Psychosocial Interventions For People Research Articles

Anxiety sensitivity moderates the relationship between internet addiction and cyberchondria among nurses.

Internet addiction and cyberchondria have a bidirectional relationship. However, no known studies have evaluated the moderating role of anxiety sensitivity in that relationship. The study aimed to determine whether anxiety sensitivity moderates the relationship between internet addiction and cyberchondria among Jordanian nurses. Data were collected from 303 nurses using a web-based survey and convenience snowballing sampling methods using a cross-sectional research design. The Internet Addiction Test and the short version of the Cyberchondria Severity Scale were used to assess internet addiction and cyberchondria. Nurses reported mild internet addiction, low anxiety sensitivity, and moderate cyberchondria. Also, these findings suggested that sensitivity to anxious feelings moderates the relationship between internet addiction and cyberchondria. These findings would help nurses use psychosocial interventions for people with internet addiction and cyberchondria by understanding how their anxiety sensitivity promotes their internet addiction and cyberchondria.

Psychosocial interventions for people with amyotrophic lateral sclerosis and motor neuron disease and their caregivers: a scoping review

BackgroundAs amyotrophic lateral sclerosis/motor neuron disease (ALS/MND) is a fatal progressive neurodegenerative disorder, patients experience severe impairments, with patients and family caregivers facing emotional distress and exhaustion. Several psychosocial interventions are aimed at providing tailored support for ALS/MND patients and caregivers. The aim of this study was to conduct a scoping review and present a comprehensive overview of psychosocial interventions designed for individuals and families affected by ALS/MND, while also pinpointing research gaps.MethodsThis scoping review utilized Arksey and O'Malley's methodological framework to investigate psychosocial interventions designed for individuals with ALS/MND and their families. The study adhered to the PRISMA-ScR checklist for reporting.ResultsA total of 27 articles describing 25 interventions met the inclusion criteria. The predominant interventions observed in the research encompassed education-related strategies, closely followed by behavior therapy, counseling, social support interventions, and psychotherapy interventions. Across the majority of the studies, findings indicated promising feasibility and acceptability of these interventions. Notably, a significant proportion of quantitative investigations yielded one or more statistically significant effects, while qualitative studies consistently reported favorable outcomes, including enhancements in well-being and heightened awareness of individual circumstances.ConclusionsGiven the progressive and debilitating nature of this condition, coupled with the absence of a cure, the adoption of a psychosocial approach can prove beneficial for both ALS/MND patients and their families. However, high-quality RCTs with a large sample size are recommended to examine and confirm the effectiveness.

Cognitive Therapy, Mindfulness-Based Stress Reduction, and Behavior Therapy for the Treatment of Chronic Pain: Predictors and Moderators of Treatment Response

Psychosocial interventions for people with chronic pain produce significant improvements in outcomes, but these effects on average are modest with much variability in the benefits conferred on individuals. To enhance the magnitude of treatment effects, characteristics of people that might predict the degree to which they respond more or less well could be identified. People with chronic low back pain (N = 521) participated in a randomized controlled trial which compared cognitive therapy, mindfulness-based stress reduction, behavior therapy and treatment as usual. Hypotheses regarding predictors and/or moderators were based on the Limit, Activate, and Enhance model; developed to predict and explain moderators/predictors of psychosocial pain treatments. Results were: 1) low levels of cognitive/behavioral function at pre-treatment predicted favorable pre- to post-treatment outcomes; 2) favorable expectations of benefit from treatment and sound working alliances predicted favorable pre- to post-treatment outcomes; 3) women benefited more than men. These effects emerged without regard to treatment condition. Of note, high levels of cognitive/behavioral function at pre-treatment predicted favorable outcomes only for people in the treatment as usual condition. Analyses identified a set of psychosocial variables that may act as treatment predictors across cognitive therapy, mindfulness-based stress reduction and behavior therapy, as hypothesized by the Limit, Activate, and Enhance model if these 3 treatments operate via similar mechanisms. Findings point toward people who may and who may not benefit fully from the 3 psychosocial treatments studied here, and so may guide future research on matching people to these kinds of psychosocial approaches or to other (eg, forced-based interventions) non-psychosocial approaches. Trial RegistrationThe ClinicalTrials.gov Identifier is NCT02133976. PerspectiveThis article examines potential predictors/moderators of response to psychosocial treatments for chronic pain. Results could guide efforts to match people to the most effective treatment type or kind.

