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1.
Eur Geriatr Med ; 2024 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-39261400

RESUMEN

PURPOSE: This study describes the effects of a mobile geriatric acute team (GAT) treating acutely ill geriatric patients in their homes. GAT offered more advanced diagnostic and treatment options than are normally available to primary-care led mobile teams. The aim of this study was to evaluate if interventions by GAT had effect on the number of emergency department (ED) visits, hospitalisations, and length of stay in hospital. METHODS: This is a before-after study, with outcomes recorded for each participant during the 3 months prior to the first visit by GAT and compared to the same outcomes for each participant during the 3 months after the first visit. RESULTS: The participant's mean age was 84.6 years, 56% were women. There was no observed difference in ED visits, hospitalisations, and length of stay in hospital for all participants (n = 102). However, for the 27 participants living in nursing homes; ED-visits reduced on average by 0.5/participant (p = 0.002), the number of hospitalisations reduced by 0.3/participant (p = 0.018) and length of stay in hospital reduced by 4.3 days/participant (p = 0.045). For the 13 participants referred by ambulance, the number of hospitalisations reduced by 0.7/participant (p = 0.044) and length of stay in hospital reduced by 4.1 days/participant (p = 0.028). The participants who got intravenous antibiotics also had less hospital care. CONCLUSION: This geriatric acute mobile team did not cause reduced hospital care among the participants overall. However, it might have reduced hospitalization in some subgroups, such as patients living in nursing homes or those who got intravenous antibiotics.

2.
Soins Pediatr Pueric ; 45(339): 18-23, 2024.
Artículo en Francés | MEDLINE | ID: mdl-38945676

RESUMEN

In 2023, the "Amae" mobile perinatal early intervention team in the child psychiatry department of the Pitié-Salpêtrière hospital followed 49 families for almost 412 home visits. The coexistence of biopsychosocial vulnerability factors was the rule. Generally requested by maternity hospitals (45% in antenatal care), the team offers care focused on parent-child bonds during visits at home, and facilitates the articulation of the different fields involved in contexts at high risk of care breakdown.


Asunto(s)
Atención Perinatal , Humanos , Femenino , Embarazo , Unidades Móviles de Salud , Recién Nacido , Grupo de Atención al Paciente , Intervención Médica Temprana
3.
Soins Pediatr Pueric ; 45(339): 24-27, 2024.
Artículo en Francés | MEDLINE | ID: mdl-38945677

RESUMEN

The parent-baby unit at the Jean-Verdier hospital in Seine-Saint-Denis offers outpatient and mobile care. Migrant families in extremely precarious situations, often with traumatic histories, are met. Home visits facilitate access and continuity of care. Nonetheless, this work and the broader context in which it is carried out have an impact on the therapists' experience and care methods. This makes it all the more essential to have a co-therapy system in place, to take primary needs into account and to support mothering care in therapeutic work.


Asunto(s)
Servicios de Atención de Salud a Domicilio , Humanos , Femenino , Recién Nacido , Embarazo , Atención Perinatal , Francia
4.
Soins Psychiatr ; 45(352): 44-48, 2024.
Artículo en Francés | MEDLINE | ID: mdl-38719361

RESUMEN

The deployment of case management and advanced nursing practice is shaking up the roles of the various professionals on mental health teams, and the usual organization of care in psychiatry. These changes can be perceived as either positive or worrying, depending on each individual's role and position. For the past 3 years, the mobile teams of the Centre rive gauche cluster at Le Vinatier hospital have been organized according to the principles of Flexible Assertive Community Treatment, and include an advanced practice nurse (APN) on their staff. The roles of the case manager and the APN have been rethought. A number of measures have facilitated the implementation of these new functions.


Asunto(s)
Enfermería de Práctica Avanzada , Enfermería Psiquiátrica , Humanos , Francia , Rol de la Enfermera/psicología , Trastornos Mentales/enfermería , Comunicación Interdisciplinaria , Gestores de Casos/psicología , Grupo de Atención al Paciente
5.
J Clin Nurs ; 2024 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-38685812

RESUMEN

AIM: To explore criteria evaluating the effectiveness of psychiatric home care-mobile team practices, that have been developed widely in the last decades. DESIGN: Systematic review of the literature. METHODS: We included 24 studies published between January 2010 and October 2023. DATA SOURCES: CINAHL, APA PsycInfo, Embase, Scopus and PubMed. RESULTS: The evaluation criteria differed according to the studies: impact on hospital stay, symptomatic clinical impact, repercussions on functioning, quality of life, analysis of profitability, safety, therapeutic alliance and finally, cooperation network. CONCLUSION: The variability of the criteria used to judge the effectiveness of psychiatric home care-mobile team practices shows their richness and diversity, and the absence of standardisation. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: The variability of the criteria used to judge the effectiveness of psychiatric home care-mobile team practices supports a qualitative and multidisciplinary approach, with enhanced teamwork. IMPACT: Psychiatric home care-mobile team practice have widely developed in the last years and their effectiveness need to be evaluated. Our main finding is that there is a rich variety of practices and that evaluation criteria are very diverse, thus not standardised. We suggest using a mixed-method approach to capture the subjective experience of patients and caregivers. These findings also highlight the significance of institutional cooperative work and call for a redefinition of team construction. REPORTING METHOD: The authors adhered to PRISMA guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

