Clinical trial NCT01732575: Enrichment of Day Centers in Community-based Psychiatry
Official title: Effectiveness of an Intervention Tailored for Day Centers for People With Psychiatric Disabilities
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Enrichment With Meaning-generating Activities
Rehabilitation as Usual
Keywords: everyday activities
rehabilitation
mental illness
occupational therapy
Lead sponsor: Lund University
Sponsor class: OTHER
Collaborators: name: The Swedish Research Council
First posted: 2012-11-26
Enrollment: 107
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

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.


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

Primary outcomes:
measure: Score on questionnaire regarding perceived meaning in day center occupations
timeFrame: Up to 14 months
Secondary outcomes:
measure: Score on satisfction with the rehabilitation
timeFrame: Up to 14 months
Other outcomes:
measure: Quality of life score
timeFrame: Up to 14 monts
Locations:
Study officials:
References:
citation: 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.