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BACKGROUND: The development of de-hospitalization policies in mental health has resulted in a growing emphasis on self-management. In the chronic care model, self-management support is an essential element. Because of the episodic nature of severe mental illness (SMI) and its high relapse rates, we assume that the extent of self-management support needs of individuals with an SMI is considerable. However, a clear overview of the nature of the self-management support needs of persons with SMI is missing. AIMS: This study aimed to identify self-management support needs from the perspective of individuals with SMI. METHOD: A systematic review was conducted using the method of thematic synthesis of qualitative studies. After searching the databases MEDLINE, PsycINFO, CINAHL, and EMBASE, we screened the papers for the eligibility criteria: individuals with an SMI, adequately representing the voice of persons with SMI and describing their self-management support needs. Thirty-one papers were included. RESULTS: The main findings showed that participants in the studies described the need for informational support, emotional support, acknowledgment, encouragement, and guidance to make sense of their illness experiences, ease suffering, obtain validation and recognition, execute self-management tasks, and be led through unfamiliar territory. CONCLUSION: The perspectives of persons with SMI can provide a road map for constructing a self-management support intervention for persons with SMI. Important others have an essential role in fulfilling support needs. Independently managing an SMI is difficult. Therefore, it is preferable to let important others participate in self-management interventions and to introduce peer support. [ABSTRACT FROM AUTHOR]

The Ambient Assisted Living Joint Programme, instituted in 2008 by the European Union, aimed to create better living conditions for older adults through the funding of information and communications technology projects. This review aimed to uncover what can be learned from the Ambient Assisted Living Joint Programme by determining (1) the target populations served, (2) technology-based interventions used and (3) effects on health and well-being outcomes. Information from the Ambient Assisted Living catalogue, project websites and deliverables and from papers in PubMed and EMBASE was reviewed. Overall, 152 projects from the first six rounds of funding were identified. Sensors, computers, phones, tablets and televisions were used for various purposes, that is, monitoring, feedback, coaching, reminders and communication. In total, 12 projects reported evaluating health and well-being outcomes; however, these evaluations demonstrated poor methodological quality. Only three projects reported exact values. For all other projects, published evidence on the effect of these projects on health and well-being outcomes was not available. [ABSTRACT FROM AUTHOR]

BACKGROUND: The degree of informal caregiver involvement influences the self-management of individuals living with bipolar disorder (BD). OBJECTIVE: This article aims to provide a description of informal caregivers’ learning experiences in self-management support of BD in order to guide professionals in tailoring future psychosocial and psychoeducational interventions. DESIGN: In-depth open interviews with 10 informal caregivers of patients with BD who followed treatment in the context of specialized outpatient bipolar care were conducted. RESULTS: Four learning phases emerged from the phenomenological analysis describing the informal caregivers learning process: (1) understanding BD, (2) overcoming the dilemmas in self-management support for individuals living with BD, (3) dividing tasks and responsibilities, and (4) acquiring a personal definition of self-management support for individuals living with BD. CONCLUSION: By grasping the concept of BD, informal caregivers gradually learn how to overcome dilemmas resulting from living with someone with BD, and how to control the expression of emotions. They learn to reflect on the nature of conflicts and how to share the responsibilities of illness management with individuals living with BD and professionals. Mastering these skills eventually allows them to define and delimit their supporting informal caregiver role in the self-management of BD. PRACTICE IMPLICATIONS: Our findings provide information regarding the educational needs of informal caregivers to tailor counseling, and psychosocial and psychoeducational interventions in specialized outpatient care for individuals living with BD. [ABSTRACT FROM AUTHOR]

