Psychiatric Teaching Hospital Research Articles

Digital Collateral Information Through Electronic and Social Media in Psychotherapy: Comparing Clinician-reported Trends Before and During the COVID-19 Pandemic.

Patient clinical collateral information is critical for providing psychiatric and psychotherapeutic care. With the shift to primarily virtual care triggered by the COVID-19 pandemic, psychotherapists may have received less clinical information than they did when they were providing in-person care. This study assesses whether the shift to virtual care had an impact on therapists' use of patients' electronic and social media to augment clinical information that may inform psychotherapy. In 2018, we conducted a survey of a cohort of psychotherapists affiliated with McLean Hospital. We then reapproached the same cohort of providers for the current study, gathering survey responses from August 10, 2020, to September 1, 2020, for this analysis. We asked clinicians whether they viewed patients' electronic and social media in the context of their psychotherapeutic relationship, what they viewed, how much they viewed it, and their attitudes about doing so. Of the 99 respondents, 64 (64.6%) had viewed at least 1 patient's social media and 8 (8.1%) had viewed a patient's electronic media. Of those who reported viewing patients' media, 70 (97.2%) indicated they believed this information helped them provide more effective treatment. Compared with the 2018 prepandemic data, there were significantly more clinicians with>10 years of experience reporting media use in therapy. There was also a significant increase during the pandemic in the viewing of media of adult patients and a trend toward an increase in viewing of media of older adult patients. Review of patients' electronic and social media in therapy became more common among clinicians at a large psychiatric teaching hospital during the COVID-19 pandemic. These findings support continuing research about how reviewing patients' media can inform and improve clinical care.

Psychometric Properties of a Safety Culture Index among Mental Health Workers in Ghana

Safety culture among mental health workers is essential, especially in developing countries where workplace safety seems neglected. However, few studies have provided detailed psychometric analyses of convenient safety instruments with practical relevance for the healthcare industry in the Sub-Saharan African context. We sampled 574 (54.4 % females, 45.6 % males) mental health workers from three Specialist Psychiatric Teaching Hospitals in Ghana. Initially, we collected data using adapted items from Edkins and Coakes’ 25-item Airline Safety Culture Index (ASCI). Consequently, we conducted a Confirmatory Factor Analysis (CFA) using the Diagonally Weighted Least Squares estimator. We also used the item reduction analysis (Gradual Response Model) to reduce the adapted 25-item scale to 11 items (Modified Safety Culture Index, MSCI- 11). Finally, we conducted reliability analyses (alpha and omega) for the MSCI-11. We observed that the data in the CFA showed adequate fit indices [χ2 (df = 44, N = 574) = 223.752, p < 0.001; CFI = 0.975; TLI = 0.968; RM- SEA = 0.084 (CI 90 % 0.074- 0.096); SRMR = 0.063]. The MSCI- 11 is parsimonious and has good reliability estimates [α = 0.853 (95 % CI 0.835 – 0.870) and ω = 0.853 (95 % CI 0.837- 0.087)]. Future studies should use additional cross-validation in other high-risk jobs to generalise the new scale.

Association of Disease Duration and Duration of Olanzapine Use with Blood Sugar, Blood Pressure, BMI, and Lipid Profile among Schizophrenic Patients in Iraq

Background: The association of olanzapine with hyperglycemia, an elevated lipid profile, and high blood pressure was early recognized after its approval and has become of increased concern. Objective: To determine the association of olanzapine use with blood sugar levels, lipid profiles, and blood pressure in hospitalized Iraqi patients with schizophrenia. Methods: A cross-sectional study involving 50 hospitalized patients with schizophrenia who met the Diagnostic and Statistical Manual of Mental Disorders (DSM)-V diagnostic criteria and had taken olanzapine for at least two years was carried out between November 2022 and February 2023 at two facilities in Baghdad, Iraq (Ibn Rushd Psychiatric Teaching Hospital and Al Rashad Hospital for Mental Health). Blood pressure, fasting blood sugar, and serum lipid profile (triglycerides [TG], high-density lipoprotein [HDL], low-density lipoprotein [LDL], and very-low-density lipoprotein [VLDL]) were measured at baseline and after olanzapine use. Results: Olanzapine significantly increases fasting blood glucose (P< 0.001). After using olanzapine, both systolic and diastolic blood pressures significantly increased. It significantly increased the levels of cholesterol, triglycerides, and VLDL (P<0.001). Moreover, HDL levels were drastically lowered. The current investigation found no significant link between the patient's waist circumference and current weight and the length of their illness or olanzapine use. In addition, there was no association between the duration of olanzapine use and blood sugar, blood pressure, or lipid profiles. Conclusion: Different doses and durations of olanzapine use in Iraqi schizophrenic patients are associated with a negative impact on glycemic control, blood pressure, and lipid profiles.

