Mental Rehabilitation Research Articles

Improving the efficiency and person-centredness of occupational therapy input into care-plans in a forensic mental health and rehabilitation service

Care-planning is vital to the delivery of timely, person-centred, safe and effective care. Despite the understanding of the benefits of person-centred care-plan in both services, occupational therapists (OTs) within our...

Unlocking the mentally ill in Indonesia: An empirical study of the effectiveness of a "Bebas Pasung" program in Central Java.

Locking or confinement of persons with severe mental illness has been common in Indonesia. In 2010, the Ministry of Health declared a policy that persons who were locked (pasung) should be unlocked or freed (bebas) from confinement and provided mental health services. This study is an empirical evaluation of the effectiveness of one Bebas Pasung program in Indonesia at two-year follow-up. From medical records in Soerojo Mental Hospital, Magelang, Central Java, 114 persons with severe mental illness who had been unlocked, treated, and returned to the community from four districts served by the hospital were identified. At two-year follow-up, 62 caregivers were able to be contacted and willing to participate in a study. Data were collected from hospital records about condition of the patient at time of "unlocking" and at discharge, and primary caregivers were interviewed about the previous locking and care of the patient since return, as well as experiences of caregiving. We provide descriptive data concerning history of illness, reasons for locking, type of confinement, and care of the individual since return. 58% of those unlocked were men, 80% had diagnoses of schizophrenia, and mean age was 35. At follow-up, 24% of this sample had been re-locked; only 44% took medications regularly, including 33% of those re-locked and 47% of those not relocked. A majority cared for themselves, half were partially or fully productive, and the quality of life of family caregivers improved significantly since their family member was unlocked, treated, and returned home. This program successfully unlocked, treated, and returned to their homes persons with severe mental illness living in pasung or restraints. Findings suggest such unlocking programs need to be linked more closely to community-based mental health and rehabilitation services, maintain care of the patient, and provide a path toward recovery.

The Relationship between Erectile Dysfunction, Self-Esteem, and Depression in Post-Myocardial Infarction Patients.

Background: The interplay between the physical and mental health of patients recovering from myocardial infarction (MI) is crucial. Erectile dysfunction (ED) is a common sexual issue, particularly among patients who have had a myocardial infarction and arterial diseases, and it significantly affects self-esteem and overall psychological well-being. Despite significant advances in cardiac rehabilitation, the psychosocial aspects, especially those related to sexual health, remain underexplored. Objectives: The objective of this study was to examine the relationship between ED, self-esteem, and depression in male patients post-MI, and to assess how ED treatment affects patients' psychological health. Methods: This cross-sectional study involved 80 male patients with a confirmed MI within the last six months, aged between 35 and 77 years. The Beck Depression Inventory-II (BDI-II) and Rosenberg Self-Esteem Scale (SES) were used to assess psychological well-being, while the International Index of Erectile Function-5 (IIEF-5) was employed specifically to evaluate ED. Results: This study demonstrates a strong interdependence between mental and physical health in post-myocardial infarction (MI) patients, with ED being a key factor affecting self-esteem. There is a significant negative correlation between self-esteem and depression, highlighting the importance of psychological resilience in post-MI rehabilitation. Elevated self-esteem helps mitigate depressive symptoms, contributing to improved mental health and rehabilitation outcomes. Conclusions: Older patients tend to have lower self-esteem, likely due to the presence of multiple comorbidities and a longer, more challenging recovery period post-MI. Age was a significant factor in predicting lower self-esteem, but other demographic characteristics did not have a strong influence on self-esteem, depression, or ED.

Development of an evaluation list for older adult community-based rehabilitation needs through a Delphi method

Older adults’ functional and intrinsic abilities may decline with increasing age. The positive effects of comprehensive community-based rehabilitation services to maintain physical, mental, and social function are essential. Nevertheless, few tools are available to assess the community-based rehabilitation needs of older adults. Therefore, we aimed to construct a list for the comprehensive evaluation of community-based rehabilitation needs of older adults. The International Classification of Functioning, Disability, and Health (ICF) was used to construct a first draft of the assessment list. From September to November 2023, 18 experts from five provinces and nine tertiary hospitals and institutions of higher education in China participated in this Delphi study. The older adult community-based rehabilitation needs evaluation list included six dimensions and 29 items. The weights of the six dimensions, from high to low, included mental function rehabilitation need (0.30), body function rehabilitation need (0.24), social participation need (0.18), individual activity rehabilitation need (0.14), environmental rehabilitation need (0.09) and rehabilitation information need (0.05). Using the Delphi method, an assessment list of older adult community-based rehabilitation needs based on ICF was developed. Future work should evaluate the list’s reliability and validity and its application in managing community-based rehabilitation for older adults.

