The effect of structural and functional changes in a psychiatric state hospital on the quality of psychiatric treatment

2013 ◽  
Vol 14 (2) ◽  
pp. 100
Author(s):  
Mustafa Bilici ◽  
Ergun Sevinc ◽  
Cuneyt nsal ◽  
Aytul Hariri ◽  
Hulya Ensari
Keyword(s):  
State Hospital ◽  
Psychiatric Treatment ◽  
Functional Changes ◽  
Psychiatric State

HASTANELERİN HİZMET KALİTESİNİN HASTA TATMİN ÖLÇEĞİ İLE ÖLÇÜLMESİ: KARABÜK DEVLET HASTANESİNDE YATAN HASTALAR ÜZERİNDE BİR ARAŞTIRMA THE MEASUREMENT SERVICE QUALITY OF THE HOSPITALS BY THE PATIENT SCALE: A RESEARCH ON THE PATIENTS IN KARABUK STATE HOSP

2013 ◽  
Vol 1 (1) ◽  
pp. 100
Author(s):  
Selçuk Yurtsever
Keyword(s):  
Patient Satisfaction ◽  
Health Services ◽  
Literature Review ◽  
Private Sector ◽  
State Hospital ◽  
Continuous Change ◽  
Satisfaction Scale ◽  
The World ◽  
Main Factors

It has been known that both in the world and in Turkey a continuous change has been experienced in the provision of health services in recent years. In this sense by adopting the customer(client) focused approach of either public or private sector hospitals; it has been seen that they are in the struggle for presenting a right, fast, trustuble, comfy service. The purpose of this research is to measure the satisfaction degree, expectations and perceptions of the patients in Karabük State Hospital through comparison. In this context, the patient satisfaction scale which has been developed as a result of literature review has been used and by this scale it has been tried to measure the satisfaction levels of the patients in terms of material and human factors which are the two main factors of the service that was presented. In the study, with the scales of Servqual and 0-100 Points together, in the part of the analysis MANOVA have been used. The expectations and the perceptions of the patient has been compared first by generally and then by separating to different groups according to the various criterias and in thisway it has been tried to be measured their satisfaction levels. According to the results that were obtained, although, the satisfaction levels of the patients who have taken service from Karabük State Hospital are high in terms of thedoctors and the nurses; it has been reached to the result that their satisfaction levels are low in terms of the materials that have been used at the presenting of the service and the management.

scholarly journals Effectiveness and cost effectiveness of interpersonal community psychiatric treatment (ICPT) for people with long-term severe non-psychotic mental disorders: a multi-Centre randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mark van Veen ◽  
Bauke Koekkoek ◽  
Steven Teerenstra ◽  
Eddy Adang ◽  
Cornelis L. Mulder
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Cost Effectiveness ◽  
Community Mental Health ◽  
Mental Health Treatment ◽  
Psychiatric Treatment ◽  
Illness Management ◽  
Illness Management And Recovery ◽  
Perceived Difficulty

Abstract Background Long-term community mental health treatment for non-psychotic disorder patients with severe mental illness (SMI) who are perceived as difficult by clinicians, is poorly developed and lacks a structured, goal-centred approach. This study compares (cost-)effectiveness of Interpersonal Community Psychiatric Treatment (ICPT) with Care As Usual (CAU) on quality of life and clinician perceived difficulty in the care for non-psychotic disorder SMI-patients. A multi-centre cluster-randomized clinical tria was conducted in which Community Mental Health Nurses (Clinicians) in three large community mental health services in the Netherlands were randomly allocated to providing either ICPT or CAU to included patients. A total of 56 clinicians were randomized, who treated a total of 93 patients (59 in ICPT-group and 34 in CAU-group). Methods Primary outcome measure is patient-perceived quality of life as measured by the Manchester Short Assessment of Quality of Life (MANSA). Secondary outcome measures include clinician-perceived difficulty, general mental health, treatment outcomes, illness management and recovery, therapeutic relationship, care needs and social network. Patients were assessed at baseline, during treatment (6 months), after treatment (12 months) and at 6 months follow-up (18 months). Linear mixed-effects models for repeated measurements were used to compare mean changes in primary and secondary outcomes between intervention and control group of patients over time on an intention to treat basis. Potential efficiency was investigated from a societal perspective. Economic evaluation was based on general principles of a cost-effectiveness analysis. Outcome measures for health economic evaluation, were costs, and Quality Adjusted Life Years (QALYs). Results Half of the intended number of patients were recruited. There was no statistically significant treatment effect found in the MANSA (0.17, 95%-CI [− 0.058,0.431], p = 0.191). Treatment effects showed significant improvement in the Different Doctor-Patient Relationship Questionnaire-scores and a significant increase in the Illness Management and Recovery–scale Client-version scores). No effects of ICPT on societal and medical costs nor QALYs were found. Conclusions This is the first RCT to investigate the (cost)-effectiveness of ICPT. Compared with CAU, ICPT did not improve quality of life, but significantly reduced clinician-perceived difficulty, and increased subjective illness management and recovery. No effects on costs or QALY’s were found. Trial registration NTR 3988, registered 13 May 2013.

