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Biomedical subjects

F Schmidl

Publications and source records attributed to F Schmidl.

12 recordsLinked to original sources
PubMed2002

Predictors of treatment discontinuity in outpatient mental health care.

BACKGROUND: Discontinuity of service utilisation among newly referred community outpatients is a common concern. However, knowledge about factors associated with service utilisation is inconsistent. METHOD: This study examined service utilisation of 323 newly referred patients in three community mental health centres (CMHCs) in Vienna, Austria over a 4-month period. Of this original cohort, 111 patients were interviewed at treatment start to identify factors associated with treatment discontinuity. RESULTS: After 4 months, one-third of the 323 newly referred patients had dropped out of CMHC treatment; one-third discontinued treatment at the CMHCs because of referrals or mutual agreement on treatment termination, and one-third was still in CMHC treatment. Multivariate analyses yielded a negative association between treatment discontinuity and the diagnosis of schizophrenia, availability of home care, living alone, and a high quality of life in the domains living situation and family/significant others. A positive association was found with unemployment, previous psychiatric admissions, low patient satisfaction with staff competence, and high self-assessment in global functioning. CONCLUSION: In treatment, differing perceptions of a patient's health status by the patient and by the psychiatrist should be addressed. Professionals should be aware that patients' difficulties in private social relations might affect both treatment alliance and service utilisation.

Adult↗
PubMed2002

Development of specific social skills training programmes for schizophrenia patients: results of a multicentre study.

OBJECTIVE: The efficacy of three newly developed cognitive social skills training programmes for residential, vocational and recreational functioning (experimental groups) were compared with a traditional social skills training programme (control group) referring to cognitive and social abilities, psychopathology and generalisation effects. METHOD: One hundred and five patients with a diagnosis of schizophrenia or schizoaffective disorder according to ICD-10 criteria were selected and assigned to the different treatment groups, using a matching procedure. The treatment phase lasted 6 months. A follow-up assessment was carried out after 1 year. RESULTS: Higher global therapy effects were obtained on almost all dependent variables in the experimental groups. Analyses of variance and covariance indicated higher symptom reduction for the experimental groups, but significantly greater improvements in some cognitive variables for the control group. Correlation analysis suggested associations between improvement of social behaviour with symptom reduction and improvements of cognitive skills. CONCLUSION: In view of these favourable effects, the developed cognitive social skills training programmes might facilitate the abilities of schizophrenia patients for their integration in the community.

Adult↗
PubMed2001

[Effects of new cognitive-behavioral therapy programs for improvement of specific social skills of schizophrenics--a controlled study].

Based on the Integrated Psychological Therapy (IPT) for schizophrenia patients, the Berne group developed three specific cognitive behaviour therapy programmes for treating residential, vocational, and recreational functioning. We added new cognitive-emotional methods to these programmes that were devised especially for schizophrenia patients, taking into consideration the criticism of traditional social skill training methods. In the present multicentre study, these new programmes (experimental group) were compared with a traditional social skills training programme (control group, IPT "Social Skills" subprogramme). Both the therapy and aftercare phase each lasted 12 weeks and the follow-up phase 1 year. Assessment instruments covered psychopathology, cognitive functioning, and social adjustment. Higher ratings of global treatment effects and significant reductions in symptoms were obtained in the experimental group. In view of the favourable results, these newly designed social skill training programmes may replace more conventional therapy approaches in the future.

Adult↗
PubMed2001

Satisfaction of inpatients and outpatients with staff, environment, and other patients.

The study described here compared levels of satisfaction with staff, environment, and other patients among 420 first-time and long-term patients in psychiatric outpatient and inpatient settings. The demographic, clinical, and outcome variables associated with satisfaction were explored. Patient satisfaction was related to quality of life, social functioning, treatment expectations, and one-year psychological and physical prognoses. Perceptions of other patients were significantly more positive among long-term patients than among first-time patients. The concerns of first-time patients about other patients are of special importance, and they should be addressed during initial treatment.

Adult↗
PubMed2000

[Assisted living for former long-term hospitalized psychiatric patients].

OBJECTIVES: The aim of the study is the evaluation of essential characteristics of patients who entered the sheltered group homes of the Psychosozialen Dienst (PSD) in the city of Vienna after the establishment of sectorized psychiatric out-patient care facilities. METHOD: Eighty patients who lived in these group homes on the first key day, June 30th 1993, were investigated. Any change in their living situation and rate of hospitalization was ascertained at follow-up, 3.5 years after the first key day. RESULTS: The patients had an average period of hospitalization of 240.5 days per year before entry to a group home, which decreased to 12.4 days per year after entry to a sheltered group home. At follow-up more than half of all patients (65%) were still able to live in the community successfully. The number and the length of hospitalizations between the first key day and the follow-up were lowest for patients who had moved to private homes. CONCLUSIONS: Sheltered group homes play an essential role in the process of rehabilitation towards independent living within the community. The results demonstrate that rehabilitation in private apartments can be possible even after 5.7 years of residence in sheltered group homes.