Influence of guideline recommendations, care structures and individual factors on the use of psychosocial therapies in severely mentally ill people

The influence of guideline recommendations and other factors on the utilization of psychosocial interventions in people with severe mental illness was examined. Data from a cross-sectional study of 397 people with severe mental illness were analysed descriptively. Patients are less likely to receive therapies with a strong recommendation compared to other levels of recommendation. Various other factors are diffusely associated with utilization rates, but no ubiquitous predictors could be identified across all therapies. Current practice in the use of psychosocial interventions does not follow guideline recommendation strength. Interventions with strong recommendations are probably not available across services. Consequently, routine practice is not able to follow guideline recommendations according to their strength. Other consistent predictors could not be identified.

The “COGS CLUB” : A psychosocial intervention for people with Alzhiemer’s disease

AbstractBackgroundThe “Cogs Club” is a multi‐modal intervention based on the Cognitive Stimulation Therapy (CST, Spector A.).CST is cost‐effective for people with mild‐to‐moderate dementia and is recommended in the UK by NICE. CST, in our adaptative model, is related to other psycho‐social activities (OT, music, physical activity). Cogs Club changes a traditional session of about an hour into 4 hours of activities.Objectives: the aim of this study is to verify the efficacy of this muldimodal psychosocial interventionMethodthe project is promoted by the local Alzhemer’s associations situated in Modena (Italy) and conducted by 3 professionals (a psychologist, an OT and a fisioterapist) who provide scheduled interventions ad : cognitive stimulation therapy (CST), occupational therapy and physical activities with music. Partecipants who took part in the study (n° 26 people with mild‐ moderate Alzheimer’s dementia, M9: F17, mean age 78.23 ±5.11 years, education: 7.2 ± 3.86 years) were submitted at T0 (basal evaluation) and T1 (after 3 months) to an assessment composed by ACE‐R, GDS‐15, DAD, QoL‐AD and ZBI. People with sensorial deficit, motor or behaviour disorder was excluded.Resultat T1 all indicators (cognitive: MMSE 22,6 vs 23,4, p 0,096; ACE – R 63,54 vs 65,96 p 0,066; functional: DAD 0,68 vs 0,69, p 0,103; emotional‐affective : GDS 5,35 vs 4,12 p 0,039 and quality of life : QoL AD pz 31,5 vs 33,38, p 0.129; Qol AD cg: 29,04 vs 30,96, p 0,459) of the PWD have improved even if only the depression is of clinical relevance. Regarding the caregiver we found an improvement in their quality of life even with an increase in perceived care stress (Zarit 34,09 vs 36,65, p 0,098).Conclusionthe purpose of the project is also to create a context for the socialisation and a net of formal and informal connection to people with mild‐ moderate dementia who traditionally don’t ask to access health services. The main goal is to delay as much as possible the development of the disability but further studies are necessary to encourage this preliminary results.

Adaptation and Incremental Validity of the Pemberton Happiness Index: A New Measure of Integrative well-being for People with Intellectual Disabilities

ABSTRACT Introduction The assessment of well-being is crucial for measuring the effects of psychosocial interventions in people with intellectual disabilities. The aim of this study was to adapt and validate a measure of integrative well-being, the Pemberton Happiness Index (PHI) to use it specifically for this population. Methods The Pemberton Happiness Index was first tailored to individuals with intellectual disabilities (PHI-Intellectual Disabilities). Then a sample of 130 adults with mild-moderate intellectual disabilities completed this adapted version alongside other well-being and affective measures. Results The psychometric properties of this new PHI-Intellectual Disabilities were shown to be very good (i.e., internal consistency, convergent and incremental validity). Conclusion The study provides initial evidence of the reliability and validity of a brief measure of well-being that can be used for both applied and research purposes specifically for adults with mild-moderate intellectual disabilities.

