The effects of intensive home treatment on self-efficacy in patients recovering from a psychiatric crisis
Tóm tắt
This study evaluated whether providing intensive home treatment (IHT) to patients experiencing a psychiatric crisis has more effect on self-efficacy when compared to care as usual (CAU). Self-efficacy is a psychological concept closely related to one of the aims of IHT. Additionally, differential effects on self-efficacy among patients with different mental disorders and associations between self-efficacy and symptomatic recovery or quality of life were examined. Data stem from a Zelen double consent randomised controlled trial (RCT), which assesses the effects of IHT compared to CAU on patients who experienced a psychiatric crisis. Data were collected at baseline, 6 and 26 weeks follow-up. Self-efficacy was measured using the Mental Health Confidence Scale. The 5-dimensional EuroQol instrument and the Brief Psychiatric Rating Scale (BPRS) were used to measure quality of life and symptomatic recovery, respectively. We used linear mixed modelling to estimate the associations with self-efficacy. Data of 142 participants were used. Overall, no difference between IHT and CAU was found with respect to self-efficacy (B = − 0.08, SE = 0.15, p = 0.57), and self-efficacy did not change over the period of 26 weeks (B = − 0.01, SE = 0.12, t (103.95) = − 0.06, p = 0.95). However, differential effects on self-efficacy over time were found for patients with different mental disorders (F(8, 219.33) = 3.75, p < 0.001). Additionally, self-efficacy was strongly associated with symptomatic recovery (total BPRS B = − 0.10, SE = 0.02, p < 0.00) and quality of life (B = 0.14, SE = 0.01, p < 0.001). Although self-efficacy was associated with symptomatic recovery and quality of life, IHT does not have a supplementary effect on self-efficacy when compared to CAU. This result raises the question whether, and how, crisis care could be adapted to enhance self-efficacy, keeping in mind the development of self-efficacy in depressive, bipolar, personality, and schizophrenia spectrum and other psychotic disorders. The findings should be considered with some caution. This study lacked sufficient power to test small changes in self-efficacy and some mental disorders had a small sample size. Trial registration This trial is registered at Trialregister.nl, number NL6020.
Tài liệu tham khảo
Johnson S, Nolan F, Pilling S, Sandor A, Hoult J, McKenzie N, et al. Randomised controlled trial of acute mental health care by a crisis resolution team: the north Islington crisis study. BMJ (Clinical research ed). 2005;331(7517):599.
Stulz N, Wyder L, Maeck L, Hilpert M, Lerzer H, Zander E, et al. Home treatment for acute mental healthcare: randomised controlled trial. Br J Psychiatry. 2019;8:1–8.
James RK. Crisis intervention strategies. Belmont, CA: Thomson Brooks/Cole; 2008.
Prinsen E. Wel Bv. Mulder N. Handboek intensive home treatment. Utrecht: De Tijdstroom; 2016.
Johnson S. Crisis resolution and home treatment teams: an evolving model. Adv Psychiatr Treat. 2013;19(2):115–23.
Health Do. The Mental Health Policy Implementation Guide. In: Health; Do, editor. UK: Crown Copyright; 2001.
Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215.
Bandura A. Social foundations of thought and action: A social cognitive theory: Englewood Cliffs. NJ: Prentice Hall; 1986.
Bandura A. Self-efficacy: The exercise of control. New York, NY, US: W H Freeman/Times Books/ Henry Holt & Co; 1997. ix, 604-ix, p.
Abraham KM, Miller CJ, Birgenheir DG, Lai Z, Kilbourne AM. Self-efficacy and quality of life among people with bipolar disorder. J Nerv Ment Dis. 2014;202(8):583–8.
Castro EM, Van Regenmortel T, Vanhaecht K, Sermeus W, Van Hecke A. Patient empowerment, patient participation and patient-centeredness in hospital care: a concept analysis based on a literature review. Patient Educ Couns. 2016;99(12):1923–39.
Van Eck RM, Burger TJ, Vellinga A, Schirmbeck F, de Haan L. The relationship between clinical and personal recovery in patients with schizophrenia spectrum disorders: a systematic review and meta-analysis. Schizophr Bull. 2017;44(3):631–42.
Tonga JB, Eilertsen D-E, Solem IKL, Arnevik EA, Korsnes MS, Ulstein ID. Effect of self-efficacy on quality of life in people with mild cognitive impairment and mild dementia: the mediating roles of depression and anxiety. Am J Alzheimer’s Dis Other Dementias. 2020;35:1533317519885264.
Macpherson R. The relationship between clinical and recovery dimensions of outcome in mental health. Schizophr Res. 2016;175(1–3):142.
Thomas KA, Rickwood D. Clinical and cost-effectiveness of acute and subacute residential mental health services: a systematic review. Psychiatric Services. 2013;64:1140–9.
Isaac V, Wu CY, McLachlan CS, Lee MB. Associations between health-related self-efficacy and suicidality. BMC Psychiatry. 2018;18(1):126.
Buckman JEJ, Underwood A, Clarke K, Saunders R, Hollon SD, Fearon P, et al. Risk factors for relapse and recurrence of depression in adults and how they operate: a four-phase systematic review and meta-synthesis. Clin Psychol Rev. 2018;64:13–38.
Iancu I, Bodner E, Ben-Zion IZ. Self esteem, dependency, self-efficacy and self-criticism in social anxiety disorder. Compr Psychiatry. 2015;58:165–71.
Schmidt SJ, Grunert V-M, Schimmelmann BG, Schultze-Lutter F, Michel C. Differences in coping, self-efficacy, and external control beliefs between patients at-risk for psychosis and patients with first-episode psychosis. Psychiatry Res. 2014;219(1):95–102.
