Browsing by Subject "mental health disorders"

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    Activation in persons with mental health disorders: An integrative review
    (Wiley, 2021-07-26) Keen, Alyson; Lu, Yvonne; Oruche, Ukamaka M.; Mazurenko, Olena; Burke Draucker, Claire; School of Nursing
    WHAT IS KNOWN ON THE SUBJECT?: Evidence indicates a strong relationship between patient activation (i.e. confidence, knowledge and skills to self-manage health) and positive health behaviours and outcomes in a variety of clinical populations. Because persons with mental health disorders experience significant disease burden but often underutilize mental health treatment or experience poor treatment outcomes, they would likely benefit from increases in activation. No systematic reviews have been conducted to summarize and synthesize research on patient activation in persons with mental health disorders. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: To our knowledge, this is the first comprehensive review to identify factors associated with activation and interventions that have shown to be effective in persons with mental health disorders. This integrative review indicates that better health status, less depression, positive health attitudes and behaviours, and higher quality therapeutic relationships may be associated with higher levels of activation in persons with mental health disorders. This review also indicates that a variety of interventions, most notably educational programs, are effective in increasing levels of patient activation in persons with mental health disorders. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Psychiatric mental health nurses and other clinicians should consider routine assessment of patient activation to inform individualized treatment plans for their clients. Clinicians should aim to form high-quality therapeutic relationships with clients as a way to promote higher levels of activation. Interventions that have been found to be effective in improving activation could be offered in a variety of mental health settings. ABSTRACT: Introduction Patient activation is understanding one's role in the healthcare process and having confidence, knowledge, and skills to self-manage one's health and health care. Researchers have begun to investigate patient activation in persons with mental health disorders, but no systematic reviews have been conducted to summarize and synthesize this research. For psychiatric mental health nurses and other clinicians to develop strategies to increase patient activation in this population, more information is needed about factors associated with activation and interventions that increase activation. Review Questions (1) What factors are associated with levels of activation in persons diagnosed with mental health disorders? (2) What interventions have shown to be effective at increasing levels of activation in persons diagnosed with mental health disorders? Method A 5-stage integrative review as described by Whittemore & Knafl. Results Twenty-nine articles were included in the review. Ten provided correlations between activation and other factors, and 20 examined the effects of interventions on activation. Some studies revealed significant correlations between a variety of health and treatment-related factors, and others revealed that some interventions, most notably educational programs, were shown to increase activation. Discussion The findings of this comprehensive review can inform psychiatric mental health nurses and other clinicians in developing strategies to increase activation in the patients with whom they work. More research is needed to provide a deeper understanding of the role of activation in the recovery and treatment of persons with mental health disorders. Implications for Practice Psychiatric nurses and other clinicians should assess for patient activation and incorporate strategies to increase levels of activation in patients in their practice. Positive therapeutic relationships likely enhance activation in persons with mental health disorders.
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    Adverse Childhood Events, Empathy, and Altruism
    (Office of the Vice Chancellor for Research, 2015-04-17) Le, Ava; Mahurin, Emily; Zarins, Sasha
    With a growing prevalence of adverse treatment of children, it is important to look into the longterm effects of negative childhood experiences – specifically their capacities for empathic concern and helping behavior. Empathy is the tendency to read and interpret others’ emotions. Long-term outcomes of adverse childhood events (ACE) include a host of mental health disorders. Other studies have found that, on the other hand, ACE is correlated to an increase in empathy. Previous studies have also indicated that stress can increase prosocial behavior; the latter seems to function in offsetting the effects of the former. Clarification can be found in a motivational process model, which theorizes that experiencing ACE increases one’s motivation to help others who may experience the same circumstances. While ACE may indeed initially result in a blunting of affect, successfully overcoming the effects of these events often leads to a desire to change outcomes for others. 836 adults (72.5% female) completed an online survey that included the Interpersonal Reactivity Index, the Adverse Childhood Events scale, and the altruistic behaviors scale. In line with previous research, both Adverse Childhood Events, r=.155, p<.001, and empathic concern, r=.188, p<.001, are positively correlated with altruism. However, there is little research that determines the link between adverse childhood events and empathy. Not only are empathic concern, B=.153, p=<.001, and the experience of adverse childhood events, B=.190, p<.001, positively associated with altruism, but there is a strong interaction affect between empathic concern and adverse childhood events, B=.107, p=.002. In other words, the interaction between empathic concern and a history of adverse childhood events is positively associated with altruism. Most research on factors associated with altruism has focused on simple main effects. However, by exploring interaction effects, we can better determine what types of people are more likely to behave altruistically.
