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Marmarosh C, Nguyen J, Williams M, Flanagan M, Rosmarin DH. Members' Feedback After a Spiritual Group Psychotherapy for Inpatient, Residential, and Intensive Treatment (SPIRIT). Int J Group Psychother 2024; 74:304-329. [PMID: 38980293 DOI: 10.1080/00207284.2024.2361239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Six hundred and fifty-four inpatients who participated in a spiritual group therapy intervention provided qualitative feedback regarding what helped them and what could be improved. Patients revealed that enjoying a sense of connection with other people and a sense of openness in the groups and simply talking about spirituality with other people was helpful to them. Many group members requested that groups go on for a longer amount of time than 12 sessions, to have longer sessions, and to have more frequent meetings. In addition, members described improvements that could be made to the group, including members' being better screened, leaders preventing individual members from dominating discussions or from being quiet or leaving the group early, and members' wanting more structure as well as more open discussion. The findings highlight the importance of connection, openness, and spirituality when implementing spiritual group interventions in hospital settings. Implications for future research, training, and clinical interventions are discussed.
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Fakhrou AA, Adawi TR, Ghareeb SA, Elsherbiny AM, AlFalasi MM. Role of family in supporting children with mental disorders in Qatar. Heliyon 2023; 9:e18914. [PMID: 37636376 PMCID: PMC10447922 DOI: 10.1016/j.heliyon.2023.e18914] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/17/2023] [Accepted: 08/02/2023] [Indexed: 08/29/2023] Open
Abstract
Background Mental disorders can significantly impact children's lives and affect their emotional, cognitive, and behavioral development. Family support and care is critical to the well-being of children, particularly children with mental disorders. However, given the "gap" between research and practice"," there have been very few studies in the Arab region that focus on the role of the family in supporting children with mental disorders. The study also examines how families cope with caring for a person with mental disorders and what behaviors may influence the patient's distress. In addition, the study will examine the importance of family rehabilitation and integration of people with mental disorders into society. Methods The study adopts the descriptive-analytical method and uses a questionnaire to gather data from the participants. The 350-parents sample (with 113 boys, 237 girls) was selected from the Shafallah Center for Integrating People with Disability. Morgan's law is used to determine the sample size. Results The results show that there are statistically significant differences in the role of family members in supporting people with mental disorders due to two variables: Gender and Work. Age has no statistically significant effect on the role of family members in supporting people with mental disorders. Conclusion This study is the first study conducted to investigate the role of family in supporting children with mental disorders in the Gulf Cooperation Council (GCC) in general and Qatar in particular. The results show that families should cope with the needs of a person with a mental disorder. Family rehabilitation is important in the care of people with mental disorders. There are certain behaviors of family members that can increase or decrease stress for the person. The results suggest that the family plays an essential role in supporting and promoting the lives of people with mental disorders and recommending effective ways to cope with them.
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Rani A, Raman KJ, Ammapattian T, Antony S, Prabhu SG, Basavarappa C. Lived Experiences of Persons with Chronic Schizophrenia Living in the Community. Indian J Psychol Med 2023; 45:374-382. [PMID: 37483575 PMCID: PMC10357909 DOI: 10.1177/02537176221084500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Background Each individual with schizophrenia experiences life uniquely, despite the sameness in their diagnosis. Understanding their experiences is vital for their better community integration and social work practice. Method We used the interpretative phenomenological approach. Persons with schizophrenia seeking outpatient services at a tertiary care institute in Bengaluru, India, were recruited through purposive sampling. In-depth interviews were conducted with six participants. Results Some of the meta-themes and subthemes identified were as follows: (a) perception about self (struggling with the sense of self, desire for normalcy, wanting to be in control of self and desire to live independently), (b) relationship with others (feeling supported by others and feeling rejected by others), (c) coping with consequences of illness (coping with disruptions in personal life and coping with disruptions in family life), and (d) experience of seeking treatment (reasons for seeking treatment, being on medication, and behavior of mental health professionals). The participants tried to find meaning in their lives by making sense of their illness. Family and community can have a significant impact on how persons with schizophrenia perceive their lives. Conclusion Mental health professionals need to encourage persons' and their families' greater participation in treatment planning and clinical interventions, which will enhance persons integration within the community and will help decrease the feeling of isolation commonly experienced when one lives with chronic mental illnesses.
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Affiliation(s)
- Akanksha Rani
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Kalayasundram Janaki Raman
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Thirumoorthy Ammapattian
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sojan Antony
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sphoorthi G. Prabhu
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Chethan Basavarappa
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Ma M, Shi Z, Chen Y, Ma X. Recovery journey of people with a lived experience of schizophrenia: a qualitative study of experiences. BMC Psychiatry 2023; 23:468. [PMID: 37369995 DOI: 10.1186/s12888-023-04862-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 05/11/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Mental health recovery involves an integration of clinical and psychosocial frameworks. The recovery journey of individuals diagnosed with schizophrenia and the factors that influence it have been extensively studied. Because the recovery journey is culturally influenced, we examined the recovery process expriences of individuals diagnosed with schizophrenia in China, focusing on the influence of a Confucian-dominated collectivist and family-centred culture. METHODS An Interpretive Phenomenological Analysis (IPA) study was conducted; data were gathered through in-depth interviews with 11 individuals with lived experience of schizophrenia. RESULTS Four themes were identified in this study: traumatic illness experiences, influence of the family, motives for recovery, and posttraumatic growth, comprising ten subthemes. "For the family" and "relying on oneself" are the main drivers of recovery for individuals with a Chinese cultural background. Some people believe that taking care of themselves is an important way to ease the burden on their families and treat them well. There is a link between 'for the family' and 'relying on oneself. CONCLUSIONS Individuals living with schizophrenia in China have undergone significant traumatic experiences and have profound interactions with their families. Post-traumatic growth reflects an increase in the individual's connection to others and individual agency. It also suggests that the individual is not receiving enough support outside of the family. The impact of individual agency and family relationships should be considered in services that promote recovery, and clinic staff should enhance support outside the home to the individuals.
