Background and Objectives: Tuberculosis (TB) continues to be a public health concern in the Philippines. Vulnerable populations in congregate settings such as drug abuse treatment and rehabilitation centers (DATRCs) have higher risks of TB transmission and infection. With the Duterte administration’s intensified campaign against illegal drugs, government-retained DATRCs are filled to capacity. There is an identified need to profile drug users and dependents living in DATRCs. Furthermore, national guidelines for TB management specific to this population is absent. A study was conducted to determine the profile of admitted clients diagnosed with TB, TB prevalence, treatment outcomes and choice of TB diagnostic modalities in six (6) Luzon-based DATRCs from 2013-2015. Methods: All medical records of drug users admitted in this period were reviewed. Information on the total patient census was sought from DATRC heads and used to compute for prevalence. Results: A total of 347 records were obtained. Overall TB prevalence in the study sites was 7,216 per 100,000 population. The typical individual diagnosed with TB in a DATRC was male, with a mean age of 35 years, with at least high school education, and unemployed. Weight loss and fatigue were the most common symptoms reported. The majority (79.83%) completed TB treatment in the DATRCs. Sputum microscopy and chest x-ray were both used for TB diagnosis in 92.80% (322) of the cases. Conclusion The high burden of TB in Luzon-based, government-retained DATRCs is alarming and underscore the critical need for standards and guidelines in the National Tuberculosis Control Program addressing the unique context of these facilities.
Substance Abuse Treatment Centers ; Prevalence ; Philippines ; Tuberculosis ; Psychiatric Rehabilitation ; Behavior Therapy

OBJECTIVES: To identify factors related to physical health monitoring of patients with schizophrenia spectrum disorder. METHODS: A total of 172 patients with schizophrenia spectrum disorder registered in mental health welfare centers and rehabilitation facilities in Gwangju were recruited. Physical health monitoring was defined by two health behaviors; fasting blood tests within recent 2 years in all participants and routine medical check-ups covered by national insurance within recent 5 years in participants aged 40 years or older. Demographic and clinical characteristics including overweight, metabolic syndrome and knowledge about physical illness were compared according to physical health monitoring. RESULTS: Prevalence of overweight and metabolic syndrome were 62.8% and 40.1%, respectively. The rates of fasting blood tests and routine medical check-ups were 34.9% and 67.9%, respectively. The rates of fasting blood tests were significantly higher in general hospital and university hospital compared to mental hospital or private clinic. Rates of routine medical check-ups were significantly lower in individuals using daily rehabilitation service and smokers. Knowledge about cancer and chronic illness were significantly better in individuals receiving routine medical check-ups compared with those not receiving it. CONCLUSION: Education about physical health should be integrated to mental health service in community mental health center.
Chronic Disease ; Education ; Fasting ; Gwangju ; Health Behavior ; Hematologic Tests ; Hospitals, General ; Hospitals, Psychiatric ; Humans ; Insurance ; Mental Health ; Mental Health Services ; Overweight ; Prevalence ; Rehabilitation ; Schizophrenia ; Smoking

PURPOSE: This study aimed to determine the influence of injury and/or injured area classification on depression in patients with industrial injuries. METHODS: The participants comprised438 patients who consented to participate and completed self-reported questionnaires. Data were analyzed using SPSS/WIN version 22.0 for descriptive statistics, χ² test, fisher's exact test, ANOVA, and post-hoc Scheffé test. A stepwise multiple regression analysis was used to identify factors influencing depression. RESULTS: The results indicated that the effect of disease classification and injured areas on depression were significantly different in patients with industrial injuries. The results further showed that severe depression was significantly higher in cardiovascular patients and patients with an injured area of the head and waist. The most powerful predictor was age (50~59 years), return to work (reemployment), disease classification (cardiovascular), and injured area (head, including vascular disease). CONCLUSION: This study showed that the most influential variable of depression in patients with industrial injuries were cardiovascular issues, injury areas of the head and waist, being aged 50~59 years, and reemployment. To reduce depression in these patients, it is important to develop and implement a psychiatric rehabilitation program that helps patients to formulate a concrete plan and goal for recovery, enabling patients to actively engage in their rehabilitation.
Accidents, Occupational ; Classification ; Depression ; Head ; Humans ; Occupational Diseases ; Psychiatric Rehabilitation ; Rehabilitation ; Return to Work

