A Randomized Controlled Trial Examining the Effectiveness of Digital Picture Frame Use on the Long Term Inpatient Experience
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Schizophrenia
- Sponsor
- Centre for Addiction and Mental Health
- Enrollment
- 33
- Locations
- 1
- Primary Endpoint
- Change in Recovery Self Assessment (RSA; O'Connell et al., 2005)
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
This study will be a randomized controlled trial that investigates the effectiveness of digital picture frames (DPF) installed in inpatient rooms on long stay inpatient wards servicing schizophrenia clients at CAMH. The effects on client experience will consider the domains of self-concept, interactions with healthcare staff, perception of space, and implications for the recovery process. The comparison of inpatient client experience with DPFs versus a control group (Treatment as Usual - TAU), offers the opportunity to examine the effectiveness of this type of environmental adaptation. This trial builds upon earlier work that demonstrated the feasibility of DPFs in this context.
Detailed Description
Long term stays in mental health facilities have been shown to have unique challenges and implications. To a considerable extent these challenges grow out of the stigmatized nature of severe mental illnesses (SMI) such as schizophrenia. The social and self-stigma surrounding SMI can have major effects on those affected including decreased self-esteem, self-deprecation, and the development of a self-concept defined by the illness. When stigmatized interpretations of mental illness are internalized, those affected can find it very challenging to sustain non-illness identities and can ultimately result in the loss of non-illness related aspects of self-concept. Inpatient contexts are particularly challenging in this regard, with non-illness oriented identities very difficult to sustain given considerations of power differentials with providers, the reduction of autonomy and choice, and the removal of the individual from environments that are demonstrative of non-illness aspects of self. Accordingly, a randomized controlled trial design will be used to consider the question: Does having a DPF in psychiatric inpatient unit rooms lead to improvements in interactions with the clinical team, perceptions of enhanced quality of physical space, and an improvement in the sustaining of non-illness aspects of self-concept? While the promising feasibility study findings might suggest hypotheses of improvement in these domains, we will consider this study exploratory given the complex environments inpatient units represent in the study of care quality and outcomes and the modest scope of this intervention. Finally, we will continue to collect feasibility data qualitatively, to inform further refinement of metrics and otherwise consider enhancements in intervention and research design.
Investigators
Sean Kidd
Independent Clinician Scientist
Centre for Addiction and Mental Health
Eligibility Criteria
Inclusion Criteria
- •All participants will have severe mental illness (SMI) defined as diagnosis with a major mental illness (in practice, will be primarily schizophrenia spectrum) and inherent to hospital admission will be substantive contact with services and disability affecting day-to-day functioning (Ruggeri, Leese, Thornicroft, Bisoffi, \& Michelle, 2000).
- •Admitted to a CAMH inpatient unit, specifically units 2-2 and 2-3, with an anticipated length of stay of 4 weeks or more, as determined by the clinical team
- •Chart diagnosis of a major mental illness
- •Determined appropriate for study by staff psychiatrist and clinical team (capacity to consent confirmed, no precautions against having the device in the participant's room indicated)
- •18 years of age or older
- •Proficiency in English
Exclusion Criteria
- •Do not meet the above criteria
Outcomes
Primary Outcomes
Change in Recovery Self Assessment (RSA; O'Connell et al., 2005)
Time Frame: Baseline and after 4 weeks (post intervention)
To examine the degree to which inpatient staff are perceived as recognizing the individuality of the individual and engage in a hopeful and holistic manner. 4 items from the patient version will be used (1-5 point Likert scale).
Client Satisfaction Questionnaire-8 (CSQ-8; Attkisson et al., 1995)
Time Frame: After 4 weeks (post intervention)
Investigators will only use the general satisfaction question from this measure (1-5 point Likert scale). Only participants in the intervention arm will complete this question.
Change in Rosenberg Self-Esteem Scale (Rosenberg, 1965)
Time Frame: Baseline and after 4 weeks (post intervention)
The broadest reaching and high factor loading item, 'On the whole I am satisfied with myself' will be used (1-4 point Likert scale).
Change in Scale to Assess Therapeutic Relationship (STAR; Mcguire-Snieckus et al., 2007)
Time Frame: Baseline and after 4 weeks (post intervention)
Three items assessing common factors in the therapeutic relationship with the clinical team are from the scale will be used (1-5 point Likert scale).
Semi structured interviews
Time Frame: After 4 weeks (post intervention)
SC participants will be asked broad questions about how satisfied they were with the inpatient unit space and what might be improved. These same questions will be asked of DPF participants, but will be followed by questions specific to the DPF support.
Change in Satisfaction with the physical environment of the inpatient unit
Time Frame: Baseline and after 4 weeks (post intervention)
One question developed my investigators due to lack of standardized measures to specifically measure participant satisfaction with the physical environment of the inpatient unit (1-5 point Likert scale)
Change in Satisfaction with the rooms on the inpatient unit
Time Frame: Baseline and after 4 weeks (post intervention)
One question developed by investigators due to lack of standardized measures to specifically measure participant satisfaction with their room on the inpatient unit (1-5 point Likert scale)
Change in Empowerment Scale (Rogers et al., 1997)
Time Frame: Baseline and after 4 weeks (post intervention)
Measures dimensions of self efficacy, self stigma and self concept (1-9 point Likert scale).
Change in Modified Engulfment Scale (McCay & Seeman, 1998)
Time Frame: Baseline and after 4 weeks (post intervention)
Only two items from this measure focussing specifically on self-concept will be used (1-5 point Likert scale).