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A H Schene

Publications and source records attributed to A H Schene.

27 records · Page 2Linked to original sources

A survey of an organization for families of patients with serious mental illness in The Netherlands.

OBJECTIVES: Members of Ypsilon, a Dutch family organization for relatives of patients with schizophrenia or chronic psychosis, were surveyed to determine whether patients whose families were involved in the organization were representative of all patients with schizophrenia in the Netherlands and whether Ypsilon was similar to family organizations in other countries, to learn about members' experience of the course of their relatives' illness, to determine the kinds of mental health care received by the patients, and to discern members' opinions of that care. METHODS: An extended version of the Involvement Evaluation Questionnaire, which measures consequences of psychiatric disorders for patients' relatives, was sent to a random sample of 1,000 Ypsilon members. The response rate was 70 percent. RESULTS: Members of Ypsilon are mainly older mothers of young male patients with a long history of schizophrenia. The patients as a group appeared to be more severely ill than the overall population of patients with schizophrenia in the Netherlands. Many respondents reported dissatisfaction with the quality of mental health care for their relative, particularly with their lack of access to treatment professionals, lack of information about their relative's illness, and lack of family involvement in treatment planning. CONCLUSIONS: Members of Ypsilon represent patients with severe mental illness who do not benefit sufficiently from treatment. Members want a greater role in treatment planning and more information and support from mental health care professionals. Members of Ypsilon and of family organizations in other countries have much in common, even though the extent of deinstitutionalization varies between countries.

Adult↗

Instruments measuring family or caregiver burden in severe mental illness.

The consequences of psychiatric disorders for family members, usually called family or caregiver burden, have been studied during the last 4 decades. During this period a variety of instruments have been developed to measure the impact of mental illness on family members, but not all instruments have been described systematically in the published literature. The authors review 21 instruments that have been used or developed during the last 10 years, including several that have not previously been reported. The protocols are described in terms of their method and comprehensiveness, precursors and theoretical foundations, and types of psychometric information available. The instruments are assessed for potential use as research tools, and also for application in routine clinical practice.

Activities of Daily Living↗

The Utrecht comparative study on psychiatric day treatment and inpatient treatment.

A prospective randomized comparative study on the effectiveness of psychiatric day treatment and inpatient treatment is described. The target population consisted of patients who would normally have been admitted to an open inpatient unit. Outcome indicators were psychopathology, social functioning, interpersonal functioning, social network and social support. No differences in effectiveness were found between the two forms of treatment, although more patients accepted and completed day treatment, and day patients were more satisfied. Although a uniform treatment programme for both departments was established, distinct differences did arise in the actual treatment programme offered to the patients. The duration of treatment for the day patients was considerably longer, and the intensity of treatment was more low-key. No striking differences in the amount of medication prescribed and in the occurrence of crisis situations (including suicide) were found. Day treatment turns out to be a realistic alternative for 33% of all patients admitted for inpatient treatment. It was not possible to predict which type of patient in particular is suitable for day treatment.

Adult↗

The evaluation of mental health care transformation in the cities of Europe.

At the WHO International Conference 'Changing Mental Health Care in the Cities of Europe' an invitational workshop was organised for participants interested in evaluation research. This report of the workshop first summarises the activities of the Commission of European Communities working on the 'Evaluation of Comprehensive Care of the Mentally Ill'. Secondly current issues which arose in the discussions on problems of scientific evaluation of changing mental health care in Europe are described. Thirdly three particular research programmes are summarised especially focussing on research methodology.

Comprehensive Health Care↗

Objective and subjective dimensions of family burden. Towards an integrative framework for research.

In this article the consequences for those in close contact with a severely disturbed psychiatric patient, the burden of the family, are elaborated within an integrative framework. Burden areas are described and their objective and subjective dimensions are distinguished. The framework comprises three approaches: the systems approach, role theory and the stress process. An outline of the more important burden instruments developed up to now and suggestions for further research are given.

Activities of Daily Living↗

Different types of partial hospitalization programs: results of a nationwide survey in The Netherlands.

An outline is presented of four characteristically different types of partial hospitalization programs currently operating in the Netherlands. The findings are based on empirical data gathered from a study of 85 institutions active in this particular field. The institutions are distinguished according to the function they perform within the total mental health care system, the assumption being that these programs are capable of fulfilling four main functions: 1) an alternative to full-time hospitalization; 2) a continuation of full-time hospitalization; 3) an extension of ambulatory treatment; 4) a day care or rehabilitation service for the chronically mental ill. A study was made of the differences and similarities between four types of institution specializing in one of the four functions mentioned above. In this connection, the authors have particularly concentrated on staffing, number of places, accommodation, organization, referral, patient population (age, education, diagnoses), treatment (type, duration, drug use) and contraindications.

Ambulatory Care↗

Effectiveness and application of partial hospitalization.

Especially during the past 15 years, partial hospitalization (PHP) has been studied extensively. This article reviews the effectiveness and applicability of PHP. To clarify where PHP might fit into the overall mental health care system, the results of empirical research are evaluated with special attention to topics such as treated population, program evaluation, comparison of PHP with inpatient treatment, PHP as alternative to outpatient treatment, comparison of different PHP's, cost effectiveness and burden on the family. The general conclusion is that PHP can be a reasonable alternative to inpatient as well as to outpatient treatment, taking into account factors such as symptomatology, cost and family burden. PHP seems in particular to enhance social role functioning, which might be attributed to the fact that contact between patient and environment is not disturbed by hospitalization. Suggestions for further research are presented. Furthermore it is recommended in order to improve generalizability of results to differentiate the different functions PHP can fulfil in the mental health care system.

Ambulatory Care↗