State Hospital Staff Research Articles

Devlet hastanesi çalışanlarının sigara kullanma alışkanlıklarına bakış

Devlet hastanesi çalışanlarının sigara kullanma alışkanlıklarına bakış

Exhaustion Concept: Examining the Exhaustion Level of Karabük State Hospital Employees

The aim of this study is to examine the exhaustion concept based on an experimental approach by considering the previous studies and researches and to take the average of the exhaustion level of the Karabük state hospital staff. The employee groups, who were above the average and observed to have their exhaustion levels increased, will be created and subjected to an exhaustion syndrome management program. After applying exhaustion syndrome management training, the data obtained from the result of the study, is aimed to be made asecond scale in comparison with the control group.

934 – Evaluation of death anxiety among staffs of a state hospital

Aim Considering the excessive contacts of the hospital staff with death and the ability of death anxiety to reduce functional ability in an individual.the aim of this study was to evaluate the prevalence of death anxiety among a state hospital staff. Methods This is a descriptive study that conducted in an overall of 612 individuals received a questionnaire at a state hospital in Sari(Iran) during spring 2008. The questionnaire was consisted of two parts; demographic part and Templer Death Anxiety Scale (DAS; Templer, 1970). The data were analyzed by SPSS software version 16.0 using t test and chi-square test. Results The range of age was 20-53. About 42.2% of the participants had mild death anxiety while 57.8% had severe death anxiety. The mean scores achieved by the individuals was 7.70 ± 3.133 in women and 6.19 ± 2.552 in men. The severity of death anxiety had a significant correlation with sex while having no correlation with age, marital status, having or not having children, educational level and occupation. Conclusion Due to high levels of death anxiety among the staffs, mental Health interventions are recommended to the same population in order to improve the mental health Quality. Additionally, performing comprehensive studies in the general population is needed.

Recovery-Oriented Training and Staff Attitudes over Time in Two State Hospitals

Recovery attitudes and concepts are often promoted to community mental health staff through educational and in-service trainings, but no study found has examined this in state hospitals. The current observational study aimed to examine the types of recovery-oriented trainings that occurred at two state hospitals over 1 year and subsequent changes in staff recovery attitudes. A total of 184 state hospital staff completed questionnaires assessing their personal optimism, consumer optimism, and agency recovery orientation at baseline and 1 year later. The types of recovery-oriented trainings staff received were categorized as general/inspirational or specific/practical training. Results found that the majority of staff at the two state hospitals received some recovery-oriented training, mostly general/inspirational training. Staff who received specific/practical training had a greater increase in agency recovery attitudes than staff who received only general/inspirational training or no training. However, the more trainings staff had, the higher their consumer optimism. These results suggest state hospitals are incorporating recovery-oriented staff trainings, but more specific trainings may be needed and all staff involved in different levels of care need to be included.

Factors Influencing Placement Recommendations for Hospitalized Individuals with Chronic Mental Illness

This study was undertaken to identify factors that may preclude a patient's discharge from a community mental health center and result in the patient being labeled "unplaceable." Placement recommendations differed between the state hospital staff and a mental health professional employed by the center to evaluate 28 patients. A measure designed to assist in the assessment of patients' competencies suggested the professionals' recommendations were more related to patients' skills in areas associated with community living than were those of the state hospital staff. Follow-up indicated that 15 patients discharged according to the professionals' recommendations maintained community tenure. Use of a more psychometrically sound and comprehensive assessment concerning discharge and placement may improve likelihood of success.

FACTORS INFLUENCING PLACEMENT RECOMMENDATIONS FOR HOSPITALIZED INDIVIDUALS WITH CHRONIC MENTAL ILLNESS

This study was undertaken to identify factors that may preclude a patient's discharge from a community mental health center and result in the patient being labeled “unplaceable.” Placement recommendations differed between the state hospital staff and a mental health professional employed by the center to evaluate 28 patients. A measure designed to assist in the assessment of patients' competencies suggested the professionals recommendations were more related to patients' skills in areas associated with community living than were those of the state hospital staff Follow-up indicated that 15 patients discharged according to the professionals' recommendations maintained community tenure Use of a more psychometrically sound and comprehensive assessment concerning discharge and placement may improve likelihood of success.

Use of state hospital staff to provide training for staff of community residential facilities

State hospital staff and other hospital resources in a region of Washington State were used to train staff of community residential facilities in the care of persons with serious mental illness. Forty-six staff members from 17 community facilities received week-long training in the program's first year. Participants expressed a high level of satisfaction with the program, and facility administrators indicated that it had a positive impact on the overall quality of services in their facility. The annual staff turnover rate among participants was dramatically lower than among other staff in the community facilities.

A Model Hospital Policy on Prosecuting Patients for Presumptively Criminal Acts

Evidence suggests that violence by psychiatric inpatients, especially in public-sector hospitals, may be on the rise. The authors present a model policy developed at a state hospital for deciding whether to prosecute presumptively criminal assaults by patients. The policy addresses the circumstances under which it is ethically permissible to file a criminal complaint while emphasizing the need to use clinical interventions first and to consider the clinical sequelae of prosecution. The authors also review criticisms made of the policy, which reflect opposing views that prosecution is unjustified and that the policy unduly restricts the use of prosecution. In the first six months after the policy became effective, state hospital staff considered filing charges against five patients, but no case progressed beyond the first steps in the implementation procedure.

Diagnostic consultation to a state hospital.

