Enrichment of Day Centers in Community-based Psychiatry

NCT ID: NCT01732575

Last Updated: 2015-08-25

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 107 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2008-10-31
• Study Completion Date: 2015-03-31

Brief Summary

This RCT study addresses the topic of improving the possibilities for people with severe mental illness (SMI) to be engaged in meaningful daily occupations at community-based activity (CBA) centers. Meaningful occupation, which includes not only work-related activities, but also leisure, household and social activities, is assumed to generate health and wellbeing. It is well established that there is a relationship between satisfaction with daily occupations and well-being.

A Swedish mental health care reform stated that the social services should provide meaningful daily occupations to people with SMI. However, evaluations of the effects of the reform conclude that the target group's needs for meaningful daily occupation have not been met.

Thus, on the basis of governmental reports and evaluations, there is an urgent need for improving the quality of the activities and support offered at CBA centers. Therefore, the overarching aim of this project is to develop and implement an intervention method for improving the activities offered and support given at CBA centers, and evaluate the outcomes of that intervention.

Specific aims

• Developing and implementing an intervention that means reorganization of CBA centers in such a way that they become enriched with characteristics that have been identified as rewarding and meaningful in previous research.
• Evaluating the outcome of that intervention on:

• the unit level, i.e., in terms of changes in the characteristics of the CBA centers,
• the individual level, in terms of changes among the consumers regarding satisfaction with the activities at the CBA center, perceived control, social interaction, quality of life, etc.

Cluster randomization is used. Day centers are randomized to either giving the new intervention ("enrichment") or continuing with "care as usual" during the study period, which is 14 months. This means that all participants in a day center get the type care their specific day center offers during the study period.

Conditions

Enrichment With Meaning-generating Activities; Rehabilitation as Usual

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Enrichment

Enrichment with meaning-generating activities

Group Type: EXPERIMENTAL

Enrichment with meaning-generating activities

Intervention Type: BEHAVIORAL

Gaps in the rehabilitation are identified by staff and researchers in dialogue. Staff gets relevant education. An intervention is tailored by staff and researchers to bridge the gaps. Consumers have a say and the intervention is revised accordingly. The intervention is implemented and continues for 14 months.

Rehabilitation as usual

The ongoing, normal day center program.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Enrichment with meaning-generating activities

Gaps in the rehabilitation are identified by staff and researchers in dialogue. Staff gets relevant education. An intervention is tailored by staff and researchers to bridge the gaps. Consumers have a say and the intervention is revised accordingly. The intervention is implemented and continues for 14 months.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• severe mental illness > 2 years
• age 18-65 years
• visiting the day center > 4 hrs per week

Exclusion Criteria

• comorbidity of dementia or developmental disorder
• acute psychosis
• primary diagnosis of substance use disorder
• insufficient knowledge of Swedish

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

The Swedish Research Council

OTHER_GOV

Sponsor Role: collaborator

Lund University

OTHER

Sponsor Role: lead

Responsible Party

Mona Eklund

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

References

Eklund M, Sandlund M. Predictors of valued everyday occupations, empowerment and satisfaction in day centres: implications for services for persons with psychiatric disabilities. Scand J Caring Sci. 2014 Sep;28(3):582-90. doi: 10.1111/scs.12085. Epub 2013 Oct 8.

Reference Type: DERIVED

PMID: 25066326 (View on PubMed)

Other Identifiers

Enrich

Identifier Type: -

Identifier Source: org_study_id