Participatie en herstel van mensen met psychische aandoeningen en psychosociale beperkingen, 2021
Dit artikel beschrijft bevindingen uit de pilot Samen voor Herstel.1 In een specifieke wijk in de... more Dit artikel beschrijft bevindingen uit de pilot Samen voor Herstel.1 In een specifieke wijk in de stad Groningen namen ggz, verslavingszorg en het sociale wijkteam met behulp van de nieuwe resourcegroepenmethodiek het initiatief om tot een betere herstelondersteunende samenwerking te komen tussen cliënt, diens formele en informele netwerk, en binnen het formele netwerk. Met een kwantitatief en kwalitatief cohortonderzoek is in kaart gebracht hoe de deelnemers aan de pilot (cliënten) deze werkwijze hebben ervaren en wat de effecten waren op hun herstel en zorgtevredenheid.
BACKGROUND Use of decision aids in mental health care is increasing and will also be introduced i... more BACKGROUND Use of decision aids in mental health care is increasing and will also be introduced in the Dutch mental healthcare system. We describe the context of this development and discuss how decision aids could facilitate evidence-based psychiatry. AIM: To describe the development of the decision aid TReatment E-Assist (TREAT) in the Dutch mental healthcare system that aims to optimize treatment of people with a psychotic illness. METHOD: We describe how the TREAT application works and discuss its potential contribution to the treatment of people with a psychotic illness. RESULTS: In a pilot study TREAT was judged as user friendly and useful. TREAT seemed to increase the integration of ROM-results in treatment and the advice offered new view points for practioners. CONCLUSION: TREAT is a novel application which combines routine outcome monitoring results with current treatment guidelines and standards of care in order to generate personalised treatment recommendations in the con...
Background Feasible and effective interventions to improve daily functioning in people with a sev... more Background Feasible and effective interventions to improve daily functioning in people with a severe mental illness (SMI), such as schizophrenia, in need of longer-term rehabilitation are scarce. Aims We assessed the effectiveness of Cognitive Adaptation Training (CAT), a compensatory intervention to improve daily functioning, modified into a nursing intervention. Method In this cluster randomized controlled trial, 12 nursing teams were randomized to CAT in addition to treatment as usual (CAT; n = 42) or TAU (n = 47). Daily functioning (primary outcome) was assessed every 3 months for 1 year. Additional follow-up assessments were performed for the CAT group in the second year. Secondary outcomes were assessed every 6 months. Data were analyzed using multilevel modeling. Results CAT participants improved significantly on daily functioning, executive functioning, and visual attention after 12 months compared to TAU. Improvements were maintained after 24 months. Improved executive func...
The clinical presentation, course and outcome of recent-onset psychosis patients are heterogeneou... more The clinical presentation, course and outcome of recent-onset psychosis patients are heterogeneous, resulting in a demand for a practical clinical tool that can help predict an individual's outcome (e.g., functioning, psychotic symptoms, subjective quality of life [sQoL]) early on in the course of the disorder. Risk calculators can aid in stratifying recent-onset psychosis patients according to their predicted outcome, thereby aiding in the development of more personalized treatment plans. Furthermore, risk calculators support clinicians in informing patients about their potential outcome profile and present a useful point of departure for shared-decision making. This study aims to develop and validate, both internally and externally, multivariable prognostic prediction models for eight outcomes: functional remission (two models), symptomatic remission and good subjective quality of life at two years and at five years after referral for a suspected recent-onset psychosis. Separa...
Journal of Psychiatric and Mental Health Nursing, 2022
Evidence-based interventions in psychiatry often fail to reach clinical practice. Cognitive Adapt... more Evidence-based interventions in psychiatry often fail to reach clinical practice. Cognitive Adaptation Training (CAT) is an evidence-based psychosocial intervention that aims to improve daily functioning of people diagnosed with a severe mental illness. Implementation of CAT remains challenging, despite demonstrated effectiveness. Identifying facilitators and barriers of CAT on the intervention, nursing, and organizational levels, and investigating relationships between capability, opportunity, motivation, and appraisal using the COM-B model. The Measurement Instrument for Determinants of Innovations and CAT-specific questions were administered to 46 nurses. The relationship between capability, opportunity, motivation, and appraisal was calculated using the Pearson's r correlation coefficient. Nine barriers (mostly organizational level) and 13 facilitators (mostly intervention and nursing level) were identified. Significant moderate correlations were found between capability and opportunity, capability and motivation, capability and appraisal, and a strong correlation between motivation and appraisal. The results suggest that barriers at the organizational level should be removed and facilitators at intervention and nursing levels may be exploited to improve implementation. Future implementation initiatives require ongoing training and supervision of CAT specialists, appointment of local champions to increase commitment among nursing staff, and inclusion and commitment of management to overcome organizational barriers.
