Authors (including presenting author) :
Yu DFJ(1), Wong W(1), Ng TW(1), Lee WK(2), Ho YT(2), To NY(2), Yeung WS(1),LUI SF(1),Cheng KC (3)
Affiliation :
(1) Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital (2) Department of Occupational Therapy, Pamela Youde Nethersole Eastern Hospital (3) Medical Media Unit, Pamela Youde Nethersole Eastern Hospital
Introduction :
Mental wellness is the foundation of a healthy life.Adverse mental health is not only a threat to physical health/quality of life (QOL) but a precipitator to mental breakdown as well.The increasing length of hospital stay has emerged as a continual challenge in the delivery of short-term acute psychiatric service. Through interdisciplinary collaboration,the rehabilitation project ‘花Fit活動’ in an acute psychiatric setting was piloted in June 2019 and served as an evolution of traditional psychiatric rehabilitation.It not only focused on mental health recovery for psychiatric patients but multifaceted on physical health endurance in the community after discharge.This made our patient recovery model more comprehensive.
Objectives :
-Promoting and enhancing the mental and physical wellness of psychiatric patients -Encourage patients’ engagement on a holistic recovery journey -Strengthen autonomy and confidence to face reality after discharge -Train up the muscle tone and enhance their balance for patients with polypharmacy -Increase patient immunity and prevent infection outbreaks in psychiatric setting -Develop a therapeutic team morale and therapeutic relationship with patients -Limit episodes of violence outburst of psychiatric patients. -Reduce the use of restraint -Facilitates patient discharge.
Methodology :
A 18-month multidisciplinary collaboration program ‘花Fit活動’ was implemented in June 2019.Psychiatric patients were motivated.They recognized the importance of comprehensive rehabilitation on the ‘healing mind and body’.Several positive-oriented lifestyle programs were promoted at ward meetings.Nurses, occupational therapists, doctors and supporting staff met together with psychiatric patients.The Post-90 staff formed a video production team to ‘DIY’ a series of positive-oriented videos.The content included stretching and mindfulness exercises.Nursing and occupational therapists provided in total 156 sessions of ‘花Fit活動’ on every Tuesday,Friday afternoon for 78 consecutive weeks. During each session,the team provided 30 minutes of ‘花Fit活動’ exercises and 15 minutes educational talk on healthy eating and lifestyle.
Result & Outcome :
219 patients with schizoaffective disorder (n=130) and depression (n=89) participated in this program. All participants were evaluated at baseline and endpoint for Patient Health Questionnaire -9 (PHQ-9).We aimed at assessing patients’ mood change and severity of mood disorder.The scoring system indicated that the higher the score, the greater level of depression.According to the result, 71.2% of participants received decreasing score compared with baseline which indicated that ‘花Fit活動’ can improve mood with less depressed mood (P< 0.001).Pre- test of PHQ-9 score (mean= 6.51 ; ± SD=6.30) while post- test of PHQ-9 score (mean= 2.97; ± SD=5.02 ).Patients showed a significant improvement in mood.Apart from this, fall incident rate minimized from 2 (2019 3Q and 4Q) to 1 case (2020 3Q and 4Q),fall incident rate decreased 50 % in 2020 3Q and 4Q.No staff injury noted due to violence outburst.Infection cohort cases rate in 3Q and 4Q 2020 decreased 26.7% when compared to that of 2019 3Q and 4Q. There was none infection outbreak.According to Patient Relations Office (PRO) statistic, the number of appreciation received 792 cases from 2020 1Q to 4Q and zero complaints were received. To conclude,‘花Fit活動’ was an evolving rehabilitation program with teamwork and support from senior managers.80% of participants were satisfied with our program with positive feedback.Participants suggested program time can be extended longer period."花fit活動可幫助提升生活質素，提升身體健康，提升心理健康 " ‘花Fit活動’ videos can be provided with QR codes in future.Participants can use QR codes to practice with family after discharge. Now we have achieved a core value of ‘花Fit活動’ slogan “花多點時間去keep，身心都會fit” on “healing mind and body’’.We hope to promote a positive culture to our community. Patients and their families will do ‘花Fit活動’ at homes.Their QOL and family harmony will be achieved in long term.
