Aim: validate a Dual Integrated Attention Program (D-AIP) for mental health nursing in people with Severe Dual Diagnosis admitted to a psychiatric hospitalization unit Design: Randomized Controlled Trial. Population: Inpatients with dual diagnosis.
The main objective of the project is to validate a Dual Integrated Attention Program (D-AIP) for mental health nursing in people with Severe Dual Diagnosis admitted to a psychiatric hospitalization unit, assessing change motivation, insight, medication adherence, drug consumption abstinence or reduction, therapeutic alliance, hopelessness and anxiety, which this context generates. For this purpose, a randomized, prospective, one-year-longitudinal clinical trial will be conducted. This study will be applied on patients with diagnosis of schizophrenia, schizoaffective disorder and bipolar disorder types I and II who, after accepting to participate in the study and signing the informed consent, answer the PRISM questionnaire of admission in the hospitalization unit and fulfill the dual pathology criteria. After, they will be randomized in control group and intervention group (only the later will complete the D-AIP). The D-AIP will consist on 6 individualized sessions with the psychiatric inpatients, and during follow-up up to one year after discharge in which 4 individual sessions and 3 telephone contacts will be made. In both groups, a different person from the one who performs the intervention and without knowledge of the group belonging will assess them with questionnaires in 9 moments during the whole follow-up year (Socrates 8D, Scale of Unawareness of Mental Disorder "SUMD", Morisky Medication Adherence Scale "MMAS-8", Working Alliance Inventory "WAI", Hamilton Anxiety Rating Scale "HARS" y Hopelessness Scale "HS") and will collect a urine sample in each evaluation. The sample size will be 86 subjects, for α=0.05 and power=0.80.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
86
Intervention on change motivation, insight, medication adherence, drug consumption abstinence or reduction, therapeutic alliance, hopelessness and anxiety
Stages of Change Readiness
Assessed by Questionnaire SOCRATES 8D
Time frame: 12 months
Insight
Assessed by Scale Unawareness of Mental Disorders (SUMD)
Time frame: 12 months
Medication Adherence
Assessed by Medication Adherence Scale (MMAS-8)
Time frame: 12 months
Therapeutic Alliance
Assessed by Working Alliance Inventory in patients and therapist (WAI-P and WAI-T)
Time frame: 2-3 months
Anxiety
Assessed by Hamilton Anxiety Rating Scale (HARS)
Time frame: 12 months
Hopelessness
Assessed by Hopelessness Scale (HS)
Time frame: 12 months
Containments methods
Number of registered containments methods
Time frame: 2-3 months
Drug use change
Presence of drug abuse through a urine sample with "10-panel drug test"
Time frame: 12 months
Hospital readmissions
Number of registered hospital readmissions
Time frame: 12 months
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Dual diagnosis knowledge
Assessed by ad-hoc questionnaire
Time frame: 12 months