Factors influencing patients' recovery and the efficacy of a psychosocial post-discharge intervention: post hoc analysis of a randomized controlled trial

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art_HENGARTNER_Factors_influencing_patients_recovery_and_the_efficacy_of_2016.PDF (572.74 KB)
Citações na Scopus
2
Tipo de produção
article
Data de publicação
2016
Editora
SPRINGER HEIDELBERG
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
HENGARTNER, Michael P.
PASSALACQUA, Silvia
HEIM, Gisela
ANDREAE, Andreas
WYL, Agnes von
Autor de Grupo de pesquisa
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Organizadores
Citação
SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, v.51, n.12, p.1667-1677, 2016
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
The aim of this post hoc analysis was to examine self-reported recovery following a post-discharge intervention and to focus on the moderators of this intervention programme. RCT using parallel group block randomisation, including 151 patients with ae<currency>3 hospitalisations within the last 3 years, a GAF score ae<currency>60, and aged 18-64 years, assessed at two psychiatric hospitals from Zurich, Switzerland, between September 2011 and February 2014. In the present study, the main outcome was the OQ-45 as assessed prior to discharge from the index hospitalisation and at 12-month follow-up. Participants received either the post-discharge intervention provided by a social worker or treatment as usual (TAU). Patients in the intervention group showed substantially less recovery over the 12-month observation period than controls (d = 0.44). In the TAU group, 15.6 % remained clinically impaired at 12-month follow-up as opposed to 48.1 % in the intervention group (p = 0.001). Among participants in the intervention group, an interdisciplinary meeting of significant network members was associated with less recovery (d = 0.46). Involuntary index admission (d = 0.42) and high educational degree (d = 0.52) were significant moderators of the intervention. Both factors related to less recovery over time in the intervention group relative to TAU. According to the OQ-45, this psychosocial post-discharge intervention revealed an unintended negative effect on self-reported recovery over time. Specifically, the meeting of significant network members related to a moderate deteriorating effect, suggesting that the involvement of some carers, relatives, or friends may cause harm to the patient. Considering with reservation pending replication, these findings could have important implications for brief interventions targeted at patients' social networks. This study was supported by a private foundation. ISRCTN58280620.
Palavras-chave
Randomized controlled trial, Recovery, Social support, Discharge intervention, Case management
URI
https://observatorio.fm.usp.br/handle/OPI/18032
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Coleções
Artigos e Materiais de Revistas Científicas - LIM/27