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Toplum ruh sağlığı merkezinden yararlanan hastaların yaşam kalitesi, tıbbi tedaviye uyumu, içgörü ve işlevsellikleri

Yıl 2019, Cilt 44, Sayı 2, 431 - 438, 30.06.2019
https://doi.org/10.17826/cumj.461779

Öz

Amaç: Bu çalışmanın amacı bipolar bozukluk, şizofreni ve diğer psikozlar gibi psikiyatrik hastalıklarda; azalmış içgörü, tedavi uyumsuzluğu, işlevsellik ve yaşam kalitesi üzerinde Toplum Ruh Sağlığı Merkezleri (TRSM)’nin etkilerini belirlemektir

Gereç ve Yöntem: Çalışmaya daha önce TRSM hizmetlerinden faydalanmayan 88 hasta ile en az 6 ay faydalanmış olan 88 hasta dahil edilmiştir. Hastalar Klinik Global İzlem ölçeği, Tıbbi Tedaviye Uyum Oranı Ölçeği, Genel İşlevsellik Değerlendirmesi Ölçeği, Pozitif ve Negatif Sendrom Ölçeği, Yaşam Kalitesi Ölçeği, İçgörünün Üç Bileşenini Değerlendirme Ölçeği ve Şizofreni Hastalarında İşlevsel İyileşme Ölçeği ile değerlendirilerek karşılaştırılmıştır.

Bulgular: 112’si (63,64%) erkek, 64’ü (36,36%) kadın toplam 176 hastalanın klinik değerlendirmeleri sonucunda TRSM hizmeti alan grubun ortalama klinik değerlendirme ölçek puanları, TRSM hizmeti almayan hastalarla karşılaştırıldı. Yapılan tüm değerlendirme testleri arasında her iki grup arasında anlamlı farklılık vardı.

Sonuç: TRSM'de verilen hizmetler sayesinde hastaların içgörü, yaşam kalitesi, genel ve sosyal işlevselliğinin belirgin olarak arttığı; hastalık belirtilerinin ise önemli oranda azaldığı gözlendi. Bu çalışma, kronik ruhsal sağlık sorunları olan yetişkinlerde bütüncül bakım kalitesinde iyileşme sağlamak için TRSM’de verilen birincil hizmetlerin yeteneği ile ilgili yeni kanıtlar sunmaktadır

