Development and testing of a Shared decision making ExpeRience in mENtal hEalth (SERENE) measure

Introduction Shared decision making (SDM) is a health communication approach focusing on patient-clinician interactions around treatment decisions, with the goals of improving clinical and functional outcomes and providing personalized care. Moreover, decision making may need to be negotiated between, and communicated to, multiple health and social care practitioners, as well as patients and their social networks (SNs). The skills for sharing and discussing personal information with patients, and their SNs, can be hard to embed in mental health services. Compared to physical health, SDM in mental health is characterized by inconsistent definitions, models, and measurement, and evidence for the effectiveness of SDM interventions is inconclusive. Therefore, there is a need to define what is considered an effective SDM approach in mental healthcare, and to determine the core elements and steps required for its successful implementation in mental health populations. Objectives To better understand the concept and role of patients’ social networks in treatment decision-making in mental health. Methods A two-phase process (compliant with the International Patient Decision Aid Standards) will be used to develop the first polyadic SDM measure of patient experience to support a wide range of models of mental health care. The new measure of patient experience will focus for the first time on the patient’s perception of individual qualities/behaviour of a patient, clinician, caregiver, and their interaction. Phase I of this thesis involved reviewing the existing SDM interventions and SN interventions in mental health, as well as reviewing the existing instruments used to measure SDM in mental health research and practice. Phase II will involve developing and revising the new measure of SDM using stakeholder feedback in an iterative process. Stakeholders will include patients, their caregivers, and clinicians recruited from community mental health services in England. Results To define SDM and the most relevant aspects of it, data from the literature review and exploratory focus groups will be evaluated together. A pool of draft questions will be generated, covering all aspects of the identified themes. These questions will be further refined following discussions with people with lived experience of mental illness (i.e., peers) and academics who have the relevant expertise in SDM and psychometric measure development. This will establish content validity and ensure wording clarity, to be accessible for all English language requirements. Conclusions The new SDM measure will ensure effective evaluation of SDM experiences of people with mental illness. It will be an important step forward in advancing the study and application of SDM in mental health care. It will lay the foundation for further research into the needs of patients and their SNs regarding SDM in mental healthcare. Disclosure of Interest None Declared

Introduction: Metabolic syndrome and other cardiovascular risk factors are highly prevalent in people with mental severe illness (Sun & Jang, 2020).Metabolic disorders in people with schizophrenia increase their risk of developing cardiovascular disease, consequently reducing their life expectancy by approximately 10 to 25 years (Heald et al., 2017)In part these cardio-metabolic risk factors are attributable to unhealthy lifestyle, including poor diet and sedentary behaviour.Lifestyle interventions (diet, increased physical activity) are the first-line treatments to decrease that risk.Objectives: Our objective is to carry out a prospective study on the application of a program of healthy habits in outpatients unit Methods: Patients with mental severe illness were recruited at a mental health center in the Hospital Clinic of Valencia.Inclusion criteria: age from 18 to 65 years and diagnosis of severe/persistent mental illness Exclusion criteria: acute illness, were not understanding Spanish, not be able to read and understand questionnaries.We included following data: sociodemographic data and aspects of the health behaviors, anthropometric measurements and analytical with hemogram and biochemistry pre and post-intervention.All subjects gave informed consent for participation in the study.Results: We included 12 patients, but only 9 completed the full program.Average baseline data suggests that participants were at increased health risk when entering the program.At the end of the program, differences were observed: a reduction in glucose profile, a reduction of an average of 3.33 kg from the initial weight and a Introduction: Shared decision making (SDM) is a health communication approach focusing on patient-clinician interactions around treatment decisions, with the goals of improving clinical and functional outcomes and providing personalized care.Moreover, decision making may need to be negotiated between, and communicated to, multiple health and social care practitioners, as well as patients and their social networks (SNs).The skills for sharing and discussing personal information with patients, and their SNs, can be hard to embed in mental health services.Compared to physical health, SDM in mental health is characterized by inconsistent definitions, models, and measurement, and evidence for the effectiveness of SDM interventions is inconclusive.Therefore, there is a need to define what is considered an effective SDM approach in mental healthcare, and to determine the core elements and steps required for its successful implementation in mental health populations.Objectives: To better understand the concept and role of patients' social networks in treatment decision-making in mental health.Methods: A two-phase process (compliant with the International Patient Decision Aid Standards) will be used to develop the first polyadic SDM measure of patient experience to support a wide range of models of mental health care.The new measure of patient experience will focus for the first time on the patient's perception of individual qualities/behaviour of a patient, clinician, caregiver, and their interaction.Phase I of this thesis involved reviewing the existing SDM interventions and SN interventions in mental health, as well as reviewing the existing instruments used to measure SDM in mental health research and practice.Phase II will involve developing and revising the new measure of SDM using stakeholder feedback in an iterative process.Stakeholders will include patients, their caregivers, and clinicians recruited from community mental health services in England.Results: To define SDM and the most relevant aspects of it, data from the literature review and exploratory focus groups will be evaluated together.A pool of draft questions will be generated, covering all aspects of the identified themes.These questions will be further refined following discussions with people with lived experience of mental illness (i.e., peers) and academics who have the relevant expertise in SDM and psychometric measure development.This will establish content validity and ensure wording clarity, to be accessible for all English language requirements.Conclusions: The new SDM measure will ensure effective evaluation of SDM experiences of people with mental illness.It will be an important step forward in advancing the study and application of SDM in mental health care.It will lay the foundation for further research into the needs of patients and their SNs regarding SDM in mental healthcare.

