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I am the person who knows myself best : perception on shared decision-making among hospitalized people diagnosed with schizophrenia in China

- Huang, Chongmei, Plummer, Virginia, Wang, Yun, Lam, Louisa, Cross, Wendy

  • Authors: Huang, Chongmei , Plummer, Virginia , Wang, Yun , Lam, Louisa , Cross, Wendy
  • Date: 2020
  • Type: Text , Journal article
  • Relation: International Journal of Mental Health Nursing Vol. 29, no. 5 (2020), p. 846-855
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  • Description: Shared decision-making is related to better health outcomes in serious mental illness. It is not well addressed in non-Western cultures, for example Chinese culture. Chinese could be influenced by both paternalism and familism when making treatment decisions. However, this is unexplored. The study purpose is to explore shared decision-making from perspectives of inpatients diagnosed with schizophrenia in China. This study adopted qualitative descriptive approach. Through semi-structured interviews, twelve participants from the psychiatry department of a tertiary hospital shared their perceptions of shared decision-making. An inductive thematic approach was used to analyse the transcripts. Primary results included three main themes with nine subthemes: (1) Having a positive attitude: i) wanting my voice to be heard, ii) needing my family to be involved, and iii) preferring the psychiatrist to decide; (2) Feeling excluded: i) having limited financial capacity, ii) lacking interactive communication, iii) too few psychiatrists, and iv) being unsatisfied with informed consent process; and (3) Self-motivation in decision-making by: i) easing the burden on the family and ii) actively collecting health information. In this context, patients have fewer treatment options and a limited role in SDM. Yet, they have preference for SDM, actively seeking health information from mental health professionals particularly nurses. © 2020 Australian College of Mental Health Nurses Inc.
  • Description: China Scholarship Council, CSC, [2017] 3109

Machine learning in mental health: a scoping review of methods and applications

- Shatte, Adrian, Hutchinson, Delyse, Teague, Samantha

  • Authors: Shatte, Adrian , Hutchinson, Delyse , Teague, Samantha
  • Date: 2019
  • Type: Text , Journal article
  • Relation: Psychological Medicine Vol. 49, no. 9 (2019), p. 1426-1448
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  • Description: This paper aims to synthesise the literature on machine learning (ML) and big data applications for mental health, highlighting current research and applications in practice. We employed a scoping review methodology to rapidly map the field of ML in mental health. Eight health and information technology research databases were searched for papers covering this domain. Articles were assessed by two reviewers, and data were extracted on the article's mental health application, ML technique, data type, and study results. Articles were then synthesised via narrative review. Three hundred papers focusing on the application of ML to mental health were identified. Four main application domains emerged in the literature, including: (i) detection and diagnosis (ii) prognosis, treatment and support (iii) public health, and (iv) research and clinical administration. The most common mental health conditions addressed included depression, schizophrenia, and Alzheimer's disease. ML techniques used included support vector machines, decision trees, neural networks, latent Dirichlet allocation, and clustering. Overall, the application of ML to mental health has demonstrated a range of benefits across the areas of diagnosis, treatment and support, research, and clinical administration. With the majority of studies identified focusing on the detection and diagnosis of mental health conditions, it is evident that there is significant room for the application of ML to other areas of psychology and mental health. The challenges of using ML techniques are discussed, as well as opportunities to improve and advance the field.

Translation and psychometric testing of a decision-making scale

- Huang, Chongmei, Plummer, Virginia, Lam, Louisa, Cross, Wendy

  • Authors: Huang, Chongmei , Plummer, Virginia , Lam, Louisa , Cross, Wendy
  • Date: 2020
  • Type: Text , Journal article
  • Relation: Journal of Psychiatric and Mental Health Nursing Vol. 27, no. 5 (2020), p. 533-542
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  • Description: What is known about shared decision-making?: There is increasing investigation of shared decision-making in mental health services. Exploration of shared decision-making and relevant instrument is scant in China. What this paper adds to existing knowledge?: In this study, the Clinical Decision-making Involvement and Satisfaction (CDIS) was translated into Chinese and validated with patients and mental health professionals. The Chinese version of the CDIS is a reliable and valid instrument for measuring perception of involvement and satisfaction with treatment decision for schizophrenia. What are the implications for practice?: Mental health nurses could use the CDIS patient-rated and health professional-rated versions to compare their perceptions of the decision-making process. Abstract: Introduction There is growing interest in shared decision-making in Chinese mental health services. However, few specific instruments are available to measure decision-making satisfaction and involvement. Aim To translate and validate Clinical Decision-making Involvement and Satisfaction (CDIS) in a Chinese population. Methods The translation process was completed based on the Brislin translation method. Convenience sampling of 505 participants including 212 people diagnosed with schizophrenia and 293 mental health professionals for psychometric testing (e.g., content and construct validity, and test-retest reliability). Results The CDIS Chinese version has good internal consistency and temporal stability. Factor analysis determined two factors including satisfaction and involvement subscales, explaining 60.08% of the total variance. The Cronbach's α was 0.70, and the intraclass correlation coefficient ranged from 0.83 to 0.89. The composite reliability value was 0.85, and the average variance extracted was 0.50. Critical Ratio values ranged from 5.28 to 17.95, and item-total correlation values ranged from 0.48 to 0.75. Discussion The CDIS Chinese version is a feasible and reliable instrument. © 2020 John Wiley & Sons Ltd
  • Description: Chongmei Huang is supported by a China Scholarship Council (Res: [2017] 3109).