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Affiliation(s)
- Min Ma
- Wuhan Mental Health center, Wuhan Hospital for Psychotherapy, Rehabilitation Department, Wuhan, China
| | - Zhidao Shi
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Yanhong Chen
- China University of Geosciences Wuhan, Wuhan, China
| | - Xiquan Ma
- Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Saguem BN, Ouanes S, Rhouma A, Nakhli J. Effectiveness of an educational program for reducing mental illness stigma targeting family medicine trainees in Tunisia: A quasi-experimental study. Appl Psychol Health Well Being 2022; 15:686-704. [PMID: 36178042 DOI: 10.1111/aphw.12405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/18/2022] [Indexed: 11/29/2022]
Abstract
Reducing stigma among mental health and health professionals has been an ultimate priority in many countries worldwide. This study aimed to evaluate the effectiveness of a four-session educational intervention for reducing stigma of mental illness targeting family medicine trainees in Tunisia. A quasi-experimental design was adopted with an intervention group (N = 51) and a control group (N = 56). Pre-intervention data were collected using an online survey. A four-session seminar series was implemented and organized. Post-intervention data were collected immediately after the end of the intervention then 2 months thereafter. Instruments included Attribution Questionnaire (AQ-27), Self-Determination Scale (SDS), Empowerment Scale (ES), and Recovery Scale (RS). Repeated measures analysis of covariance and multiple analysis of covariance tests were carried out. Results revealed that the intervention had moderate effects on the AQ-27 score and on six of its stigma factors including factors of the dangerousness model. The intervention improved SDS score, but not ES or RS scores. Positive effects were observed immediately after the intervention and 2 months thereafter. Regular implementation of educational programs in clinical practice would be beneficial. Developing other anti-stigma methods is needed to address the concepts of recovery and responsibility of patients with mental illness.
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Affiliation(s)
- Bochra Nourhène Saguem
- Research Laboratory LR12ES04, Farhat Hached Hospital, Department of Psychiatry, University of Sousse, Sousse, Tunisia
| | - Sami Ouanes
- Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar
| | - Amal Rhouma
- Research Laboratory LR12ES04, Farhat Hached Hospital, Department of Psychiatry, University of Sousse, Sousse, Tunisia
| | - Jaâfar Nakhli
- Research Laboratory LR12ES04, Farhat Hached Hospital, Department of Psychiatry, University of Sousse, Sousse, Tunisia
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Yu Y, Zhou W, Shen M, Wang Y, Xiao S, Tebes JK. Clinical and personal recovery for people with schizophrenia in China: prevalence and predictors. J Ment Health 2022; 31:263-272. [PMID: 35014917 DOI: 10.1080/09638237.2021.2022635] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Recovery from schizophrenia is a multidimensional construct that includes two categories: clinical recovery (symptomatic and functional remission) and personal recovery. AIMS To investigate the overlap between clinical and personal recovery and identify correlates of each. METHODS A cross-sectional study was conducted with 356 people living with schizophrenia and randomly selected from 12 communities in China. Clinical recovery was assessed using both the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF). Personal recovery was assessed using the 8-item Recovery Assessment Scale (RAS). Disability and quality of life were assessed using the WHODAS 2.0 and WHOQOL-BREF-2, respectively. RESULTS Our results showed a recovery proportion of 36.52% for clinical recovery (66.57% for symptomatic remission and 40.73% for functional remission), and 17.42% for personal recovery. Only 8.99% of individuals achieved overall recovery (i.e. they met criteria for both clinical and personal recovery), and there was only a modest correlation (r = 0.26) between these two types of recovery. Overall recovery was only correlated with the quality of life (OR = 1.46, 95% CI: 1.05, 2.03), but there were various correlates for clinical recovery and personal recovery separately. CONCLUSIONS Recovery from schizophrenia involves both clinical and personal recovery, but when examined in the same sample, personal recovery, and thus overall recovery, is less common, particularly among people with schizophrenia in China.
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Affiliation(s)
- Yu Yu
- Division of Prevention and Community Research, Yale School of Medicine, New Haven, CT, USA
| | - Wei Zhou
- School of Public Administration, Hunan University, Changsha, Hunan, China
| | - Minxue Shen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yao Wang
- Department of Midwifery, Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jacob Kraemer Tebes
- Division of Prevention and Community Research, Yale School of Medicine, New Haven, CT, USA
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Yu Y, Shen M, Niu L, Liu YE, Xiao S, Tebes JK. The relationship between clinical recovery and personal recovery among people living with schizophrenia: A serial mediation model and the role of disability and quality of life. Schizophr Res 2022; 239:168-175. [PMID: 34896871 DOI: 10.1016/j.schres.2021.11.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 09/28/2021] [Accepted: 11/26/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE We examine the relationship between two perspectives on recovery from schizophrenia: clinical recovery and personal recovery. Clinical recovery emphasizes an individual's psychiatric symptoms and functioning, whereas personal recovery emphasizes adaptation to one's illness that includes taking responsibility for one's recovery, establishing an identity apart from the illness, and finding meaning, purpose, and hope in life. METHODS Using serial mediation analysis, we examine the relationship between clinical and personal recovery in the context of two potential mediators, disability and quality of life. Study participants were 356 people with a diagnosis of schizophrenia and living with family in Changsha City of Hunan Province, China. RESULTS Although clinical recovery was modestly associated with personal recovery (r = 0.27, p < 0.001), subsequent serial mediation analysis showed that clinical recovery is not directly related to personal recovery when accounting for disability and quality of life. Clinical recovery was a significant predictor of disability, which predicted quality of life and personal recovery. Among the three mediation paths, quality of life accounted for most of the mediation effect (54%), followed by disability (24%), and disability and quality of life serially (22%). We discuss the implications of these findings for theory development, intervention, and future research.