BACKGROUND: Brief admission (BA) is a widely used intervention for patients with a borderline personality disorder but it has not yet clearly defined and still lacks clear operational standards. To fully develop this intervention, the relevant components need to be identified and clearly documented. OBJECTIVE: To obtain consensus on the components of BA as a crisis intervention for patients with a borderline personality disorder. DESIGN: Modified Delphi study. RESULTS: Consensus of 100% was reached for the components: "BA plan must be developed together with the patient"; "The BA intervention should be mentioned in the care plan for the patient ";"Not all behavior on the part of the patient has to be accepted during a BA "; and "The BA can only be offered together with treatment by a community care professional. " CONCLUSION: Consensus on the components of BA was reached for 82 of the 90 components. This indicates a substantial degree of agreement on what BA should entail. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study describes the use of brief admissions to a psychiatric ward by a single patient across a period of 7 years. The patient suffered from a borderline personality disorder and a complex posttraumatic stress disorder. OBJECTIVE: The purpose of this study was to describe how brief admission may be used during a long-term treatment process. DESIGN: A single-case descriptive study with triangulation of the data was undertaken. Semistructured interviews were conducted with the patient and the patient’s spouse, psychiatrist, ward nurse, and community psychiatric nurse. Other data were retrieved from the medical records of the patient. RESULTS: Four phases could be distinguished in the treatment of the patient: crisis, treatment of posttraumatic stress disorder, treatment of borderline personality disorder, and recovery. The use of brief admissions positively influenced the course of treatment. CONCLUSIONS: Brief admissions were initially used to prevent self-harm and suicide. The goals and functions expanded to prevention of prolonged admission, prevention of dropout from evidence-based therapy, and practicing with newly acquired skills and promotion of autonomy. [ABSTRACT FROM AUTHOR]

Background. The application of evidence-based lifestyle interventions is suboptimal, but little is known what interventions are actually used. This study aimed to explore the range of lifestyle interventions used in Dutch ambulatory health care settings. Method. We conducted interviews (n = 67) in purposefully selected hospitals, general practices, and community care organizations. Interviews focused on identifying activities to help patients stop smoking, reduce alcohol consumption, increase physical activity, eat a healthy diet, and lose weight. We also asked who developed the interventions. All reported activities were registered and analyzed. Results. Four categories of health promotion activities emerged: giving advice, making referrals, offering counseling, and providing lifestyle interventions organized separately from the care process. In total, 102 lifestyle interventions were reported. Forty-five interventions were developed by researchers, of which 30 were developed by the Dutch Expert Center on Tobacco Control. Providers did not know the source of 31 interventions. Eighteen interventions were developed by the providers themselves, and eight were based on evidence-based guidelines. Conclusions. Health promotion activities seemed to be widely present in Dutch health care, in particular smoking cessation interventions. Although health care providers use many different interventions, replacing nontested for evidence-based interventions is required. [ABSTRACT FROM AUTHOR]

BACKGROUND: Psychiatric nurses commonly refer to “providing structure” (PS) as a key intervention. But no consensus exists about what PS entails. PS can be understood as a complex intervention. In four previous studies, a definition, activities, and context variables were described that were presented to experts in a Delphi study. OBJECTIVE: To reach consensus about the definition of PS, its activities, and context variables. DESIGN: In a qualitative study, a Delphi study is used to gather the opinions of experts. The Delphi study consisted of three rounds with statements to score in each round. RESULTS: Experts reached consensus about a definition of PS, its activities, and context variables. Eleven statements related to the definition were accepted. Fourteen statements of a total of 17 statements related to the specific activities reached sufficient agreement, and 4 statements related to context variables were accepted. CONCLUSIONS: A definition could be given of PS with 4 general PS activities, 15 specific activities, and 3 context variables. Psychiatric nurses can use the information about PS to reflect on the use of PS activities within their own working environment, and these insights can help nurses develop their professional growth. [ABSTRACT FROM AUTHOR]

Increasingly, hospitals use the data from their quality measurement activities, as feedback information for their nurses. It is argued that feedback on quality measurements can result in quality improvement at the expense of or for the benefit of nurses' well-being. The proposed relationship is assumed to be mediated by (1) nurses' attribution about management's purpose in providing feedback, and (2) nurses' perception of feedback as a job demand versus a job resource. This contribution describes the development and validation of an instrument to measure these constructs, based on research on HR attributions (Nishii et al., 2008) and the Job Demands-Resources model (Bakker & Demerouti, 2007). The measure has been discussed with several experts and practitioners, and pilot-tested among 55 nurses. Our pilot study reveals promising results regarding the content, construct and predictive validity of our measure. [ABSTRACT FROM AUTHOR]