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213 results on '"Gildberg, Frederik A."'

6. Mental health patients' preferences regarding restrictive interventions: An integrative review.

Author

Lindekilde, Camilla Rosendal, Pedersen, Martin Locht, Birkeland, Søren Fryd, Hvidhjelm, Jacob, Baker, John, and Gildberg, Frederik Alkier

Subjects
PSYCHOTHERAPY patients, PATIENT autonomy, MEDICAL information storage & retrieval systems, PATIENTS, RESEARCH funding, CONTROL (Psychology), MENTAL health, PSYCHIATRY, HOSPITAL admission & discharge, CINAHL database, RESTRAINT of patients, SECLUSION of psychiatric hospital patients, TRANQUILIZING drugs, DESCRIPTIVE statistics, SYSTEMATIC reviews, THEMATIC analysis, MEDLINE, COMMUNICATION, PSYCHIATRIC hospitals, PSYCHOSOCIAL factors, PATIENTS' attitudes, PSYCHOLOGY information storage & retrieval systems
Abstract

Accessible summary: What is known on the subject?: The use of restrictive interventions is described as a violation of patients' rights and autonomy. It must only be used as a last resort to manage dangerous behaviour, to prevent or reduce the risk of mental health patients harming themselves or others.International mental health policy and legislation agree that when restrictive interventions are applied, the least restrictive alternative should be chosen. What the paper adds to existing knowledge?: The results are ambiguous, as to which restrictive intervention is preferred over others, but there are tendencies towards the majority preferring observation, with mechanical restraint being the least preferred.To make the experience less intrusive and restrictive, certain factors are preferred, such as a more pleasant and humane seclusion room environment, staff communicating during the application and staff of same gender applying the intervention. What are the implications for practice?: When applying restrictive interventions, mental health professionals should consider environment, communication and duration factors that influence patient preferences, such as the opportunity to keep some personal items in the seclusion room, or, when using restraint, to communicate the reason and explain what is going to happen.More research is needed to clarify patients' preferences regarding restrictive interventions and their views on which are the least restrictive. Preferably, agreement is needed on standard measures, and global use of the same definition of restrictive interventions. Introduction: The use of restrictive interventions is a violation of patients' rights that causes physical and psychological harm and which is a well‐known challenge globally. Mental health law and legislative principles and experts agree that when restrictive interventions are applied, the least restrictive alternative should be used. However, there is no consensus on what is the least restrictive alternative, especially from the patient perspective. Aim: To investigate the literature on mental health patients' preferences regarding restrictive interventions applied during admission to a psychiatric hospital. Method: An integrative review informed by the PRISMA statement and thematic analysis were undertaken. Results: There were tendencies towards patients preferring observation and, for the majority, mechanical restraint was the least preferred restrictive intervention. Factors such as environment, communication and duration were found to influence patients' preferences. Discussion: There is a lack of agreement on how best to measure patients' preferences and this complicates the choice of the least restrictive alternative. Nonetheless, our findings show that staff should consider environment, communication and duration when applying restrictive interventions. Implications for Practice: More research on restrictive interventions and the least restrictive alternative is warranted, but agreement is needed on standard measures, and a standard global definition of restrictive interventions. [ABSTRACT FROM AUTHOR]

Published
2024
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14. A systematic review of interventions to reduce mechanical restraint in adult mental health inpatient settings.

Author

Pedersen, Martin Locht, Gildberg, Frederik Alkier, Baker, John, and Tingleff, Ellen Boldrup

Subjects
*MEDICAL information storage & retrieval systems, *MENTAL health services, *MENTAL health, *RESEARCH funding, *CONTENT analysis, *CINAHL database, *HOSPITAL patients, *RESTRAINT of patients, *SYSTEMATIC reviews, *MEDLINE, *EVIDENCE-based medicine, *ONLINE information services, *PSYCHIATRIC nursing
Abstract