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Affiliation(s)
- Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, China; Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT, USA.
| | - Minxue Shen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, China
| | - Lu Niu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, China
| | - Yu-E Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, China; The Affiliated Hainan Hospital, Hainan Medical University, 31 Longhua Road, Longhua District, Haikou City, Hainan, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, China
| | - Jacob Kraemer Tebes
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT, USA.
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Kovács A, Ladányi B, Farkas N, Stempel L, Kiss D, Bittermann É, Rácz J. The recovery of homicidal people diagnosed with schizophrenia and schizoaffective disorder-An interpretative phenomenological analysis. Front Psychiatry 2022; 13:951678. [PMID: 36741576 PMCID: PMC9892903 DOI: 10.3389/fpsyt.2022.951678] [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: 05/24/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Identity recovery in people diagnosed with schizophrenia who have committed homicide poses several difficulties. Premorbid mental illnesses, the experience of psychosis, and the absence of cohesive ego functions may result in the inability to integrate the homicidal act into self-identity. Problems with integration increase the risk of recidivism and further mental problems. The aim of the present research was to explore how homicidal people diagnosed with schizophrenia make sense of their actions, and how they identify with the homicide. METHOD Six semi-structured interviews were conducted at a long-term psychiatric home with people who had committed homicide and who had been diagnosed with schizophrenia. The interviews were transcribed verbatim and analysed using interpretative phenomenological analysis (IPA), an idiographic method rooted in phenomenologist traditions that focuses on how participants experience and make sense of events in their lives, and how those events affect their identity and sense of self. RESULTS Three personal experiential themes were established as a result of the analysis: (1) homicide and responsibility; (2) homicide and self; and (3) control over threats to self and self-evaluation. (1) Homicide was often reported to have been committed in a non-conscious, delusional state that may have led to the loss of self-determination. (2) Our interviewees struggled to integrate their acts into their identities. They distanced themselves from the crime or held multiple, parallel interpretations of the act. (3) Recovering patients experienced the constant threat of entering into a delusional reality and losing control. The importance of control was central to their self-evaluation. The patients appeared to distance themselves from the homicidal act and to regard their delusional selves as a threat to their lives. CONCLUSION Therapy aimed at bolstering self-control, supporting the integration of the fragmented self, and raising awareness of the connections between delusional reality and standard, intersubjective reality may be helpful in reducing the instability of the self. Therapy aimed at processing complex grief and loss of family is also needed.
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Affiliation(s)
- Asztrik Kovács
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary.,Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Bence Ladányi
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Department of Criminal Investigation, Hungarian National Police Headquarters, Budapest, Hungary
| | - Noémi Farkas
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Laura Stempel
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Dániel Kiss
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | | | - József Rácz
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Department of Addictology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
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Mccauley CO, Mckenna H, Keeney S, Mclaughlin D. "Surviving out of the Ashes" - An exploration of young adult service users' perspectives of mental health recovery. J Psychiatr Ment Health Nurs 2021; 28:794-803. [PMID: 33369801 DOI: 10.1111/jpm.12728] [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] [Received: 12/11/2019] [Revised: 11/27/2020] [Accepted: 12/17/2020] [Indexed: 11/26/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: The conceptual components of mental health recovery have been proposed, however, the barriers to their sustainability within the context of internal and external stressors require further exploration. Within their emerging adult role, young people will experience the personal challenges that will directly impact their understanding of their recovery, which will be different from other age groups. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Findings revealed recovery is understood as an uncharted, timely and personal process of engaging and transcending pain. Perceived barriers to mental health recovery and the internal dynamics experienced within the process have been explored. Recovery in young adulthood involved the reclaiming of their active and purposeful life force. It acquires real-life relevance when applied to the social and cultural factors that provide meaning in life for young adults. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This research will impact how mental health nurses understand the catalytic effects of personal, social and cultural meaning of suffering in young adults' actualization of mental health recovery. Findings have significance for practice as the process of mental health recovery must not be presented as a clinical pathway, but understood as a personalized strategy of individual wellness in young adulthood. ABSTRACT INTRODUCTION: Within their emerging adult role, young people will embark on employment, form intimate relationships and live independently. This indicates that how recovery is experienced and actualized in young adulthood may be different from other age groups. AIM/QUESTION To explore young adult service user's perspectives of mental health recovery in Northern Ireland. METHOD Semi-structured individual qualitative interviews were analysed using a Gadamerian-based hermeneutic method and interpreted using a novel theoretical framework. The sample comprised 25 participants with an average age of 28 years. FINDINGS Five key themes evolved: Services: A Losing Battle Straight Away; From your Foundations to a Step in the Dark; Let Go of the Pain not the Experience; Surviving Out of the Ashes Recovery; and Needs to be More than a Word. DISCUSSION The main findings were that recovery involved the reclaiming of their active and purposeful life force. It is suggested that young adults have developed an explanatory model of "use that stuff you wanna bury" to transform an illness narrative to a wellness strategy. IMPLICATIONS FOR PRACTICE This research has implications for mental health nursing so the process of mental health recovery is not presented as a clinical pathway, but a personalized strategy of individual wellness.
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Affiliation(s)
| | - Hugh Mckenna
- Medical School Development, Ulster University, Coleraine, UK
| | - Sinead Keeney
- Lecturer in Health Sciences, School of Nursing, Ulster University, Derry City, UK
| | - Derek Mclaughlin
- School of Nursing and Midwifery Nursing, Queen's University Belfast, Belfast, UK
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10
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Kurniati SR, Daulima NHC, Susanti H. Ambivalence of mothers' emotions in dealing with aggressive behavior from mentally ill adult children. ENFERMERIA CLINICA 2021. [PMID: 33849229 DOI: 10.1016/j.enfcli.2020.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study aims to explore the lived experience of mothers who are caregivers for mentally ill adult children displaying aggressive behavior. This study used a qualitative research design with an interpretative phenomenological approach to explore mothers' experiences in facing aggressiveness from their adult children with mental disorders. Ten participants were recruited by using purposive sampling and data were collected through in-depth interviews. This study reveals two themes, namely emotional bonding as the trigger for an ambivalent response and the conflict between mothers' love and hatred toward adult children with mental illness. The aggressiveness of people with mental illness causes emotional ambivalence among their mothers. This research may serve as reference material to develop nursing interventions focusing on caregivers who care for adult children with aggressiveness, especially helping them to adapt with their ambivalent responses.
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Affiliation(s)
- Safra Ria Kurniati
- Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia; Mental Health and Community Nursing Department, STIKES Hang Tuah Tanjungpinang, Kepulauan Riau, Indonesia
| | | | - Herni Susanti
- Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia
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11
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He SJ, Fang YW, Huang ZX, Yu Y. Validation of an 8-item Recovery Assessment Scale (RAS-8) for people with schizophrenia in China. Health Qual Life Outcomes 2021; 19:119. [PMID: 33849558 PMCID: PMC8045355 DOI: 10.1186/s12955-021-01763-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 04/05/2021] [Indexed: 11/20/2022] Open
Abstract
Background The 24-item Recovery Assessment Scale (RAS) is the most widely-used and well-validated tool for measuring recovery for people with mental illness. The current study aims to assess the reliability and validity of an 8-item short form of RAS (RAS-8) among a Chinese sample of people living with schizophrenia. Methods A sample of 400 people living with schizophrenia were recruited for scale validation. Internal consistency was tested by calculating Cronbach's α. Test–retest reliability was calculated using the intraclass correlation coefficient (ICC) for the total score and weighted kappa for each item. Factor structure was tested with confirmatory factor analysis, and concurrent validity was examined by investigating the correlation of the RAS-8 with patient symptoms, disability, depression, anxiety, patient functioning, quality of life and general health. Results The RAS-8 full scale and subscales showed good internal consistency with Cronbach’s alpha ranging from 0.87 to 0.92. ICC of 0.99 and weighted kappa ranged from 0.62 to 0.88, which generally indicates good test–retest reliability. The findings supported an a priori two-factor structure, χ2/df = 2.93, CFI = 0.98, TLI = 0.98, RMSEA = 0.07, SRMR = 0.035. Concurrent validity of the RAS-8 was further supported by its significant negative correlations with patient symptoms (r = −0.24, p < 0.01), disability (r = −0.30, p < 0.01), depression (r = −0.16, p < 0.05), and anxiety (r = −0.14, p < 0.05), and its significant positive relationships with patient functioning (r = 0.26, p < 0.01), quality of life (r = 0.39, p < 0.01) and general health (r = 0.34, p < 0.01). Conclusions This study confirmed the reliability and validity of an 8-item short-form RAS for people living with schizophrenia in Chinese communities. The validation of the RAS-8 allows for its use as an alternative for the full RAS as a rapid assessment tool in clinical and research settings. The findings are discussed for their implications for application and validation with other populations and in other countries.
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Affiliation(s)
- Si-Jia He
- Department of Sociology, School of Public Management, Central South University, Lushan South Road 932, Changsha, 410083, Hunan, China
| | - Yan-Wen Fang
- Department of Public Health, Faculty of Medicine, University of Queensland, 20 Weightman St, Herston, QLD, 4006, Australia
| | - Zi-Xin Huang
- Department of Public Health, Faculty of Medicine, University of Queensland, 20 Weightman St, Herston, QLD, 4006, Australia
| | - Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China. .,Division of Prevention and Community Research, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA.
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12
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Yu BCL, Mak WWS, Chio FHN. Family involvement moderates the relationship between perceived recovery orientation of services and personal narratives among Chinese with schizophrenia in Hong Kong: a 1-year longitudinal investigation. Soc Psychiatry Psychiatr Epidemiol 2021; 56:401-408. [PMID: 32797245 DOI: 10.1007/s00127-020-01935-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 08/07/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Family has been found to have an influential role on clinical and recovery outcomes of people with schizophrenia. While recovery-oriented services can facilitate service users to develop a rich and positive identity, it is unclear how different levels of family involvement may interact with recovery-oriented services in affecting personal recovery. The present study aimed to examine how family involvement moderates the relationship between perceived recovery-orientation of services and personal narratives of Chinese people in Hong Kong who had recent onset of schizophrenia spectrum disorder longitudinally. METHOD Multi-method approach (semi-structured interview, researcher ratings, self-report measures) was adopted. 167 participants completed assessments at baseline; 93 and 68 of them were retained at 6-month and 12-month follow-up assessment, respectively. RESULTS Baseline perceived recovery orientation of services significantly predicted richer personal narratives at 6-month follow-up when baseline family involvement was optimal (B = 0.26, p = 0.03, 95% CI [0.02-0.48]). As to 12-month assessment, baseline perceived recovery orientation of services significantly predicted poorer personal narratives when family was perceived as under-involved at baseline (B = - 0.45, p = 0.02, 95% CI [- 0.88 to - 0.07]). CONCLUSION Without proper family involvement, recovery-oriented services could be ineffectual in facilitating the development of rich personal narratives for Chinese people in Hong Kong.
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Affiliation(s)
- Ben C L Yu
- Department of Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
| | - Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.
| | - Floria H N Chio
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong
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13
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Zaraza Morales DR, Contreras Moreno JR. The Mental Health Recovery Model and Its Importance for Colombian Nursing. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 49:305-310. [PMID: 33328026 DOI: 10.1016/j.rcp.2018.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 09/16/2018] [Accepted: 10/16/2018] [Indexed: 06/12/2023]
Abstract
The article aims to describe the Mental Health Recovery Model, the Tidal Model in Mental Health Recovery and their relevance to implementation within the practice of Colombian nursing. Some concepts about mental health recovery and the theoretical model proposed by Phil Barker are presented in the text, analysing these with the challenges of the nursing professional to improve mental health care, taking into account the current context of care practice. The principles proposed with the Recovery model help to focus care on the person and not on the symptomatology of the illness, understanding that the person has different dimensions which make it possible for him/her to explore his/her own path to recovery. We can conclude that, through the theory, we can develop interventions and nursing activities that contribute to improving the quality of life of people who have been diagnosed with a mental illness, modifying the traditional healthcare models.
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Faith LA, Collins JO, Decker J, Grove A, Jarvis SP, Rempfer MV. Experiences of empowerment in a community cognitive enhancement therapy program: an exploratory qualitative study. PSYCHOSIS 2019. [DOI: 10.1080/17522439.2019.1632920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Laura A. Faith
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Jen O. Collins
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Jenna Decker
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Amber Grove
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Stephen P. Jarvis
- Truman Medical Center Behavioral Health, Kansas City, MO, USA
- Department of Psychiatry, University of Missouri, Kansas City, MO, USA
| | - Melisa V. Rempfer
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
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Ellison ML, Belanger LK, Niles BL, Evans LC, Bauer MS. Explication and Definition of Mental Health Recovery: A Systematic Review. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2019; 45:91-102. [PMID: 27709376 DOI: 10.1007/s10488-016-0767-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This review assessed the concordance of the literature on recovery with the definition and components of recovery developed by the Substance Abuse and Mental Health Services Administration (SAMHSA). Each SAMHSA identified recovery component was first explicated with synonyms and keywords and made mutually exclusive by authors. Inter-rater reliability was established on the coding of the presence of 17 recovery components and dimensions in 67 literature reviews on the recovery concept in mental health. The review indicated that concordance varied across SAMHSA components. The components of recovery with greatest concordance were: individualized/person centered, empowerment, purpose, and hope.
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Affiliation(s)
- Marsha Langer Ellison
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, 200 Springs Rd, Bedford, MA, 01730-0012, USA. .,Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Lindsay K Belanger
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA
| | - Barbara L Niles
- National Center for PTSD Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
| | - Leigh C Evans
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA.,School of Public Health, Boston University, Boston, MA, USA
| | - Mark S Bauer
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Bitter N, Roeg D, van Assen M, van Nieuwenhuizen C, van Weeghel J. How effective is the comprehensive approach to rehabilitation (CARe) methodology? A cluster randomized controlled trial. BMC Psychiatry 2017; 17:396. [PMID: 29228919 PMCID: PMC5725818 DOI: 10.1186/s12888-017-1565-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 11/30/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The CARe methodology aims to improve the quality of life of people with severe mental illness by supporting them in realizing their goals, handling their vulnerability and improving the quality of their social environment. This study aims to investigate the effectiveness of the CARe methodology for people with severe mental illness on their quality of life, personal recovery, participation, hope, empowerment, self-efficacy beliefs and unmet needs. METHODS A cluster Randomized Controlled Trial (RCT) was conducted in 14 teams of three organizations for sheltered and supported housing in the Netherlands. Teams in the intervention group received training in the CARe methodology. Teams in the control group continued working according to care as usual. Questionnaires were filled out at baseline, after 10 months and after 20 months. A total of 263 clients participated in the study. RESULTS Quality of life increased in both groups, however, no differences between the intervention and control group were found. Recovery and social functioning did not change over time. Regarding the secondary outcomes, the number of unmet needs decreased in both groups. All intervention teams received the complete training program. The model fidelity at T1 was 53.4% for the intervention group and 33.4% for the control group. At T2 this was 50.6% for the intervention group and 37.2% for the control group. CONCLUSION All clients improved in quality of life. However we did not find significant differences between the clients of the both conditions on any outcome measure. Possible explanations of these results are: the difficulty to implement rehabilitation-supporting practice, the content of the methodology and the difficulty to improve the lives of a group of people with longstanding and severe impairments in a relatively short period. More research is needed on how to improve effects of rehabilitation trainings in practice and on outcome level. TRIAL REGISTRATION ISRCTN77355880 , retrospectively registered (05/07/2013).
