| 1 | J Psychiatr Ment Health Nurs 2003 Dec 10: 669-77 |
|---|---|
| PMID | 15005479 |
| Title | Perceptions on the development of a care pathway for people diagnosed with schizophrenia on acute psychiatric units. |
| Abstract | Policy development and practice for hospital mental health care has shifted towards a user-focused and evidence-based direction. Important within this policy development has been a guideline for inpatient care, particularly the establishment of an inpatient Acute Care Forum. A vehicle to both commission and develop this agenda is the Implementation of a care pathway. A research study was designed to explore how a care pathway could be developed for inpatients diagnosed withschizophrenia。Interviews with a range of health care professionals and observation of the process of care pathway development were the data-collection tools. Analysis was driven by emergent themes across the data set. Themes were then presented as one possible interpretation of the factors to be considered for the development of a care pathway for people diagnosed withschizophrenia。Clinicians experienced many difficulties in finding and including evidence-based practice (EBP) within a care pathway. Professions on the whole felt that there was a certain futility to psychiatric care given the paucity of evidence to support practice. This may contribute towards the poor use of hospital care as a therapeutic intervention as part of the wider spectrum of care. Difficulties arise when trying to develop a care pathway withEBP, given the paucity of knowledge on why certain interventions are only partially effective. The development of a care pathway may inform the priorities of the inpatient Acute Care Forum for people diagnosed withschizophrenia。但是，护理途径不应受到约束EBPand should incorporate therapeutic activities to improve the overall experience of service users. Limitations on the study and the collection of evidence supporting these conclusions conclude the paper. |
| SCZ关键字 | schizophrenia |
| 2 | Schizophr. Res. 2005 Jun 75: 119-28 |
| PMID | 15820330 |
| Title | An empirical conceptualization of the recovery orientation. |
| Abstract | 恢复运动对严重精神疾病的人的政策产生越来越大的影响。然而，关于恢复方向的经验文献很少，并且尚未发布恢复的经验概念化。 We identified items reflecting recovery themes and measuring aspects of subjective experience, and used principle components and confirmatory factor analyses to develop an empirical conceptualization of the recovery orientation, using data from a large, systematic study ofschizophrenia。 We identified four domains of the recovery orientation: empowerment, hope and optimism, knowledge and life satisfaction. We propose here an initial approach to measuring and conceptualizing recovery attitudes. We also suggest that the evidence-based practice (EBP) movement may help to identify interventions that promote the recovery orientation and help to advance recovery attitudes. We suggest that there is a bidirectional relationship between recovery attitudes and the positive clinical outcomes that are the goals ofEBPs. Through the use of empirically derived conceptualizations of recovery,EBPs can provide a mechanism for identifying treatments that promote the recovery orientation. The conceptualization proposed here can, thus, serve as a tool to assess changes in recovery attitudes during participation in specificEBPs. |
| SCZ关键字 | schizophrenia |
| 3 | Biol. Psychiatry 2008 Jul 64: 98-103 |
| PMID | 18281018 |
| Title | Chitinase-3-like 1 (CHI3L1) gene and schizophrenia: genetic association and a potential functional mechanism. |
| Abstract | Gene expression data and association analyses in two Chinese samples implicate chitinase 3-like 1 (CHI3L1), a cellular survival gene, inschizophreniasusceptibility. We tested whether the association data are robust to replication in a Caucasianschizophreniasample and performed a comprehensive investigation of common genetic variation at the locus. In a sample of 375 case and 812 control subjects we identified significant association with the same risk allele at the promoter single nucleotide polymorphism (SNP) associated in the original study (rs10399805; p = .018) and with another SNP at intron 7 of CHI3L1 (rs2275351; p = .008). The rs10399805 SNP is located at position -247 and disrupts the C/EBP-AML-1 binding site in the gene promoter; the risk allele is predicted to increase CHI3L1 expression, as has been reported in several postmortemschizophrenia研究。运营商的风险变异with fewer positive symptoms and relatively spared cognitive performance compared with otherschizophreniapatients. These findings support a functional mechanism for involvement of CHI3L1 inschizophrenia敏感性，可能导致不太严重的疾病。这项研究中的相关变体并未得到所有全基因组协会（WGA）平台的标记，这表明尽管来自大型SZ样品的WGA数据迫在眉睫，但仍需要附加基因分型。由于CHI3L1可能参与压力诱导的细胞反应的传播，因此也可能有必要研究与已知环境风险因素的相互作用。 |
| SCZ关键字 | schizophrenia |
| 4 | J Psychosoc Nurs Ment Health Serv 2013 Nov 51: 35-44 |
| PMID | 23944183 |
| Title | Organizational fidelity to a medication management evidence-based practice in the treatment of schizophrenia. |