Assessment Of Nurses' Knowledge About Ethical And Legal Issues Of Mental Health Nursing At Psychiatric Teaching Hospitals

Assessment Of Nurses' Knowledge About Ethical And Legal Issues Of Mental Health Nursing At Psychiatric Teaching Hospitals

Dependence Severity, Locus of Control, and Readiness to Change in Male Alcoholic Clients: A Correlational Study

Objectives: To assess the level of dependence severity, locus of control, and readiness to change in male alcohol clients and measure the correlation between dependence with a locus of control and readiness to change.
 Methodology: A descriptive correlational design was conducted in the substance use rehabilitation centers at psychiatric teaching hospitals in Baghdad city from November /2021 to May 2022. The instrument of the study was designed by using sociodemographic, the clinical characteristics of the client, the Short-form Alcohol Dependence Data Questionnaire (SADD), Drinking Related Internal-External Locus of Control Scale: (DRIE), and the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). The data was collected through the use of a semi-structured form and analyzed by Social Package for Statistical Sciences SPSS version 26.0
 Results: The study showed a highly significant difference in dependence severity with an internal and external locus of control at p-value= .001, a significant reverse relationship between readiness to change among clients with regard to the duration of alcohol use at p-value= .008, and amount of alcohol use per day at p-value=.009. A significant relationship between readiness to change and clients’ level of education, and age of alcoholic clients’ is significant at p-value= .005.and significant relationship between locus of control and monthly income.
 Conclusions: Alcoholic male clients have a moderate dependence severity of alcohol and moderate external locus of control, low internal locus of control, and high readiness to change.
 Recommendations: Further research should be conducted on AUD, activating the media’s role to increase community awareness about the harmful effects of alcohol and the possible treatment methods.

Effectiveness of an educational program on nurses’ knowledge about factors contributing to suicide

Background: Suicide is linked to unmet needs, hopelessness and helplessness, an ambiguous conflict between survival and excruciating stress, a shrinking of seen options, and a wish for escape, the suicidal person's distress signal. Material and Method:A convenience sample was recruited from the aforementioned hospitals. Based on an effect size of 0.25, an alpha error probability of 0.05, a power of 0.80, number of groups = 2, and 3 measurements, the total sample size would be 72 who work in the previous mentioned setting were selected randomly for this study. The final sample size would be 72; 36 for the study group and 36 for the control group.A quasi-experimental design with study and control groups was used in this study, pretest-posttest research design was used in this study. The study was carried out in Al-Rashad Psychiatric Teaching Hospital and Ibn Rushd Psychiatric Teaching Hospital in Baghdad City. Data were analyzed using the statistical package for social science (SPSS) for windows, version 26.

Assessment of Suicide Prevention on Nurses’ Knowledge at Psychiatric Teaching Hospitals in Baghdad City

Background: Suicide is very sophisticated to be described in three brief words. Suicide attempts are also very uncommon and describing and foretelling them can be very hard. Theory, has the virtue in that it is an important tool in transforming information into knowledge. Material and Method: The study was carried out in Al-Rashad Psychiatric Teaching Hospital and Ibn Rushd Psychiatric Teaching Hospital in Baghdad City. A convenience sample was recruited from the aforementioned hospitals. Based on an effect size of 0.25, an alpha error probability of 0.05, a power of 0.80, number of groups = 2, and 3 measurements, the total sample size would be 72 who work in the previous mentioned setting were selected randomly for this study. The final sample size would be 72; 36 for the study group and 36 for the control group. The study instrument consists of participants’ sociodemographic sheet (age, gender, and marital status), employment profile (educational qualification, years of experience in nursing, years of experience in psychiatric units, and nurse-to-bed ratio. Results: The finding of study show that the participants in the study group is 34.33 ± 10.24; a half age 20-29-years (43%), followed by those who age 30-39-years (34.7%),and those who age 40-49-years (15.3%). Conclusion: The student researcher concluded that the nurses’ knowledge about suicide as a concept, nurses’ knowledge about suicide rate, nurses’ knowledge about factors contributing to suicide was weak. Keywords: Assessment, Suicide, Psychiatric Teaching Hospitals, Nurses’ Knowledge.