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Affiliation(s)
- Neis Bitter
- Department of Social and Behavioural Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
| | - Diana Roeg
- Department of Social and Behavioural Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
- GGzE Institute for Mental Health Care, PO BOX 909, 5600 AX Eindhoven, The Netherlands
| | - Marcel van Assen
- Department of Social and Behavioural Sciences, Methodology and statistics, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
- Department of Sociology, Utrecht University, PO BOX 80140, 3508 TC Utrecht, The Netherlands
| | - Chijs van Nieuwenhuizen
- Department of Social and Behavioural Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
- GGzE Institute for Mental Health Care, PO BOX 909, 5600 AX Eindhoven, The Netherlands
| | - Jaap van Weeghel
- Department of Social and Behavioural Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
- Phrenos Centre of Expertise, PO Box 1203, 3500 BE Utrecht, The Netherlands
- Parnassia Group, Dijk en Duin Mental Health Centre, PO Box 305, 1900 AH Castricum, The Netherlands
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Zaraza-Morales DR, Hernández-Holguín DM. Encerrado a oscuras: significado de vivir con esquizofrenia para diagnosticados y sus cuidadores, Medellín-Colombia. AQUICHAN 2017. [DOI: 10.5294/aqui.2017.17.3.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Vivir con esquizofrenia representa un enigma para todas aquellas personas que no presentan la enfermedad o conviven con alguien que la padece. Objetivo: comprender el significado de vivir con esquizofrenia para personas que presentan la enfermedad y sus familiares, quienes acudieron a una institución estatal para la atención de problemas de salud mental de alta complejidad en Colombia durante el 2014 y 2015. Materiales y método: se utilizó un enfoque cualitativo y la información fue analizada por medio del método de la teoría fundamentada. Las técnicas de recolección de información fueron ocho entrevistas a profundidad y dos grupos focales, con una participación de 21 personas diagnosticadas y sus cuidadores. Resultados: por medio de la codificación, el muestreo teórico, la comparación constante y los memos analíticos, se llegó a la categoría “Vivir con esquizofrenia es vivir encerrado, a oscuras y con los sueños truncados”. Conclusiones: para los pacientes, la familia y para los cuidadores, vivir con esquizofrenia conlleva una sensación de encerramiento que afecta el proyecto de vida de unos y otros.
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Galbusera L, Fellin L, Fuchs T. Towards the recovery of a sense of self: An interpretative phenomenological analysis of patients' experience of body-oriented psychotherapy for schizophrenia. Psychother Res 2017; 29:234-250. [PMID: 28532254 DOI: 10.1080/10503307.2017.1321805] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Increasing evidence supports the efficacy of body-oriented psychotherapy (BPT) for schizophrenia. Yet, so far no research has investigated outcome in relation to therapy process: Why and how BPT is effective. In this study, we qualitatively explore participants' experience of a manualized BPT for schizophrenia to shed light on the process of therapeutic change. METHOD We conducted in-depth interviews with 6 participants who completed a 10-week BPT group intervention. Interviews explored participants' experience of change and helpful aspects of therapy and were analysed using interpretative phenomenological analysis. FINDINGS We identified six master themes across the interviews: (i) Being a whole: body-mind connection; (ii) Being agentic and being able; (iii) Being unique and worthy: Being accepted for who one is; (iv) Changing interactions: Engaging in authentic interpersonal contact; (v) Being part of a group: Feeling integrated; and (vi) Hope and investing in the future. CONCLUSION We discuss the clinical implications for each theme and bring the findings together by describing therapeutic change in schizophrenia as a recovery of sense of self at different but interlocked levels. Moreover, we put forward recommendations for both specific and common factors for schizophrenia therapy. Clinical or methodological significance of this article: The clinical significance of this study is twofold. On the one hand, the findings of this analysis might inform the theory and practice of BPT and might directly feedback into a further development of the manual guidelines. On the other hand, common helpful factors have been identified thatmight also be relevant for the more general clinical practice concerning patients with schizophrenia. Here, we summarize our key messages for the clinical practitioner emerging from the findings: The inclusion of bodily aspects and a focus on pre-reflective experience in psychotherapy can help persons with schizophrenia recover the sense of being a body-mind unity. Empowering persons with schizophrenia, instead of instructing them, seems to foster a sense of agency and self-confidence, which are crucial to the recovery process. A twofold therapeutic stance characterized by openness towards the other and authenticity was experienced by patients as facilitating the rapport building. This might help persons with schizophrenia engage in the relation. Social inclusion might enhance therapeutic change and recovery in schizophrenia. Group therapy might be helpful for fostering a feeling of social belonging, but the inclusion in the wider social and community context remains a critical issue. The experience of joyful moments in psychotherapy might positively contribute to therapeutic change in that it fosters a sense of hope for the future. Overall our paper contributes to the literature aiming at expanding the range of therapeutic modalities, focussing on the creation and use of mixed models of therapy within and beyond talking practices.
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Affiliation(s)
- Laura Galbusera
- a Clinic for General Psychiatry , University of Heidelberg , Heidelberg , Germany
| | - Lisa Fellin
- b School of Psychology , University of East London , London , UK
| | - Thomas Fuchs
- a Clinic for General Psychiatry , University of Heidelberg , Heidelberg , Germany
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The Incorporation of a Spiritual Emergency Experience Into a Client’s Worldview: A Grounded Theory. JOURNAL OF HUMANISTIC PSYCHOLOGY 2016. [DOI: 10.1177/0022167816668114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study is focused on the process of constructing the meaning of a spiritual emergency experience. In the context of this study, spiritual emergency is understood as an experience of psychotic nature, defined by criteria such as good preepisode functioning, nonordinary states of consciousness, awareness of the intrapsychic nature of the process, or preserved ability to cooperate. In-depth interviews with 13 participants who experienced an episode of spiritual emergency were analyzed using the grounded theory method. The analysis yielded a core category titled “The incorporation of a spiritual emergency experience into a client’s worldview.” The process of incorporation was conceptualized by two complementary paths: (a) a Suppressive path characterized by an effort to mitigate or eliminate symptoms, considering them as a personally meaningless pathology, and return to a previous state of functioning and (b) a Facilitative path characterized by an acceptance of symptoms, a search for their meaning, and eventually, the adoption of a new perspective. The results are discussed in relation to different theoretical approaches to psychotic experiences.