Cognitive behavioural therapy (group) for schizophrenia.

Cognitive behavioural therapy (group) for schizophrenia.

Psychosocial Interventions for People With Dementia and Their Caregivers in Primary Care

Psychosocial interventions, such as occupational and behavioral therapy are effective opportunities to support people with dementia and their caregivers in adapting to the cognitive and behavioral changes and the resulting challenges in everyday life they are facing. However, psychosocial interventions do not seem to have found their way into routine care yet. We wanted to get an insight into the knowledge and attitudes general practitioners have about occupational and behavioral therapy. In an online survey we asked medical students about the relevance of dementia, occupational therapy, and behavioral therapy during their studies. In another online survey we asked practitioners what they had learned about these topics and to what extent they are making use of psychosocial interventions. Then semi-structured interviews were carried out with general practitioners all over Germany, exploring their experiences with dementia and psychosocial interventions in primary care as well as their expectations regarding interdisciplinary cooperation. It became obvious that psychosocial interventions are not conveyed sufficiently within medical school. A lack of occupational therapy prescriptions for people with dementia seemed to result from uncertainties regarding the content of the approach and the budgeting of the prescriptions. Barriers for prescriptions of behavioral treatment were a lack of therapy places and the perceived inadequacy of the approach for this target group. General retentions to invest in people with dementia were expressed. These obstacles need to be overcome in order to provide optimal care for people with dementia and their family caregivers.

Psychosocial Interventions for People With Dementia and Their Caregivers in Primary Care

Psychosocial interventions, such as occupational and behavioral therapy are effective opportunities to support people with dementia and their caregivers in adapting to the cognitive and behavioral changes and the resulting challenges in everyday life they are facing. However, psychosocial interventions do not seem to have found their way into routine care yet. We wanted to get an insight into the knowledge and attitudes general practitioners have about occupational and behavioral therapy. In an online survey we asked medical students about the relevance of dementia, occupational therapy, and behavioral therapy during their studies. In another online survey we asked practitioners what they had learned about these topics and to what extent they are making use of psychosocial interventions. Then semi-structured interviews were carried out with general practitioners all over Germany, exploring their experiences with dementia and psychosocial interventions in primary care as well as their expectations regarding interdisciplinary cooperation. It became obvious that psychosocial interventions are not conveyed sufficiently within medical school. A lack of occupational therapy prescriptions for people with dementia seemed to result from uncertainties regarding the content of the approach and the budgeting of the prescriptions. Barriers for prescriptions of behavioral treatment were a lack of therapy places and the perceived inadequacy of the approach for this target group. General retentions to invest in people with dementia were expressed. These obstacles need to be overcome in order to provide optimal care for people with dementia and their family caregivers.

Efficacy of cognitive stimulation therapy virtual program for older adults with dementia in COVID-19 isolation.

BackgroundCognitive stimulation virtual therapy (CSVT) is an evidence‐based psychosocial intervention for people with mild‐to‐moderate dementia due to various etiological factors.ObjectiveThe aim of the present study was to assess the efficacy of a cognitive stimulation virtual therapy CSVT program, in individuals who have vascular or Alzheimer dementia in COVID‐19 isolation.MethodsOlder adults with mild vascular or Alzheimer dementia (N = 20) were assigned to one of two programs: one group (N = 10) attended during six months, two sessions per week program of the cognitive stimulation virtual therapy CSVT program, while the other, active control group (N = 10) took part in alternative activities. The following tests were applied to their primary caregivers. A short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and quality of life (Quality of Life (QoL)ResultsCompared with the active controls, the cognitive stimulation virtual therapy CSVT program showed a greater improvement in general cognitive functioning after the intervention (i.e. score increase on the IQCODE test). A trend towards improvement was also identified in short term/working memory and perceived quality of life (Quality of life (QoL) of elderly with dementia). The primary caregivers also perceived an improvement in mood, stress, anxiety and quality of sleep after the start of the virtual therapy during COVID‐19 isolation.ConclusionThe present results support the efficacy of cognitive stimulation virtual therapy CSVT program in people with dementia during COVID‐19 isolation.

