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Reliability and validity of a performance-based measure of skills for communicating with doctors for older people with serious mental illness
- Authors:
- PRATT Sarah I., et al
- Journal article citation:
- Journal of Mental Health, 16(5), October 2007, pp.569-579.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Older people with serious mental illnesses (SMI) have high rates of medical comorbidity and impaired social skills, including basic communication skills that are imperative for medical encounters. The aim was to examine two role-plays developed to evaluate communication in a health care visit. A total of 152 people over age 50 with SMI were rated on two standardized medical visit role-plays. This assessment had excellent inter-rater reliability and test-retest reliability. Performance was not related to gender or age, although participants with a mood disorder had better social skill performance than those with schizophrenia or schizoaffective disorder. Performance was strongly related to the Social Skills Performance Assessment (SSPA), designed to assess basic communication skills in older people with SMI. Performance was also correlated with self-care skills, social functioning, number of medical visits within the past six months, and informant rating of the effect of physical condition on functioning. This assessment demonstrates acceptable psychometric properties, including reliability and convergent validity, and may be a useful tool to assess basic communication skills for discussing health care concerns.
Illness beliefs in schizophrenia
- Authors:
- KINDERMAN Peter, et al
- Journal article citation:
- Social Science and Medicine, 63(7), October 2006, pp.1900-1911.
- Publisher:
- Elsevier
Beliefs about health and illness shape emotional responses to illness, health-related behaviour and relationships with health-care providers in physical illness. Researchers are beginning to study the illness beliefs of people with psychosis, primarily using models developed in relation to physical illness. It is likely that modifications to these models will be necessary if they are to apply to mental disorders, and it is probable that some of the assumptions underlying the models will be inappropriate. In particular, different dimensions of understanding may be present in mental illness in comparison to those identified in physical illness. The present study examines the beliefs of 20 patients in the UK diagnosed with schizophrenia, including 10 currently psychotic inpatients and 10 outpatients in remission, about their experiences, using qualitative interviews and thematic analysis. Patients currently experiencing psychosis did not identify their experiences as separable ‘illnesses’ and did not have ‘illness beliefs’. Patients currently in a period of remission appraised their experiences as distinct from their own normal behaviour, but used conceptual frameworks of understanding that deviated significantly from conventional ‘health belief’ models. Patients’ ways of understanding mental illness did not parallel those described in physical illnesses. Methods for assessing beliefs about mental illness should therefore not be transferred directly from studies of beliefs about physical illness, but should be tailored to the nature of patients’ beliefs about mental illness.
Dissemination and adoption of social skills training: social validation of an evidence-based treatment for the mentally disabled
- Author:
- LIBERMAN Robert Paul
- Journal article citation:
- Journal of Mental Health, 16(5), October 2007, pp.595-623.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
The UCLA modules for training social and independent living skills (SILS) were developed to teach persons with severe mental illness skills for disease management, affiliative relationships, and instrumental role functioning. Eight modules have been produced and evaluated in controlled studies. The aim was to review the adoption of the modules by practitioners, and identify procedures for dissemination. Practitioner and program experiences with the modules were inventoried to identify factors associated with adoption and utility. Secondary dissemination was evaluated in agencies that disseminated the modules beyond their own patients by training other professionals. Determination was made of cultural adaptation of modules for use in various countries. The SILS modules have been widely implemented throughout the US, translated into 23 languages, and implemented in more than 30 countries. International studies document their cross-cultural efficacy, effectiveness, and utility. Factors associated with successful adoption included the modules' user-friendliness, preparation and interpersonal strategies with the adopting agencies, and follow-up consultation. International adoption and empirical evaluation of the SILS modules have established their external, social, and professional validity. Widespread utilization of the modules was facilitated by their utility in meeting the functional needs of patients participating in a range of existing clinical programs.
Care needs of elderly people with schizophrenia: assessment of an epidemiologically defined cohort in Scotland
- Authors:
- McNULTY Seamus V., et al
- Journal article citation:
- British Journal of Psychiatry, 182(3), March 2003, pp.241-247.
- Publisher:
- Cambridge University Press
Little is known of the needs of elderly patients with psychotic illnesses. The aim of this artilce was to measure the care needs of an epidemiologically based group of patients over the age of 65 years suffering from psychotic illness, using a standardised assessment. All patients aged 65 years and over with a diagnosis of schizophrenia and related disorders from a defined catchment area were identified. Their health and social care needs were investigated using the Cardinal Needs Schedule. The 1-year prevalence of schizophrenia and related disorders was 4.44 per 1000 of the population at risk. There were high levels of unmet need for many patients, including those in National Health Service (NHS) continuing-care beds. Many needs were identified, all of which could be addressed using the existing skills of local health and social care professionals. The investigation raises serious concerns about standards of hospital and community care for elderly patients with schizophrenia. The findings may be unique, reflecting long-standing problems within a particularly hard-pressed part of the NHS. However, it is not known whether a similar situation exists in other parts of the UK.
Perceptions of problems and needs for service Among Middle-Aged and Elderly Outpatients with schizophrenia and related psychotic disorders
- Authors:
- AUSLANDER Lisa A., JESTE Dilip V.
- Journal article citation:
- Community Mental Health Journal, 38(5), 2002, pp.391-402.
- Publisher:
- Springer
In this article the authors examined the perceived problems and needs for services among 72 middle-aged and elderly outpatients with schizophrenia and related psychotic disorders. The survey questionnaire included 50 Likert scaled items involving everyday functioning skills, health, clinical symptoms, and social skills. Subjects assigned the highest priority to physical health and memory. Other areas of high priority were: social functioning, education about their own mental illness, and improvements in sleep and mood. Reducing frequency of psychiatric hospitalization, and drug or alcohol rehabilitation received low priority. Focused interventions targeting health-related and social issues are needed in older patients with schizophrenia.
What works for whom? a critical review of treatments for children and adolescents
- Authors:
- FONAGY Peter, et al
- Publisher:
- Guilford Press
- Publication year:
- 2002
- Pagination:
- 525p.,bibliog.
- Place of publication:
- New York
This books explains the principles of evidence based medicine and addresses methodological concerns examining the prevalence, stability and outcomes of mental health problems in youth. Chapters offer coverage of what is known about treating such problems as anxiety, ADHD, Touraines's disorder and psychotic and pervasive development disorders.