The twelve-month outcome of patients with neurotic illness in general practice

1981 ◽  
Vol 11 (3) ◽  
pp. 535-550 ◽  
Author(s):  
A. H. Mann ◽  
R. Jenkins ◽  
E. Belsey
Keyword(s):  
Social Life ◽  
Function Analysis ◽  
Psychiatric Morbidity ◽  
The Social ◽  
Assessment Measures ◽  
Psychiatric State ◽  
One Year

SYNOPSISOne hundred patients, selected to be representative of those attending general practitioners with non-psychotic psychiatric disorders were followed up for one year. standard assessments of mental state, personality, social stresses and supports were carried out for each patient at the outset and after a year.The outcome for this cohort determined both by the level of psychiatric morbidity at interview after one year and by the pattern of the psychiatric morbidity during the year has been analysed with reference to the assessment measures. Discriminant function analysis indicates that the initial estimate of the severity of the psychiatric morbidity and a rating of the quality of the social life at the time of follow-up are the only factors that significantly predict the psychiatric state after one year. Social measures also predict a pattern of illness charactorized by a rapid recovery after the initial assessemtn. Patients who reported continuous psychiatric morbidity during the year were, older, physically ill and very likely to have recevied psychotropic drugs. Receipt of this medication during the year was associated with initial assessments of abnormality of personality, older age, and a diagnosis of depression.The findings of this study are seen to support a triaxial assessment and classification of non-psychotic psychiatirc disorders, with symptoms, personality and social state being rated independently.

Schizophrenic Patients in Different Treatment Settings During the Era of Deinstitutionalization: Three-Year Follow-Up of Three Discharge Cohorts in Finland

2003 ◽  
Vol 37 (2) ◽  
pp. 160-168 ◽  
Author(s):  
Teija Honkonen ◽  
Hasse Karlsson ◽  
Anna-Maija Koivisto ◽  
Eija Stengård ◽  
Raimo K.R. Salokangas
Keyword(s):  
Psychosocial Functioning ◽  
Psychiatric Treatment ◽  
Structured Interview ◽  
Global Assessment Scale ◽  
Use Of Services ◽  
Schizophrenic Patients ◽  
Nationally Representative ◽  
Somatic State ◽  
Treatment Settings

Objective: We investigated differences in psychosocial and clinical characteristics, as well as the use of services, of schizophrenic patients in different treatment settings three years after their discharge from a psychiatric hospital. Furthermore, we examined secular changes in these phenomena during the era of rapid deinstitutionalization in Finland. Method: Three nationally representative samples comprised 3257 schizophrenic patients who had been discharged in 1986, 1990 and 1994. The patients were interviewed three years after discharge by each district's psychiatric professionals using a structured interview schedule specifically designed for the purposes of the present study. Psychosocial functioning was assessed on the Global Assessment Scale and on a modified version of the Medical Research Council Practices Profile. Results: In the 1990s, more patients with a poor clinical and psychosocial state were transferred from hospital to alternative outpatient facilities, such as sheltered workshops or supported residences. In successive cohorts, the proportion of patients who had dropped out of treatment decreased and the psychiatric and somatic state of the drop-outs improved. Conclusion: In general, the psychiatric treatment system has worked well for most deinstitutionalized patients. In the future, however, it is important that the quality of care and adequate resources in the alternative outpatient facilities are ensured.

scholarly journals Structural and Functional Disorders in Glaucoma: the Prospects for Preclinical Diagnosis. Part 1. Is the Search for what Comes First Relevant?

2020 ◽  
Vol 17 (3) ◽  
pp. 336-343 ◽  
Author(s):  
V. V. Neroev ◽  
M. V. Zueva ◽  
A. N. Zhuravleva ◽  
I. V. Tsapenko
Keyword(s):  
Functional Neuroimaging ◽  
Open Angle Glaucoma ◽  
Ocular Blood Flow ◽  
Illusory Correlation ◽  
Functional Changes ◽  
Close Relationship ◽  
Preclinical Diagnosis ◽  
Modern Technologies ◽  
New Strategies