6.
Soins Psychiatr ; 45(351): 26-28, 2024.
Artículo en Francés | MEDLINE | ID: mdl-38527869

RESUMEN

Many elderly people live well and at home, but some require somatic and psychiatric care. Mobile psychiatric teams for the elderly are called upon to intervene with people aged 65-70 and over who are experiencing psychological distress. Among senior citizens, addictive disorders are very common, and are associated with psychiatric and geriatric co-morbidities. Alcohol, tobacco and benzodiazepine use disorders require holistic, individualized care, based on identification, prevention and referral, as well as training and coordination of professionals and caregivers.


Asunto(s)
Comorbilidad , Anciano , Humanos
7.
Rev Infirm ; 72(294): 47-49, 2023 Oct.
Artículo en Francés | MEDLINE | ID: mdl-37838374

RESUMEN

There are 24 regional pediatric palliative care resource teams (ERSP) in metropolitan and overseas France. An initial review of the ERSPs was carried out in 2015. The ERSP commission of the Société française de soins palliatifs pédiatriques (French Society for Pediatric Palliative Care) wanted to review the situation again, ten years after the creation of these teams. This article presents the main findings.


Asunto(s)
Enfermería de Cuidados Paliativos al Final de la Vida , Cuidados Paliativos , Niño , Humanos , Francia
8.
BMC Emerg Med ; 23(1): 80, 2023 07 27.
Artículo en Inglés | MEDLINE | ID: mdl-37501146

RESUMEN

INTRODUCTION: Provision of mobile care at the home of patients appears to become necessary as the population becomes increasingly older. But there are challenges in moving emergency care from hospitals to the home of patients. The aim of the study was therefore to describe the experiences of the mobile care in Sweden. METHOD: Semi structured interviews were conducted with 12 persons with experience of mobile care in Sweden, such as nurses, physicians, civil servants and politicians. Qualitative latent content analysis was used as an analysis method. RESULT: The results show that cooperation is of utmost importance to achieve functioning mobile care. Cooperation both on an inter-organizational level and on a close team-work is required for all of the involved parties in mobile care to take on a joint responsibility for the patient. As mobile care is primarily provided to elderly multimorbid patients, a comprehensive view on patient care is required in which the patient and their relatives experience security. CONCLUSION: Mobile care is seen as a moving care that comes to the seeking person and not the other way around. The resources are distributed where they make the most use, that is, closest to the individual. Mobile care is seen as a complement to the traditional hospital care. This means a different way of working that requires close collaboration between different categories of personnel and organizations, where there should not be any discussions about boundaries, rather, the discussion should include patient's needs and situation instead.


Asunto(s)
Servicios Médicos de Urgencia , Humanos , Anciano , Suecia , Hospitales , Investigación Cualitativa
9.
Soins Gerontol ; 28(161): 28-30, 2023.
Artículo en Francés | MEDLINE | ID: mdl-37328204

RESUMEN

The caregiver plays a key role in the mobile geriatric team. She has a very varied activity. She performs geriatric assessments, evaluates toilets, transmits geriatric culture, maintains the city-hospital link, intervenes in residential facilities for dependent elderly people (Ehpad), performs post-emergency telephone interviews and provides training to paramedics. Testimonial.


Asunto(s)
Cuidadores , Casas de Salud , Femenino , Anciano , Humanos , Evaluación Geriátrica
10.
Soins Psychiatr ; 44(344): 36-40, 2023.
Artículo en Francés | MEDLINE | ID: mdl-36871975

RESUMEN

The "transitional mobile team" has been developed to optimize the management of the transition from prison to the community for people with psychiatric disorders in France. The objectives are to limit the risk of relapse and death during this high-risk period and to ensure the links between psychiatry in prison and community psychiatry.


