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Biomedical subjects

Catherine Manley

Publications and source records attributed to Catherine Manley.

5 recordsLinked to original sources

Predicting violence in schizophrenia: a prospective study.

BACKGROUND: People with schizophrenia are more violent than the general population, but this increased risk is attributable to the actions of a small subgroup. Identifying those at risk has become an essential part of clinical practice. AIMS: To estimate the risk factors for assault in patients with schizophrenia. METHODS: Two hundred seventy-one patients with schizophrenia were interviewed using an extensive battery of instruments. Assault was measured from multiple data sources over the next 2 years and criminal records were obtained. Multiple sociodemographic and clinical variables measured at baseline were examined as possible predictors of assault during follow-up. RESULTS: Sixty-nine (25%) patients committed assault during the 2-year follow-up. The model that best predicted assault included a history of recent assault (OR 2.33, 95% CI 1.17-4.61), a previous violent conviction (OR 2.02, 95% CI 1.04-3.87), having received special education (OR 2.76, 95% CI 1.22-6.26) and alcohol abuse (OR 3.55, 95% CI 1.24-10.2). CONCLUSIONS: Previously established risk factors including a history of violence and alcohol abuse are replicated in this study. Although low premorbid IQ did not predict violence, a need for special education did.

Adolescent↗

Patients or partners? Case studies of user involvement in the planning and delivery of adult mental health services in London.

User or patient involvement (UI) in the planning and delivery of health services is an aspiration of many industrialized economies, and has been promoted by United Kingdom (UK) governments for over two decades. This paper reports the findings of qualitative case studies of UI in two mental health provider Trusts in London. Semi-structured interviews were conducted with a variety of stakeholders, including Trust staff at all levels and user group members, to compare the expectations of diverse stakeholders and the extent to which these were achieved. We found that UI remained in the gift of provider managers: providers retained control over decision making, and expected users to address Trust agendas and conform to Trust management practices. Users wanted to achieve concrete changes to policies and services, but had broader aspirations to improve the status and condition of people with mental health problems. Suggestions are made about the direction of future strategies to improve UI.

Adult↗

Systematic review of involving patients in the planning and development of health care.

OBJECTIVE: To examine the effects of involving patients in the planning and development of health care. DATA SOURCES: Published and grey literature. STUDY SELECTION: Systematic search for worldwide reports written in English between January 1966 and October 2000. DATA EXTRACTION: Qualitative review of papers describing the effects of involving patients in the planning and development of health care. RESULTS: Of 42 papers identified, 31 (74%) were case studies. Papers often described changes to services that were attributed to involving patients, including attempts to make services more accessible and producing information leaflets for patients. Changes in the attitudes of organisations to involving patients and positive responses from patients who took part in initiatives were also reported. CONCLUSIONS: Evidence supports the notion that involving patients has contributed to changes in the provision of services across a range of different settings. An evidence base for the effects on use of services, quality of care, satisfaction, or health of patients does not exist.

Attitude to Health↗

Patients' perceptions of intensive case management.

OBJECTIVE: The authors examined patients' perceptions of their case management care and the factors that influenced those perceptions. METHODS: A nine-item patients' perceptions questionnaire was administered to 225 patients with severe psychosis who were enrolled in a randomized controlled trial evaluating the efficacy of intensive versus standard case management. RESULTS: Factor analysis of the responses to the perceptions questionnaire revealed two principal components: quality of care received (including relationship and contact with the case manager) and overall perception of case management. Patients had a better overall perception of intensive case management compared with standard case management, but no significant differences were noted in perceived quality of care. Patients with female case managers had more positive perceptions of the quality of the care they received than those with male case managers. Several clinical and social variables were strongly associated with perceived quality of care but less so with overall perception of case management. CONCLUSIONS: Patients' general perceptions of intensive case management seemed more favorable than patients' general perceptions of standard case management, but no difference was noted in their perceptions of quality of care.

Adult↗

The effect of intensive case management on the relatives of patients with severe mental illness.

OBJECTIVE: Relatives play a vital role in caring for patients with severe mental illness but receive inadequate support from psychiatric services. Evidence suggests that although intensive case management is directed primarily at patients, relatives may benefit as well. This study examined whether relatives of patients who were receiving intensive case management had more contact with mental health professionals than relatives of patients who were receiving standard case management. It also examined whether relatives of patients receiving intensive case management appraised caregiving less negatively and experienced less psychological distress than relatives of patients receiving standard case management. METHODS: The sample was drawn from the pool of patients participating in the UK700 randomized controlled trial of intensive case management. Prospective data on contact between case managers and the relatives of 146 patients were collected over a two-year period. At a two-year follow-up assessment, relatives of 116 patients were interviewed with the Experience of Caregiving Inventory and the 12-item General Health Questionnaire. RESULTS: Considerably more relatives of patients receiving intensive case management had contact with a case manager during the study period than relatives of patients receiving standard case management (70 percent compared with 45 percent). However, relatives of patients receiving intensive case management did not appraise caregiving less negatively or experience less psychological distress than relatives of patients who were receiving standard case management. CONCLUSIONS: Reducing case managers' caseloads alone will not guarantee adequate support for relatives. Instead, providing more support will need to be an explicit aim, and staff will require specific additional training to achieve it.

Adolescent↗