Kaynakça

  • 1. Lee SJ, Kim KR, Lee SY, An SK. Impaired social and role function in ultra-high risk for psychosis and first-episode schizophrenia: Its relations with negative symptoms. Psychiatry investig 2017; 14:186-92. doi: 10.4306/pi.2017.14.2.186.
  • 2. Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S et al. The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiol and Psychiatr 2009;18(1):23-33.
  • 3. Organization WH. The World Health Report 2001: Mental health: new understanding, new hope. World Health Organization; 2001.
  • 4. Randall JR, Vokey S, Loewen H, Martens PJ, Brownell M, Katz A et al. A systematic review of the effect of early interventions for psychosis on the usage of inpatient services. Schizophr bull 2015;41:1379-86. doi: 10.1093/schbul/sbv016.
  • 5. Semahegn A, Torpey K, Manu A, Assefa N, Tesfaye G, Ankomah A. Psychotropic medication non-adherence and associated factors among adult patients with major psychiatric disorders: a protocol for a systematic review. Syst Rev 2018;7:10. doi: 10.1186/s13643-018-0676-y.
  • 6. Ascher-Svanum H, Faries DE, Zhu B, Ernst FR, Swartz MS, Swanson JW. Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care. The J clin psychiatry 2006;67(3):453-60.
  • 7. Guo X, Zhai J, Liu Z, Fang M, Wang B, Wang C et al. Effect of antipsychotic medication alone vs combined with psychosocial intervention on outcomes of early-stage schizophrenia: a randomized, 1-year study. Arch gen psychiatry 2010;67(9):895-904. doi: 10.1001/archgenpsychiatry.2010.105.
  • 8. Soygür H. Community Mental Health Services: Quo Vadis? Arch Neuropsychiatr 2016; 53: 1-3. DOI: 10.5152/npa.2016.15022016.
  • 9. Mitchell AJ, Selmes T. Why don’t patients attend their appointments? Maintaining engagement with psychiatric services. Adv psychiatr treat 2007;13:423-434.
  • 10. Daumerie N, Vasseur SB, Giordana J, Bourdais CM, Caria A, Roelandt J. Discrimination perceived by people with a diagnosis of schizophrenic disorders. International study of Discrimination and stigma Outcomes (INDIGO): French results. Encephale 2012;38:224-231. doi: 10.1016/j.encep.2011.06.007.
  • 11. Swain SP, Behura SS. A comparative study of quality of life and disability among schizophrenia and obsessive-compulsive disorder patients in remission. Ind psychiatry J 2016;25(2):210-215. doi: 10.4103/ipj.ipj_94_15.
  • 12. Sims H, Sanghara H, Hayes D, Wandiembe S, Finch M, Jakobsen H et al. Text message reminders of appointments: a pilot intervention at four community mental health clinics in London. Psychiatr Serv 2012;63: 9161-1968. doi: 10.1176/appi.ps.201100211.
  • 13. Ensari H, Gültekin BK, Karaman D, Koc A, Beskardes AF. The effects of the service of community mental health center on the schizophrenia patients -evaluation of quality of life, disabilities, general and social functioning- a summary of one year follow-up). Anatolian J Psychiatry 2013;14:108-14 114. doi: 10.5455/apd.36380.
  • 14. Evensen S, Ueland T, Lystad JU, Bull H, Klungsoyr O, Martinsen EW et al. Employment outcome and predictors of competitive employment at 2-year follow-up of a vocational rehabilitation programme for individuals with schizophrenia in a high-income welfare society. Nord J psychiatry 2017;71:180-187. doi: 10.1080/08039488.2016.1247195.
  • 15. Targum SD, Houser C, Northcutt J, Little JA, Cutler AJ, Walling DP. A structured interview guide for global impressions: increasing reliability and scoring accuracy for CNS trials. Ann gen psychiatry 2013;12:22. doi: 10.1186/1744-859X-12-2.
  • 16. Thompson K, Kulkarni J, Sergejew A. Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses. Schizophr res 2000;42:241-247.
  • 17. Jones SH, Thornicroft G, Coffey M, Dunn G. A brief mental health outcome scale-reliability and validity of the Global Assessment of Functioning (GAF). The Br J Psychiatry 1995; 166:(5):654-9.
  • 18. Kay SR, Fiszbein A, Opfer LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr bull 1987;13:261-276.
  • 19. Soygür H, Aybaş M, Hınçal G, Aydemir Ç. ( The Quality of Life Scale for schizophrenia: reliability and construct validity). Düsünen Adam Psikiyatri ve Nörolojik Bilimler Dergisi 2000;13:204-210.
  • 20. David AS. Insight and psychosis. The Br J Psychiatry 1990;156:798-808.
  • 21. Arslan S, Günay Kılıç B, Karakılıç H. (Assessment of Three Components of Insight reliability and validity). Türkiye’de Psikiyatri 2000;3:17-24.
  • 22. Emiroglu B, Karadayi G, Aydemir O, Ucok A. Validation of the Turkish Version of the" Functional Remission of General Schizophrenia"(FROGS) Scale. Archives of Neuropsychiatry 2009;46:15-24.
  • 23. Organization WH. Mental health: facing the challenges, building solutions. Report from the WHO European Ministerial Conference on Mental Health, Helsinki, Finland, January 2005. In: Mental health: facing the challenges, building solutions Report from the WHO European Ministerial Conference on Mental Health, Helsinki, Finland, January 2005. 2005; World Health Organization.
  • 24. T.C. Ministry of Health. National Mental Health Action Plan (2011-2023). Ankara, T.C. Ministry of Health, 2011.25. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med 2005;353:487-97.
  • 26. Kane JM, Robinson DG, Schooler NR, Mueser KT, Penn DL, Rosenheck RA et al. Comprehensive versus usual community care for first-episode psychosis: 2-year outcomes from the NIMH RAISE early treatment program. Am J Psychiatry 2015; 173: 362-372. doi: 10.1176/appi.ajp.2015.15050632.
  • 27. Haddad PM, Brain C, Scott J. Nonadherence with antipsychotic medication in schizophrenia: challenges and management strategies. Patient Relat Outcome Meas 2014; 5:43-62. doi: 10.2147/PROM.S42735. eCollection 2014.
  • 28. Üçok A, Atlı H, Çetinkaya Z, Kandemir P. (The effect of holistic approach group therapy on quality of life in schizophrenic patients: results of one-year application. Nöropsikiyatri Arşivi) 2002; 39: 113-118.
  • 29. Aydın E, Tabo A, Karamustafalıoğlu KO, Alataş G, Aydın E, Yiğit S, et al. Revolving door phenomenon: the effect of application of community-based mental health services model at acute psychiatric hospitalization. Anatolian J Psychiatry 2014;15: 185-91. doi: 10.5455/apd.33996 .
  • 30. Corrigan PW, Druss BG, Perlick DA. The impact of mental illness stigma on seeking and participating in mental health care. Psychol Sci Public Interest 2014;15:37-70. doi: 10.1177/1529100614531398.