BACKGROUND Most research focuses on the impact of COVID-19 for the general population. People wit... more BACKGROUND Most research focuses on the impact of COVID-19 for the general population. People with mental health problems may suffer even more from its consequences. AIM Measuring mental health, experiences with outpatient care and government measures of 105 people in mental health care in the Northern Netherlands during the first wave of COVID-19. METHOD Anonymous, online survey among people in care with autism- or FACT-teams in the Northern Netherlands between July-September 2020. RESULTS Few participants reported recent COVID-19-related symptoms (n=2); no participant had lab-confirmed COVID-19. Both positive (clear world, tranquility, few stimuli: 28%) and negative experiences (missing face-to-face contact with mental health care professionals: 22%) were reported. Although there was some fluctuation in happiness, the average happiness score did not change due to the first wave. Three-quarters were satisfied with their mental health care. Although in-person contact with mental hea...
Background Cognitive Adaptation Training is a psychosocial intervention that focuses on reducing ... more Background Cognitive Adaptation Training is a psychosocial intervention that focuses on reducing the negative effects of cognitive disorders, especially executive functions such as planning and targeted action. International research has shown that Cognitive Adaptation Training enhances multiple aspects of daily functioning in people with severe mental illnesses. Despite this evidence, implementation of the intervention into routine care remains a challenge. Objective In this implementation research, a newly developed implementation program based on previous experience and scientific literature, is tested. The primary aim of this research is to assess the effectiveness of the implementation program. The secondary aim of this study is to evaluate the factors that impede or facilitate the implementation of Cognitive Adaptation Training. Methods To test the effectiveness of the implementation program, a multicenter cluster randomized controlled trial was conducted comparing the impleme...
Participatie en herstel van mensen met psychische aandoeningen en psychosociale beperkingen, 2021
Dit artikel beschrijft bevindingen uit de pilot Samen voor Herstel.1 In een specifieke wijk in de... more Dit artikel beschrijft bevindingen uit de pilot Samen voor Herstel.1 In een specifieke wijk in de stad Groningen namen ggz, verslavingszorg en het sociale wijkteam met behulp van de nieuwe resourcegroepenmethodiek het initiatief om tot een betere herstelondersteunende samenwerking te komen tussen cliënt, diens formele en informele netwerk, en binnen het formele netwerk. Met een kwantitatief en kwalitatief cohortonderzoek is in kaart gebracht hoe de deelnemers aan de pilot (cliënten) deze werkwijze hebben ervaren en wat de effecten waren op hun herstel en zorgtevredenheid.
BACKGROUND Use of decision aids in mental health care is increasing and will also be introduced i... more BACKGROUND Use of decision aids in mental health care is increasing and will also be introduced in the Dutch mental healthcare system. We describe the context of this development and discuss how decision aids could facilitate evidence-based psychiatry. AIM: To describe the development of the decision aid TReatment E-Assist (TREAT) in the Dutch mental healthcare system that aims to optimize treatment of people with a psychotic illness. METHOD: We describe how the TREAT application works and discuss its potential contribution to the treatment of people with a psychotic illness. RESULTS: In a pilot study TREAT was judged as user friendly and useful. TREAT seemed to increase the integration of ROM-results in treatment and the advice offered new view points for practioners. CONCLUSION: TREAT is a novel application which combines routine outcome monitoring results with current treatment guidelines and standards of care in order to generate personalised treatment recommendations in the con...
