Introduction: Assessment of the results of treatment for mental disorders becomes more complete when the patient's perspective is incorporated. Here, we aimed to evaluate the psychometric properties and application of the Perceived Change Scale - Patient version (PCS-P) in a sample of inpatients with mental disorders. Methods: One hundred and ninety-one psychiatric inpatients answered the PCS-P and the Patients' Satisfaction with Mental Health Services Scale (SATIS) and were evaluated in terms of clinical and sociodemographic data. An exploratory factor analysis (EFA) was performed and internal consistency was calculated. The clinical impressions of the patient, family, and physician were correlated with the patient's perception of change. Results: The EFA indicated a psychometrically suitable four-factor solution. The PCS-P exhibited a coherent relationship with SATIS and had a Cronbach's alpha value of 0.856. No correlations were found between the physician's clinical global impression of improvement and the patient's perception of change, although a moderate positive correlation was found between the patients' clinical global impression of improvement and the change perceived by the patient. Conclusions: The PCS-P exhibited adequate psychometric proprieties in a sample of inpatients with mental disorders. The patient's perception of change is an important dimension for evaluation of outcomes in the treatment of mental disorders and differs from the physician's clinical impression of improvement. Evaluation of positive and negative perceptions of the various dimensions of the patient's life enables more precise consideration of the patient's priorities and interests.
Background: General Hospital Psychiatric Units have a fundamental importance in the mental health care systems. However, there is a lack of studies regarding the level of improvement of patients in this type of facility. Objective: To assess factors related to good and poor outcomes in psychiatric inpatients using an index composed by clinical parameters easily measured. Methods: Length of stay (LOS), Global Assessment of Functioning (variation and at discharge) and Clinical Global Impression (severity and improvement) were used to build a ten-point improvement index (I-Index). Records of psychiatric inpatients of a general hospital during an 18-month period were analyzed. Three groups (poor, intermediate and good outcomes) were compared by univariate and multivariate models according to clinical and sociodemographic variables. Results: Two hundred and fifty patients were included, with a percentage in the groups with poor, regular and good outcomes of 16.4%, 59,6% and 24.0% respectively. Poor outcome at the discharge was associated mainly with lower education, transient disability, antipsychotics use, chief complaint "behavioral change/aggressiveness" and psychotic features. Multivariate analysis found a higher OR for diagnoses of "psychotic disorders" and "personality disorders" and others variables in relation to protective categories in the poor outcome group compared to the good outcome group. Discussion: Our I-Index proved to be an indicator of that allows an easy and more comprehensive evaluation to assess outcomes of inpatients than just LOS. Different interventions addressed to conditions such as psychotic disorders and disruptive chief complaints are necessary.
CONTEXTO: A angiogênese terapêutica é uma modalidade de tratamento para pacientes com insuficiência arterial crônica que não têm indicação para revascularização direta ou angioplastia e que não tiveram uma resposta satisfatória ao tratamento clínico. Entre as drogas utilizadas para essa finalidade está a prostaglandina E1 (PGE1). OBJETIVO: Estudar os aspectos morfológicos na gênese de capilares sanguíneos em músculo esquelético do membro caudal de ratos submetidos à isquemia sob a ação da PGE1, administrada por via intramuscular (IM) ou endovenosa (EV). MÉTODOS: Foram utilizados 48 ratos, linhagem Wistar-UEM, distribuídos aleatoriamente em três grupos de 16, redistribuídos igualmente em dois subgrupos, observados no 7º e 14º dias, sendo um grupo controle onde apenas foi provocada a isquemia no membro, outro com a isquemia e a injeção da PGE1 via IM e outro com a isquemia e a injeção da PGE1 EV. Para análise dos resultados, foram realizadas a coloração com hematoxilina e eosina (HE) e coloração imuno-histoquímica. RESULTADOS: Constatou-se um aumento estatisticamente significativo no número de capilares nos subgrupos com o uso da PGE1 IM e EV, através da contagem nos cortes corados com HE. A imunomarcação não foi eficiente para a quantificação dos capilares. CONCLUSÕES: A PGE1, administrada por via IM ou EV, promoveu, após 14 dias de observação, um aumento no número de capilares no músculo esquelético de ratos submetido à isquemia, identificáveis histologicamente com a coloração em HE. A imunocoloração não permitiu estabelecer uma correlação com o aumento de vasos encontrados na coloração com HE.
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