Functioning, quality of life, treatment adherence and insight among patients who received community mental health center services

Yıl 2019, Cilt 44, Sayı 2, 431 - 438, 30.06.2019
https://doi.org/10.17826/cumj.461779

Öz

Purpose: The purpose of this study is to determine the effects of Community Mental Health Centers (CMHC) on decreased insight, nonadherence to treatment, functionality and quality of life in psychiatric diseases such as bipolar disorder, schizophrenia and other psychoses.

Materials and Methods: 88 patients that previously received CMHC services for at least 6 months and 88 patients that did not previously receive services were included in the study. Patients were evaluated and compared using the Clinical Global Impression, Medication Adherence Rating Scale, Global Assessment of Functioning Scale, Positive and Negative Syndrome Scale, Quality of Life Scale, Schedule for Assessing the Three Components of Insight and Functional Remission of General Schizophrenia scale.

Results: After the clinical evaluation of 176 patients consisting of 112 (63.64%) males and 64 (36.36%) females, the mean scale scores of the group that received CMHC services were compared with those of the patients who did not receive CMHC services. There were significant differences between the two groups in all the assessment tests.

Conclusion:Patients’ insight, quality of life, general and social functioning increased remarkably and disease symptoms were significantly reduced as a result of provided services. This study provides new evidence regarding the ability of primary services offered in community mental health centers to achieve improvement in the quality of holistic care in adults with chronic mental health issues.  