Severity of illness and distress in caregivers of patients with schizophrenia : do internalized stigma and caregiving burden mediate the relationship?

- Guan, Ziyao, Wang, Yuwei, Lam, Louisa, Cross, Wendy, Wiley, James

  • Authors: Guan, Ziyao , Wang, Yuwei , Lam, Louisa , Cross, Wendy , Wiley, James
  • Date: 2021
  • Type: Text , Journal article
  • Relation: Journal of Advanced Nursing Vol. 77, no. 3 (2021), p. 1258-1270
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  • Description: Aims: To test a multiple mediation model of internalized stigma and caregiving burden in the relationship between severity of illness and distress among family caregivers of persons living with schizophrenia. Design: This is a cross-sectional study. Methods: Data were collected from a consecutive sample of 344 Chinese family caregivers of persons living with schizophrenia between April-August 2018. Instruments used in this research included the Clinical Global Impression-Severity of Illness, the Internalized Stigma of Mental Illness Scale, the Caregiver Burden Inventory, and the Distress Thermometer. Data analysis was conducted using descriptive statistics, the Spearman correlation, and regression analysis to estimate direct and indirect effects using bootstrap analysis. Results: This research found that internalized stigma and caregiving burden can separately and sequentially mediate the relationship between severity of illness and distress. Moreover the mediation of internalized stigma plays the largest role among the multiple mediations. Conclusion: The severity of illness, internalized stigma, and caregiving burden are significant factors of distress among family caregivers of persons living with schizophrenia. The future intervention studies which be designed aiming at the three factors may be beneficial for family caregivers of persons living with schizophrenia. Impact: This research examined the psychosocial development of distress and indicated that interventions improving patients’ symptoms and decreasing internalized stigma and caregiving burden can help to prevent or reduce distress among family caregivers. © 2020 John Wiley & Sons Ltd. *Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliates “Louisa Lam, Wendy Cross” is provided in this record**

A comprehensive review of computational methods for automatic prediction of schizophrenia with insight into indigenous populations

- Ratana, Randall, Sharifzadeh, Hamid, Krishnan, Jamuna, Pang, Shaoning

  • Authors: Ratana, Randall , Sharifzadeh, Hamid , Krishnan, Jamuna , Pang, Shaoning
  • Date: 2019
  • Type: Text , Journal article , Review
  • Relation: Frontiers in Psychiatry Vol. 10, no. (2019), p.
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  • Description: Psychiatrists rely on language and speech behavior as one of the main clues in psychiatric diagnosis. Descriptive psychopathology and phenomenology form the basis of a common language used by psychiatrists to describe abnormal mental states. This conventional technique of clinical observation informed early studies on disturbances of thought form, speech, and language observed in psychosis and schizophrenia. These findings resulted in language models that were used as tools in psychosis research that concerned itself with the links between formal thought disorder and language disturbances observed in schizophrenia. The end result was the development of clinical rating scales measuring severity of disturbances in speech, language, and thought form. However, these linguistic measures do not fully capture the richness of human discourse and are time-consuming and subjective when measured against psychometric rating scales. These linguistic measures have not considered the influence of culture on psychopathology. With recent advances in computational sciences, we have seen a re-emergence of novel research using computing methods to analyze free speech for improving prediction and diagnosis of psychosis. Current studies on automated speech analysis examining for semantic incoherence are carried out based on natural language processing and acoustic analysis, which, in some studies, have been combined with machine learning approaches for classification and prediction purposes. © Copyright © 2019 Ratana, Sharifzadeh, Krishnan and Pang.

Feasibility of brief distress screening for family caregivers of adults diagnosed with schizophrenia in Changsha, Hunan, China

- Guan, Ziyao, Cross, Wendy, Lam, Louisa, Wiley, James, Sun, Mei, Bai, Xiaoling, Tang, Siyuan