Effect of Cognitive Behavioural Therapy on Pupils with Attention Deficit Hyperactivity Disorder in Two Selected Primary Schools in Cape Coast Metropolis, Ghana

This study focused on investigating the effect of the Cognitive Behavioural Therapeutic treatment (CBT) on pupils with Attention Deficit Hyperactivity Disorder (ADHD) at Bekkyford and Felicomfort Primary Schools in Cape Coast, Ghana. The quasi-experimental design was used for the study. The sample for the study was 43 participants which include 8 parents, 6 teachers, 16 siblings of participants, 13 pupils made up of 9 males and 4 females. The pupils were purposively sampled for the study with the aid of the Scheduled for Affective Disorders and Schizophrenia for School-Aged Children (K-SADS). Data were collected with the Scheduled for Affective Disorders and Schizophrenia for School-Aged Children (K-SADS), questionnaire, and Clinical Global Impression Severity Scale (GCI-I). The results revealed that three out of the 9 males (representing 30 percent) reported minimal improvement in their symptoms regarding impulsivity and inattentiveness. There was a significant difference between the experimental group (M = 18.70, SD = 2.243) and the control group (M = 08.45, SD = 4.185), t(37)= 8.023; sig.=.003, P<.05 with respect to the CBT. It was recommended that parents, teachers and siblings should be included in all psychosocial interventions for people with ADHD for lasting and effective management of the symptoms.

How does supportive therapy compare with other psychological or psychosocial interventions for people with schizophrenia?

How does supportive therapy compare with other psychological or psychosocial interventions for people with schizophrenia?

Psychosocial interventions for people with a first episode psychosis: between tradition and innovation.

Assessing recent evidence on psychosocial interventions for people with first episode psychosis (FEP). Family interventions (FI) reduce relapse rates, whilst cognitive behavioural therapy (CBT) shows a moderate effect in improving positive psychotic symptoms. Vocational interventions (VI) appear to be worthy of implementation within early intervention for psychosis (EIP) teams, but it is still unclear what is the most cost-effective strategy for their delivery. Promising interventions, which need more careful evaluation, focus on substance misuse, physical health comorbidities, improvement of social participation, peer support and the potential of new technologies. The first five years after the onset of psychotic symptoms are a 'critical period' in which psychosocial interventions can be particularly influential in determining prognosis. Traditional EIP interventions have different effectiveness profiles, i.e., FI reduce relapse rates, CBT has a moderate effectiveness on overall and positive symptoms and VI can improve educational and employment-related functioning. Newer interventions show promise on important targets for FEP treatment but require higher-quality evaluations. Decisions on which interventions to implement within EIP teams should be informed by high-quality evidence, but difficult choices will have to be made based on costs, professionals and technologies available, and local priorities.

Clinicians' Perspectives on Self-Harm in Pakistan: A Qualitative Study.

Background: Suicide is a serious public health problem, ranked amongst the leading causes of death worldwide. There are no official data on self-harm and suicide in Pakistan; both are illegal acts, and are socially and religiously condemned. This study explored the views of clinicians, including general practitioners (GPs) and hospital physicians (HPs) on self-harm, about their management of people who self-harm and what interventions might be appropriate in Pakistan.Methods: This qualitative study, generating data using semi-structured interviews, was nested within a Randomized Controlled Trial (RCT) of a psychosocial intervention for people following self-harm. Clinicians (n = 18) with experience of treating people who self-harm were recruited from public hospitals and general practices.Results: Face-to-face interviews were conducted in Urdu and digitally recorded with consent, transcribed and translated into English. Transcripts were checked for cultural and interpretive interpretations by the research team, then analyzed thematically using the principles of constant comparison. The following themes will be presented: encountering people with self-harming behaviors; challenges encountered in managing people who self-harm; barriers to accessing care, and what ideal care might look like. Participants identified their lack of training and expertise in the management of people with self-harm behavior.Conclusions: This is the first study to explore clinicians’ perspectives on self-harm in Pakistan. The study highlighted the need for training for doctors in the identification and management of mental health problems, including the management of people who self-harm.