Mechanical restraint is a commonly used restrictive practice worldwide, although reducing its use is an international priority. Interventions to reduce mechanical restraint are needed if reducing mechanical restraint is to succeed. Therefore, this systematic review aimed to examine evaluated evidence‐based interventions that seek to reduce the incidence of and/or time in mechanical restraint in adult mental health inpatient settings. The JBI framework was used to guide this systematic review. The search strategy included peer‐reviewed primary research literature published between 1999 and 2023. Two authors independently conducted the systematic search, selection process and data extraction process. Forty‐one studies were included in this review. Using content analysis, we grouped interventions into four categories: (I) calm‐down methods, (II) staff resources, (III) legal and policy changes and (IV) changing staff culture. Interventions to reduce mechanical restraint in adult mental health inpatient settings have shown some promise. Evidence suggests that a range of interventions can reduce the incidence of and/or time in mechanical restraint. However, controlled trials were lacking and consensus was lacking across studies. Furthermore, specific findings varied widely, and reporting was inconsistent, hampering the development of interventions for this issue. Further research is needed to strengthen the evidence base for reducing mechanical restraint in mental health inpatient settings. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Brug af mindst indgribende tvangsforanstaltninger på psykiatriske afdelinger::et registerbaseret kohortestudie af 131.632 første og efterfølgende tvangsepisoder under 35.812 indlæggelser

Author

Linkhorst, Thea, Birkeland, Søren Fryd, Gildberg, Frederik Alkier, Mainz, Jan, Torp-Pedersen, Christian Tobias, and Bøggild, Henrik

Abstract

Introduktion: Psykiatrilovgivningen i Danmark indeholder et princip om at anvende de mindst indgribende former for tvang først. Vi undersøgte rækkefølgen, hvori tvangstyper blev brugt, idet de først anvendte forventedes at være mindre indgribende end de følgende typer.Materiale og metoder: For tvangsepisoder indberettet til det nationale register over tvang i psykiatrien for perioden 2011-16 blev rækkefølgen på 12 tvangsindgreb under hver indlæggelse undersøgt. Sammenlignet med bæltefiksering blev odds ratio (OR) og konfidensintervaller (95 % CI) for at være første eller efterfølgende brugte typer estimeret ved hjælp af betingede (96.611 episoder) og ubetingede (131.632 episoder) logistiske regressionsmodeller, stratificeret på køn. Analyserne blev desuden gentaget for alle regioner.Resultater: I alt 17.796 patienter i alderen 18+ blev udsat for mindst én tvangsepisode. Mediantiden mellem indlæggelse og første episode var 4 dage hos mænd og 6 for kvinder. For kvinder blev tvangstilbageholdelse, tvangsernæring, tvangsbehandling af somatisk lidelse, låsning af døre og personlig skærmning iværksat før bæltefiksering, og tvungen opfølgning, ECT, tvangsbehandling, brug af handsker og remme, fysisk fastholdelse og indgift af intramuskulær medicin ved tvang brugt senere. Hos mænd blev kun tvangstilbageholdelse iværksat før bæltefiksering, mens ECT, skærmning, administration af lægemidler, brug af handsker og remme, fysisk fastholdelse og tvungen intramuskulær medicin blev anvendt statistisk signifikant hyppigere senere end bæltefiksering. Der var forskelle i mønstrene mellem regionerneDiskussion og konklusion: Rækkefølgen af anvendte tvangstyper synes ikke at stemme overens med mindste middel princippet, især bruges bæltefiksering som første tvangstype hos mænd og hos yngre voksne.

Published
2023

27. Use of the least intrusive coercion at Danish psychiatric wards:A register-based cohort study of 131,632 first and subsequent coercive episodes within 35,812 admissions

Author

Linkhorst, Thea, Birkeland, Søren Fryd, Gildberg, Frederik Alkier, Mainz, Jan, Torp-Pedersen, Christian, Boggrid, Henrik, Linkhorst, Thea, Birkeland, Søren Fryd, Gildberg, Frederik Alkier, Mainz, Jan, Torp-Pedersen, Christian, and Boggrid, Henrik