Long COVID syndrome: An unfolding enigma.

Post-acute sequelae of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease (COVID-19), called as long COVID syndrome, is a major global public health issue after recovery from COVID-19. The disease occurs in symptomatic patients irrespective of illness severity. The symptoms continue after four wk of recovery from acute illness and persist beyond three months. Risk factors for long COVID include older age, female gender, multiple co-morbidities including diabetes mellitus, prior chronic respiratory illnesses, hospitalized patients with severe disease, especially receiving assisted ventilation, high viral load, reactivation of Epstein Barr (EB) virus and human herpes virus 6 (HH6), circulating auto antibodies against various organs and type I interferon. The prevalence varies from 10 to 20 per cent, and most data have been reported from high-income countries. Any system can get involved in long COVID. The symptoms include fatigue, cognition impairment, cough and dyspnoea, anosmia, hair loss and diarrhoea, among others. While there are no laboratory tests for confirmation of diagnosis, reduced complement C7 complexes at six months, and a two-gene biomarker including FYN and SARS-CoV-2 antisense ribonucleic acid (RNA) are emerging as potentially useful biomarkers for long COVID. There should be no alternative disease to explain various symptoms. Vaccination against SARS-CoV-2 and early use of oral antiviral nirmatrelvir within the first five days in patients with acute mild disease having various risk factors for progression to severe disease help in preventing long COVID. Several clinical trials are underway for the treatment of long COVID and the results of these are eagerly awaited. Physical and mental rehabilitation at home, at community level or in the hospital setting as appropriate is essential in patients with long COVID.

Designing Mental Disorder Rehabilitation Facilities in Medan Using a Healing Architectural Approach

Designing Mental Disorder Rehabilitation Facilities in Medan Using a Healing Architectural Approach

Utilising co-design to develop a lived experience informed personal safety tool within a mental health community rehabilitation setting.

Mental health personal safety tools aim to promote a recovery focus and empower an individualised approach to consumer care. These clinical tools are predominantly utilised in acute mental health settings with a person during or straight after a crisis. There is currently a gap in the literature regarding the preparation of personal safety tools in non-acute mental health settings. This descriptive article discusses the learnings and outcomes from a co-designed project that aimed to develop a personal safety tool suitable for a community mental health rehabilitation setting. Seven people with lived experience engaging within a mental health community-based rehabilitation service were recruited through convenience sampling to participate in the co-design project. A focus group approach was utilised during four group meetings to develop a personal safety tool template. Experiences and ideas about safety planning were transcribed during meetings and thematic analysis extracted key themes. Five steps underpinned the co-design process that included identifying the need, establishing the co-design group, planning, design and development, and review and closure. Consumer involvement commenced at step two of the co-design process. The completed personal safety tool was designed with consumer input and review. The personal safety tool consisted of nine intervention components. Four key themes emerged from focus group meetings that informed the content of the tool: (i) ensuring the personal safety tool is individualised and meaningful, (ii) promoting exploration of personal strengths and interests, (iii) enabling opportunities to learn self-management skills, and (iv) treating the personal safety tool as a dynamic and adaptable tool. Findings suggest that a personal safety tool targeted to a mental health community-based rehabilitation setting should have an individualised and preventative focus to mental health care. Embedding co-design principles can support opportunities for meaningful consumer engagement and establishing consumer and clinician partnerships.

Review on the use of AI-based methods and tools for treating mental conditions and mental rehabilitation

Review on the use of AI-based methods and tools for treating mental conditions and mental rehabilitation

Exploring the Quality-of-Care Dynamics of Inpatient Psychosocial Rehabilitation in Community-Based Mental Health Services: A Comprehensive Analysis.