Exploring the feasibility of an individual cognitive stimulation therapy application and related technology for use by people with dementia and carers in Indonesia: A mixed-method study.

Cognitive stimulation therapy (CST) is a psychosocial intervention for people with dementia and can benefit cognition and quality of life. A touch-screen individualised CST (iCST) application has been developed to improve on accessibility and provide increased interactivity. This study aimed to explore the attitudes of people with dementia, carers and healthcare professionals in Indonesia towards the iCST application and related technology. Four focus groups were organised: one comprising family carers (n = 3), two comprising people with dementia and family carers (n = 12) and one made up of family carers and home care workers (n = 3). Participants discussed the uses of technology, tried out the iCST application and completed a usability and acceptability questionnaire. Furthermore, 21 healthcare professionals attended an expert meeting to discuss the potential of implementing the iCST application in the community. Attitudes towards technology were positive but lack of experience, difficulties with operating devices and a limited infrastructure to support technology were described as barriers. The iCST application was seen as an interesting tool to support mental stimulation. Compared with people with dementia, carers were more willing to use the application and rated its usability higher. Healthcare professionals were positive about the interactive features of the application and judged that it could be useful within the family context. Low-cost and low-infrastructure technology like iCST can meet the needs for stimulation of people with dementia in Indonesia and other countries. By understanding the attitudes of people with dementia and carers towards IT and their willingness to adopt technology like the iCST application, we are better placed to overcome potential obstacles to its implementation. It appears that systemic changes are needed to facilitate wider use of IT particularly in dementia care. These include needs to empower end users, strengthen access and connectivity to technology, and improve diagnostic support.

Exploring the feasibility and acceptability of a comprehensive resilience‐building psychosocial intervention (CREST) for people with dementia in the community: A non‐randomised feasibility study

AbstractBackgroundA dementia diagnosis can prevent people from participating in society, leading to a further decline in cognitive, social and physical health. However, it may be possible for people with dementia to continue to live meaningful lives and continue to participate actively in society if a supportive psychosocial environment exists. This feasibility study seeks to create such an environment by determining the feasibility of conducting a multifaceted complex resilience‐building psychosocial intervention for people with dementia and their caregivers living in the community.MethodTen participants with dementia and their primary caregivers living in the community were recruited and received the CREST intervention. The intervention provided (a) a 7‐week cognitive stimulation programme (CST) followed by an 8‐week physical exercise programme for people with dementia and (b) a 6‐week educational programme for caregivers. Members of the wider community were invited to a dementia awareness programme and GP practices to a dementia‐training workshop. Trained professionals delivered all intervention components. Outcomes assessed the feasibility and acceptability of all study processes such as: recruitment; intervention content and delivery; and data collection methods.ResultRecruiting participants was difficult, with local community organisations/groups proving more successful than GP practices. Preliminary results indicate that participants (people with dementia and carers) enjoyed the content of the CREST intervention, that the delivery method and timing worked well and overall they found the programme beneficial. Carers reported that the educational programme provided them with valuable information which was accessible and easy to understand. However, the group activities and learning from each other was identified as crucial to their enjoyment and learning. The people with dementia likewise enjoyed the CST and exercise components, some reporting that the CST enhanced their concentration and that exercising with an exercise buddy was more sociable and enjoyable.ConclusionThe evidence from participants indicates that CREST is feasible and acceptable to carers and people with dementia in the community.