Kaynakça

  • 1. Lee SJ, Kim KR, Lee SY, An SK. Impaired social and role function in ultra-high risk for psychosis and first-episode schizophrenia: Its relations with negative symptoms. Psychiatry investig 2017; 14:186-92. doi: 10.4306/pi.2017.14.2.186.
  • 2. Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S et al. The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiol and Psychiatr 2009;18(1):23-33.
  • 3. Organization WH. The World Health Report 2001: Mental health: new understanding, new hope. World Health Organization; 2001.
  • 4. Randall JR, Vokey S, Loewen H, Martens PJ, Brownell M, Katz A et al. A systematic review of the effect of early interventions for psychosis on the usage of inpatient services. Schizophr bull 2015;41:1379-86. doi: 10.1093/schbul/sbv016.
  • 5. Semahegn A, Torpey K, Manu A, Assefa N, Tesfaye G, Ankomah A. Psychotropic medication non-adherence and associated factors among adult patients with major psychiatric disorders: a protocol for a systematic review. Syst Rev 2018;7:10. doi: 10.1186/s13643-018-0676-y.
  • 6. Ascher-Svanum H, Faries DE, Zhu B, Ernst FR, Swartz MS, Swanson JW. Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care. The J clin psychiatry 2006;67(3):453-60.
  • 7. Guo X, Zhai J, Liu Z, Fang M, Wang B, Wang C et al. Effect of antipsychotic medication alone vs combined with psychosocial intervention on outcomes of early-stage schizophrenia: a randomized, 1-year study. Arch gen psychiatry 2010;67(9):895-904. doi: 10.1001/archgenpsychiatry.2010.105.
  • 8. Soygür H. Community Mental Health Services: Quo Vadis? Arch Neuropsychiatr 2016; 53: 1-3. DOI: 10.5152/npa.2016.15022016.
  • 9. Mitchell AJ, Selmes T. Why don’t patients attend their appointments? Maintaining engagement with psychiatric services. Adv psychiatr treat 2007;13:423-434.
  • 10. Daumerie N, Vasseur SB, Giordana J, Bourdais CM, Caria A, Roelandt J. Discrimination perceived by people with a diagnosis of schizophrenic disorders. International study of Discrimination and stigma Outcomes (INDIGO): French results. Encephale 2012;38:224-231. doi: 10.1016/j.encep.2011.06.007.
  • 11. Swain SP, Behura SS. A comparative study of quality of life and disability among schizophrenia and obsessive-compulsive disorder patients in remission. Ind psychiatry J 2016;25(2):210-215. doi: 10.4103/ipj.ipj_94_15.
  • 12. Sims H, Sanghara H, Hayes D, Wandiembe S, Finch M, Jakobsen H et al. Text message reminders of appointments: a pilot intervention at four community mental health clinics in London. Psychiatr Serv 2012;63: 9161-1968. doi: 10.1176/appi.ps.201100211.
  • 13. Ensari H, Gültekin BK, Karaman D, Koc A, Beskardes AF. The effects of the service of community mental health center on the schizophrenia patients -evaluation of quality of life, disabilities, general and social functioning- a summary of one year follow-up). Anatolian J Psychiatry 2013;14:108-14 114. doi: 10.5455/apd.36380.
  • 14. Evensen S, Ueland T, Lystad JU, Bull H, Klungsoyr O, Martinsen EW et al. Employment outcome and predictors of competitive employment at 2-year follow-up of a vocational rehabilitation programme for individuals with schizophrenia in a high-income welfare society. Nord J psychiatry 2017;71:180-187. doi: 10.1080/08039488.2016.1247195.
  • 15. Targum SD, Houser C, Northcutt J, Little JA, Cutler AJ, Walling DP. A structured interview guide for global impressions: increasing reliability and scoring accuracy for CNS trials. Ann gen psychiatry 2013;12:22. doi: 10.1186/1744-859X-12-2.
  • 16. Thompson K, Kulkarni J, Sergejew A. Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses. Schizophr res 2000;42:241-247.
  • 17. Jones SH, Thornicroft G, Coffey M, Dunn G. A brief mental health outcome scale-reliability and validity of the Global Assessment of Functioning (GAF). The Br J Psychiatry 1995; 166:(5):654-9.
  • 18. Kay SR, Fiszbein A, Opfer LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr bull 1987;13:261-276.
  • 19. Soygür H, Aybaş M, Hınçal G, Aydemir Ç. ( The Quality of Life Scale for schizophrenia: reliability and construct validity). Düsünen Adam Psikiyatri ve Nörolojik Bilimler Dergisi 2000;13:204-210.
  • 20. David AS. Insight and psychosis. The Br J Psychiatry 1990;156:798-808.
  • 21. Arslan S, Günay Kılıç B, Karakılıç H. (Assessment of Three Components of Insight reliability and validity). Türkiye’de Psikiyatri 2000;3:17-24.
  • 22. Emiroglu B, Karadayi G, Aydemir O, Ucok A. Validation of the Turkish Version of the" Functional Remission of General Schizophrenia"(FROGS) Scale. Archives of Neuropsychiatry 2009;46:15-24.
  • 23. Organization WH. Mental health: facing the challenges, building solutions. Report from the WHO European Ministerial Conference on Mental Health, Helsinki, Finland, January 2005. In: Mental health: facing the challenges, building solutions Report from the WHO European Ministerial Conference on Mental Health, Helsinki, Finland, January 2005. 2005; World Health Organization.
  • 24. T.C. Ministry of Health. National Mental Health Action Plan (2011-2023). Ankara, T.C. Ministry of Health, 2011.25. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med 2005;353:487-97.
  • 26. Kane JM, Robinson DG, Schooler NR, Mueser KT, Penn DL, Rosenheck RA et al. Comprehensive versus usual community care for first-episode psychosis: 2-year outcomes from the NIMH RAISE early treatment program. Am J Psychiatry 2015; 173: 362-372. doi: 10.1176/appi.ajp.2015.15050632.
  • 27. Haddad PM, Brain C, Scott J. Nonadherence with antipsychotic medication in schizophrenia: challenges and management strategies. Patient Relat Outcome Meas 2014; 5:43-62. doi: 10.2147/PROM.S42735. eCollection 2014.
  • 28. Üçok A, Atlı H, Çetinkaya Z, Kandemir P. (The effect of holistic approach group therapy on quality of life in schizophrenic patients: results of one-year application. Nöropsikiyatri Arşivi) 2002; 39: 113-118.
  • 29. Aydın E, Tabo A, Karamustafalıoğlu KO, Alataş G, Aydın E, Yiğit S, et al. Revolving door phenomenon: the effect of application of community-based mental health services model at acute psychiatric hospitalization. Anatolian J Psychiatry 2014;15: 185-91. doi: 10.5455/apd.33996 .
  • 30. Corrigan PW, Druss BG, Perlick DA. The impact of mental illness stigma on seeking and participating in mental health care. Psychol Sci Public Interest 2014;15:37-70. doi: 10.1177/1529100614531398.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Araştırma
Yazarlar

Şengül ŞAHİN (Sorumlu Yazar)
FACULTY OF MEDICINE
0000-0002-5371-3907
Türkiye


Gülçin ELBOĞA
FACULTY OF MEDICINE
0000-0003-3903-1835
Türkiye

Yayımlanma Tarihi 30 Haziran 2019
Yayınlandığı Sayı Yıl 2019, Cilt 44, Sayı 2

Kaynak Göster

MLA Şahin, Ş. , Elboğa, G. "Toplum ruh sağlığı merkezinden yararlanan hastaların yaşam kalitesi, tıbbi tedaviye uyumu, içgörü ve işlevsellikleri" . Cukurova Medical Journal 44 (2019 ): 431-438 <https://dergipark.org.tr/tr/pub/cumj/issue/42404/461779>