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    Mental health challenges among adolescents living with HIV
    (Wiley, 2017-05-16) Vreeman, Rachel C.; McCoy, Brittany M.; Lee, Sonia; Pediatrics, School of Medicine
    Introduction: Mental health is a critical and neglected global health challenge for adolescents infected with HIV. The prevalence of mental and behavioural health issues among HIV-infected adolescents may not be well understood or addressed as the world scales up HIV prevention and treatment for adolescents. The objective of this narrative review is to assess the current literature related to mental health challenges faced by adolescents living with HIV, including access to mental health services, the role of mental health challenges during transition from paediatric to adult care services and responsibilities, and the impact of mental health interventions., Methods: For each of the topics included in this review, individual searches were run using Medline and PubMed, accompanied by scans of bibliographies of relevant articles. The topics on which searches were conducted for HIV-infected adolescents include depression and anxiety, transition from paediatric to adult HIV care and its impact on adherence and mental health, HIV-related, mental health services and interventions, and the measurement of mental health problems. Articles were included if the focus was consistent with one of the identified topics, involved HIV-infected adolescents, and was published in English., Results and Discussion: Mental and behavioural health challenges are prevalent in HIV-infected adolescents, including in resource-limited settings where most of them live, and they impact all aspects of HIV prevention and treatment. Too little has been done to measure the impact of mental health challenges for adolescents living with HIV, to evaluate interventions to best sustain or improve the mental health of this population, or to create healthcare systems with personnel or resources to promote mental health., Conclusions: Mental health issues should be addressed proactively during adolescence for all HIV-infected youth. In addition, care systems need to pay greater attention to how mental health support is integrated into the care management for HIV, particularly throughout lifespan changes from childhood to adolescence to adulthood. The lack of research and support for mental health needs in resource-limited settings presents an enormous burden for which cost-effective solutions are urgently needed.
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    Post-Traumatic Epilepsy Associations with Mental Health Outcomes in the First Two Years after Moderate to Severe TBI: A TBI Model Systems Analysis
    (Elsevier, 2017-08) Juengst, Shannon B.; Wagner, Amy K.; Ritter, Anne C.; Szaflarski, Jerzy P.; Walker, William C.; Zafonte, Ross D.; Brown, Allen W.; Hammond, Flora M.; Pugh, Mary Jo; Shea, Timothy; Krellman, Jason W.; Bushnik, Tamara; Arenth, Patricia M.; Physical Medicine and Rehabilitation, School of Medicine
    Purpose Research suggests that there are reciprocal relationships between mental health (MH) disorders and epilepsy risk. However, MH relationships to post-traumatic epilepsy (PTE) have not been explored. Thus, the objective of this study was to assess associations between PTE and frequency of depression and/or anxiety in a cohort of individuals with moderate-to-severe TBI who received acute inpatient rehabilitation. Methods Multivariate regression models were developed using a recent (2010–2012) cohort (n = 867 unique participants) from the TBI Model Systems (TBIMS) National Database, a time frame during which self-reported seizures, depression [Patient Health Questionnaire (PHQ)-9], and anxiety [Generalized Anxiety Disorder (GAD-7)] follow-up measures were concurrently collected at year-1 and year-2 after injury. Results PTE did not significantly contribute to depression status in either the year-1 or year-2 cohort, nor did it contribute significantly to anxiety status in the year-1 cohort, after controlling for other known depression and anxiety predictors. However, those with PTE in year-2 had 3.34 times the odds (p = .002) of having clinically significant anxiety, even after accounting for other relevant predictors. In this model, participants who self-identified as Black were also more likely to report clinical symptoms of anxiety than those who identified as White. PTE was the only significant predictor of comorbid depression and anxiety at year-2 (Odds Ratio 2.71; p = 0.049). Conclusions Our data suggest that PTE is associated with MH outcomes 2 years after TBI, findings whose significance may reflect reciprocal, biological, psychological, and/or experiential factors contributing to and resulting from both PTE and MH status post-TBI. Future work should consider temporal and reciprocal relationships between PTE and MH as well as if/how treatment of each condition influences biosusceptibility to the other condition.