Abstract

Objective: Psychiatric legislation in Denmark implies a principle of using the least intrusive types of coercion first. The intrusiveness is not universally agreed upon. We examined the order in which coercive measures during admission were used, implying that the first used should be less intrusive than the following types. Methods: For coercive episodes reported to the national administrative register for the period 2011-16, the order of 12 legal coercive interventions during each admission was examined. Comparing with mechanical restraint, the odds ratio (OR) and confidence interval (95%CI) of being first or subsequent used types were estimated using conditioned (96,611 episodes) and unconditioned (131,632 episodes) logistic regression models, stratified on sex.Results: Totally 17,796 patients aged 18+ were subjected to at least one coercive episode. The median time between admission and the first episode was 4 days in men and 6 for women. For females, involuntary detention, forced feeding, coercive treatment of somatic disorder, locking of doors and close observations in females were used before mechanical restraint, and forced follow-up, involuntary electro convulsive therapy (ECT), forced treatment, use of gloves and straps, physical restraint and forced intramuscular medication was used later. In men, only involuntary detention was used before mechanical restraint, while involuntary ECT, close observa-tions, administration of drugs, use of gloves and straps, physical restraint and forced intramuscular medication was used after mechanical restraint.Conclusion: The order of used coercive measures is not consistent with the international ranking of the least intrusive types, especially in men and in younger adults.

Published
2022

32. Hospitalisation time is associated with weight gain in forensic mental health patients with schizophrenia or bipolar disorder.

Author

Pedersen, Anne Louise Winkler, Gildberg, Frederik Alkier, Hjorth, Peter, Højlund, Mikkel, and Andersen, Kjeld

Subjects
*WEIGHT gain, *BIPOLAR disorder, *PEOPLE with mental illness, *MENTAL health, *PEOPLE with schizophrenia
Abstract

People with mental disorders have higher mortality from lifestyle diseases than the general population. Forensic mental health patients (FMHPs) are often hospitalised for longer periods of time than non-FMHPs. Thus, hospitalisation may have a greater effect on the risk of lifestyle diseases in FMHPs. Investigate associations between proportional hospitalisation time (PHT) and change in body weight or other cardiometabolic risk factors among FMHPs. Retrospective cohort study including all FMHPs with schizophrenia or bipolar disorder, prescribed antipsychotics, and treated between 01 January 2016 and 06 April 2020 in the Region of Southern Denmark either in forensic units or as outpatients. Associations between PHT and, respectively, primary and secondary outcomes were analysed using linear regression. PHT was determined between each measurement of the outcomes as the number of days hospitalised divided by the total number of days within the time-period. The primary outcome was weight change and secondary outcomes were change in waist circumference (WC), blood pressure, estimated average glucose (eAG), HDL, LDL, total cholesterol, and triglycerides. Analyses were adjusted for gender, age, smoking, and antipsychotics. The cohort included 490 FMHPs, of which 440 were diagnosed with schizophrenia. PHT had a significant positive dose-response association with weight change, with an estimated difference of +4.0 kg/year for FMHPs who were hospitalised 100% of the time, compared to FMHPs who were exclusively treated as outpatients. The association interacted with baseline BMI. From the secondary outcomes, the association with PHT was only statistically significant for WC. PHT was positively associated with weight gain. [ABSTRACT FROM AUTHOR]

Published
2023
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35. Videoconferences and Treatment of Depression:Satisfaction Score Correlated with Number of Sessions Attended but Not with Age

Author

Christensen, Lone Fisker, Gildberg, Frederik, Sibbersen, Christian, Skjøth, Mette Maria, Nielsen, Connie Thurøe, and Hansen, Jens Peter

Subjects
videoconferences, age, Depression, telehealth, Videoconferencing, Age Factors, e-Health, satisfaction, telemedicine, Telemedicin
Abstract

Aim: To investigate whether there is a correlation between age and satisfaction with the use of videoconferences (VCs) and whether the number of video sessions had an impact on satisfaction. Methods: This study was a subanalysis of the joint European project, MasterMind, and participants were recruited from15 pilot studies in 11 different countries. The Client Satisfaction Questionnaire 8 (CSQ 8) was used as assessment tool, and scores were summed to give total scores. Results: Participants were included if they had filled out the CSQ 8 questionnaire and demographic data were available. This resulted in a total of 199 participants. We found that the total score was not significantly correlated with age (Spearman's rho = −0.0415, p = 0.563) and gender (Wilcoxon W = 5,066, p = 0.409). There was a significant positive correlation between number of sessions attended (Spearman's rho = 0.5777, p < 0.001) and total score after adjusting for age, gender, region, symptoms score, and education level in a multiple linear regression model (coefficient = 0.170, SE = 0.059, p = 0.004). Excluded responders were significantly younger than included responders, had lower symptoms score, attended fewer sessions, had a higher education, and were more likely to be employed. Conclusions: VC satisfaction scores in patients with unipolar depression do not depend on age but increase with experience in all age groups.