Background: Psychosocial care remains an important component in holistic care nursing and is crucial for patients’ recovery outcomes. Objective: The purpose of the study was to determine nurses’ perception towards their role in psychosocial care. Methodology: The research design was descriptive and cross-sectional. Nurses’ Role in Psychosocial Care Questionnaire (NRPCQ) was used for data collection and approximately 110 registered nurses (response rate = 52.38%) participated in the study via convenience sampling. Descriptive and inferential statistics, Mann-Whitney U test were used for data analysis. Results: In general, nurses’ perception towards their role in providing psychosocial care was positive (M = 73.71, SD ± 12.20). Items on “demonstrating warmth and friendliness by smiling” (M = 3.92, SD ± 0.28); and “explaining nursing procedures or interventions to the patient” (M = 3.88, SD ± 0.32) were rated most positive. Nevertheless, items on “referring patients to other health care team members” (M = 3.32, SD ± 0.83), and “discussing with patient and patient’s family regarding planned care” (M = 3.44, SD ± 0.69) were rated the least positive. The Mann-Whitney U test analysis revealed significant association between nurses’ age and perception towards their role in psychosocial care (p = 0.025), in which the older nurses have a more positive perception towards their role in psychosocial care than the younger nurses. Conclusion: The findings highlighted some important gaps in the practice of psychosocial care among the registered nurses. The information serves as a baseline for the planning and implementing of relevant strategies in enhancing nurses’ role in psychosocial care provision.
Perception ; Role ; Psychiatric Rehabilitation ; Nurses ; Hospitals

OBJECTIVES: Severe mental illness is a major risk factor for suicide. This study aimed to identify characteristics of patients who died by suicide among subjects who had been received service from a community mental health center. METHODS: We searched individuals who had committed suicide in Gwangju Bukgu Community Mental Health Center since 2006. Sociodemographic and clinical data were gathered from medical records and their case managers and they were compared with those of general members in the center. Characteristics of schizophrenia patients who died by suicide were particularly summarized. RESULTS: Twelve person committed suicide between 2006 and 2016. The characteristics of those who died by suicide were male (67%), diagnosis of schizophrenia (75%), aged below 50 (83%), unemployed (92%), past history of psychiatric hospitalization (100%), recent admission within 3 months (67%), past history of suicidal attempt (78%), family history of schizophrenia (58%), poor adherence to medication (58%), and use of daily rehabilitation program (42%). Ten out of twelve (83%) showed warning sign for suicide. All identified method of suicide in patients with schizophrenia was jumping from high building. Many patients with schizophrenia, who committed suicide, suffered from comorbid depressive symptoms (67%) and auditory hallucination (78%). CONCLUSION: Case managers should pay attention to and carefully manage individuals who showed suicidal warning, particularly with risk factors for suicide, such as unemployment, admission state or recent discharge from psychiatric hospital, poor adherence to medication, family history of schizophrenia, and a history of suicidal attempt.
Case Management ; Depression ; Diagnosis ; Gwangju ; Hallucinations ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Male ; Medical Records ; Mental Health* ; Methods ; Rehabilitation ; Risk Factors ; Schizophrenia ; Suicide* ; Unemployment

OBJECTIVES: Severe mental illness is a major risk factor for suicide. This study aimed to identify characteristics of patients who died by suicide among subjects who had been received service from a community mental health center. METHODS: We searched individuals who had committed suicide in Gwangju Bukgu Community Mental Health Center since 2006. Sociodemographic and clinical data were gathered from medical records and their case managers and they were compared with those of general members in the center. Characteristics of schizophrenia patients who died by suicide were particularly summarized. RESULTS: Twelve person committed suicide between 2006 and 2016. The characteristics of those who died by suicide were male (67%), diagnosis of schizophrenia (75%), aged below 50 (83%), unemployed (92%), past history of psychiatric hospitalization (100%), recent admission within 3 months (67%), past history of suicidal attempt (78%), family history of schizophrenia (58%), poor adherence to medication (58%), and use of daily rehabilitation program (42%). Ten out of twelve (83%) showed warning sign for suicide. All identified method of suicide in patients with schizophrenia was jumping from high building. Many patients with schizophrenia, who committed suicide, suffered from comorbid depressive symptoms (67%) and auditory hallucination (78%). CONCLUSION: Case managers should pay attention to and carefully manage individuals who showed suicidal warning, particularly with risk factors for suicide, such as unemployment, admission state or recent discharge from psychiatric hospital, poor adherence to medication, family history of schizophrenia, and a history of suicidal attempt.
Case Management ; Depression ; Diagnosis ; Gwangju ; Hallucinations ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Male ; Medical Records ; Mental Health* ; Methods ; Rehabilitation ; Risk Factors ; Schizophrenia ; Suicide* ; Unemployment

PURPOSE: The purpose of this research was to examine the effects of a Mindfulness-based Stress Reduction (MBSR) program on stress response and power in psychiatric inpatients in a closed ward. METHODS: For this study a quasi-experiment design was used to examine the effects of the intervention. The MBSR program conducted in this study was a six-session program, in which participants were asked to meditate for 45 minutes twice a week for 3 weeks. Homogeneity between the experimental and control group was assessed using χ² test, t-test, and Fisher's exact test. The results of the assessment showed that the variances of the two groups were equal. Demographic variables of the study participants were analyzed using descriptive statistics. The study hypotheses were verified using t-test. Cronbach's α was measured to assess the reliability of each test. RESULTS: Compared with the control group, patients in the experimental group showed significant improvement in scores for stress response (t=3.62, p=.001) and power (t=-3.42, p=.001). CONCLUSION: These results suggest that the mindfulness meditation program can be used as a psychosocial rehabilitation intervention for psychiatric inpatients by capitalizing on its positive effects on emotional reactivity and behavioral regulation.
Humans ; Inpatients* ; Meditation ; Mindfulness ; Psychiatric Nursing ; Psychiatric Rehabilitation