Clarke J, Proudfoot J, Birch MR, Whitton AE, Parker G, Manicavasagar V, et al. Effects of mental health self-efficacy on outcomes of a mobile phone and web intervention for mild-to-moderate depression, anxiety and stress: secondary analysis of a randomised controlled trial. BMC Psychiatry. 2014;14:272.
Chang WC, Kwong VWY, Hui CLM, Chan SKW, Lee EHM, Chen EYH. Relationship of amotivation to neurocognition, self-efficacy and functioning in first-episode psychosis: a structural equation modeling approach. Psychol Med. 2017;47(4):755–65.
Morant N, Lloyd-Evans B, Lamb D, Fullarton K, Brown E, Paterson B, et al. Crisis resolution and home treatment: stakeholders’ views on critical ingredients and implementation in England. BMC Psychiatry. 2017;17(1):254.
Winness MG, Borg M, Kim HS. Service users’ experiences with help and support from crisis resolution teams: a literature review. J Ment Health (Abingdon, England). 2010;19(1):75–87.
Crisis Resolution and Home Treatment in Mental Health. Cambridge: Cambridge University Press; 2008.
Singh NN, Barber JW, Van Sant S. Handbook of recovery in inpatient psychiatry. Singh NN, editor. Augusta, USA: Springer; 2016.
Cornelis J, Barakat A, Dekker J, Schut T, Berk S, Nusselder H, et al. Intensive home treatment for patients in acute psychiatric crisis situations: a multicentre randomized controlled trial. BMC Psychiatry. 2018;18:1.
Zelen M. A new design for randomized clinical trials. N Engl J Med. 1979;300(22):1242–5.
Castelein S, van der Gaag M, Bruggeman R, van Busschbach JT, Wiersma D. Measuring empowerment among people with psychotic disorders: a comparison of three instruments. Psychiatric Serv (Washington, DC). 2008;59(11):1338–42.
Carpinello SE, Knight EL, Markowitz FE, Pease EA. The development of the Mental Health Confidence Scale: A measure of self-efficacy in individuals diagnosed with mental disorders. Psychiatr Rehabil J. 2000;23(3):236–43.
Versteegh M, Vermeulen K, Evers S, de Wit GA, Prenger R, Stolk E. Dutch Tariff for the Five-Level Version of EQ-5D. Value in Health. 2016;19(4):343–52.
Pitkänen A, Välimäki M, Endicott J, Katajisto J, Luukkaala T, Koivunen M, et al. Assessing quality of life in patients with schizophrenia in an acute psychiatric setting: Reliability, validity and feasibility of the EQ-5D and the Q-LES-Q. Nord J Psychiatry. 2012;66(1):19–25.
Ruggeri M, Koeter M, Schene A, Bonetto C, Vazquez-Barquero JL, Becker T, et al. Factor solution of the BPRS-expanded version in schizophrenic outpatients living in five European countries. Schizophr Res. 2005;75(1):107–17.
Mancini MA. The role of selfefficacy in recovery from serious psychiatric disabilities: A qualitative study with fifteen psychiatric survivors. Qualitative Social Work. 2007;6(1):49.
Benight CC, Bandura A. Social cognitive theory of posttraumatic recovery: the role of perceived self-efficacy. Behav Res Ther. 2004;42(10):1129–48.
González-Blanch C, Hernández-de-Hita F, Muñoz-Navarro R, Ruíz-Rodríguez P, Medrano LA, Cano-Vindel A. The association between different domains of quality of life and symptoms in primary care patients with emotional disorders. Sci Rep. 2018;8(1):11180.
Karow A, Wittmann L, Schoettle D, Schaefer I, Lambert M. The assessment of quality of life in clinical practice in patients with schizophrenia. Dialogues Clin Neurosci. 2014;16(2):185.
Tahmassian K, Jalali MN. Relationship between self-efficacy and symptoms of anxiety, depression, worry and social avoidance in a normal sample of students. Iran J Psychiatry Behav Sci. 2011;5(2):91–8.
Bonsaksen T, Heir T, Ekeberg Ø, Grimholt TK, Lerdal A, Skogstad L, et al. Self-evaluated anxiety in the Norwegian population: prevalence and associated factors. Arch Public Health. 2019;77:10.
Schwarzer R. Self-Efficacy: Thought Control of Action1992.
Greenfield BL, Venner KL, Kelly JF, Slaymaker V, Bryan AD. The impact of depression on abstinence self-efficacy and substance use outcomes among emerging adults in residential treatment. Psychol Addict Behav. 2012;26(2):246–54.
Aldao A, Nolen-Hoeksema S, Schweizer S. Emotion-regulation strategies across psychopathology: a meta-analytic review. Clin Psychol Rev. 2010;30(2):217–37.
Aldao A, Sheppes G, Gross JJ. Emotion regulation flexibility. Cogn Ther Res. 2015;39(3):263–78.
Carver CS, Connor-Smith J. Personality and coping. Annu Rev Psychol. 2010;61:679–704.
Knowles R, Tai S, Jones SH, Highfield J, Morriss R, Bentall RP. Stability of self-esteem in bipolar disorder: comparisons among remitted bipolar patients, remitted unipolar patients and healthy controls. Bipolar Disord. 2007;9(5):490–5.
Lima IMM, Peckham AD, Johnson SL. Cognitive deficits in bipolar disorders: Implications for emotion. Clin Psychol Rev. 2018;59:126–36.
IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp.