Exploring the Relationship Between Brief Inpatient Treatment Intensity and Treatment Outcomes for Mood and Anxiety Disorders

Abstract

BACKGROUND: Few studies have identified effective nursing interventions for today’s psychiatric settings. OBJECTIVES: This article reports findings from a study that explored the relationship between brief inpatient treatment intensity (average daily frequencies of treatment activities) and treatment outcomes (symptomatology, functioning, and readmission rates up to 3 months postdischarge) among 67 inpatients treated for mood and anxiety disorders. DESIGN: By using an evaluation design, multiple outcome measures were completed by patients, family members, and clinicians at admission and discharge. Nurses recorded all patient activities on a tool developed by the authors. RESULTS: Spearman rank correlations and nonparametric regression models indicated that greater community/leisure treatment activities were associated with greater improvements in patient symptoms and functioning. In addition, lower admission functioning was associated with poorer functioning improvements (p < .05). CONCLUSIONS: Patients may have better outcomes when they actively engage in the inpatient treatment milieu. Further study with rigorous methods is needed to identify effective psychiatric nursing interventions.

An examination of frequent nursing interventions and outcomes in an adolescent psychiatric inpatient unit

“…The results also showed that a higher HoNOSCA total score on admission (an indication of severe or multiple difficulties across problem areas) was associated with a greater reduction in the HoNOSCA total score over the course of admission and that a higher symptom score on admission was associated with a greater reduction in the symptom score at discharge. These findings replicate that of a Danish child and adolescent study (Bilenberg 2003) that also utilized the HoNOSCA, but is in contrast to adult studies which show that lower functioning on admission is predictive of poorer outcomes (Tucker et al. 2001).…”

“…1999). Further, research among US adults with mood and anxiety disorders found that patients have better outcomes when they actively engage in the inpatient treatment milieu, including psychotherapeutic interventions, community and leisure activities, mental health education, and independent patient work using journals, videotapes, and reading materials (Tucker et al. 2001).…”

“…Research in the Netherlands in an adult, long-term psychiatric home care facility identified coping enhancement, including assessment of patient attempts to cope with problems arising from illness, the use of activity therapy as a coping strategy, and medication management as essential components of the package of care (Boomsma et al 1999). Further, research among US adults with mood and anxiety disorders found that patients have better outcomes when they actively engage in the inpatient treatment milieu, including psychotherapeutic interventions, community and leisure activities, mental health education, and independent patient work using journals, videotapes, and reading materials (Tucker et al 2001).…”

Relationships Between Psychiatric Clinical Assessment Scores and Patients’ Daily Activities

“…Nursing Record of Patient Daily Activity. The third measure used in both the primary and secondary studies was the Nursing Record of Patient Daily Activity (NRPDA) (Tucker et al, 2001), which was developed by the primary research team to keep a record of daily patient activities. The NRPDA only indicates that patients were exposed to the treatment activity; the level of active participation was not measured.…”

“…In addition, treatment components were examined to identify the ones that were associated with the greatest patient outcome variability. The primary study findings indicated the treatment category most predictive of outcomes was community/leisure activities (Tucker, Luedtke, & Moore, 2001). These activities were those prescribed, encouraged, and facilitated by nursing and multidisciplinary staff as part of the inpatient treatment process.…”