The feasibility of a Comprehensive Resilience-building psychosocial Intervention (CREST) for people with dementia in the community: protocol for a non-randomised feasibility study

BackgroundA dementia diagnosis can prevent people from participating in society, leading to a further decline in cognitive, social and physical health. However, it may be possible for people with dementia to continue to live meaningful lives and continue to participate actively in society if a supportive psychosocial environment exists. Resilience theory, which focuses on strengthening personal attributes and external assets in the face of serious challenges, may provide a scaffold on which an inclusive multifaceted psychosocial supportive environment can be built. This protocol paper describes a study to determine the feasibility of conducting a multifaceted complex resilience building psychosocial intervention for people with dementia and their caregivers living in the community.MethodsThis is a non-randomised feasibility study. Ten participants with dementia and their primary caregivers living in the community will be recruited and receive the CREST intervention. The intervention provides (a) a 7-week cognitive stimulation programme followed by an 8-week physical exercise programme for people with dementia and (b) a 6-week educational programme for caregivers. Members of the wider community will be invited to a dementia awareness programme and GP practices to a dementia training workshop. Trained professionals will deliver all intervention components. Outcomes will assess the feasibility and acceptability of all study processes. The feasibility and acceptability of a range of outcomes to be collected in a future definitive trial, including economic measurements, will also be explored. Finally, social marketing will be used to map a route toward stigma change in dementia for use in a subsequent trial. Quantitative feasibility outcome assessments will be completed at baseline and after completion of the 15-week intervention while qualitative data will be collected at recruitment, baseline, during and post-intervention delivery.ConclusionThis feasibility study will provide evidence regarding the feasibility and acceptability of a comprehensive multifaceted psychosocial intervention programme for people with dementia and their caregivers (CREST). The results will be used to inform the development and implementation of a subsequent RCT, should the findings support feasibility.Trial registrationISRCTN25294519 Retrospectively registered 07.10.2019

473 - Post-diagnostic Dyadic Intervention for People with Dementia and their Family Carers

Background and objectives Support directly after the diagnosis is often experiences as inadequate by people with dementia and their family carers. In this phase, appropriate psychosocial support is important to adapt to and cope with the dementia diagnosis. Often, available support is focused on practical matters and not on the emotional impact of the diagnosis. Also, very often problems have already started to accumulate before support is provided. In the US, the intervention SHARE [Support, Health, Activities, Resources, Education] was therefore developed and studied. This intervention is innovative, because it is designed for dyads (e.g., the person with dementia and their family carer) dealing with early-stage dementia. Its’ primary goal is to enhance communication between people with dementia and their family carers and to prepare them for the future. Several years ago, the intervention was adjusted and pilot -tested in the Netherlands, with positive results. This RCT study evaluates the (cost-)effectiveness of the Dutch SHARE intervention.Methods During four or five session and a pre-session, a healthcare psychologist carries out the intervention with dyads dealing with early-stage dementia. This to enhance skills of the dyad to cope with changes and stressors that might be expected in the future due to the dementia. The intervention takes place in an early stage when the person with dementia is still able to participate actively and before the family carer is overwhelmed by care-related stress. The primary outcome measurements are the quality of life of the person with dementia and self-efficacy of the family carer. Secondary outcomes are stress, communication in the relationship and perspective taking measured only for family carers. The design and procedures of the RCT will be presented in this session as well as the content of the intervention and demographic characteristics of participating dyads.Conclusion This intervention increases the ability of the dyad to cope with the disease and capacity to deal with the situation, with positive experiences of participating dyads and professionals. The study enhances knowledge about psychosocial interventions for people with dementia and family carer

"It's Feasible to Write a Song": A Feasibility Study Examining Group Therapeutic Songwriting for People Living With Dementia and Their Family Caregivers.

