illness of patients.
基金2023 Guangzhou Kangning Hospital Hospital-Level Scientific Research Project(KN2023-008)。
文摘Objective:To study the application effect of the plan-do-check-act(PDCA)cycle management in the hand hygiene management of psychiatric medical staff.Methods:One hundred and twenty medical staff from a psychiatric hospital from May 2023 to December 2023 were selected and divided into two groups.The control group(May 2023 to August 2023)applied the conventional management model,and the observation group(September 2023 to December 2023)applied the PDCA cycle management.The hand hygiene compliance,hand hygiene knowledge,and hygiene qualifications were compared,including the amount of hand sanitizer used.Results:The proportion of medical staff’s hand hygiene compliance and hand hygiene knowledge mastery scores in the observation group were higher than those in the control group(P<0.05);the hand hygiene passing rate in the observation group was higher than that of the control group(P<0.05);the daily amount of hand sanitizer per patient bed and the amount of hand sanitizer used was higher than that of the control group(P<0.05).Conclusion:The PDCA cycle management model for psychiatric medical staff promoted the improvement of hand hygiene compliance and increased their hand hygiene qualifications.It is suitable for further popularization and application in future clinical practice.
文摘Objective: to analyze the methods to improve the nursing quality in psychiatric department. Methods: A number of psychiatric patients in our hospital were randomly divided into humanistic management group and control group with 31 cases in each group. The improvement of mental status of the two groups was compared. Results: the anxiety score of the humanized management group after intervention was (37.52±4.33) points, as compared with (50.30±5.41) points of the control group (P < 0.05). Conclusion: humanistic management is beneficial to improve the mental state of patients with mental diseases and promote their physical and mental rehabilitation, with significant nursing effect.
文摘At present, social development is rapidly, the economic level is constantly improving, people's life pressure is gradually enhanced, various mental diseases appear in people's vision. In recent years, the term depression and anxiety disorder has been greatly mentioned, and people will gradually pay attention to it. Depression and anxiety have a great impact on physical and mental effects, which will seriously hinder the normal life of patients and reduce the quality of life. The disease factors and treatment methods of depression and anxiety disease have also been intensified in recent years. How to inhibit depression and anxiety disease research and clinical treatment are urgent problems to be solved at the current stage.
文摘Objective: to explore the effect of applying high-quality nursing combined with psychotherapy in psychiatric schizophrenia nursing. Methods: from January 2020 to December 2021 in our hospital, 46 female patients with schizophrenia in the psychiatric department of our hospital were selected as the research objects, and the satisfaction degree of patients disease education, environment arrangement, personnel attitude, nursing operation, humanistic care, cognition degree of schizophrenia disease knowledge and compliance of schizophrenia treatment were observed and analyzed. Results: through the questionnaire survey, it was found that after the treatment, the patients satisfaction of disease education, environment arrangement, personnel attitude, nursing operation and humanistic care were 91.2%, 90.6%, 94.1%, 96.2% and 93.6% respectively. The satisfaction of the patients and their families was at a high level. Before treatment, the cognition degree of schizophrenia disease knowledge and the compliance of schizophrenia treatment were 83.12±12.36 and 84.23±12.45, and after treatment, the cognition degree of schizophrenia disease knowledge and the compliance of schizophrenia treatment were 89.12±12.55 and 91.12±13.49, the difference was statistically significant. After a period of treatment, 26 cases (56.52%) were effectively improved, 10 cases (21.74%) were improved, and the effective rate was 78.26%. Conclusion: the combination of high-quality nursing and psychotherapy can effectively improve patients cognitive level, enhance patients treatment compliance, improve patients and family members satisfaction with nursing, and effectively improve patients disease status.
文摘Objective: to explore the effect of humanistic nursing in the nursing of psychiatric patients. Methods: 86 inpatients in the psychiatric department of our hospital from July 2019 to August 2021 were selected and divided into the observation group (43 cases) and the control group (43 cases) according to the random number table method. The nursing satisfaction, SAS and SDS scores of the patients in the two groups were observed and analyzed. Results: the SAS and SDS scores of the observation group after nursing were 40.98 ± 4.69 and 41.21 ± 5.01 respectively, which were significantly lower than those of the control group 46.98 ± 4.88 and 47.36 ± 4.97, and the difference was statistically significant (P 0.05);The satisfaction rate of the observation group was 95.35%, which was significantly higher than that of the control group (74.42%), and the difference was statistically significant (P 0.05). Conclusion: humanized nursing can improve the nursing satisfaction of psychiatric patients, enhance the treatment compliance of patients, relieve the anxiety of patients, provide better treatment environment for patients, and promote the recovery of patients.
文摘Introduction: Mechanical or physical restraint is an exceptional therapeutic resource to immobilize a subject and thus guarantee the safety of the patient and/or third parties in the face of high-risk behaviors, but it entails multiple crossings (bioethical, philosophical, medical, psychological, legal). Framed in the so-called “safety culture” developed by the WHO, based on the Protocol for its implementation of the CABA and attentive to its frequent use in CABA by different hospital services (medical clinic, geriatrics, intensive care and medical guards) we consider it necessary its study in terms of compliance with the risks it entails and its management. Objectives: Identify regulatory compliance with the GCABA Mechanical restraint (MR) Protocol from a patient safety perspective, as well as describe the clinical and medicolegal aspects, and propose the usefulness of a tool for its management and control. Methodology: Observational, descriptive, transversal and prospective work through the analysis of Clinical Records with indication of MR using a rubric-type form. 177 cases were analyzed between September-November 2023 from three hospitals of the Government of the City of Buenos Aires, statistical parameters were applied and graphs were made. Results: Only 12.99% complied with the Protocol. In the mental health specialized hospital compliance was almost 5 times greater than in the general one, and in the emergency services compliance was 12 times greater than in Inpatient services. We found that the start or end time of MR was not recorded and only 43% described the causes/justifications for the indication (mostly in Emergency and Specialized hospitals), with the MR average time being shorter in Emergency. Conclusions: Only 1.3 out of 10 patients reliably completed the Protocol and it was mostly in the mental health specialized hospital and the emergency services. The results show non-compliance behavior in the application and management of the risk that the use of mechanical restraints entails, being causes for criminal litigation. We consider that the checklists are useful to complete the Protocol and thus provide security to patients and professionals.
