RCT Examining the Effectiveness of Digital Picture Frame Use in Inpatient Setting

Schizophrenia Clinical Trial

Official title:

A Randomized Controlled Trial Examining the Effectiveness of Digital Picture Frame Use on the Long Term Inpatient Experience

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02950571
• Other study ID #: 074/2016
• Status: Completed
• Phase: N/A
• Start date: October 2016
• Est. completion date: December 2017

Study information

• Verified date: March 2019
• Source: Centre for Addiction and Mental Health
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study will be a randomized controlled trial that investigates the effectiveness of digital picture frames (DPF) installed in inpatient rooms on long stay inpatient wards servicing schizophrenia clients at CAMH. The effects on client experience will consider the domains of self-concept, interactions with healthcare staff, perception of space, and implications for the recovery process. The comparison of inpatient client experience with DPFs versus a control group (Treatment as Usual - TAU), offers the opportunity to examine the effectiveness of this type of environmental adaptation. This trial builds upon earlier work that demonstrated the feasibility of DPFs in this context.

Description:

Long term stays in mental health facilities have been shown to have unique challenges and implications. To a considerable extent these challenges grow out of the stigmatized nature of severe mental illnesses (SMI) such as schizophrenia. The social and self-stigma surrounding SMI can have major effects on those affected including decreased self-esteem, self-deprecation, and the development of a self-concept defined by the illness. When stigmatized interpretations of mental illness are internalized, those affected can find it very challenging to sustain non-illness identities and can ultimately result in the loss of non-illness related aspects of self-concept. Inpatient contexts are particularly challenging in this regard, with non-illness oriented identities very difficult to sustain given considerations of power differentials with providers, the reduction of autonomy and choice, and the removal of the individual from environments that are demonstrative of non-illness aspects of self.

Accordingly, a randomized controlled trial design will be used to consider the question: Does having a DPF in psychiatric inpatient unit rooms lead to improvements in interactions with the clinical team, perceptions of enhanced quality of physical space, and an improvement in the sustaining of non-illness aspects of self-concept? While the promising feasibility study findings might suggest hypotheses of improvement in these domains, we will consider this study exploratory given the complex environments inpatient units represent in the study of care quality and outcomes and the modest scope of this intervention. Finally, we will continue to collect feasibility data qualitatively, to inform further refinement of metrics and otherwise consider enhancements in intervention and research design.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 33
• Est. completion date: December 2017
• Est. primary completion date: September 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• All participants will have severe mental illness (SMI) defined as diagnosis with a major mental illness (in practice, will be primarily schizophrenia spectrum) and inherent to hospital admission will be substantive contact with services and disability affecting day-to-day functioning (Ruggeri, Leese, Thornicroft, Bisoffi, & Michelle, 2000).

• Admitted to a CAMH inpatient unit, specifically units 2-2 and 2-3, with an anticipated length of stay of 4 weeks or more, as determined by the clinical team

• Chart diagnosis of a major mental illness

• Determined appropriate for study by staff psychiatrist and clinical team (capacity to consent confirmed, no precautions against having the device in the participant's room indicated)

• 18 years of age or older

• Proficiency in English

Exclusion Criteria:

• Do not meet the above criteria

Related Conditions & MeSH terms

• Mental Disorders
• Psychosis
• Psychosis NOS
• Psychotic Disorders
• Schizophrenia

Intervention

Behavioral:
• Digital Picture Frame
The intervention is the provision of digital picture frames in long stay inpatient rooms in a ward at CAMH.
• Standard Care
High level of support from an interdisciplinary team.

Locations

Country	Name	City	State
Canada	Centre for Addiction and Mental Health	Toronto	Ontario

Sponsors (1)

Lead Sponsor	Collaborator
Centre for Addiction and Mental Health

Country where clinical trial is conducted

Canada, 

References & Publications (6)

Attkisson, C. C., & Greenfield, T. K. (1995). The Client Satisfaction Questionnaire (CSQ) scales. Outcome assessment in clinical practice. Baltimore, MD: Williams & Wilkins, 2-10.

McCay EA, Seeman MV. A scale to measure the impact of a schizophrenic illness on an individual's self-concept. Arch Psychiatr Nurs. 1998 Feb;12(1):41-9. — View Citation

McGuire-Snieckus R, McCabe R, Catty J, Hansson L, Priebe S. A new scale to assess the therapeutic relationship in community mental health care: STAR. Psychol Med. 2007 Jan;37(1):85-95. Epub 2006 Nov 9. — View Citation

O'Connell M, Tondora J, Croog G, Evans A, Davidson L. From rhetoric to routine: assessing perceptions of recovery-oriented practices in a state mental health and addiction system. Psychiatr Rehabil J. 2005 Spring;28(4):378-86. — View Citation

Rogers ES, Chamberlin J, Ellison ML, Crean T. A consumer-constructed scale to measure empowerment among users of mental health services. Psychiatr Serv. 1997 Aug;48(8):1042-7. — View Citation

Rosenberg, M. (1965). Rosenberg self-esteem scale (RSE). Acceptance and commitment therapy. Measures package, 61.

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in Recovery Self Assessment (RSA; O'Connell et al., 2005)	To examine the degree to which inpatient staff are perceived as recognizing the individuality of the individual and engage in a hopeful and holistic manner. 4 items from the patient version will be used (1-5 point Likert scale).	Baseline and after 4 weeks (post intervention)
Primary	Client Satisfaction Questionnaire-8 (CSQ-8; Attkisson et al., 1995)	Investigators will only use the general satisfaction question from this measure (1-5 point Likert scale). Only participants in the intervention arm will complete this question.	After 4 weeks (post intervention)
Primary	Change in Empowerment Scale (Rogers et al., 1997)	Measures dimensions of self efficacy, self stigma and self concept (1-9 point Likert scale).	Baseline and after 4 weeks (post intervention)
Primary	Change in Modified Engulfment Scale (McCay & Seeman, 1998)	Only two items from this measure focussing specifically on self-concept will be used (1-5 point Likert scale).	Baseline and after 4 weeks (post intervention)
Primary	Change in Rosenberg Self-Esteem Scale (Rosenberg, 1965)	The broadest reaching and high factor loading item, 'On the whole I am satisfied with myself' will be used (1-4 point Likert scale).	Baseline and after 4 weeks (post intervention)
Primary	Change in Scale to Assess Therapeutic Relationship (STAR; Mcguire-Snieckus et al., 2007)	Three items assessing common factors in the therapeutic relationship with the clinical team are from the scale will be used (1-5 point Likert scale).	Baseline and after 4 weeks (post intervention)
Primary	Change in Satisfaction with the physical environment of the inpatient unit	One question developed my investigators due to lack of standardized measures to specifically measure participant satisfaction with the physical environment of the inpatient unit (1-5 point Likert scale)	Baseline and after 4 weeks (post intervention)
Primary	Change in Satisfaction with the rooms on the inpatient unit	One question developed by investigators due to lack of standardized measures to specifically measure participant satisfaction with their room on the inpatient unit (1-5 point Likert scale)	Baseline and after 4 weeks (post intervention)
Primary	Semi structured interviews	SC participants will be asked broad questions about how satisfied they were with the inpatient unit space and what might be improved. These same questions will be asked of DPF participants, but will be followed by questions specific to the DPF support.	After 4 weeks (post intervention)

External Links

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