A quantitative study on completeness rate of documentation in psychiatric medical records.

Background:Mental disorders are one of the leading causes of illness and disability worldwide. According to the World Health Organization (WHO), one in four people in the world will be affected by mental or neurological disorders during their lifetime. Regular evaluation of mental health outcomes plays an important role in making decisions about timely treatment of the patient. Studies show that a medical record does not provide enough information about the diagnosis, current symptoms, psychiatric medications, and side effects of current medications and treatments for ongoing health care. In this study, the completeness of paper-based psychiatric records was investigated.Aim:The current study aimed to explore the completeness rate of paper-based psychiatric medical records (PMRs) and to investigate the factors effective on documentation status.Setting:The study was conducted in Ebnesina and Dr. Hejazi Psychiatric Hospital and Education Center. The case hospital is a psychiatric teaching hospital, which has 900 beds.Materials and Methods:The completeness rate of PMRs was determined using descriptive statistics. Fleiss’ Kappa agreement and effective factors on PMRs’ documentation status were assessed.Results:In total, 83.65% (n = 312) of the PMRs had at least one documentation defect. A significantly higher level of documentation completeness rate between different psychiatric wards was observed.Conclusion:Based on our results, it is suggested to conduct regular evaluation and provide feedback to the health-care providers, and conduct training courses.

Effectiveness of a Sexual Health Care Training to Enhance Psychiatric Nurses' Knowledge, Attitude, and Self-Efficacy: A Quasi-Experimental Study in Southern Taiwan.

Sexual health is a taboo issue in some societies. Limited assessments were conducted during nursing care in mental health services. It is unknown whether psychiatric nurses' competencies would be enhanced through short training courses. The present study employed a quasi-experimental design to evaluate the effectiveness of an 8-hour sexual health care training for psychiatric nurses to improve sexual health knowledge, attitude, and self-efficacy in a teaching psychiatric hospital in southern Taiwan. Volunteered psychiatric nurses were randomly assigned to the experimental or control group. The 8-hour training program contained sexual health knowledge and attitudes, case discussion, role play, and sexual identity or harassment issues. Each nurse received a pretest and a posttest in the 1-month period between August and September 2019. Descriptive and multivariate statistical analyses were used to evaluate the effects. Among the 75 psychiatric nurses, 43 were in the control group and 32 were in the experimental group. The two groups were not significantly different in the working year, gender, education, marriage, and other psychosocial variables. After the training, the overall performance of sexual health care knowledge, attitudes, and self-efficacy of the experimental group improved significantly than the controls. The sexual health care training program enhanced psychiatric nurses' confidence and generally improved their sexual knowledge and attitudes. It is suggested that sexual health care needs to be highlighted during in-job training to augment the well-being and life quality of psychiatric patients.

The Investigation of the Effectiveness of Mobile-based Psychoeducation in Patients with Bipolar Disorder: A Randomized Controlled Trial (RCT)