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20
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Lundmark M, Lennerling A, Almgren M, Forsberg A. Recovery after lung transplantation from a patient perspective - proposing a new framework. J Adv Nurs 2016; 72:3113-3124. [PMID: 27346667 DOI: 10.1111/jan.13058] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2016] [Indexed: 02/02/2023]
Abstract
AIMS The aims of this study were two-fold: to develop the concept analysis by Allvin et al. from lung recipients' perspective of their post-transplant recovery process and to identify the recovery trajectories including critical junctions in the post-transplant recovery process after lung transplantation. BACKGROUND Lung transplantation is an established treatment for patients with end-stage lung disease. The recovery process after lung transplantation is very demanding. Today, patients are expected to play an active role in their own recovery but require ongoing support during the process. DESIGN A deductive, retrospective interview study using directed content analysis and Allvin's recovery concept analysis. METHOD Fifteen adult lung transplant recipients who were due their 12-month follow-up were consecutively included and interviewed during 2015. Patients who were medically unstable or had difficulties speaking Swedish were excluded from this multi-centre study. FINDINGS Allvin's concept analysis is partly applicable to the context of lung transplantation. The recipients' experience of the post-transplant recovery process could be confirmed in the main dimensions of the concept analysis, while several sub-dimensions were contradictory and were excluded. Six new sub-dimensions emerged; symptom management, adjusting to physical restraints, achieving an optimum level of psychological well-being, emotional transition, social adaptation and reconstructing daily occupation. CONCLUSION The concept analysis by Allvin et al. was possible to expand to fit the lung transplantation context and a new contextual definition of post-transplant recovery after solid organ transplantation was developed. Recovery and health were viewed as two different things.
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Affiliation(s)
- Martina Lundmark
- Skåne University Hospital, Thoracic Intensive Care Unit, Lund, Sweden.,Department of Health Sciences at Lund University, Sweden
| | - Annette Lennerling
- The Transplant Center, Sahlgrenska University Hospital, Gothenburg, Sweden.,The Institute of Health and Caring Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Matilda Almgren
- Skåne University Hospital, Thoracic Intensive Care Unit, Lund, Sweden.,Department of Health Sciences at Lund University, Sweden
| | - Anna Forsberg
- Department of Health Sciences at Lund University, Sweden.,Skåne University Hospital, Department of Transplantation and Cardiology, Lund, Sweden
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Waite F, Knight MTD, Lee D. Self-Compassion and Self-Criticism in Recovery in Psychosis: An Interpretative Phenomenological Analysis Study. J Clin Psychol 2015; 71:1201-17. [PMID: 26389845 DOI: 10.1002/jclp.22211] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To increase understanding of the internal processes of recovery in psychosis, with particular consideration given to self-compassion and self-criticism. METHOD Qualitative data were collected by semistructured interviews, from 10 participants with psychosis, and analyzed using interpretative phenomenological analysis. RESULTS Five superordinate themes emerged: (a) "my mind can't take the load": the "curse" of psychosis; (b) the "trap" of self-criticism; (c) "coming to terms" with psychosis in my life to "move on"; (d) "on my own two feet"; and (e) "an opportunity" for growth. The themes included a reciprocal relationship between psychosis and self-criticism, processes of acceptance, empowerment, and posttraumatic growth. CONCLUSIONS The internal process of self-to-self relating contributed to 2 maintenance cycles: self-criticism maintained distressing experiences of psychosis and compassionate self-acceptance resulted in empowered action and promoted recovery and growth. The dual process of acceptance and change in relationship to self was central to recovery.
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Affiliation(s)
- Felicity Waite
- The Oxford Institute of Clinical Psychology Training (OXICPT), Oxford Health NHS Foundation Trust, University of Oxford, Warneford Hospital
| | - Matthew T D Knight
- The Oxford Institute of Clinical Psychology Training (OXICPT), Oxford Health NHS Foundation Trust, University of Oxford, Warneford Hospital.,Berkshire Healthcare NHS Foundation Trust
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22
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Bitter NA, Roeg DPK, van Nieuwenhuizen C, van Weeghel J. Effectiveness of the Comprehensive Approach to Rehabilitation (CARe) methodology: design of a cluster randomized controlled trial. BMC Psychiatry 2015; 15:165. [PMID: 26198855 PMCID: PMC4510908 DOI: 10.1186/s12888-015-0564-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is an increasing amount of evidence for the effectiveness of rehabilitation interventions for people with severe mental illness (SMI). In the Netherlands, a rehabilitation methodology that is well known and often applied is the Comprehensive Approach to Rehabilitation (CARe) methodology. The overall goal of the CARe methodology is to improve the client's quality of life by supporting the client in realizing his/her goals and wishes, handling his/her vulnerability and improving the quality of his/her social environment. The methodology is strongly influenced by the concept of 'personal recovery' and the 'strengths case management model'. No controlled effect studies have been conducted hitherto regarding the CARe methodology. METHODS/DESIGN This study is a two-armed cluster randomized controlled trial (RCT) that will be executed in teams from three organizations for sheltered and supported housing, which provide services to people with long-term severe mental illness. Teams in the intervention group will receive the multiple-day CARe methodology training from a specialized institute and start working according the CARe Methodology guideline. Teams in the control group will continue working in their usual way. Standardized questionnaires will be completed at baseline (T0), and 10 (T1) and 20 months (T2) post baseline. Primary outcomes are recovery, social functioning and quality of life. The model fidelity of the CARe methodology will be assessed at T1 and T2. DISCUSSION This study is the first controlled effect study on the CARe methodology and one of the few RCTs on a broad rehabilitation method or strength-based approach. This study is relevant because mental health care organizations have become increasingly interested in recovery and rehabilitation-oriented care. TRIAL REGISTRATION The trial registration number is ISRCTN77355880 .