OBJECTIVE: Our pilot study aims to investigate the efficacy of a Short-Term (4 weeks) Psychiatric Rehabilitation Program (S-T PsyRP), without specific cognitive remediation trainings, on the neuropsychological performance and psychosocial functioning of inpatients with Major Depressive Disorder (MDD) or Bipolar Disorder (BD). Published studies with similar aims are lacking. METHODS: Fifty-three inpatients with MDD and 27 with BD (type I/II) were included. The S-T PsyRP was usually performed as clinical practice at Villa San Benedetto Menni Hospital and included a variety of activities aimed at promoting personal autonomies, interpersonal/social skills, and self-care. At the beginning and the end of the hospitalization we evaluated: neuropsychological performance (cognitive tests on verbal/visual working memory, attention, visual-constructive ability, language fluency, and comprehension); psychosocial functioning by the Rehabilitation Areas Form (RAF, handbook VADO); illness severity by the Brief Psychiatric Rating Scale (BPRS). Repeated-measure ANOVA and Pearson's linear correlation were used. RESULTS: We found significant improvement (p<0.01) in all the neuropsychological tests except for one, in 4 out of 6 RAF psychosocial areas (“involvement in ward activities”, “autonomies”, “self-care”, and “self-management of health”) and in clinical symptoms severity. No associations were found between the amelioration of clinical symptoms and neuropsychological or psychosocial improvement. CONCLUSION: A S-T PsyRP without specific cognitive remediation trainings may improve several cognitive/functional domains in MDD or BD inpatients, probably by offering opportunities to engage in demanding problem-solving conditions and cognitively stimulating activities.
Bipolar Disorder* ; Brief Psychiatric Rating Scale ; Depression ; Depressive Disorder, Major ; Hospitalization ; Humans ; Inpatients ; Memory, Short-Term ; Neuropsychological Tests ; Neuropsychology ; Pilot Projects ; Psychiatric Rehabilitation* ; Rehabilitation ; Self Care

OBJECTIVES: There has been long lasting trend of deinstitutionalization and public health centered care in management of individuals with disabling mental illness. We aimed to investigate current vocational rehabilitation state and effectiveness of system in korea. METHODS: We carried basic survey via telephone and e-mail beforehand to figure out how many and which institutions are operating vocational rehabilitation programs to psychiatric patients. A questionnaire packages were sent to total of 108 institutions in Korea which were operating occupation rehabilitation program. RESULTS: Of 108 institutions, 40.74% were returned with answers. The person in charge of vocational rehabilitation at each institution was mainly mental health social worker(48.8%), and the budget under \1,000,000 was the majority(61.5%) among surveyed institutions. The most commonly used vocational rehabilitation programs was case management(23.1%), followed by psychosocial rehabilitation program(21.2%), and on-the-job training(17.9%). The most effective program was case management(27.4%), followed by psychosocial rehabilitation program(19.8%), on-the-job training(17.9%). The main barrier of occupation rehabilitation to be conducted widely was ‘worries about being excluded from beneficiary of National Basic livelihood Protection Act’. CONCLUSIONS: Our results suggest that, in spite of high demand in vocational rehabilitation programs, government financial support is still lacking.
Budgets ; Deinstitutionalization ; Electronic Mail ; Financial Support ; Government Programs ; Humans ; Korea ; Mental Disorders ; Mental Health ; Occupations ; Psychiatric Rehabilitation ; Public Health ; Rehabilitation ; Rehabilitation, Vocational ; Schizophrenia ; Telephone

OBJECTIVE: Equine-assisted activities and therapy (EAA/T) have been used as adjunct treatment options for physical and psychosocial rehabilitation. However, the therapeutic effects on resting-state brain function have not yet been studied. The aim of this study is to investigate the effects of EAA/T on participants with attention-deficit/hyperactivity disorder (ADHD) by comparing resting-state functional magnetic resonance imaging (rs-fMRI) signals and their clinical correlates. METHODS: Ten participants with ADHD participated in a 12-week EAA/T program without any medication. Two rs-fMRIs were acquired for all participants before and after EAA/T. For estimating therapeutic effect, the regional homogeneity (ReHo) method was applied to capture the changes in the regional synchronization of functional signals. RESULTS: After the EAA/T program, clear symptom improvement was found even without medication. Surface-based pairwise comparisons revealed that ReHo in the right precuneus and right pars orbitalis clusters had significantly diminished after the program. Reduced ReHo in the right precuneus cluster was positively correlated with changes in the scores on DuPaul’s ADHD Rating Scale-Korean version. CONCLUSION: Our results indicate that EAA/T is associated with short-range functional connectivity in the regions related to the default mode network and the behavioral inhibition system, which are associated with symptom improvement.
Attention Deficit Disorder with Hyperactivity ; Brain* ; Equine-Assisted Therapy ; Magnetic Resonance Imaging ; Methods ; Parietal Lobe ; Pilot Projects* ; Psychiatric Rehabilitation ; Therapeutic Uses