Needs, Perceived Support, and Hospital Readmissions in Patients with Severe Mental Illness

Guzmán-Parra, José; Moreno-Küstner, Berta; Rivas, Fabio; Alba-Vallejo, Mercedes; Hernández-Pedrosa, Javier; Mayoral-Cleries, Fermín

doi:10.1007/s10597-017-0095-x

Cited by 33 publications

(14 citation statements)

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“…Many individuals with SMI experience multiple psychiatric readmissions [ 5 ]. A number of factors have been proposed to be associated with psychiatric readmission among patients with SMI including the patients’ previous number of hospitalization, which had been consistently reported to be the highest risk factor for readmission [ 54 , 55 ] and the post-discharge factors, such as poor social support [ 56 ]. Therefore, the screening of cardiovascular metabolic risk factors at or before admission and after patients had been discharged from hospital might overstate the importance of monitoring the cardiovascular metabolic risk factors while the patient was in hospital, although those unmeasured confounders beyond the in-hospitalization period would be unlikely to fully explain our findings.…”

Section: Discussionmentioning

confidence: 99%

Association of cardiovascular metabolic risk factor measurements with psychiatric readmission among in-hospital patients with severe mental illness: a retrospective study

et al. 2022

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Background Patients with severe mental illness (SMI) and comorbid physical conditions were often associated with higher risks of mortality and hospital readmission. In this study, we aim to examine the association of cardiovascular metabolic risk factor measurements with risks of psychiatric readmissions among in-hospital patients with severe mental illness (SMI). Methods We collected the longitudinal information of laboratory investigations, blood pressure and body mass index (BMI) among in-hospital patients who had been diagnosed with schizophrenia, major depression disorder or bipolar disorder and with comorbid diagnosis of hypertension, hyperlipidemia or diabetes from Jan 2014 to Jan 2019. The primary outcome was time to first psychiatric readmission. Cox proportional hazard model was utilized to calculate the hazard risks (HR) of cardiovascular metabolic risk factors with psychiatric readmission. Results A total of 5,256 patients were included in the analysis. Compared to patients with normal blood parameters, patients with aberrant tests of high-density dyslipidemia (HDL) and diastolic blood pressure (DBP) during in-hospitalization period were associated with higher risks to first psychiatric readmission [ HR (Hazard Ratio), 1.37 95% Confidence interval (CI), 1.03–1.83 for HDL and HR, 1.32 (95% CI, 1.04–1.67])for DBP]. Compared to patients with optimal monitoring, patients with suboptimal monitoring of blood lipids and blood pressure during in-hospitalization period or recommended window period of cardiovascular disease (CVD) risk management were associated with higher risks to first psychiatric readmission. Conclusions Aberrant cardiovascular metabolic blood test and blood pressure and missing measurements among in-hospital patients with SMI were associated with increased risks of psychiatric readmissions. This calls for more active screening and monitoring of CVD risk factors for those in-hospital patients in need.

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Section: Discussionmentioning

confidence: 99%

Association of cardiovascular metabolic risk factor measurements with psychiatric readmission among in-hospital patients with severe mental illness: a retrospective study

et al. 2022

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“…In fact, a previous study of our group associated the lack of psychological support from informal carers with the risk of readmission. 5 …”

Section: Discussionmentioning

confidence: 99%

“… 3 , 4 Better relationships with informal care networks have been associated with reducing informal needs and use of hospital services. 5 Therefore, finding the most important areas and factors influencing the maintenance of unmet needs is key to design better personalised interventions and to improve services according to the real needs of psychiatry inpatients. 2 , 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