Asunto(s)
Trastornos Mentales , Prisiones , Humanos , Psicoterapia , Psiquiatría Comunitaria , Francia
11.
Encephale ; 49(4): 373-377, 2023 Aug.
Artículo en Francés | MEDLINE | ID: mdl-35725519

RESUMEN

INTRODUCTION: Since their French naturalization in 1969, Amerindians of French Guiana have been facing a full and fast reorganization of their way of life. Teenagers, at the forefront of this cultural transition, are challenging French school institutions, as well as cultural society and care system organizations in Amazonian French remote villages. Rates of autolytic behaviors such as toxic substance abuse or suicide attempts, but mostly completed suicides, are alarming among this adolescent population. To improve care delivery to those teenagers, a mobile child psychiatric team was implemented in 2013. METHODS: We describe this device, its activities and the problematics encountered. RESULTS: This team's purpose is to lead a psychiatric evaluation of teenagers in order to determine a possible psychiatric diagnosis and elaborate a care plan. Although the results are mostly encouraging, this device seems to show some limitations: lack of time dedicated to these interventions, lack of psychiatric care available for follow-up in these villages, tremendous numbers of social distress situations implicated in psychological issues. Moreover, it appears that cultural aspects must be considered in the analysis of the Amerindian adolescent population's issues and the determination of providing care. CONCLUSION: Implementation of actions based on more educational and social levels might be a solution.


Asunto(s)
Trastornos Relacionados con Sustancias , Intento de Suicidio , Humanos , Niño , Adolescente , Guyana Francesa/epidemiología , Intento de Suicidio/psicología , Atención a la Salud
12.
Soins Gerontol ; 27(156): 23-26, 2022.
Artículo en Francés | MEDLINE | ID: mdl-35926969

RESUMEN

The Ti-Sage mobile geronto-psychiatry team provides semi-emergency care in the Sud Bretagne public mental health establishment sector. The system favours fluidity and responsiveness. Requests can be made by telephone without filling in a form. The multidisciplinary team assesses the disorders, directs and ensures follow-up as close as possible (living and care areas), quickly (within forty-eight hours), with the aim of forging links and avoiding inappropriate hospitalisations. Interventions are carried out in all the geriatric care structures in the area, by visit or telemedicine. The team works in a network to coordinate care with care partners and offer support to carers.


Asunto(s)
Servicios Médicos de Urgencia , Telemedicina , Anciano , Hospitalización , Humanos , Titanio
13.
Emerg Infect Dis ; 27(11): 2932-2936, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34670655

RESUMEN

This study describes the apparent discontinuation of cholera transmission in Haiti since February 2019. Because vulnerabilities persist and vaccination remains limited, our findings suggest that case-area targeted interventions conducted by rapid response teams played a key role. We question the presence of environmental reservoirs in Haiti and discuss progress toward elimination.


Asunto(s)
Cólera , Cólera/epidemiología , Cólera/prevención & control , Haití/epidemiología , Humanos , Vacunación
14.
Consort Psychiatr ; 2(4): 54-61, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-39045450

RESUMEN

Georgia has recently made a commendable effort to reform mental health care. The "Concept on Mental Health Care" adopted by the Government and the two strategic plans for 2014-2020 and 2021-2031, which aimed to develop comprehensive evidence-based, culturally appropriate, and human rights-oriented mental health care, have promoted the deinstitutionalization and development of community mental health services. Since 2018, new standards of care for mental health ambulatories and mobile teams have been imposed and implemented in the state programme and funded accordingly. The study aimed to investigate the quality of care in community mental health services. As a result, we monitored the mental health ambulatories in all major cities and regional centres of the country (in total, 16 ambulatories) and the mobile teams which had at least two years of experience (in total, 14 mobile teams). The data analyses showed that the new standards for ambulatories and mobile teams increased access to and coverage of mental health care across the country. However, further effort is still needed to achieve comprehensive treatment by mental health care services.

15.
Soins Psychiatr ; 41(331): 39-41, 2020.
Artículo en Francés | MEDLINE | ID: mdl-33357667

RESUMEN

Based on a clinical situation of a patient infected with COVID-19, the caregivers of the Saint-Étienne mobile psychiatric team describe their anxieties. Are the procedures carried out appropriate? Did we respect the safety measures? Are we at risk of contracting the virus and contaminating other people? The scientific discourse of "experts", who used to guide our actions, has throughout this crisis been inadequate and people's beliefs have crumbled. This abandonment is a source of anxiety for everyone, an anxiety about death. However, this reflection should kindle hope, a precious emotion for those working with patients in psychiatry.


Asunto(s)
Ansiedad/psicología , COVID-19/psicología , Cuidadores/psicología , Trastornos Mentales/terapia , COVID-19/epidemiología , Francia/epidemiología , Humanos , Unidades Móviles de Salud , Grupo de Atención al Paciente , Filosofía
16.
Soins Gerontol ; 25(143): 22-23, 2020.
Artículo en Francés | MEDLINE | ID: mdl-32444077

RESUMEN

The elderly subject's mobile psychiatric team goes to meet the patient out of hospital. Its aim is to assess patients, guide their care, and train health professionals and social workers in the psychiatry of the elderly patient. The nurse's autonomy and expertise are essential to her functioning. Feedback from the Corentin-Celton Hospital in Issy-les-Moulineaux (Assistance Publique-Hôpitaux de Paris, 92).


