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Abstract
BACKGROUND Recovery in mental illness is not synonymous with cure. Personal recovery approach consider recovery as a process and not as an outcome. This approach takes into account the subjective meaning of recovery by assessing how a person has learned to accommodate and live with an illness. AIM To study the personal meaning of recovery among persons with schizophrenia. METHOD This article presents the findings of a qualitative study about what 'recovery' means to persons with schizophrenia. A semi structured interview schedule was prepared based on literature review and expert opinion. Twenty participants who met the inclusion criteria and personally consider themselves recovering/recovered from schizophrenia were selected for the in-depth qualitative interviews. Data was analyzed using Interpretative Phenomenological Analysis (IPA). Meaning of recovery from each participant's perspective was recorded. FINDINGS The results indicate factors that patients deem important for their recovery are, absence of symptoms, regaining functioning, being able to work, having adequate emotional stability and not being on medicines. The findings are examined in the background of the previous studies and suggestions for clinical practice and research is also discussed. CONCLUSION Recovery is far more than remission of symptoms. Persons with mental illness has their own criteria of recovery, which could be very distinct from the clinical definition. Current study findings can help in identifying meaning of recovery through the perspectives of persons with mental illness and in developing and implementing recovery-oriented services.
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Affiliation(s)
- Shari Tess Mathew
- School of Social Work, St. Joseph's College (Autonomous), Bengaluru, Karnataka, India
| | - Bergai Parthsarathy Nirmala
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - John Vijay Sagar Kommu
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bengaluru, Karnataka, India
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Peck CKH, Thangavelu DP, Li Z, Goh YS. Effects of peer-delivered self-management, recovery education interventions for individuals with severe and enduring mental health challenges: A meta-analysis. J Psychiatr Ment Health Nurs 2023; 30:54-73. [PMID: 35737863 DOI: 10.1111/jpm.12853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 05/11/2022] [Accepted: 06/16/2022] [Indexed: 01/15/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The paradigm shifts in the conceptualization of recovery have led to a wide adoption of peer-delivered self-management interventions among individuals with severe and enduring mental health challenges. Peers with experiential knowledge on managing their own mental health conditions act as role models for affected individuals. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The meta-analysis demonstrated significant small-to-medium effects favouring such interventions on symptom severity, self-perceived recovery, hopefulness and empowerment. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: With peer-delivered self-management interventions, individuals with severe and enduring mental health challenges could self-direct their care, thus reducing their reliance on service providers. Individuals with severe and enduring mental health challenges equipped to seek their recovery within the community beyond institutional care, regaining independence and gradually reintegrate into society. ABSTRACT: Introduction The shift in mindset within mental health care has led to the adoption of peer-delivered self-management interventions in promoting recovery among individuals with severe and enduring mental health challenges. However, no reviews have hitherto examined their effectiveness. Aim To determine the effectiveness of peer-delivered self-management interventions in improving symptom severity, self-perceived recovery, hopefulness and empowerment. Method A search was performed in nine English databases for published studies and grey literature from inception to the 5 January 2021. The methodological quality of the studies was graded with the Joanna Briggs Institute's critical appraisal tools. The overall effects were pooled through a meta-analysis with heterogeneity evaluated via the chi-square test and I-square statistics. This review was guided by the PRISMA 2020 statement on transparent reporting of systematic review and meta-analyses. Results Seventeen publications involving 3189 participants were included in this review, and ten were included for the meta-analysis and accounted for 2725 participants. The meta-analysis demonstrated significant small-to-medium effects favouring such interventions on symptom severity, self-perceived recovery, hopefulness and empowerment. Discussion Peer-delivered self-management interventions should be implemented as it is effective in promoting recovery among individuals with severe and enduring mental health challenges. Implications for practice With peer-delivered self-management interventions, individuals with severe and enduring mental health challenges could self-direct their care and reduce their reliance on service providers.