This study aims to investigate the intricacies of inpatient psychosocial rehabilitation by examining a community-based mental health inpatient rehabilitation service in Nova Scotia, Canada. It provides a comparative analysis with national standards using the Quality Indicator for Rehabilitative Care (QuIRC) and offers recommendations for improvement. The study will link findings to research on enhancing specific domains, focusing on strategies to address identified challenges and leverage opportunities to meet or exceed national benchmarks in promoting recovery and social inclusion. This study utilizes the QuIRC as a primary assessment tool to evaluate the quality of care in psychiatric and psychosocial rehabilitation care unit. The QuIRC assessment findings reveal crucial insights across several domains, including the living and therapeutic environment, treatments and interventions, self-management and autonomy, social interface, human rights, and recovery-based practices. The study identifies strengths and areas for improvement by comparing unit scores with national averages in Canada, offering a detailed examination of the quality of care provided in a community-based psychosocial rehabilitation service. Using the QuIRC identifies strengths and areas for improvement of current care provided, opening opportunities for positive change and improved quality of care. By highlighting the critical indicators of the quality of care and best practices derived from the QuIRC assessment, this study provides practical insights that can be directly applied by practitioners, policymakers, and stakeholders, fostering an understanding of essential elements that support effective mental health rehabilitation within community settings.

The green spaces of the city and their significance in rehabilitation of cognitive functions – The spatial method of stimulation

The article addresses the spatial aspect as a factor of significant importance for the success of rehabilitation functions. The location of cognitive rehabilitation activities in an open, urban space allows people with reduced fitness to take up stress-free rehabilitation activity without time limitations and without stigmatization. The architectural design of the positions for mental rehabilitation implemented in public space was addressed to people with dysfunctions of all ages and people suffering from covid fog as a result of a past disease. This article presents the results of preliminary observational studies conducted on a focus group of COVID19 convalescents, who were provided with an open rehabilitation space equipped with 12 rehabilitation tables. The results showed the decisive influence of the placement of rehabilitation elements in the open green space for rehabilitation results. The task of the mind training path is to raise and maintain intellectual fitness in a friendly recreational space. Prototype studies have shown that, de-pending on the arrangement of individual stops, the mind training path offers different efficiency of exercises, but it is always a better result than in closed spaces of medical facilities.

Pertanggungjawaban Pidana Anak Pelaku Penyalahguna Narkotika Perspektif Hukum Pidana Islam

Decision number 03/Pid.sus-Anak/2018/PN.Skt regarding child offenders who abuse narcotics even though the child has been legally and convincingly proven guilty in article 127 paragraph 1 letter a of law number 35 of 2009, but the child is only given a lenient criminal sentence. The research was conducted to examine the criminal liability of children as drug users. The research method used is qualitative research with normative research. The data analysis techniques used is content analyis. The result of this research explain that the criminal responsibility of children who abuse drugs in verdict number 03/Pid.sus-Anak/2018/PN.Skt is because children have fulfilled the theory of criminal responsibility and based on law number 11 of 2012 children can be held accountable for their actions, the sentence given is to undergo treatment at the SINAI Sukoharjo Mental and Drug Rehabilitation Foundation for 6 (six) months, the decision is also based on the judge’s consideration. Meanwhile, in Islamic criminal law, children as perpetrators of criminal acts will not be subject to punishment in the form of hudud, qishas/diyat, or ta’zir. Children will only be subject to ta’dibi which is coaching that provides lessons but does not affect their psycholog.

Spanish Version of the Netherlands Empowerment List: Adaptation, Psychometric Validation, and Gender Differential Item Functioning Analysis

AbstractThere is a lack of valid instruments to measure empowerment in Spanish-speaking populations. This study aimed to adapt the Netherlands Empowerment List (NEL), a 40-item scale, into Spanish and to test its psychometric properties examining its dimensional structure, internal consistency, temporal stability, relationships with other variables, and differential item functioning by gender. Participants were 406 users of mental health community rehabilitation services (52.5% male), with a mean age of 47.8 years. Results confirmed a six first-order factor structure of the scale. Internal consistency was excellent for the total score and ranged from excellent to adequate for subscale scores. Temporal stability was excellent for four subscales and good for the remaining two. The analysis of relationships between the Spanish NEL with other variables (i.e., empowerment, recovery, hope, perceived social support) provided additional evidence of its validity. Although four items showed uniform differential item functioning by gender, the effect size was negligible. The Spanish NEL yields valid and reliable scores, and it may be used to assess empowerment in Spanish-speaking countries.