  • Authors: Guan, Ziyao , Cross, Wendy , Lam, Louisa , Wiley, James , Sun, Mei , Bai, Xiaoling , Tang, Siyuan
  • Date: 2021
  • Type: Text , Journal article
  • Relation: Journal of Psychiatric and Mental Health Nursing Vol. 28, no. 2 (2021), p. 174-185
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  • Description: What is known on the subject? Distress screening amongst FGs is emphasized in worldwide studies, but existing general tools were found time-consuming and sometimes inconvenient when using them amongst FGs of patients diagnosed with schizophrenia. The DT, a single-item scale, was widely used to detect distress amongst FGs of cancer patients, showing good reliability, validity and discrimination power. The 21-item Depression Anxiety and Stress Scale (DASS21) can identify distress in the general population and serve as a criterion to determine an optimal cut-off score of the DT. What does the paper add to existing knowledge?: The DT presented good reliability, validity and discriminatory power amongst FGs of adults diagnosed with schizophrenia. A cut-off score of six maximized sensitivity (77%) and specificity (76%). Over half of the FGs of adults diagnosed with schizophrenia reached this cut-off score and experienced significant distress. Distress was higher in FGs of male patients, when FGs were parents, and for FGs whose educational background was primary school or below. What are the implications for practice?: The DT is an effective alternative to existing instruments in identifying distressed FGs of adults diagnosed with schizophrenia. It is important to provide FGs with distress screening programmes and interventions (e.g. skill-building psychoeducation) to identify and relieve distress. In addition, future research could explore brief measures to simultaneously recognize potential negative and positive impacts of caregiving in FGs. © 2020 John Wiley & Sons Ltd

Shared decision-making in serious mental illness : a comparative study

- Huang, Chongmei, Plummer, Virginia, Lam, Louisa, Cross, Wendy

  • Authors: Huang, Chongmei , Plummer, Virginia , Lam, Louisa , Cross, Wendy
  • Date: 2020
  • Type: Text , Journal article
  • Relation: Patient Education and Counseling Vol. 103, no. 8 (2020), p. 1637-1644
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  • Description: Objective: To compare consumer and mental health professionals’ (MHPs) preferences for decision-making in China and Europe. Methods: This study used cross-sectional design; Chinese data were collected by questionnaires and European data were obtained from the literature. Data were analysed using t-test, One-way ANOVA and Pearson correlation coefficient as appropriate. Results: This study involved 800 people diagnosed with severe mental illness and 506 MHPs. Chinese participants rated lower scores on preference for participation in decision-making (PD = 1.88) and information (IN = 2.70) than European participants (PD = 2.05, IN = 2.83). Chinese consumers rated a higher score on IN (2.78) but lower on for PD (1.75) than MHPs (IN = 2.64, PD = 1.97). Chinese consumers’ education level is positively associated with preference for PD and IN. The gender, occupation and age of Chinese MHPs are associated with preference for PD. Conclusion: Both Chinese and Europeans had preference for shared involvement in mental health, while the preference in China is less. Opinions of consumers and MHPs might be different, regarding the level of patient involvement in specific decisions. Practice implication: It is essential that consumers’ preferences are understood for provision of optimal support for a shared decision-making approach. © 2020 Elsevier B.V.

Validation of the distress thermometer for caregivers of children and adolescents with schizophrenia

- Bai, Xiaoling, Wang, Anni, Cross, Wendy, Lam, Louisa, Plummer, Virginia, Guan, Ziyao, Sun, Mei, Tang, Siyuan

  • Authors: Bai, Xiaoling , Wang, Anni , Cross, Wendy , Lam, Louisa , Plummer, Virginia , Guan, Ziyao , Sun, Mei , Tang, Siyuan
  • Date: 2020
  • Type: Text , Journal article
  • Relation: Journal of Advanced Nursing Vol. 76, no. 2 (Feb 2020), p. 687-698
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  • Description: Aim To develop and psychometrically test the distress thermometer for caregivers (DT-C) and document the distress level in primary caregivers of children and adolescents diagnosed with schizophrenia. Design A validation diagnostic accuracy study and descriptive cross-sectional survey. Methods DT-C was adopted based on Harverman's distress thermometer for parents. The cut-off score was detected by using receiver operating characteristic analysis with the Depression Anxiety Stress Scale-21 as a reference standard in a sample of 324 caregivers of children and adolescents diagnosed with schizophrenia in China collected between Jan 2017 and Feb 2018. Results One-item DT of DT-C indicated a good retest reliability (r = 0.86) and one-item DT and the Problem List (PL) indicated good convergent validity (r = 0.67-0.88). Overall and individual PL domains showed good internal consistency (KR 20 values ranged from 0.70-0.90). Setting seven as the cut-off score, the values of sensitivity (0.72-0.81), specificity (0.86-0.90), Youden's index (0.61-0.70), positive predictive value (0.67-0.74), and negative predictive value (0.84-0.92) were most satisfactory and area under curve values showed significantly excellent discrimination (0.88-0.90). The average DT score for the 324 participants was 6.34 (SD 2.49), with 46.9% of the participants above the cut-off. Caregivers above the cut-off score faced significant multiple problems in practical, family/social, cognitive, emotional, and parenting domains. Conclusion The DT-C, with six domains containing 35 items in Problem List and with the cut-off score at seven, can be a rapid screening tool to measure distress in these caregivers. The level of distress in caregivers was relatively high. Psychoeducation on specific needs and a solid mutual support network are recommended for mitigating caregivers' distress. Impact This study adapted a reliable DT-C to measure distress of caregivers, which has the potential to be introduced to caregivers of other types of child and adolescent mental disorders in research, assessments and care planning for health professionals.
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