The review analyzes the capabilities of modern technologies of structural neuroimaging of the retina, standard perimetry, and studies of ocular blood flow in the early diagnosis and management of glaucoma. The relevance of the search for those structural and functional changes that are primary in the development of glaucomatous optical neuropathy (GON) and the diagnostic method that has the greatest clinical significance is discussed. Progress in understanding the pathogenesis of glaucoma and the expansion of scientific understanding of key risk factors for the development and progression of the disease, including genetic factors, can be crucially important to substantiate new strategies for preclinical diagnosis and the development of radically new approaches to personalized and preventive glaucoma therapy. However, the search for what arises most early with in primary open-angle glaucoma — changes in structure or function — will not have clinical relevance unless you take into account the capabilities of specific methods of structural and functional neuroimaging that represent information at various levels of organization of the visual system. The search for a single primary factor in the pathogenesis of GON can lead to an erroneous exaggeration of the close relationship between the variables being studied, which in reality either does not exist as a causal relationship or is significantly less than what is supposed — the phenomenon called “illusory correlation”. The reliable diagnosis of early changes that occur before the clinical manifestation of glaucoma is most likely to be based on a combination of structural, functional, and hemodynamic indicators, aimed not only to increase the sensitivity of diagnosis in detecting the earliest events in the development of GON, but rather to dramatically improve the understanding and quality of interpretation of those markers that we own.

scholarly journals Clinico-expert diagnostics of gastrointestinal form of diabetic neuropathy

2011 ◽  
Vol 14 (2) ◽  
pp. 94-97
Author(s):  
Irina Alekseevna Kurnikova ◽  
Tatiana Evgen'evna Chernyshova ◽  
Irina Vladimirovna Gur'eva ◽  
Guzyal' Ilgisovna Kliment'eva
Keyword(s):  
Gastrointestinal Tract ◽  
Diabetic Neuropathy ◽  
Diabetic Patients ◽  
Parasympathetic Innervation ◽  
Gastric Tone ◽  
Functional Changes ◽  
Gastrointestinal Pathology ◽  
Upper Gastrointestinal

Aim. To estimate dynamics of secretory and motor-evacuational functions of the stomach in patients with type 1 diabetes mellitus and gastrointestinalform of diabetic neuropathy. Materials and methods. 32 patients with DM1 without gastrointestinal pathology allocated to different groups depending on DM duration (gr. 1 lessthan 10 yr, gr. 2 over 10 yr). Vegetative equilibrium was estimated from the Kerdo index, rehabilitative potential from its basic constituent (morphophysiologicalindex). The motor-evacuational function of the stomach was studied with the use of a scintillation gamma-chamber, the gastric secretoryfunction by pH measurements. Results. Half of the patients in gr 2 presented with hypersympathicotony. The frequency of hypertonic form of gastric tone increased with durationof DM while the acid-producing and evacuational functions of the stomach decreased (as estimated by pH-measurement and gastroscintiographyrespectively). The propulsive function most significantly decreased in the pyloric part. The efficacy of rehabilitation of diabetic patients with gastrointestinalform of diabetic neuropathy was much lower than in those with preserved vegetative function of the stomach. Conclusion. Impairment of evacuational function of the stomach and duodenum with DM1 duration may be a cause of unstable blood glucose level.Hypomotor dyskinesia of the upper gastrointestinal tract due to DM1 and deficit of parasympathetic innervation occurs more frequently in patientswith low rehabilitative potential. Functional changes in the gastrointestinal tract of DM1 patients do not depend on the quality of compensation ofmetabolic disorders but correlate (r=-0.39) with DM duration. It is concluded that the gastrointestinal form of diabetic neuropathy impairs rehabilitativepotential of fhe patients.

scholarly journals Cosmetic Gynecology: Present and Future Perspectives

2021 ◽  
Vol 6 (11) ◽  
pp. 845-853
Author(s):  
Prabhu Chandra Mishra ◽  
Diana Mihai ◽  
Nidhi Khurana ◽  
Manar Jabbar
Keyword(s):  
Well Being ◽  
Physical Structure ◽  
Fat Grafting ◽  
Functional Changes ◽  
Non Invasive ◽  
High Prevalence ◽  
Regulatory Guidelines ◽  
Stem Cells Therapy ◽  
Cosmetic Gynecology

Postmenopausal women and events like childbirth, and aging may cause structural and functional changes in women genitalia. The arising indications do not only cause psychological distress to women but negatively affect the sexual well-being and deteriorate the quality of their lives. Regenerative/ cosmetic gynecology procedures enable women to treat the functionality issues and modify the physical structure of vagina. This review discusses the latest developments in this field with regards to various kinds of procedures that are available, particularly the use of energy-based devices, and adipose tissue derived stem cells therapy for fat grafting which have revolutionized the regenerative gynecology procedures. These offer non-invasive modalities to treat the conditions like urinary incontinence among others which occur in high prevalence among women. Despite the advancements made in this field, it lacks regulatory guidelines and standardized procedures which imposes one of the biggest challenges of the field. Alongside, we have documented a procedure called Intimacell® which has been standardized for fat grafting procedures in vulvovaginal region.

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