Background: Bipolar disorder is a chronic and debilitating psychiatric condition. Mobile-based psychoeducation is a very important tool for the treatment of this disorder. Objectives: The study aimed to provide scientific evidence regarding the effectiveness of these tools for patients with bipolar disorder. Methods: In a randomized control trial (RCT) with a sample size of 41, the participants were randomly assigned to one of the intervention or the control arms based on the random number table. The study was performed in a psychiatric teaching hospital in Mashhad, Iran. The primary targets of the study was to measure the depression, manic, and anxiety symptoms that were measured at baseline and 3 months follow‐up for the intervention and the control group. A mobile application was developed and provided to the intervention group after discharge from the case hospital. The control group did not receive the application and received routine health care services during the study. A baseline comparison was performed between the groups, comparisons of the primary outcomes between the groups and within each group were carried out. Results: The results showed that the score of anxiety, depression, and mania at baseline and after the follow-up did not have a significant decrease within the groups. In addition, a slight reduction in the depression and anxiety scores within the groups was found. The mean of anxiety (P-value: 0.035), depression (P-value: 0.024), and mania (P-value: 0.007) after 3 month follow-up had a significant decrease between the groups. A baseline comparison was performed between the groups, and comparisons of the primary outcomes between the groups and within each group were carried out. Conclusions: Given the low effectiveness of using mobile-based psychoeducation on anxiety, depression, and mania in bipolar patients. It is recommended to use mobile applications as a complementary treatment along with other types of treatment for bipolar patients in future studies to obtain more evidence about the effectiveness of mobile-based psychoeducation.

Effectiveness of Psycho-Education Program for Knowledge of Family Caregivers of Patient’s with BAD at El-tigani El-mahi Psychiatric Teaching Hospital, Sudan, 2017- 2019

Background: Psycho education is among the most effective of the evidence-based practices that have emerged in both clinical trials and community settings, it showed weighed excellent benefits when administered to those with bipolar affective disorders, reducing both re-hospitalization rates and decreasing the number of days a person spends in the hospital .Aim: The study aim at assessing the effectiveness of psycho-education for family caregivers of patients with bipolar affective disorders at El-Tegani El-Mahi psychiatric teaching Hospital, Sudan, October 2017 to March 2018.Methods: This study is a quasi-experimental pre/post-tests hospital based, the sample consisted of (73) family caregivers who were all available at the hospital during the period of the data collection. They selected by total cover of all family caregivers close with patients. Data was collected by the use of Structured questionnaire to assess the family caregiver knowledge by likert scale, data was analyzed by Statistical Package for Social Science (SPSS) version 20.and presented figure and tables. Results: the study revealed that the mean score of knowledge before the psycho-education: 28.9. Their knowledge is poor according to compared with the overall mean knowledge post psycho-education were 73.0 with (p.value=,000).Conclusion & recommendation: Psycho education highly significance and improved the knowledge among the family caregivers of the patients with Bipolar Affective Disorders, the recommended establishment of collaborative relationship with families and educational interventions by the nurse under the guidance of the Psychiatric Hospital.

The Children with Attention-Deficit/Hyperactivity Disorder (ADHD) More Likely Creates to Irritable Bowel Syndrome

The research aimed study the children with attention-deficit/hyperactivity disorder (ADHD) more likely
 Creates to irritable bowel syndrome at Ibn-Rushd Psychiatric Teaching Hospital in Baghdad city, find
 out the relationship between demographic characteristic, irritable bowel syndrome and Attention-Deficit/
 Hyperactivity disorder patients. A purposive (non-probability), the sample included (100) patients, from
 (3-11) years old. A descriptive study carried out from December 10th 2018 to the February 25th 2019, from
 family Attention-Deficit/Hyperactivity Disorder outpatients of Ibn-Rushd Psychiatric Teaching Hospital
 in Baghdad city. A questionnaire was constructed for the purpose of the study, which was a consisted of
 (2) part. The 1st part included the demographic characteristics and the 2nd part included the items related
 with irritable bowel syndrome. Data were analyzed through descriptive statistical approach (frequency
 and percentage) and inferential statistical approach (correlation coefficient). Scores, Perpson, lycart scale
 analysis that include, t-test, and stepwise multiple regression. The result of the study confirmed that the
 mean of score for the age of sample was (7.1) year, most of them male urban, low score for socio-economic
 status, strong positive to irritable bowel syndrome.

Patient-on-Staff Assaults: Perspectives of Mental Health Staff at an Acute Inpatient Psychiatric Teaching Hospital in the United States.