Asunto(s)
Trastornos Mentales/enfermería , Grupo de Atención al Paciente/organización & administración , Telemedicina/organización & administración , Anciano , Redes Comunitarias , Humanos
17.
Maturitas ; 130: 38-40, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31706434

RESUMEN

Our objective was to determine whether the provision of therapeutic advice (i.e., any recommendation for an increase or decrease in drug dosage, or for the addition, withdrawal or replacement of at least one drug) by hospital geriatric mobile teams (GMTs) was associated with long-term mortality among older inpatients. Data on therapeutic advice provided by the GMT of Angers University Hospital, France, were collected from 694 consecutive inpatients examined in 2012 (mean age 84.4 ± 6.3 years; 65.6% female), who were followed up after 3 years. We found no between-group differences regarding the 3-year mortality (P = 0.30) and no cumulative survival difference (log-rank P = 0.43). The provision of therapeutic advice by a GMT was not associated with better 3-year survival (HR = 1.18, P = 0.40) in these frail inpatients.


Asunto(s)
Evaluación Geriátrica , Geriatría , Comunicación Interdisciplinaria , Anciano , Anciano de 80 o más Años , Femenino , Fragilidad/mortalidad , Fragilidad/terapia , Francia , Hospitales Universitarios , Humanos , Masculino , Grupo de Atención al Paciente , Polifarmacia , Tasa de Supervivencia
18.
Soins Psychiatr ; 40(322): 35-38, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31229145

RESUMEN

Since 2015, the mobile old age psychiatry team of the Maison-Blanche public health facility has been providing mental health and psychiatric services to the population aged 70 and over in three districts of Paris and four psychiatric sectors. The team's nurses actively take part in delivering care in the home and in maintaining the autonomy of elderly patients suffering from mental health disorders. They provide global care, both somatic and psychiatric, and offer, through their assessments, an initial response to the suffering expressed by the patients and their family.


Asunto(s)
Trastornos Mentales/enfermería , Unidades Móviles de Salud , Grupo de Atención al Paciente , Anciano , Humanos , Paris
19.
Soins Psychiatr ; 40(320): 18-20, 2019.
Artículo en Francés | MEDLINE | ID: mdl-30654874

RESUMEN

The missions of the mobile psychiatric team in Lyon involve reaching out to vulnerable people to guide them towards the most appropriate care. Establishing a bond and finding the right words to engage with them constitute a balancing act which the caregiver must undertake with the homeless. It is important to try and understand the situation, the person's life story, invent alternatives, while refraining from pushing them too much, in order to maintain their trust.


Asunto(s)
Personas con Mala Vivienda/psicología , Trastornos Mentales/terapia , Relaciones Profesional-Paciente , Poblaciones Vulnerables/psicología , Francia , Humanos , Unidades Móviles de Salud
20.
Psychiatr Q ; 90(1): 89-100, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30284094

RESUMEN

World Health Organization recommends the implementation of alternatives to full-time hospitalizations. Psychiatric home-care has known a worldwide development in the last 20 years. The psychiatric mobile team for social and medico-social institutions in Saint-Etienne, France, (Equipe mobile d'intervention en établissements Sociaux et Médico-sociaux, ESMS) aims to support professionals from medico-social housing institutions (MSHI) in order to maintain people in housing. The objective of the study was to evaluate the efficiency of home-based interventions to reduce hospitalizations and improve collaboration between psychiatric hospital facilities and MSHI. We used a pre-post study design. A same cohort of patients living in a MSHI one year before intervention and one year after implementation of the ESMS was studied. Hospitalizations were compared between the two periods. A survey was conducted for qualitative evaluation among professionals in MHSI. Sixty-three patients were included. Most patients suffered from psychotic disorders (71%). We found a significant decrease in the mean number of admissions per year from 2,06 to 1,48 (Wilcoxon signed rank test; df64; p = 0,01). Mobile-team interventions included answering phone calls, home visits, coordination meetings, or clinical interviews with patients in inpatient and outpatient services, with an average of 9,3 interventions per patient (SD = 11,4). ESMS was evaluated as "essential" for 73% of 11 professionals from MSHI who answered the questionnaire in May 2017. Assertive Community Treatment and Crisis Resolution Teams are the most studied home-care models in psychiatry. Our results tend to show the efficiency of mobile-team interventions in MSHI, to enhance partnerships.


Asunto(s)
Servicios Comunitarios de Salud Mental/estadística & datos numéricos , Servicios de Atención de Salud a Domicilio/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Hospitales Psiquiátricos/estadística & datos numéricos , Trastornos Mentales/terapia , Evaluación de Procesos y Resultados en Atención de Salud/estadística & datos numéricos , Instituciones Residenciales/estadística & datos numéricos , Adolescente , Adulto , Anciano , Estudios de Cohortes , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
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