К ВОПРОСУ О РОЛИ ПСИХОЛОГИЧЕСКОЙ КОМПОНЕНТЫ В ЛЕЧЕБНО-РЕАБИЛИТАЦИОННОМ ПРОЦЕССЕ

Rehabilitation in medicine is one of the essential elements of rehabilitation. In modern practical medicine, rehabilitation is referred to as the third stage of providing medical care to the population, which in turn belittles its effectiveness and significantly postpones the use of rehabilitation measures at a later time. In fact, the rehabilitation potential is already beginning to form at the first contact with the patient (at the stage of diagnosis and active treatment). Rehabilitation measures can be specific depending on the type of nosology and general, suitable for a wide range of diseases. It is at the initial stages and throughout the rehabilitation process that its psychological component is most important for all types of diseases. Mental and social rehabilitation is especially important for people with socially dangerous diseases (pathological dependence, infectious, venereal diseases, etc.). The delayed application of rehabilitation measures, as well as insufficient attention to its psychological component, requires a deeper study of this problem. The purpose of this work was to study and analyze modern literature on various aspects of rehabilitation and find ways to optimize it.

Penguatan Perilaku Pasien Rehabilitasi Mental Melalui Group Therapy Tentang Bahaya dan Dampak Merokok

Background: The issue of mental health has become a global concern, including in Indonesia. In 2022, according to the World Health Organization, there were 24 million cases of schizophrenia globally, with a prevalence rate of 7% in Indonesia. The primary focus of schizophrenia treatment involves antipsychotic medication therapy and mental rehabilitation. Individuals with schizophrenia often undergo perceptual changes due to smoking behavior. Method: This community service activity took place on October 28, 2023, involving the formation of a group therapy as a mental health support group. Education was provided through a method involving lectures and simulations through demonstration. This activity was attended by 19 individuals, consisting of 12 patients, 1 speaker, 1 leader, 9 facilitators, 1 minute-taker, the head of the room, and 4 room nurses. The socialization activity took place for 55 minutes. Results: Findings from the identification indicate that 30% of active smokers among the patients prefer kretek cigarettes. Additionally, 85% of the patients experience lip irritation, and 80% exhibit yellowing of the skin and fingernails due to smoking. After conducting pre-test and post-test activities, there was an increase in participants' knowledge about the understanding of the dangers and impacts of smoking, rising from 33% to 92%. Additionally, the attitude towards quitting smoking increased from 17% to 83%. Conclusion: The increase in knowledge and attitude among participants was observed through the formation of group therapy focusing on the dangers and impacts of smoking during mental rehabilitation.

Experience of naturally occurring peer support among people using psychiatric day-care in China: an interpretative phenomenology approach.

China presently does not have an established peer support system, and the efforts of peer support workers are not acknowledged in the context of the growing global trend of community-based mental rehabilitation. This study aims to examine the first-hand experiences of persons who participate in psychiatric day-care facilities in Shanghai, China, and receive support from their peers. The goal is to gain a better understanding of how these informal peer support programs function and provide valuable knowledge for the establishment of more structured peer support programs that align with Chinese social culture. A total of 14 participants attending psychiatric day-care centres were selected for face-to-face semi-structured in-depth interviews using snowball sampling. The interviews took place between July 2021 and February 2022. The text data of the interview were acquired through transcription and then augmented using the interview scripts and additional resources. The data were analysed using interpretive phenomenological analysis until the themes reached saturation. A total of three overarching themes and eight corresponding sub-themes were produced: 1. reconstructing a social network: an ordinary interpersonal connection, becoming and conducting oneself, proceeding the process of adaptation in the company of peers; 2. balance and multiple roles within the relationship: selective self-exposure, managing proximity and distance; 3. sense of meaning and sense of community: supporting others while empowering oneself, love as expanding consciousness, advocating for the notion of group identity. This study is the initial examination of the contact and naturally occurring peer support that takes place among individuals in psychiatric day-care centres in China. The study's findings revealed that participants interact with others who have undergone similar conditions in the day-care setting, enabling them to rebuild an important social network. It is crucial to consider the possible benefits of peer support, assess the obstacles, and facilitate the personal recovery of individuals with mental disorders using the theory of recovery.