Physical assaults perpetrated by patients in psychiatric hospitals against mental health staff (MHS) is a serious concern facing psychiatric hospitals. Assaulted staff reports physical and psychological trauma that affects their personal and professional lives. There is a dearth of literature exploring this phenomenon. To explore MHS perspectives of assault by psychiatric patients. A transcendental phenomenological qualitative design was used to explore and analyze the perspectives of a purposeful sample of 120 MHS perspectives at an acute inpatient psychiatric hospital. Participants' age ranged from 22 to 63 years (mean age = 32.4). Moustakas' theoretical underpinnings guided the study. Two patterns, 8 themes, and 19 subthemes were identified: (a) Psychological impacts revealed four themes-increase of anxiety/fear level, helplessness and hopelessness, flashbacks/burnout, and doubting own competency. (b) Physiosocial impacts revealed four themes-unsupportive superiors, stigmatization of staff victim, failure to report the incident, and environmental safety. Participants verbalized that assaults by patients have instilled fear and trauma in them. Most of the assaults occurred when staff were performing their routine job functions and setting limits to patient's behavior. The study allowed MHS opportunities to narrate their lived experiences of being assaulted by patients and provided validation of their perspectives. Findings illuminated the phenomenon and may help to support policy changes in psychiatric hospitals.

Assessment of Psychosocial and Physical Factors Associated with a Substance Re-abuse after Treatment among Patients with Addiction at Psychiatric Teaching Hospitals in Baghdad City-Iraq

Assessment of Psychosocial and Physical Factors Associated with a Substance Re-abuse after Treatment among Patients with Addiction at Psychiatric Teaching Hospitals in Baghdad City-Iraq

Suicide in Belgian psychiatric inpatients. A matched case-control study in a Belgian teaching hospital

Background and objectivesPatients admitted to a psychiatric hospital show an increased risk for suicide but specific risk factors are not well understood. MethodsIn this case-control study we describe suicides (n = 37) that took place during admission in a Flemish psychiatric teaching hospital between 2007 and 2015 and investigate predictive factors for suicide. ResultsInpatient suicide is a rare condition (37 patients among 20,442 admission periods between 2007 and 2015). Most inpatients who completed suicide were diagnosed with a mood disorder (68%); 38% committed suicide in the first month of hospitalization and 19% in the first week following admission. The majority of suicides took place just before or during the weekend (57%), with hanging as the prominent method (41%). Multivariate analysis showed that hopelessness was the only significant risk factor for inpatient suicide. ConclusionsInpatient suicide remains a very rare event in inpatient care. Enquiring and managing hopelessness is essential in inpatient treatment of psychiatric patients.

Mobile community learning programme's effectiveness in case management for psychiatric nurses: A preliminary randomised controlled trial

BackgroundThe global health care system has applied case management (CM) as a care delivery service provided by nurses. Nurses require continuing education in CM to enhance their professional knowledge and competence. Mobile communities have been used to promote continuing education for medical professionals. However, limited studies have examined the effectiveness of such learning programmes in CM for psychiatric nurses. ObjectiveTo evaluate the effectiveness of a mobile community learning (MCL) programme in CM for psychiatric nurses. DesignThis study used an experimental two-group pre- and post-test design. Settings and participantsPsychiatric nurses employed in a psychiatric teaching hospital situated in northern Taiwan were recruited. MethodsNurses were randomly allocated to the experimental or comparison group. The former participated in the learning intervention in CM. The CM knowledge index and a competence scale were used to determine outcomes. Pre-tests and 2-month post-tests were conducted. The MCL programme comprised five simulated learning modules, self-assessment questions, learning cases, learning resources and experience sharing. A two-way repeated-measures analysis of variance was performed to evaluate the effect of the intervention on target outcomes. ResultsThe questionnaires were completed by 48 participants. The two groups possessed high homogeneity with regard to characteristics and pre-test outcomes. Differences between the two groups regarding CM knowledge (F = 22.99, p < .01) and competence (F = 6.33, p = .015) were significant. The programme had a positive benefit on the learning experience in the experimental group; the mean satisfaction score for the programme reached 4.27 (range, 1–5). ConclusionsMCL programmes for psychiatric nurses can effectively enhance CM knowledge and competence. However, these methods cannot completely replace the continuing education approach for achieving CM competence.

Incorporating Information From Electronic and Social Media Into Psychiatric and Psychotherapeutic Patient Care: Survey Among Clinicians.

