Moller-murphy symptom management assessment tool

Last Update Posted : September 8, Study Description. This nested design clinical outcome study of psychiatric case manager education on disease state, psychopharmacology of schizophrenia, relapse, motivational interviewing, and the process of psychological adjustment post-psychosis Milestones of Adjustment Post-Psychosis Recovery Model-MAPP will test the following hypotheses: Medication non-adherence in patients with schizophrenia assigned to case managers who receive MAPP training will decrease from their pre-study rate and from the reported national average after one year enrollment compared to consumers not enrolled in the MAPP arm of the study.

Consumers in the MAPP intervention arm will have greater symptom reductions at quarterly data points compared to consumers not enrolled in the MAPP intervention arm. Detailed Description:.

After randomization, 26 case managers will receive additional manualized training in the process of post-psychotic adjustment. Outcomes of consumers 5 per case manager related to medication adherence, relapse rates, symptom intensity, and quality of life will be evaluated at quarterly intervals over a two-year period. Outcomes of consumers related to medication adherence, relapse rates, symptom intensity, quality of life, and progression through the phases of postpsychotic adjustment MAPP-Milestones of Adjustment Post-Psychosis Recovery Model will be evaluated at quarterly intervals via rating scales over a two-year period and the two groups compared.

FDA Resources. Arms and Interventions. Outcome Measures. Primary Outcome Measures : Medication Adherence [ Time Frame: Two years ] Specific consumer medication adherence outcome data will be collected quarterly for both groups for two years targeting two specific analyses of change: pharmacy records of prescription refills one year before and quarterly after the educational intervention. Secondary Outcome Measures : Psychological Adjustment Post-Psychosis [ Time Frame: 2 years ] Movement through the four phases of the MAPP: cognitive dissonance, insight, cognitive constancy, and ordinariness and resolution of stage specific themes will be evaluated quarterly for both years of the study and analyzed using latent transitional analysis.

The Quality of Life Enjoyment and Satisfaction Questionnaire Q-Les-Q will be administered quarterly to consumers in both arms of the study over two years. Symptoms associated with anxiety, depression, psychosis, mania,cognitive difficulties, activities of daily living, medication adherence, interpersonal relationships, general health concerns, and common symptom management strategies will be measured quarterly using the Moller-Murphy Symptom Management Assessment Tool. Eligibility Criteria.

Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Inclusion Criteria:Case Managers Voluntary basis-includes willingness to administer study tools quarterly for two years to at least five consumers from their assigned caseloads and to keep a log of their activities and reactions.

Contacts and Locations. Log in via OpenAthens. Log in using your username and password For personal accounts OR managers of institutional accounts. Forgot your log in details? Register a new account? Forgot your user name or password? Search for this keyword. Advanced search. Latest content Current issue Archive Authors About. Log in via Institution. Cognitive deficits also de- Facilitates Hinders crease the likelihood that an individual will inde- Habilitation Habilitation pendently develop stabilizing symptom manage- Open communication Stigma ment strategies thereby increasing their relapse Problem-solving Guilt risk.

Consequently, the individual has an ongoing Planning for relapse Grief need for social support and assistance with symp- Empowerment Threats tom management Murphy, Limit-setting Blame Planning for change Poverty Environment includes transportation resources, Gradual integration into life events, housing, employment, learning oppor- the community Control tunities, socioeconomic status, and interpersonal Normalized behavior relationships.

However, accessing these resources is Examples cited by patients include poor nutritional dependent upon knowledge and ability to use re- status, lack of sleep, use of substances that depress sources. Impaired information processing and low the central nervous system, and infections Mur- socio-economic status frequently impede system phy, The MM-SMAT sections related to access and may necessitate case management or general health include cognitive difficulties and some other form of outside assistance.

The use of health problems. Ongoing assessment and moni- available community resources facilitates interac- toring results in early identification of health prob- tions between patients and other community mem- lems and becomes crucial in preventing relapse.

In addition to replicating these findings, management. Identifying these triggers and ways Murphy also found that inability to deal of effectively managing symptoms assist the indi- with the change created by discharge was a factor vidual to attain actualization and are ultimately re- in relapse. Data from Health Variables and Triggers Related these two categories assist in identification of to Relapse problem areas related to survival in the commu- The omnipresent problem of impaired cause and nity.

As a result, ongoing environmental educa- effect reasoning skills promotes frustration and tional needs are identified. Table 2. Gaining insight into the behavior of individ- tory. The MM-SMAT facilitates discussion of uals with brain diseases requires professionals to problems faced by the patient and allows the pa- be cognizant of the extreme heightened sensitivity tient to assist in identifying potential solutions.

Individuals with NBD describe about them. We factored the techniques into six 1cameinto the hospital this time because I could no longer categories Table 3 distinguish my red dots. I see red dots all the time, 24 hours a day, but they were changing and I could no longer tell Categories one, two, three, and four incorporate the difference between my red dots, brake lights on the cars symptom-management techniques that promote in front of me, or stop lights. I knew then it was time to come back to the hospital for a medication check Moller Table 3.

Symptom Management Categories and Tachniques Categories The anxiety, depression, elation, psychosis, cog- nitive, and symptom management sections of the 1. The Going for a ride ability to comply to a medication regime is depen- 2.

Isolation tions. These measures are niques. Patients using these techniques maintain action-oriented and frequently involve enlisting stability, but do not move toward wellness. Category six methods lead to instability. Effective interventions take into account cognitive functioning and developmental level of the individual as well as personal, family, and community resources. For example, patients having difficulty re- Rehabilitation of individuals with neurobiologi- membering to take medications find the use of a cal disorders requires that variables related to well- watch with an alarm preset at medication times ness in the areas of health, environment, and atti- remarkably helpful.

This reduces the in- 5. It is helpful to have family members and ser- stances of unstable health and possible relapse but vice providers fill out the MM-SMAT to compare may not prevent them. Steps to prepare for relapse and contrast differences in perceptions with the before it occurs include the above strategies in ad- patient.

This process increases understanding dition to developing a plan for intervening when among all three groups as to the techniques that are relapse is not preventable. Suggested Education Sessions supportive interventions for patients and families Session Number as an integral part of rehabilitation planning. The Symptoms related to anxiety and method described in this paper facilitates under- depression standing and planning for relapse without placing Symptoms related to elation, blame.

Perhaps when collaborative management of psychosis, and cognitive function NBD begins, the blame often associated with re- Difficulties associated with lapse will stop. Washington, D. The take more than one session and impact of life events on chronic mental patients. Hos- need to be repeated from time to pital and Community Psychiatry, Birchwood, M. Psychological Medicine, Achieving actualization level of Buchsbaum, M. Functional and anatom- wellness by identifying factors ical brain imaging: Impact on schizophrenia research.

Personal coping styles of important to the individual in schizophrenic outpatients. Hospital and Communiry achieving the desired quality of Psychiatry. Davis, J. How medication compliance affects outcome. Psychological Bulletin, 83, 43 1. Psychiatric Annals, 16, The future of psychiatry.

Use of symp- Eaves, L. Hospital and Community Psychiatry, 37, Kendler, K. Genetics, immunology, and virology. Schizo- McCranie, E. Aftercare for psy- phrenia Bulletin, 14, Hos- Falloon, I. Family management McEvoy, J.