EPV0593
The relationship between psychiatric symtoms and childhood trauma.
M. G. Almeida1 *, M. E. C. virginio 1 and J. R. A. almeida2 Introduction: Recent evidences suggest that situations of abandonment, neglect and abuse are risks factores for onset of psychopatology in adulthood.This association occus in that traumatic events in the early stages of development and may trigger severe and disabling psychiatric disorders in adults.
Objectives: The presente study aimed to evaluate the associations between the occurence and severity of chidhood trauma and the development of psychiatric disorders in hospitalized teenagers of the Hospital Psychiatric Vida Londrina/Pr.Methods: The sample was consisted of 14 psychiatric patients, evaluated for severity of psychiatric symtoms by the Back Scale for Suicid Ideation (BSI); Beck Depression Inventory (BDI); Beck Anxiety Inventory (BAI); Back Hopelessness Scale (HAD) and the Barratt Impulsiveness Scale (BIS-11).Results: In the sample studie, 84% of the teenegers reports that they had some type of childhood trauma.The results indicate that traumas are associated mainly with the development of mood disorders and also with increasin severity of psychiatric symptoms, specially the depressive symptoms, hopelessness, suicidal ideation and impulsivity.Teenagers with emocional neglect, emocional abuse and physical neglect demonstrated having five times more risk of personality disorder.Individuals who suffered physical abuse; sexual abuse and physical neglect presentes at three times more risk of commiting suicid attemps.Conclusions: These data demonstrate the relevance of trauma childhood as a trigger for psychiatric symptoms.

EPV0594
Mental health evaluation in senior year medical students Introduction: Medical studies are known for being difficult and hard.They require a lot of dedication and hard work from students.This takes a toll on their mental health over the years.Objectives: Detect signs of anxiety, depression, and stress levels in 5 th -year medical students.Methods: This study was cross-sectional through a selfadministered pre-established questionnaire for medical students during September and October 2022.We used the General Anxiety Disorder-7 (GAD-7) questionnaire, the Patient Health Questionnaire-9 (PHQ-9) and the Perceived Stress Scale-10 (PSS-10).The satisfaction level with the choice of the medical field as a career was assessed on a scale ranging from 1 to 10. Results: Our population consisted of 54 5 th -year medical students.The average age was 22.94AE0.78and 64.8% were female.All our population were singles.Active smokers represented 9.3% and alcohol consumption was reported by 9.3% of the participants.More than half of the population (51.9%) had a regular leisure activity.Most of the students had no medical history (72.2%) or psychiatric history (94.4%).The mean satisfaction level from choosing the medical field was 7.43AE1.84.The mean GAD-7 and PHQ-9 scores were respectively 3.50AE3.80and 4.70AE4.42.The PSS-10 score had a mean of 14.07AE5.29.Five students (7.4%) presented self-harm thoughts.Students who were less satisfied with their choice of the medical field as a career had significantly higher scores of PHQ-9 (p<0.001),GAD-7 (p=0.004) and PSS-10 (p=.042).Conclusions: Medical studies are the first step for these young doctors in their professional careers, which presents further psychological stressors.More attention towards the mental health of this population is needed to properly prepare them for their future.