BackgroundObtaining collateral information from a patient is an essential component of providing effective psychiatric and psychotherapeutic care. Research indicates that patients’ social and electronic media contains information relevant to their psychotherapy and clinical care. However, it remains unclear to what degree this content is being actively utilized by clinicians as a part of diagnosis or therapy. Moreover, clinicians’ attitudes around this practice have not been well characterized.ObjectiveThis survey aimed to establish the current attitudes and behaviors of outpatient clinicians regarding the incorporation of patients’ social and electronic media into psychotherapy.MethodsA Web-based survey was sent to outpatient psychotherapists associated with McLean Hospital in Belmont, Massachusetts. The survey asked clinicians to indicate to what extent and with which patients they reviewed patients’ social and electronic media content as part of their clinical practice, as well as their reasons for or against doing so.ResultsOf the total 115 respondents, 71 (61.7%) indicated that they had viewed at least one patient’s social or electronic media as part of psychotherapy, and 65 of those 71 (92%) endorsed being able to provide more effective treatment as a result of this information. The use of either short message service text messages or email was significantly greater than the use of other electronic media platforms (χ21=24.1, n=115, P<.001). Moreover, the analysis of survey responses found patterns of use associated with clinicians’ years of experience and patient demographics, including age and primary diagnosis.ConclusionsThe incorporation of patients’ social and electronic media into therapy is currently common practice among clinicians at a large psychiatric teaching hospital. The results of this survey have informed further questions about whether reviewing patient’s media impacts the quality and efficacy of clinical care.

Pharmacy Students’ Reflections on an Experiential Learning Visit to a Psychiatric Hospital

Objective. To create a brief, experiential educational intervention for undergraduate pharmacy students aimed at developing appropriate attitudes, knowledge, and skills for the delivery of recovery-focused pharmacy services to people with mental illness, and to elicit student perceptions of the value and impact of the intervention. Methods. A brief intervention was developed in which a cohort of 44 fourth-year pharmacy students attended a psychiatric teaching hospital in groups of 10 to12. The intervention was integrated into the therapeutics module, and was based on Fink's taxonomy of learning. Delivery of the intervention included input from a multidisciplinary team of mental health professionals and the use of active-learning strategies to give students an insight into the holistic approach to care and the patient journey. Students participated in an exercise in reflective practice following the visit. Content analysis was performed on the reflective writings of consenting students to identify themes and insights gained. Results. Thirty-eight of the 44 students gave their consent for their reflective writings to be analyzed for the purpose of this research. Students expressed some apprehension before their visit to the hospital, but later gained an appreciation of the patient experience of care in the psychiatric setting. Students also described having a greater appreciation of the role of the pharmacist in caring for psychiatric patients as well as an insight into the role of other health care professionals and interventions supporting recovery. Conclusion. A brief experiential intervention helped students integrate their learning and appreciate the value of their expertise in supporting those experiencing mental illness.

Can the Pain of Vystopia Help to Create a More Compassionate World?

Can the Pain of Vystopia Help to Create a More Compassionate World?

Assessment of Nurses’ Knowledge about Restraint and Seclusion used for Aggressive Patients in Psychiatric Wards

Violence and aggression in mental health settings occur most frequently in psychiatric inpatient, and most acute hospital assaults take place in emergency departments. A descriptive correlation study used the assessment approach to assess the levels of nurses’ knowledge regarding restraint and seclusion at the psychiatric teaching hospitals in Baghdad City. A non-probability (purposive sample) study. The sample consisted of (41) nurse ((20) male and (21) female) were selected from the psychiatric teaching hospitals (AL-Rashad Psychiatric Teaching and Ibn-Rushed Psychiatric Teaching) in Baghdad City, during the period of 1st November 2017 to 16th June 2018. The data was collected by questionnaire which consisted of two parts, first part consists socio demographic data, Second part is about restraint and seclusion which consist of (50) items scale of knowledge about restraint and seclusion. In the present study, data were analyzed through the use of statistical package for social sciences (SPSS), version 21. The finding of the study indicated that Most of the nurses who participated in the study have preparative school graduates, and they have an extremely low level of knowledge more than others. And there is a non-significant relationship between demographic characteristics and domains of knowledge for the sample.