| Abstract | 组织支持对成功至关重要implementation of evidence-based practice (EBP) in clinical settings. This 3-year study used a mixed qualitative and quantitative design to implement a medication managementEBPin the treatment ofschizophreniain six community mental health clinics in a south-central state of the United States. Findings from organizational fidelity assessments indicate that support forEBPimplementation was moderate. Organizational support was highest for prescriber access to relevant patient information at each medication visit, scheduling flexibility for patients' urgent problems, and availability of medication guidelines. Organizational support was lowest for medication availability and identification of treatment refractory patients. Findings suggest that leadership is essential to support successful implementation. Nurse educators can incorporate implementation research and leadership training into graduate nursing programs to facilitate successfulEBPimplementation in practice settings. |
| SCZ关键字 | schizophrenia |
| 5 | Issues Ment Health Nurs 2014 Jul 35: 517-25 |
| PMID | 24963852 |
| Title | Challenges of implementing a medication management evidence-based practice in a community mental health setting: results of a qualitative study. |
| Abstract | The Medication Management Approaches in Psychiatry (MedMAP) is a medication management evidence-based practice (EBP) to guide the use of psychotropic medications in the treatment ofschizophrenia。This qualitative study examined facilitators and barriers to implementing MedMAP in community mental health treatment settings. Audio-taped qualitative interviews were conducted with practitioners and administrators involved in a MedMAP implementation project conducted in six community mental health centers. Data analysis was conducted using thematic analysis of transcribed interviews. Findings indicate that facilitators to MedMAP implementation included practitioner recognition of the value of MedMAP, consumer involvement, collaboration, continuity of care, and fidelity assessments. Barriers to MedMAP implementation included problematic technology, work flow issues, lack of flexibility in prescribers' ability to implement MedMAP guidelines, regulatory and financial barriers, and consumer insurance status. Recommendations for improving future implementation efforts of MedMAP emphasize technological readiness, development of innovative models of care delivery, an emphasis on treatment guided by outcomes, and active leadership to promoteEBPs within organizations and academic settings. |
| SCZ关键字 | schizophrenia |
| 6 | Trials 2015 -1 16: 438 |
| PMID | 26424639 |
| Title | Enhancing assertive community treatment with cognitive behavioral social skills training for schizophrenia: study protocol for a randomized controlled trial. |
| Abstract | schizophrenialeads to profound disability in everyday functioning (e.g., difficulty finding and maintaining employment, housing, and personal relationships). Medications can effectively reduce positive symptoms (e.g., hallucinations and delusions), but they do not meaningfully improve daily life functioning. Psychosocial evidence-based practices (EBPs）提高功能，但是这些EBPs are not available to most people withschizophrenia。The field must close the research and service delivery gap by adaptingEBPSschizophreniato facilitate widespread implementation in community settings. Our hybrid effectiveness and implementation study represents an initiative to bridge this divide. In this study we will test whether an existingEBP(i.e., Cognitive Behavioral Social Skills Training (CBSST)) modified to work in practice settings (i.e., Assertive Community Treatment (ACT) teams) commonly available to persons withschizophrenia导致更好的消费者结果。我们还将确定与制定CBSST实施策略有关的关键因素。 For the effectiveness study component, persons withschizophreniawill be recruited from existing publicly funded ACT teams operating in community settings. Participants will be randomized to one of the 2 treatments (ACT alone or ACT + Adapted CBSST) and followed longitudinally for 18 months with assessments every 18 weeks after baseline (5 in total). The primary outcome domain is psychosocial functioning (e.g., everyday living skills and activities related to employment, education, and housing) as measured by self-report, testing, and observation. Additional outcome domains of interest include mediators of change in functioning, symptoms, and quality of services. Primary analyses will be conducted using linear mixed-effects models for continuous data. The implementation study component consists of a structured, mixed qualitative-quantitative methodology (i.e., Concept Mapping) to characterize and assess the implementation experience from multiple stakeholder perspectives in order to inform future implementation initiatives. Adapting CBSST to fit into the ACT service delivery context found throughout the United States creates an opportunity to substantially increase the number of persons withschizophreniawho could have access to and benefit fromEBPs. As part of the implementation learning process training materials and treatment workbooks have been revised to promote easier use of CBSST in the context of brief community-based ACT visits. ClinicalTrials.gov NCT02254733 . Date of registration: 25 April 2014. |
| SCZ关键字 | schizophrenia |