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Affiliation(s)
- Celia Kim Huey Peck
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Dhivya Prabha Thangavelu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ziqiang Li
- Institute of Mental Health, Singapore, Singapore
| | - Yong Shian Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Alice Lee Centre for Nursing Studies, National University Health System, Singapore, Singapore
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Erdoğan E, Demir S. The Effect of Solution Focused Group Psychoeducation Applied to Schizophrenia Patients on Self-Esteem, Perception of Subjective Recovery and Internalized Stigmatization. Issues Ment Health Nurs 2022; 43:944-954. [PMID: 35708992 DOI: 10.1080/01612840.2022.2083735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The study examined the effect of Solution-Focused Group Psychoeducation on self-esteem, subjective perception of recovery, and internalized stigma among patients with schizophrenia 39 patients with schizophrenia were recruited based design of the randomized control-group with pretest and posttest. The patients completed the "Rosenberg Self-Esteem Scale (RSES)", "Subjective Recovery Assessment Scale (SubRAS)", and "Internalized Stigma of Mental Illness (ISMI) Scale" in pretest and posttest. After the psychoeducation, ISMI scores decreased in the intervention group (p < 0.001) but increased in the control group (p = 0.599). The posttest RSES score was lower in the intervention group compared to the control group (p = 0.001). A statistically significant difference was found between the pretest and posttest SRAS scores of the intervention group when compared to the control group (p = 0.018). After the psychoeducation, intervention group' self-esteem and subjective perception of recovery increased, while the severity of internalized stigma decreased.
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Affiliation(s)
- Esra Erdoğan
- Mental Health and Diseases Hospital, Samsun, Turkey
| | - Satı Demir
- Faculty of Health Sciences Nursing Deparment, Gazi University, Ankara, Turkey
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İNCEDERE A, YILDIZ M. Şizofreni Hastalarında Destekli İşe Yerleştirim: Üç Yıllık İzlem Sonucunun Değerlendirmesi. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.30934/kusbed.901262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kaşli S, Al O, Bademli K. Internalized stigmatization and subjective recovery in individuals with chronic mental illness. Int J Soc Psychiatry 2021; 67:415-420. [PMID: 32985298 DOI: 10.1177/0020764020960762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Individuals with mental illness, as they are stigmatized by society, are also stigmatized themselves, and this process is internalized. This may adversely affect the recovery process. AIMS This study was conducted to investigate the relationship between internalized stigmatization and subjective recovery in patients with schizophrenic. METHOD This research was performed for patients with schizophrenia at rehabilitation centers registered with the community mental health center. The survey was performed out with 94 patients in the recovery phase who met the inclusion criteria and who going to the center. Sociodemographic information form, internalized stigmatization scale and subjective recovery assessment scale were used in the collection of data. RESULTS In the study it was found that there is a relationship between internalized stigmatization and subjective recovery. Increased levels of internalized stigma patient outcome would decrease the level of recovery. CONCLUSION It is recommended that nurses perform intervention programs to reduce internalized stigmatization in patients with schizophrenia.
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Affiliation(s)
- Seher Kaşli
- Health University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey
| | - Orhan Al
- Antalya Ataturk Public Hospital, Antalya, Turkey
| | - Kerime Bademli
- Department of Psychiatric Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
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Can Öz Y, Duran S. The Effect of Spirituality on the Subjective Recovery of Psychiatric Patients. JOURNAL OF RELIGION AND HEALTH 2021; 60:2438-2449. [PMID: 33751330 DOI: 10.1007/s10943-021-01226-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/04/2021] [Indexed: 06/12/2023]
Abstract
Spiritual well-being is among the factors that affect subjective recovery. This study aimed to explore the relationship between subjective recovery and spiritual well-being among psychiatric patients and to identify the factors that affected their subjective recovery. A descriptive, cross-sectional study was conducted with 96 patients admitted to the psychiatry clinic of a hospital. It was found that the patients had high subjective recovery assessment levels and medium levels of spiritual well-being. There was a positive association between the patients' subjective recovery assessments and their spiritual well-being, and spiritual well-being was a significant predictor of the subjective recovery level. It is recommended that mental health professionals focus on serving patients through a holistic healthcare approach and enhancing patients' subjective recovery levels through applications that will strengthen the spiritual dimension.
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Affiliation(s)
- Yüksel Can Öz
- Faculty of Health Sciences, Department of Psychiatric Nursing, Yüksel Can ÖZ, Kocaeli University, Kocaeli, Turkey
| | - Songül Duran
- Care of Elderly Program, Izmir Demokrasi University, Health Services Vocational College, Izmir, Turkey.