As part of a program to assess the needs of patients in a state hospital scheduled to be closed, a psychiatrist provided consultation for 101 chronically ill patients, including formulation of a principal diagnosis by DSM-III-R criteria. Compared with earlier diagnoses made by the hospital, the consultant diagnosed fewer cases of schizophrenia and more cases of organic mental disorders, affective syndromes, and mental retardation and pervasive developmental disorders. The largest numbers of patients no longer diagnosed as schizophrenic received diagnoses of psychosis not otherwise specified, with further assessment recommended, or organic mental disorder. The author believes consultation programs like this one can help state hospital staff take a fresh look at long-term patients and can provide useful experience for psychiatric residents who assist with such consultations.

Insanity defenses: contested or conceded?

The authors examined 316 Oregon criminal cases in which the accused successfully pleaded the insanity defense. Prosecutors agreed to the insanity verdict in more than four out of five cases. In most cases all examining experts diagnosed the defendant as psychotic. The smaller number of defendants who were diagnosed by the state hospital staff as displaying only personality disorders accounted for a disproportionately large percentage of the contested trials. Observing that Oregon's insanity defense system is run by consensus, the authors suggest a reorientation of the insanity defense debate.

Oregon's innovative system for supervising offenders found not guilty by reason of insanity.

#{149}In the January Law & Psychiatry column, Dr. Paul Appelbaum (1) pointed out that many states have revised their procedures for dealing with post-insanitydefense cases so that they are similar to the procedures governing civil commitment. He noted that this trend has been under increasing attack by public officials and the general public as unfair and unsafe. In 1977 Oregon developed a system that was felt to respect the moral and constitutional issues inherent in the insanity defense but yet be realistic about criminal behavior and public safety. After rejecting proposals to abolish or modify the insanity defense itself, the legislature concentrated on creating innovative procedures to supervise those found not guilty by reason of insanity. The legislature addressed two major problems in the old system. The first was the problem of divided authority. Each judge maintained jurisdiction over defendants acquitted on the insanity defense in their courts, but in practice many judges deferred automatically to the opinions of state hospital staff about when a person was suitable for release from the hospital. Those opinions naturally tended to be grounded in medical judgments about the need for further hospitalization rather than in considerations of public safety. The second problem area was that there was virtually no community follow-up once a person was released from the hospital. Neither the hospital nor the judges had staff to monitor an individual’s progress. There

Managing the Treatment Activities of State Hospital Staff

Research has shown that both the frequency and topography of staff behavior can be modified, but most staff management studies have involved only small numbers of staff, for limited periods of time, in restricted settings. The present study examined the application of behavioral management strategies to a large mental health system. Treatment activites provided by staff of 12 residential units and four support services in a state hospital were monitored during an initial baseline period. Then three feedback interventions were provided and the effects measured on subsequent treatment activity. The results indicated that during the 57 weeks of the study all three feedback interventions increased the treatment activities of staff. A functional analysis of the effects of feedback concluded that performance feedback exerted multiple control, both antecedent and consequent stimulus effects, in the modification of staff treatment behaviors. The results supported the generalization of feedback as a straightforwar...

Deinstitutionalization: who is left behind?

A study of the demographic and clinical characteristics of 137 patients in a state hospital in Massachusetts on a single day in March 1977, well after the state's massive deinstitutionalization program was in effect, showed that the patients who remained in the hospital needed a high level of care, lacked social relationships, were acutely psychotic, or were dangerous to themselves or to others. The author compares this patient population with patients in all other state mental hospitals in Massachusetts and those in the United States. He believes that an answer to the question "Who is left behind?" is essential for state hospital staff members who must treat these patients and is also important for those planning community programs.

The foster community: a partnership in psychiatric rehabilitation.

While halfway house and foster care programs have returned many chronic mental patients from the state hospital to the community, a number of problems including the patients' lack of acceptance by community residents and the perpetuation of chronicity have remained. Missouri's Foster Community Project has attacked such problems by instituting foster care programs in two rural towns that involve collaboration between state hospital staff and community residents. Initial results, including rehabilitative aspects, appear promising.

Conflict between treatment and science on a research ward investigating schizophrenia.

The biological aspects of schizophrenia have been under study at the Lafayette Clinic since 1956. Previous publications described the isolation of a factor in the plasma of schizophrenic patients. The factor is identified using a chicken-cell lactate-pyruvate (L/P) ratio method. Studies have shown that schizophrenic patients can be significantly differentiated from non-schizophrenic subjects. Work has continued on the identification of the factor and on the regulation of the factor. Attempts are being made at relating behavioural attributes to some aspects of the biochemical measures. A sizeable population of subjects for these studies has been required, as well as a hospital ward. Northville State Hospital made available an adequate ward and an area sufficient for the research laboratory. The hospital ward is described. Criteria for the selection of schizophrenic patients are outlined as follows: sex, age, weight, central nervous system factors, intelligence potential, disease factors, drug factors, somatic treatment factors, duration and characteristics of illness. The selection of control subjects has always posed a problem; and at one stage of investigation, ‘trusties’, obtained through the Michigan State Department of Corrections, were utilized. The management of patients and controls is described. Discussion deals with the more serious problems encountered in the administration of this ward, including: 1) evidence of friction between staffs of a state hospital and a research clinic; 2) difficulties in obtaining a satisfactory ward physician who could willingly co-operate with both staffs; 3) feelings of nursing staff regarding patient care; 4) the unexpected difficulties encountered in the management of ‘trusties’ used as control subjects; and 5) additional efforts to help the members of the state hospital staff concerned feel that they are definitely essential for the success of the project.

A research model for the evaluation of the effect of psychopharmacological agents.

Our results indicate that minimal results were obtained from the use of this drug in our study of 47 patients. The study has also indicated that the design and methodology used in this research provided an acceptable basis for collaboration between a central Bureau of Research and a state hospital staff.