Published
2020
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36. Patients' and providers' experiences with video consultations used in the treatment of older patients with unipolar depression:A systematic review

Author

Christensen, Lone Fisker, Møller, Anne Marie, Hansen, Jens Peter, Nielsen, Connie Thurøe, and Gildberg, Frederik

Subjects
E-health, Depression, Communication, older adults, psychiatry
Abstract

WHAT IS KNOWN ON THE SUBJECT?: Depression is the most common cause of mental illness amongst older people. As a result of the growth of the older population, it is expected that an increasing number of older people will need treatment. Depression can be effectively treated-but fewer than half of those who are affected receive treatment. Barriers to receiving treatment are lack of resources and trained healthcare providers, social stigma, incorrect diagnoses and long distances to treatment facilities. There is an increased need for alternative ways of treating patients with depression. The use of video consultations has shown to be a viable option for delivering mental health care to older patients. Use of video consultations allows patients to receive treatment in their own homes. None of the existing reviews have focused on satisfaction with the use of video consultations amongst older people with depression. This paper provides knowledge regarding the use of video consultations, especially for older people with depression. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: No previous review has sought to understand the use of video consultations in mental health care to older patients with depression. The results show that video consultations support mental health practice, especially as a useful alternative when face-to-face therapy is not possible. An initial scepticism from participants quickly disappeared when video consultations were experienced in action. The challenges associated with the use of video consultations seem to consist of technical problems and lack of support from staff. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health practitioners should consider the use of video consultations because it can support mental health practice, especially as a useful alternative when face-to-face therapy is not possible. ABSTRACT: Introduction Depression is the leading cause of mental illness amongst an ageing population and fewer than half of those who are affected receive treatment. There is an increased need for alternative ways of treating patients; the use of video consultations has been shown to be a viable option for delivering mental health care. However, none of the existing reviews have focused on satisfaction with the use of video consultations amongst older people with depression and providers. Aim To conduct a systematic review of the existing literature focusing on patients' and providers' experiences of video consultations for depression. Method Eight scientific databases were searched. In all, 3,537 articles were identified and, of these, 21 peer-reviewed articles were included in this review. Results The results show that video consultations support mental health practice, especially as a useful alternative when face-to-face therapy is not possible. Any initial scepticism quickly disappeared when video consultations were experienced in action. The challenges seem to consist of technical problems and lack of support from staff. Discussion The experiences and satisfaction of older people with depression seem to be positive, although methodological limitations and deficiencies of the reviewed articles should be considered. More qualitative research is needed, and future studies should focus on specific diagnoses and providers' experiences. Implications for practice Video consultations support mental health practice, especially as a useful alternative when face-to-face therapy is not possible.

Published
2020
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37. Why do women with eating disorders decline treatment? A qualitative study of barriers to specialized eating disorder treatment

Author

Andersen, Sofie T., Linkhorst, Thea, Gildberg, Frederik A., Sjögren, Magnus, Andersen, Sofie T., Linkhorst, Thea, Gildberg, Frederik A., and Sjögren, Magnus

Abstract

Despite the fact that eating disorders (EDs) are conditions that are potentially life-threat-ening, many people decline treatment. The aim of this study was to investigate why women decline specialized ED treatment, including their viewpoints on treatment services. Eighteen semi-struc-tured qualitative interviews were conducted with women who had declined inpatient or outpatient specialized ED treatment. A thematic analysis revealed five main themes: (1) Disagreement on treatment needs, (2) rigid standard procedures, (3) failure to listen, (4) deprivation of identity, and (5) mistrust and fear. The women had declined ED treatment because they believed that treatment was only focused on nutritional rehabilitation and that it failed to address their self-identified needs. From their perspectives treatment was characterized by rigid standard procedures that could not be adapted to their individual situations and preferences. They felt that the therapists failed to listen to them, and they felt deprived of identity and reduced to an ED instead of a real person. This investigation is one of the first of its kind to provide clues as to how treatment could be moderated to better meet the needs of women who decline specialized ED treatment.

Published
2021
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