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İpçi K, Yildiz M, İncedere A, Kiras F, Esen D, Gürcan MB. Subjective Recovery in Patients with Schizophrenia and Related Factors. Community Ment Health J 2020; 56:1180-1187. [PMID: 32277339 DOI: 10.1007/s10597-020-00616-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 04/06/2020] [Indexed: 11/26/2022]
Abstract
Subjective recovery is a personally perceived recovery involving other factors beyond clinical recovery. This study aims at investigating the factors related to subjective recovery in patients with schizophrenia living in Turkey. This study assessed 120 clinically stable outpatients with schizophrenia or schizoaffective disorder using the clinical and psychosocial scales. Gender, type of the diagnosis of disease, and age of the illness onset were found to be correlated with the subjective recovery. Subjective recovery was significantly correlated with CGI-S (r = - 0.25), total PANSS score (r = - 0.29), global assessment of functioning (r = 0.27), social functioning (r = 0.43), internalized stigma (r = - 0.38), self-esteem (r = 0.56), depression (r = - 0.59), and hopelessness (r = - 0.55). Hopelessness and self-esteem were found to be predictive of the subjective recovery explaining 52% of the variance. It can be argued that efforts to promote hope and self-esteem contribute to the subjective recovery.
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Affiliation(s)
- Kübra İpçi
- Department of Psychosocial Rehabilitation, Kocaeli University Institute of Health Science, Izmit, Kocaeli, Turkey
| | - Mustafa Yildiz
- Department of Psychosocial Rehabilitation, Kocaeli University Institute of Health Science, Izmit, Kocaeli, Turkey.
- Department of Psychiatry, Kocaeli University School of Medicine, Umuttepe, 41001, Izmit, Kocaeli, Turkey.
| | - Aysel İncedere
- Department of Psychosocial Rehabilitation, Kocaeli University Institute of Health Science, Izmit, Kocaeli, Turkey
| | - Fatma Kiras
- Department of Psychiatry, Kocaeli University School of Medicine, Umuttepe, 41001, Izmit, Kocaeli, Turkey
| | - Duygu Esen
- Department of Psychiatry, Kocaeli University School of Medicine, Umuttepe, 41001, Izmit, Kocaeli, Turkey
| | - Mehmet B Gürcan
- Department of Psychiatry, Kocaeli University School of Medicine, Umuttepe, 41001, Izmit, Kocaeli, Turkey
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Erim BR, Boztaş H, Yıldız M, Uygun E. The Factors Affecting the Relationship between Remission Status and Employment in Chronic Schizophrenia Patients. Psychiatry Investig 2019; 16:860-867. [PMID: 31684714 PMCID: PMC6877458 DOI: 10.30773/pi.2019.0087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 08/23/2019] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE Symptomatic remission have substantial effects in long-term schizophrenia outcome, but exact determinants of the employment. In this study, the relationship between employment and symptomatic remission in chronic schizophrenia patients and other factors related to employment were investigated. METHODS 100 patients interviewed were evaluated by the Positive and Negative Syndrome Scale (PANSS), Functional Recovery Scale in Schizophrenia (FROGS), Global Assessment of Functioning (GAF), Quality of Life Scale (QoL) and Subjective Recovery Assessment Scale (SubRAS). Sociodemographic variables, clinical features, antipsychotic dose and past working history obtained from patient interviews were investigated. RESULTS The patients of 40% who participate in the study were symptomatic remission, but only 53.5% of these patients weren't employed. Young age, especially, -regardless of the onset of illness- working a job in the past, low and moderate use CPED (equivalent doses according to chlorpromazine), shorter disease duration, symptomatic remission was found to be closely related to employment. While QoL, FROGS, GAF, and SubRAS total scores of employment group were higher than the unemployment group, PANSS total scores in the unemployment group were higher than that of the employment group. There was a high correlation between the scales and employment status. CONCLUSION Employment status was closely related with the remission status. This study supports that symptomatic remission alone is not decisive for employment. It was found that younger age, past working history (before or after the disease), low and intermediate CPED antipsychotic use and shorter duration of disease were closely related to employment with symptomatic remission.
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Affiliation(s)
- Burcu Rahşan Erim
- Department of Psychiatry, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Hamid Boztaş
- Department of Psychiatry, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Mustafa Yıldız
- Department of Psychiatry, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Ersin Uygun
- Department of Psychiatry, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases University of Health Sciences, Istanbul, Turkey
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11th International Congress on Psychopharmacology & 7th International Symposium on Child and Adolescent Psychopharmacology. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1606883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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