Reliability and validity of the cancer-related dysfunctional beliefs and attitudes about sleep scale in cancer patients

BackgroundInsomnia is a common health problem among cancer patients, which is not only a physical problem but also a psychological problem. Sleep plays an important role in the mental and somatic rehabilitation of cancer patients, and the sleep beliefs and attitudes of cancer patients are key factors in improving their sleep situation and quality of life. The aim of this study was to translate the Cancer-Related Dysfunctional Beliefs and Attitudes about Sleep (C-DBAS-14) scale into Chinese and to validate its reliability and validity in cancer patients.MethodThe C-DBAS-14 scale was translated into Chinese using the backward and forward translation procedure. The reliability of the scale was measured by internal consistency, split-half reliability and retest reliability. The validity of the scale was assessed through the content validity indicators, exploratory factor analysis and validation factor analysis.ResultThe Cronbach's ɑ coefficient of the Chinese version of the C-DBAS-14 was 0.932 while the McDonald’s omega coefficient (ω t) was 0.934. The split-half reliability coefficient was 0.908, and the test-retest reliability was 0.857. The four-factor model was obtained using exploratory factor analysis, explaining 72.7% of the variance, with each item loading greater than 0.4 on the common factor. The results of the confirmatory factor analysis revealed that all indicators of model fit were within an acceptable range, indicating a well-fitting model.ConclusionThe Chinese version of the C-DBAS-14 has good reliability and validity among cancer patients. It can be used to measure the sleep beliefs and attitudes of Chinese cancer patients.

Ethical challenges from a problem-solving intervention with workplace involvement: a qualitative study among employees with common mental disorders, first-line managers, and rehabilitation coordinators

ABSTRACT Purpose This study aims to explore ethical challenges potentially arising from a problem-solving intervention with workplace involvement (PSI-WPI) in primary health care (with first-line manager involvement) for employees on sickness absence due to common mental disorders. Methods A qualitative design guided by the theoretical framework for systematic identification of ethical aspects of healthcare technologies. Semi-structured interviews were performed with coordinators (n = 6), employees (n = 13), and first-line managers (n = 8). Reflexive thematic analysis was used to analyse and interpret themes. Results A main theme was identified “the workplace and healthcare hold different organizational value logics” and four sub-themes: “the PSI-WPI challenged the organizational goals and values of the workplace and healthcare”, “the PSI-WPI challenged organizational values on fairness”, “the PSI-WPI challenged the professional roles of first-line managers and rehabilitation coordinators” and “the PSI-WPI introduced a need for the employee to juggle the employee and patient roles”. Conclusion Different organizational value logics, values, and goals can introduce ethical challenges. We advise clarifying stakeholders’ roles and preparing employees and managers for the return to work process by providing sufficient information. The ethical challenges and suggested measures to minimize them, should be considered when planning return to work interventions that involve several stakeholders.

Assessing the clinical and cost-effectiveness of inpatient mental health rehabilitation services provided by the NHS and independent sector (ACER): protocol

BackgroundMental health rehabilitation services provide specialist treatment to people with particularly severe and complex problems. In 2018, the Care Quality Commission reported that over half the 4,400 mental health inpatient rehabilitation beds in England were provided by the independent sector. They raised concerns that the length of stay and cost of independent sector care was double that of the NHS and that their services tended to be provided much further from people’s homes. However, there has been no research comparing the two sectors and we therefore do not know if these concerns are justified. The ACER Study (Assessing the Clinical and cost-Effectiveness of inpatient mental health Rehabilitation services provided by the NHS and independent sector) is a national programme of research in England, funded from 2021 to 2026, that aims to investigate differences in inpatient mental health rehabilitation provided by the NHS and independent sector in terms of: patient characteristics; service quality; patient, carer and staff experiences; clinical and cost effectiveness.MethodsACER comprises a:1) detailed survey of NHS and independent sector inpatient mental health rehabilitation services across England; 2) qualitative investigation of patient, family, staff and commissioners’ experiences of the two sectors; 3) cohort study comparing clinical outcomes in the two sectors over 18 months; 4) comprehensive national comparison of inpatient service use in the two sectors, using instrumental variable analysis of routinely collected healthcare data over 18 months; 5) health economic evaluation of the relative cost-effectiveness of the two sectors. In Components 3 and 4, our primary outcome is ‘successful rehabilitation’ defined as a) being discharged from the inpatient rehabilitation unit without readmission and b) inpatient service use over the 18 months.DiscussionThe ACER study will deliver the first empirical comparison of the clinical and cost-effectiveness of NHS and independent sector inpatient mental health rehabilitation services.Trial registrationISRCTN17381762 retrospectively registered.

