What makes community psychiatric nurses label non-psychotic chronic patients as ‘difficult’: patient, professional, treatment and social variables

Contains fulltext : 99981.pdf (publisher's version ) (Open Access)Purpose To determine which patient, professional, treatment and/or social variables make community psychiatric nurses (CPNs) label non-psychotic chronic patients as ‘difficult’. Methods A questionnaire was designed and administered to 1,946 CPNs in the Netherlands. Logistic regression was used to design models that most accurately described the variables that contributed to perceived difficulty. Results Six variables were retained in the final logistic model. Perception-related variables (feeling powerless, feeling that the patient is able but unwilling to change, and pessimism about the patient’s change potential) dominated treatment-related variables (number of contacts per week and admission to a locked ward in the last year) and social variables (number of psychosocial problems). Conclusion This research shows that perceived difficulty is related to complex treatment situations, not so much to individual patient characteristics. If the constructed model has good predictive qualities, which remains to be tested in longitudinal research, it may be possible to accurately predict perceived patient difficulty. When used as a screening tool, such a model could improve treatment outcomes.9 p

What do individuals with schizophrenia need to increase their well-being

The aim of this qualitative study was to deepen the knowledge of how individuals with schizophrenia themselves describe what they need in order to increase their well-being in everyday life. Seven patients were interviewed. An open explorative approach was applied and grounded theory was used for the analysis resulting in five categories illustrating how patients with schizophrenia handle their struggle for a normal life. The patients stressed first the importance of receiving information about the disease: for themselves, for society, and for their families. Taking part in social contacts such as attending meeting places and receiving home visits were identified as important as well as having meaningful employment. They also pointed out the importance of taking part in secure professional relationships. Mainly they expressed the need for continuity in the relationships and the wish to be heard and seen by the professionals. Finally, interviewees addressed the need for support for sustaining independent living through practical housekeeping and financial help. To conclude, the participants in the present study described their need for help as mainly linked to activities in their overall life situation rather than just their psychosis

Quality of Life in Metabolic Risk Patients with Psychosis in Relation to the Population

BackgroundThe International Diabetes Federation (IDF)(2004) has defined criteria for metabolic syndrome and in patients with schizophrenia four of ten meet the criteria for having the syndrome. Its important too study more about the influence of metabolic syndrome because there association with high morbidity and increased risk of influence on patients health and the treatment itself The aim of the study was to investigate metabolic risk factors influence on quality of life. The method was a prospective cohort study from specialized psychiatric outpatients departments in Sweden. The study recruits consecutively patients diagnosed with schizophrenia and other long-term psychotic disorders (ICD10). A prospective population based study is serving as a control group. Patients are assessed with a psychiatric questionnaire witch included CGI and GAF. Health-related quality of life assessed using the questionnaire EQ5D both in patients and population and health status with BMI, smoke habits and alcohol consume.ResultsThe results on patients (n = 777) and population (n = 7238) showed significant differences in lower EQ5D Index in man especially in younger age. The diagnosis of schizophrenia and schizoaffective were the most common in the patient group (n = 481). In patients was nearly 50% non alcoholic users compared to the control group (=population) were the non consumers was 18%. BMI over 35 were more common in the patient group than in the population 13.2% versus 2.8%.ConclusionIn conclusion there were differences in quality of life between metabolic risk patients with psychosis and the control group.</jats:sec

To cite: Josefsson A,

Continuation rates of oral hormonal contraceptives in a cohort of first-time users: a population-based registry study, Sweden 2005