BackgroundPsychosocial interventions for people with dementia and their family caregivers together may sustain relationship quality and social connection. No previous music therapy research has examined the effects of group therapeutic songwriting (TSW) attended by people with dementia/family caregiver dyads.MethodsThis pre–post feasibility study aimed to examine the acceptability of a group TSW intervention for people with dementia/family caregiver dyads and test the sensitivity of the following outcomes: Quality of the Caregiver–Patient Relationship (QCPR, primary); Cornell Scale for Depression in Dementia (CSDD) and Quality of Life–Alzheimer’s Dementia for people with dementia, Patient Health Questionnaire-9, Assessment of Quality of Life–8 Dimensions (AQoL-8D); and Zarit Burden Interview for family caregivers. Six weekly 1 h sessions guided participants to identify preferred music, brainstorm ideas, create lyrics, and record songs. Qualitative interviews were conducted with dyads who completed the intervention.ResultsFourteen dyads were recruited and completed baseline assessments. Participants with dementia were aged 62–92 years (M = 77, SD = 11). Caregiver participants (11 spouses, two daughters, one son) were aged 54–92 years (M = 67, SD = 10.1). Four dyads withdrew owing to declining health or inconvenience before the program commenced (n = 2) and after attending 1–2 sessions (n = 2). Ten dyads formed four homogeneous TSW groups (71% completion). No statistically significant changes were detected for any measure. High QCPR ratings at baseline (M = 57.1) and follow-up (M = 57.4) demonstrated sustained relationship quality. For participants with dementia, large effect sizes for the CSDD suggested trends toward decreased depression (d = -0.83) and improved mood (d = -0.88). For family caregivers, a large effect size suggested a trend toward improvement for the AQoL-8D sub-domain examining independent living (d = -0.93). Qualitative data indicated that session design and delivery were acceptable, and TSW was a positive shared experience with personal benefits, which supported rather than changed relationship quality.ConclusionHigh retention and qualitative data indicate that TSW was well received by participants. Effect sizes suggest that group TSW for dyads may have beneficial impacts on depression for people with dementia and quality of life for family caregivers. Future research with a fully powered sample is recommended to further examine the psychosocial impacts of group TSW for people living with dementia/family caregiver dyads.

Implementation of the patient version of the evidence-based (S3) guideline for psychosocial interventions for patients with severe mental illness (IMPPETUS): study protocol for a cluster randomised controlled trial

BackgroundThe German guideline on psychosocial interventions for people with severe mental disorders recommends a broad spectrum of evidence-based treatments. Structured implementation of the associated patient version of the guideline is missing to date. The study aims to assess whether structured implementation of a patient guideline improves the empowerment of patients with severe mental disorders, as well as knowledge, attitudes and experiences regarding psychosocial interventions, service use, treatment satisfaction, treatment needs, quality of life and burden of care.MethodsThe study is a multicentre, cluster-randomised, controlled study with two parallel groups. Inpatients and day hospital patients (all sexes; 18–65 years) with severe mental disorders will be included. Additionally, relatives of patients with mental disorders (all sexes; ≥ 18 years) will be included. In the experimental group, the patient guideline will be implemented using a multimodal strategy. Participants in the control group will receive treatment as usual but will be made aware of the patient guideline. The primary outcome is the change of empowerment, assessed by using the ‘empowerment in the process of psychiatric treatment of patients with affective and schizophrenia disorders’ (EPAS) scale. In addition, knowledge, attitudes and experiences regarding psychosocial interventions will be assessed as secondary outcomes, as well as service use, satisfaction with care, patient need and quality of life and participation and social inclusion. For relatives, the perceived burden of care also will be recorded. Results will be analysed using hierarchical linear models. For the health economic evaluation, the incremental cost-utility ratios will be computed using the differences in total costs of illness and the differences in quality-adjusted life years (QALY) between study groups.DiscussionThe study will be the first to assess the effects of a structured implementation of the patient version of a psychiatric treatment guideline. The study has some limitations regarding the transferability of the results to other patients and other regions. Furthermore, problems with the recruitment of patients and relatives and with the implementation of intervention could occur during the study.Trial registrationThe study is registered in the German Clinical Trials Register (DRKS) and the WHO International Clinical Trials Registry Platform (ICTRP) under registration number DRKS00017577 (Date of registration: 23 October 2019.