Abstract WP90: Participants With Complex Impairment Profiles Are Systematically Excluded From Stroke Psychosocial Support Research: A Scoping Review

Introduction: Disability after stroke often requires mental health treatment, but contradictorily, also restricts access to it. People with cognitive, motor, language, and perceptual impairments have been excluded from research on psychosocial supports like psychotherapy, support groups, and meaningful life activities. This exclusion adds to the inequitable distribution of benefits, including fewer treatment options and less knowledgeable providers. Very little is known about who is excluded from stroke psychosocial support research, why they are excluded, and how exclusion occurs. Methods: Exclusionary practices were investigated using a Johanna Briggs Institute-method scoping review. Independent reviewers screened searches of CINAHL, Embase, MEDLINE, and PsychInfo, resulting in 101 included studies. Content analysis was used to analyze studies following an a priori coding framework, which included: Design, inclusion/exclusion criteria, stroke impairment, psychiatric comorbidity, and psychosocial support type. Results: Samples were commonly limited to mild cognitive impairment, with other subpopulations under-represented. Moderate-to-severe cognitive and language impairments were systematically excluded from psychotherapy studies. In contrast, support group and meaningful life activity studies more often included a range of impairments, but also more often excluded psychiatric comorbidity. Studies with rigorous designs rarely included complex impairment profiles. Reasons for exclusion were seldom provided, and participant characteristics were routinely underreported. Conclusion: By including only people with mild and uncomplicated impairment profiles, the field risks neglecting the complex realities of others who arguably have even greater need for support. This scoping review offers recommendations for stroke research and practice, including: The inclusion of a range of stroke impairments in research samples, adapting procedures using compensatory strategies to facilitate inclusion, and greater cross-pollination between mental health and rehabilitation disciplines. This review serves as a call to action to make psychosocial supports equitable and accessible for all people, regardless of ability.

Abstract HUP13: Participants With Complex Impairment Profiles Are Systematically Excluded From Stroke Psychosocial Support Research: A Scoping Review

Introduction: Disability after stroke often requires mental health treatment, but contradictorily, also restricts access to it. People with cognitive, motor, language, and perceptual impairments have been excluded from research on psychosocial supports like psychotherapy, support groups, and meaningful life activities. This exclusion adds to the inequitable distribution of benefits, including fewer treatment options and less knowledgeable providers. Very little is known about who is excluded from stroke psychosocial support research, why they are excluded, and how exclusion occurs. Methods: Exclusionary practices were investigated using a Johanna Briggs Institute-method scoping review. Independent reviewers screened searches of CINAHL, Embase, MEDLINE, and PsychInfo, resulting in 101 included studies. Content analysis was used to analyze studies following an a priori coding framework, which included: Design, inclusion/exclusion criteria, stroke impairment, psychiatric comorbidity, and psychosocial support type. Results: Samples were commonly limited to mild cognitive impairment, with other subpopulations under-represented. Moderate-to-severe cognitive and language impairments were systematically excluded from psychotherapy studies. In contrast, support group and meaningful life activity studies more often included a range of impairments, but also more often excluded psychiatric comorbidity. Studies with rigorous designs rarely included complex impairment profiles. Reasons for exclusion were seldom provided, and participant characteristics were routinely underreported. Conclusion: By including only people with mild and uncomplicated impairment profiles, the field risks neglecting the complex realities of others who arguably have even greater need for support. This scoping review offers recommendations for stroke research and practice, including: The inclusion of a range of stroke impairments in research samples, adapting procedures using compensatory strategies to facilitate inclusion, and greater cross-pollination between mental health and rehabilitation disciplines. This review serves as a call to action to make psychosocial supports equitable and accessible for all people, regardless of ability.