Biomedical subjects

J Farhall

Publications and source records attributed to J Farhall.

4 recordsLinked to original sources

PubMed2001

From long-stay psychiatric hospital to Community Care Unit: evaluation at 1 year.

BACKGROUND: In the context of deinstitutionalization of psychiatric services, Community Care Units (CCUs) were developed to provide accommodation, clinical care and rehabilitation for patients discharged from the long-stay open wards of a large psychiatric hospital that was in the process of closing. CCUs are 20-bed units built in suburban locations and staffed on a 24-h basis by multidisciplinary clinical teams. METHOD: An initial group of 125 hospital patients was assessed at 1 month pre-move, 1 month post-move, and again at 1 year, on range of measures covering clinical status, personal functioning, quality of life, residential preferences, aggressive behaviour, and social networks. Staff attitudes, relative and carer perceptions and preferences, and residential environments were also assessed. RESULTS: Most of the transferred patients were still resident in their CCU at 1 year. The clearest result was that patients showed improved quality of life in relation to their living environment. Comparison of the hospital and CCU environments showed that the latter were significantly less restrictive and regimented. Most relatives and carers also preferred the CCU. On average, symptom and disability levels were little changed at 1 year. CONCLUSIONS: Our results suggest that the CCU is an appropriate form of service delivery for most long-stay hospital inpatients, but that both more and less supervised settings are also required. While symptoms and disability were little changed at 1 year, it is possible that further follow-up may detect delayed or slow changes. Given the widespread replacement of psychiatric hospitals with community-based services, the future role of the CCU needs to be reviewed.

Adult↗

PubMed2001

Hospital versus home care for the acutely mentally ill? Preferences of caregivers who have experienced both forms of service.

OBJECTIVE: Demonstration studies of community treatment as an alternative to hospitalization have reported high degrees of satisfaction by family carers. We aimed to determine the extent of carer preference for hospital versus community treatment for acute mental illness in a routine setting where carers had experienced both service types. METHOD: Patients who had contact with both a hospital inpatient service and a Crisis Assessment and Treatment (CAT) team within the previous 5 years were identified. Seventy-seven family carers of these patients completed a questionnaire which identified their preference for services, and psychological and demographic variables likely to be predictive of their choice. RESULTS: Only half the carers preferred a CAT service to treat their relative in the event of a future relapse. Psychological variables were better predictors of choice than were demographic variables. CONCLUSIONS: The proportion of caregivers who prefer community treatment for acute psychosis may be smaller than previously thought. The lower carer satisfaction found here may be associated with the short-term interventions of Victoria's CAT teams, the severity of acute relapses and the duration of the patient's mental health problem.

Acute Disease↗

PubMed1998

Training to enhance partnerships between mental health professionals and family caregivers: a comparative study.

A training program for mental health staff was collaboratively developed and delivered by family caregivers and professionals. It addressed calls for less blaming attitudes toward families and increased contact between professionals and families. Two levels of training were compared. Twenty-seven staff members completed a 30-hour extended 12-week program. Eighty-two percent of all eligible staff from area teams attended a brief program involving three or six hours of training. Self-ratings of competence and attitudes toward families improved only for staff receiving extended training. Contacts with families increased for those in the extended program but not for all types of teams, suggesting that length of training and service type may limit the impact of training.

Analysis of Variance↗

PubMed1997

Coping with hallucinations: exploring stress and coping framework.

This study explored application of the theoretical framework of Lazarus & Folkman (1984) to coping with hallucinations in schizophrenia. Eighty-one patients were interviewed with a structured schedule. Unprompted reports of coping indicated wide use of both 'hallucination-specific' and 'general' strategies. Factor analysis of a coping checklist produced three factors which were utilized in regression analyses. The active acceptance factor may relate to control of hallucinations, the passive coping factor predicted distress reduction but, surprisingly, the resistance coping factor, which contained hallucination-specific coping strategies, predicted poor distress reduction. Clinical and research implications are noted.

Adaptation, Psychological↗