Background Feasible and effective interventions to improve daily functioning in people with a sev... more Background Feasible and effective interventions to improve daily functioning in people with a severe mental illness (SMI), such as schizophrenia, in need of longer-term rehabilitation are scarce. Aims We assessed the effectiveness of Cognitive Adaptation Training (CAT), a compensatory intervention to improve daily functioning, modified into a nursing intervention. Method In this cluster randomized controlled trial, 12 nursing teams were randomized to CAT in addition to treatment as usual (CAT; n = 42) or TAU (n = 47). Daily functioning (primary outcome) was assessed every 3 months for 1 year. Additional follow-up assessments were performed for the CAT group in the second year. Secondary outcomes were assessed every 6 months. Data were analyzed using multilevel modeling. Results CAT participants improved significantly on daily functioning, executive functioning, and visual attention after 12 months compared to TAU. Improvements were maintained after 24 months. Improved executive func...
The clinical presentation, course and outcome of recent-onset psychosis patients are heterogeneou... more The clinical presentation, course and outcome of recent-onset psychosis patients are heterogeneous, resulting in a demand for a practical clinical tool that can help predict an individual's outcome (e.g., functioning, psychotic symptoms, subjective quality of life [sQoL]) early on in the course of the disorder. Risk calculators can aid in stratifying recent-onset psychosis patients according to their predicted outcome, thereby aiding in the development of more personalized treatment plans. Furthermore, risk calculators support clinicians in informing patients about their potential outcome profile and present a useful point of departure for shared-decision making. This study aims to develop and validate, both internally and externally, multivariable prognostic prediction models for eight outcomes: functional remission (two models), symptomatic remission and good subjective quality of life at two years and at five years after referral for a suspected recent-onset psychosis. Separa...
Journal of Psychiatric and Mental Health Nursing, 2022
Evidence-based interventions in psychiatry often fail to reach clinical practice. Cognitive Adapt... more Evidence-based interventions in psychiatry often fail to reach clinical practice. Cognitive Adaptation Training (CAT) is an evidence-based psychosocial intervention that aims to improve daily functioning of people diagnosed with a severe mental illness. Implementation of CAT remains challenging, despite demonstrated effectiveness. Identifying facilitators and barriers of CAT on the intervention, nursing, and organizational levels, and investigating relationships between capability, opportunity, motivation, and appraisal using the COM-B model. The Measurement Instrument for Determinants of Innovations and CAT-specific questions were administered to 46 nurses. The relationship between capability, opportunity, motivation, and appraisal was calculated using the Pearson's r correlation coefficient. Nine barriers (mostly organizational level) and 13 facilitators (mostly intervention and nursing level) were identified. Significant moderate correlations were found between capability and opportunity, capability and motivation, capability and appraisal, and a strong correlation between motivation and appraisal. The results suggest that barriers at the organizational level should be removed and facilitators at intervention and nursing levels may be exploited to improve implementation. Future implementation initiatives require ongoing training and supervision of CAT specialists, appointment of local champions to increase commitment among nursing staff, and inclusion and commitment of management to overcome organizational barriers.
BACKGROUND Most research focuses on the impact of COVID-19 for the general population. People wit... more BACKGROUND Most research focuses on the impact of COVID-19 for the general population. People with mental health problems may suffer even more from its consequences. AIM Measuring mental health, experiences with outpatient care and government measures of 105 people in mental health care in the Northern Netherlands during the first wave of COVID-19. METHOD Anonymous, online survey among people in care with autism- or FACT-teams in the Northern Netherlands between July-September 2020. RESULTS Few participants reported recent COVID-19-related symptoms (n=2); no participant had lab-confirmed COVID-19. Both positive (clear world, tranquility, few stimuli: 28%) and negative experiences (missing face-to-face contact with mental health care professionals: 22%) were reported. Although there was some fluctuation in happiness, the average happiness score did not change due to the first wave. Three-quarters were satisfied with their mental health care. Although in-person contact with mental hea...
Background Cognitive Adaptation Training is a psychosocial intervention that focuses on reducing ... more Background Cognitive Adaptation Training is a psychosocial intervention that focuses on reducing the negative effects of cognitive disorders, especially executive functions such as planning and targeted action. International research has shown that Cognitive Adaptation Training enhances multiple aspects of daily functioning in people with severe mental illnesses. Despite this evidence, implementation of the intervention into routine care remains a challenge. Objective In this implementation research, a newly developed implementation program based on previous experience and scientific literature, is tested. The primary aim of this research is to assess the effectiveness of the implementation program. The secondary aim of this study is to evaluate the factors that impede or facilitate the implementation of Cognitive Adaptation Training. Methods To test the effectiveness of the implementation program, a multicenter cluster randomized controlled trial was conducted comparing the impleme...
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