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  1. Article ; Online: Progettazione e realizzazione di un reparto psichiatrico ospedaliero a porte aperte: sintesi di un'esperienza in Piemonte.

    Piccoli, Michele / Tiraferri, Riccardo

    Assistenza infermieristica e ricerca : AIR

    2014  Volume 33, Issue 3, Page(s) 134–141

    Abstract: Planning and implementation of an open door psychiatric ward: the assessment of an experience in Piedmont. Aims. The planning of the structure and the activity of a newly created psychiatric ward are reported. Methods. Several choices characterized the ...

    Abstract . Planning and implementation of an open door psychiatric ward: the assessment of an experience in Piedmont. Aims. The planning of the structure and the activity of a newly created psychiatric ward are reported. Methods. Several choices characterized the activity of the ward: to have open doors, newly employed nurses or without experience in psychiatry, a structure that favour the contact between health professionals (HP) and patients. The education of the nurses consisted in the discussion of general principles that guided the clinical practice: the patient is a legal person, his freedom should be guaranteed as well as his right of self determination. Results. The ward was opened in April 2008. Over 55 months 722 patients were admitted (31 compulsory admission). Only 8 patients were restrained and 4 aggressions occurred; 14 patients left the ward without authorization. Pharmacological deep sedation was used only in exceptional circumstances. Conclusions. Patients can be cared, safely for patients and PS in an open doors psychiatric ward. The planning of physical spaces is fundamental in guaranteeing a care respectful of patients' rights.
    MeSH term(s) Facility Design and Construction ; Feasibility Studies ; Humans ; Italy ; Psychiatric Department, Hospital/organization & administration
    Language Italian
    Publishing date 2014-07
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 1480438-4
    ISSN 2038-1778 ; 1120-3803
    ISSN (online) 2038-1778
    ISSN 1120-3803
    DOI 10.1702/1648.18030
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Quality of care indicators for schizophrenia: determinants of observed variations among Italian Departments of Mental Health. Results from the ETAS DSM study.

    Fantini, G / Tibaldi, G / Rucci, P / Gibertoni, D / Vezzoli, M / Cifarelli, L / Tiraferri, R / Munizza, C

    Epidemiology and psychiatric sciences

    2016  Volume 26, Issue 3, Page(s) 299–313

    Abstract: Aims: The primary aim of this study is to analyse the conformance of usual care patterns for persons with schizophrenia to treatment guidelines in three Italian Departments of Mental Health (DMHs). The secondary aim is to examine possible organisational ...

    Abstract Aims: The primary aim of this study is to analyse the conformance of usual care patterns for persons with schizophrenia to treatment guidelines in three Italian Departments of Mental Health (DMHs). The secondary aim is to examine possible organisational and structural reasons accounting for variations among DMHs.
    Methods: Within the framework of the Evaluation of Treatment Appropriateness in Schizophrenia (ETAS) project, 20 consensus quality of care indicators were developed. Ten concerned pharmacological treatment and ten encompassed general care and psychosocial rehabilitation interventions. Indicators were calculated using data from a stratified random sample of 458 patients treated at three DMHs located in North-Eastern, North-Western and Southern Italy. Patients' data were collected by combining information from medical charts and from a survey carried out by the health care professionals in charge of the patients. Data on the structural and organisational characteristics of the DMHs were retrieved from administrative databases. For each indicator, the number and percentage of appropriate interventions with and without moderators were calculated. Appropriateness was defined as the percentage of eligible patients receiving an intervention conformant with guidelines. Moderators, i.e., reasons justifying a discrepancy between the interventions actually provided and that recommended by guidelines were recorded. Indicators based on a sufficient number of eligible patients were further explored in a statistical analysis to compare the performance of the DMHs.
    Results: In the overall sample, the percentage of inappropriate interventions ranged from 11.1 to 59.3% for non-pharmacological interventions and from 5.9 to 66.8% for pharmacological interventions. Comparisons among DMHs revealed significant variability in appropriateness for the indicators 'prevention and monitoring of metabolic effects', 'psychiatric visits', 'psychosocial rehabilitation', 'family involvement' and 'work'. After adjusting the patient's gender, age and functioning, only the indicators 'Prevention and monitoring of metabolic effects', 'psychiatric visits' and 'work' continued to differ significantly among DMHs. The percentage of patients receiving appropriate integrated care (at least one appropriate non-pharmacological intervention and one pharmacological intervention) was significantly different among the three DMHs and lower than expected.
    Conclusions: Our results underscore discrepancies among Italian DMHs in indicators that explore key aspects of care of patients with schizophrenia. The use of quality indicators and improved guideline adherence can address suboptimal clinical outcomes, and has the potential to reduce practice variations and narrow the gap between optimal and routine care.
    MeSH term(s) Antipsychotic Agents/therapeutic use ; Community Mental Health Services/standards ; Guideline Adherence/standards ; Health Services Research ; Humans ; Italy ; Mental Health ; Practice Guidelines as Topic/standards ; Psychiatric Rehabilitation ; Quality Indicators, Health Care ; Schizophrenia/drug therapy
    Chemical Substances Antipsychotic Agents
    Language English
    Publishing date 2016-03-28
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 2607964-1
    ISSN 2045-7979 ; 2045-7960
    ISSN (online) 2045-7979
    ISSN 2045-7960
    DOI 10.1017/S204579601600010X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Età d'esordio e familiarità nella psicosi maniaco-depressiva.

    Ravizza, L / Tiraferri, R / Rebaudengo, P / Rocca, G / Brusa, A

    Rivista di patologia nervosa e mentale

    1982  Volume 103, Issue 2, Page(s) 97–104

    Abstract: In order to test the hypothesis that age of onset of manic-depressive psychosis may be associated with family history, the authors investigated 479 clinical records of patients suffering from affective disorders and admitted to Hospital during the period ...

    Title translation Age of onset and familial occurrence of manic-depressive psychosis.
    Abstract In order to test the hypothesis that age of onset of manic-depressive psychosis may be associated with family history, the authors investigated 479 clinical records of patients suffering from affective disorders and admitted to Hospital during the period 1966-1981. Given the retrospective nature of the study, standardized diagnostic criteria were not possible. A positive family history of psychopathological disorders has been found associated with an early age of onset in comparison with a negative family history; the bipolar type has been found associated with an early age of onset in comparison with the unipolar type. Nevertheless, both these variables and their interaction appeared to be insufficiently predictive. The possible influence of other variables such as sex, marital status, years of education, migration, residence have been investigated, but none of them gave any significant result. This suggests the presence of other more predictive variables, which have not considered in this paper.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Aged ; Bipolar Disorder/epidemiology ; Bipolar Disorder/genetics ; Child ; Depressive Disorder/epidemiology ; Depressive Disorder/genetics ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies
    Language Italian
    Publishing date 1982-03
    Publishing country Italy
    Document type English Abstract ; Journal Article
    ZDB-ID 414061-8
    ISSN 0035-6433
    ISSN 0035-6433
    Database MEDical Literature Analysis and Retrieval System OnLINE

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