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Publication
The Portuguese open dialogue pilot project – Evaluation of effectiveness
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Authors
Abstract(s)
Objectivo: Este projecto-piloto de Diálogo Aberto (DA) em Portugal faz parte de um protocolo de
investigação multi-nível baseado em Pocobello et al. (2016, manuscrito não publicado), que
pretende avaliar a transferibilidade da abordagem DA para o contexto dos serviços de saúde mental
do Norte Alentejano. Este trabalho avalia a efectividade do DA com foco na análise exploratória
dos resultados clínicos pré e pós-intervenção.
Método: Os 7 participantes foram avaliados pré e pós- intervenção. As escalas aplicadas foram as
Clinical Outcome Routine Evaluation - Outcome Measure (CORE-OM), Brief Symptom Inventory
(BSI), Global Assessment of Functioning (GAF), Lubben Social Network Scale (LSNS6) e um
questionário de satisfação. Devido à pandemia de COVID-19, os contactos com os candidatos e os
participantes, o processo de inscrição, as reuniões de DA e os procedimentos de avaliação foram
realizados na sua maioria remotamente.
Resultados: Diminuição da sintomatologia e melhoria do funcionamento global e da perceção do
apoio social. O sofrimento psicológico (CORE-OM) correlaciona-se positivamente com a idade,
melhores níveis de funcionamento (GAF) com educação superior e estatuto de
empregado/estudante e percepção de apoio social (LSNS6) negativamente com o número de
reuniões atendidas. O estado civil verificou-se ser um predictor significativo da participação nas
reuniões DA. As prescrições psiquiátricas foram mantidas. Os participantes casados reportaram
maior sintomatologia, comprometimento do funcionamento, risco de isolamento social e
compareceram a mais reuniões. O programa recebeu uma avaliação muito positiva por parte dos
utilizadores.
Conclusões: A diminuição da sintomatologia e a melhoria do funcionamento global vão ao
encontro do reportado anteriormente na literatura sobre DA em relação a outcomes promissores,
sendo interpretados como sugestões encorajadoras para investigação futura. Como limitações,
sublinha-se principalmente a dimensão muito pequena da amostra, a curta duração do projeto, a
falta de aleatorização e de comparação com outras formas de tratamento ou grupo de controlo, que
impedem a significância e a generalização dos resultados. A disseminação do projecto, a
acessibilidade e a adesão dos participantes, bem como o contexto das reuniões foram
indubitavelmente afectados pela pandemia de COVID-19.
ABSTRACT: Aim: This first Open Dialogue (OD) pilot project in Portugal is part of a multi-level research protocol, based on Pocobello et al. (2016, unpublished manuscript), which intends to assess OD transferability to North Alentejo mental health services. This work evaluates the OD effectiveness, focusing on the exploratory analysis of pre- and post-intervention clinical outcomes. Method: The 7 participants were assessed through a multi-method approach, both pre- and post intervention. The scales applied were the Clinical Outcome Routine Evaluation - Outcome Measure (CORE-OM), Brief Symptom Inventory (BSI), Global Assessment of Functioning (GAF), Lubben Social Network Scale (LSNS6), and a satisfaction questionnaire. Due to the COVID-19 pandemic, contacts with candidates and participants, the enrolment process, OD meetings, and the assessment procedures were performed mainly remotely. Results: The findings indicate a decrease in symptomatology and an improvement in global functioning and social support perception. Psychological distress (CORE-OM) was positively correlated with age, higher levels of functioning (GAF) with superior education and employment/studying status, and a negative correlation between LSNS6 and meeting attendance. Marital status was a significant predictor of OD meeting attendance. Psychiatric prescriptions were kept. Overall, married participants reported higher distress symptomatology, functioning impairment, and social isolation risk and attended more meetings. The OD program received a very positive rating from users. Conclusions: The findings on decrease in symptomatology and an improvement in global functioning match previous OD literature findings and confirm promising outcomes, while suggesting further research. The main limitation is the very small sample size, the short duration of the project, the lack of randomization and comparison to other forms of treatment or control group, which hinder the significance and generalizability of the findings. The project's spread, participant accessibility and adherence, and meeting setting were undoubtedly affected by the COVID-19 pandemic.
ABSTRACT: Aim: This first Open Dialogue (OD) pilot project in Portugal is part of a multi-level research protocol, based on Pocobello et al. (2016, unpublished manuscript), which intends to assess OD transferability to North Alentejo mental health services. This work evaluates the OD effectiveness, focusing on the exploratory analysis of pre- and post-intervention clinical outcomes. Method: The 7 participants were assessed through a multi-method approach, both pre- and post intervention. The scales applied were the Clinical Outcome Routine Evaluation - Outcome Measure (CORE-OM), Brief Symptom Inventory (BSI), Global Assessment of Functioning (GAF), Lubben Social Network Scale (LSNS6), and a satisfaction questionnaire. Due to the COVID-19 pandemic, contacts with candidates and participants, the enrolment process, OD meetings, and the assessment procedures were performed mainly remotely. Results: The findings indicate a decrease in symptomatology and an improvement in global functioning and social support perception. Psychological distress (CORE-OM) was positively correlated with age, higher levels of functioning (GAF) with superior education and employment/studying status, and a negative correlation between LSNS6 and meeting attendance. Marital status was a significant predictor of OD meeting attendance. Psychiatric prescriptions were kept. Overall, married participants reported higher distress symptomatology, functioning impairment, and social isolation risk and attended more meetings. The OD program received a very positive rating from users. Conclusions: The findings on decrease in symptomatology and an improvement in global functioning match previous OD literature findings and confirm promising outcomes, while suggesting further research. The main limitation is the very small sample size, the short duration of the project, the lack of randomization and comparison to other forms of treatment or control group, which hinder the significance and generalizability of the findings. The project's spread, participant accessibility and adherence, and meeting setting were undoubtedly affected by the COVID-19 pandemic.
Description
Dissertação de Mestrado realizada sob a orientação do Professor Doutora Carolina Seybert e coorientação do Professor Doutor João G. Pereira e da Professora Doutora Sofia Tavares, apresentada no Ispa - Instituto Universitário para obtenção do grau de Mestre na especialidade de Psicologia Clínica.
Keywords
Diálogo aberto Crise psiquiátrica Prática dialógica Abordagens democráticas Cuidados de saúde mental