Adult↗
PubMed2000

[Quality of life of the mentally ill].

Object of this research project was to study the subjective quality of life of psychiatric patients. The vulnerability of 424 out- and inpatients was assessed. The Vulnerability Index, composed of: marital status, income, health, life conditions, occupation, and risk factors in childhood was used. According to their vulnerability, two groups of patients were differentiated: patients with high and low vulnerability. We compared these objective criteria of vulnerability with the subjective quality of life (Q-LES-Q). Quality of life was also compared with diagnosis, severity of illness, and treatment (first contact/long-term contacts). Quality of life of 250 patients was analysed after one year follow up. Patients with a low vulnerability score are more satisfied with 'social relations' than patients with a high vulnerability score. In-patients are more satisfied with 'social relations' than out-patients. Out-patients are more satisfied with their 'physical health', 'subjective feelings', 'leisure time activities', and 'overall life satisfaction' than in-patients. Patients with a mild affective disorder have a better 'life satisfaction' than patients with severe affective disorder. Quality of life of schizophrenics and of patients with anxiety and adjustment disorders has improved significantly after one year.

Adaptation, Psychological↗
PubMed2000

[Psychological concepts and treatments for chronic pain and somatoform syndromes].

Chronic pain syndromes and somatic syndromes not fully explained by organic pathology are common complaints presented by patients in general health care. Studies have shown the major role of psychological factors in the etiology of these disorders leading to new conceptualization of illness and cognitive behavioral approaches to treatment. Chronic pain and somatoform symptoms are dependent on individual resources of stress prevention strategies, coping skills, environmental influences on symptoms and dysfunctional cognitions and beliefs about illness. Psychological concepts, treatment approaches and specific interventions are demonstrated.

Adaptation, Psychological↗
PubMed2000

[Utilization of psychiatric treatment. Who drops out, who comes back and who stays?].

OBJECTIVE: The aim of this study is the prediction of specific factors associated with utilization patterns of mental health care. METHOD: Course of treatment of 272 out-patients and in-patients was observed for one year. Patients were asked five times (baseline, 1 month, 3, 6, and 12 months) about their utilization behavior. RESULTS: 71% of the patients continued treatment, 6% ended treatment in agreement with their therapists, and 23% dropped out of treatment. 24 patients of those who dropped out, i.e. 38% of this subgroup, returned to treatment during the one year period. Multivariate analyses indicate that continuity of treatment is associated with referrals from other institutions, male gender, the diagnosis of functional psychosis, high subjective well-being, and poor social functioning. First-time use of the corresponding institution, in-patient status, and living alone are predictors of treatment-dropout. Patients who ended treatment in agreement with their therapists are the best socially integrated group. Drop-outs who returned to treatment during the one year period have more unfavorable clinical premises, and are less well integrated socially than drop-outs who do not take up their treatment again. CONCLUSIONS: Therapeutic interventions, such as permanent efforts towards the maintenance of a supportive therapeutic relationship, motivate psychiatric patients to keep a continuing treatment-alliance. Well functioning communication between, or rather coordination of out-patient and in-patient treatment increases the chance of a continuous course of treatment.

Adult↗
PubMed2000

[Social vulnerability, social isolation of chronic psychiatric patients].

Social vulnerability and social isolation as to different, light and severe grades of chronically ill psychiatric patients were evaluated. A social vulnerability index, composed out of marital status, income, health, living conditions, occupation, and risk factors in childhood was used. The vulnerability of 64 severely chronically ill patients and of 84 chronically ill patients was assessed. According to their vulnerability, the patients were divided into a group of highly vulnerable and a group of less vulnerable patients. The social isolation of the two groups (severely chronically und chronically ill patients) was compared and assessed. We used objective criteria (such as living alone, no friends, no contact to family members) and subjective criteria (feeling isolated). Social Vulnerability and social isolation are higher in severely chronically ill patients compared to chronically ill patients. The severely sick group is significantly more affected by objective and/or by subjective isolation than the less sick group. In both groups patients have more difficulties in social relationships than non-isolated patients. There is no significant correlation between objective isolation and subjective isolation.

Adolescent↗
PubMed1996

[Ambulatory psychosocial and rehabilitation services in cerebral cognitive deficits].

Because of the well known changes in social and demographic structure of our population the availability of an integrated and coordinated attainment for psychosocial care for people with impaired cerebral function is of increasing importance. Vienna as the capital of the Federal Republic of Austria has structured psychosocial welfare services for the entire city, which consists of 8 psychosocial service regions ("catchment-areas"). 1 for every 200.00 inhabitants. For elderly psychosocially handicapped persons special supplies are provided. In this survey the methods and activities of these facilities are described. The increasing demand of psychosocial care for outpatients in the age of above 80 years is discussed; the importance of home visits is stressed.

Aged↗