Met and Unmet Needs in an Inpatient Psychiatry Setting in Spain

Sánchez-Lafuente¹,

Guzmán-Parra²,

Lopez-Zambrano³

et al. 2021

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Purpose Patients with severe mental disorder have health and social needs that require care. The aim of the study was to determine the main areas of perceived needs among inpatients with severe mental disorders and to identify risk factors of the group of patients with the greatest unmet needs. Patients and Methods A total of 150 patients with severe mental illness were assessed during admission prior to discharge from the hospital. Camberwell Assessment of Needs was used as evaluation measure, in addition to clinical status (The Brief Psychiatric Rating Scale), social functioning (Personal and Social Performance) and sociodemographic variables. A descriptive and a multivariate logistic regression analysis were used to analyse variables related to the group of patients with the highest number of unmet needs (≥3). Results Mean number of needs was 7.93, being 4.61 the mean number of needs met and 3.32 the needs unmet. The highest proportion of unmet needs were intimate relationships (44.0%), company (40.7%) and daytime activities (38.7%). A relationship was also found between the presence of three or more unmet needs and the following variables: Brief Psychiatric Rating Scale score (p=0.004), Personal and Social Performance score (p = 0.013), marital status (p=0.018), employment status (p=0.009) and voluntary admission (p=0.032). The multivariate model explained 29.5% of the variance (Nagelkerke’s R 2 : 0.295). Conclusion Treatments aimed at improving social relationships and daytime activities could be a good option for inpatients with many unmet needs.

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“…We structured the scoping review according to Levac et al's enhancement 15 to Arksey and O'Malley's six-stage methodological framework for conducting scoping reviews. 16 The framework's stages are (1) defining the research question, (2) identifying relevant literature, (3) study selection, (4) data extraction, (5) collating, summarising and reporting the results, and (6) consultation process and engagement of knowledge users. We aligned to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews 17 (online supplemental file 1).…”

Section: Methodsmentioning

confidence: 99%

Measurement of unnecessary psychiatric readmissions in the context of care transition interventions: a scoping review

et al. 2021

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ObjectiveThe objective of this study was to examine how published studies of inpatient to outpatient mental healthcare transition processes have approached measuring unnecessary psychiatric readmissions.DesignScoping review using Levac et al’s enhancement to Arksey and O’Malley’s framework for conducting scoping reviews.Data sourcesMedline (Ovid), Embase (Ovid), PsycINFO, CINAHL, Cochrane and ISI Web of Science article databases were searched from 1 January 2009 through 28 February 2019.Eligibility criteria for selecting studiesWe included studies that (1) are about care transition processes associated with unnecessary psychiatric readmissions and (2) specify use of at least one readmission time interval (ie, the time period since previous discharge from inpatient care, within which a hospitalisation can be considered a readmission).Data extraction and synthesisWe assessed review findings through tabular and content analyses of the data extracted from included articles.ResultsOur database search yielded 3478 unique articles, 67 of which were included in our scoping review. The included articles varied widely in their reported readmission time intervals used. They provided limited details regarding which readmissions they considered unnecessary and which risks they accounted for in their measurement. There were no perceptible trends in associations between the variation in these findings and the included studies’ characteristics (eg, target population, type of care transition intervention).ConclusionsThe limited specification with which studies report their approach to unnecessary psychiatric readmissions measurement is a noteworthy gap identified by this scoping review, and one that can hinder both the replicability of conducted studies and adaptations of study methods by future investigations. Recommendations stemming from this review include (1) establishing a framework for reporting the measurement approach, (2) devising enhanced guidelines regarding which approaches to use in which circumstances and (3) examining how sensitive research findings are to the choice of the approach.

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Needs, Perceived Support, and Hospital Readmissions in Patients with Severe Mental Illness

Cited by 33 publications

References 34 publications

Association of cardiovascular metabolic risk factor measurements with psychiatric readmission among in-hospital patients with severe mental illness: a retrospective study

Association of cardiovascular metabolic risk factor measurements with psychiatric readmission among in-hospital patients with severe mental illness: a retrospective study

Met and Unmet Needs in an Inpatient Psychiatry Setting in Spain

Measurement of unnecessary psychiatric readmissions in the context of care transition interventions: a scoping review

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