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Affiliation(s)
- Neis A. Bitter
- Tilburg University, Department of Social and Behavioural Sciences, Tranzo Scientific Centre for Care and Welfare, PO Box 90153, 5000 LE Tilburg, The Netherlands
| | - Diana P. K. Roeg
- Tilburg University, Department of Social and Behavioural Sciences, Tranzo Scientific Centre for Care and Welfare, PO Box 90153, 5000 LE Tilburg, The Netherlands ,GGzE Centre for Mental Health Care, PO BOX 909, 5600 AX Eindhoven, The Netherlands
| | - Chijs van Nieuwenhuizen
- Tilburg University, Department of Social and Behavioural Sciences, Tranzo Scientific Centre for Care and Welfare, PO Box 90153, 5000 LE, Tilburg, The Netherlands. .,GGzE Centre for Mental Health Care, PO BOX 909, 5600 AX, Eindhoven, The Netherlands.
| | - Jaap van Weeghel
- Tilburg University, Department of Social and Behavioural Sciences, Tranzo Scientific Centre for Care and Welfare, PO Box 90153, 5000 LE, Tilburg, The Netherlands. .,Phrenos Centre of Expertise, PO Box 1203, 3500 BE, Utrecht, The Netherlands. .,Parnassia Group, Dijk en Duin Mental Health Centre, PO Box 305, 1900 AH, Castricum, The Netherlands.
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23
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Milbourn BT, McNamara BA, Buchanan AJ. Understanding the episodic everyday of disrupted lives: Scoping the occupational therapy literature. The Canadian Journal of Occupational Therapy 2014; 81:144-53. [DOI: 10.1177/0008417414533315] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background. The concept “everyday” appears unchallenged and problematic when applied to people who experience disrupted lives through illness or disability. Purpose. This study draws upon social and philosophical theory to review the relevance of the concept “everyday” when applied to contemporary occupational therapy and the lives of individuals who experience biographical disruption. Method. A literature review guided by a scoping framework was undertaken followed by a critical analysis drawing on Bauman to determine the frequency and meaning of the concept “everyday” used in the occupational therapy and occupational science literature. Findings. Definitions of the “everyday” are used infrequently despite recurrent use of the concept. A large proportion of literature reviewed in this manuscript does not acknowledge or discuss the philosophical and sociological influences that contribute to an understanding of the “everyday,” leaving the reader to make her or his own interpretations. Implications. Reconceptualizing lived “everyday” experience within the contextual “here and now” provides a postmodern “episodic” lens for occupational therapists working with individuals who experience biographical disruption.
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24
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Dopke CA, Batscha CL. Cognitive-Behavioral Therapy for Individuals with Schizophrenia: A Recovery Approach. AMERICAN JOURNAL OF PSYCHIATRIC REHABILITATION 2014. [DOI: 10.1080/15487768.2013.876458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Tan R, Gould RV, Combes H, Lehmann S. Distress, trauma, and recovery: adjustment to first episode psychosis. Psychol Psychother 2014; 87:80-95. [PMID: 24497398 DOI: 10.1111/j.2044-8341.2012.02073.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To understand the experiences that people with early psychosis are adjusting to and their perceived barriers to recovery. METHOD Semi-structured interviews were conducted with eight participants. Grounded Theory was applied to the design and analysis. Sampling and coding ceased when saturation of the data was reached. Respondent validation was sought from participants. RESULTS A theoretical model was developed using Strauss and Corbin's (1998) framework. A core category of distress was elicited, which was evident in all participants' accounts of their recovery. Overall six main categories were identified and it was proposed that individuals were adjusting to the distress of past experiences, uncertainty, a challenged identity, being in a psychiatric system, the reaction of others and social disadvantage. CONCLUSIONS Recovery from the distress and trauma of early psychosis does not simply involve adjustment to and recovery from a single experience or set of symptoms. The results are discussed in relation to trauma, developmental, and social inequality frameworks. Specific implications for clinical practice include incorporating the findings within formulations, developing interventions that focus on trauma, identity, and uncertainty as well as addressing the social and systemic issues identified.
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Affiliation(s)
- Ranil Tan
- Rotherham Doncaster and South Humber NHS Foundation Trust, UKNorth Staffordshire Combined Healthcare NHS Trust, UKKeele University, Newcastle-under-Lyme, UKStaffordshire University, Stafford, UK
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26
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Chiba R, Miyamoto Y, Funakoshi A. The concept of "benefit finding" for people at different stages of recovery from mental illness; a Japanese study. J Ment Health 2014; 23:20-4. [PMID: 24484188 DOI: 10.3109/09638237.2013.841872] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Benefit finding is defined as finding benefits through the struggle with adversity. AIM This study explored benefit finding at different stages of recovery among people with severe mental illness in Japan. METHODS A cross-sectional questionnaire survey, which contained both open-ended questions regarding benefit finding and the Recovery Assessment Scale (RAS), was conducted. Of the responses received from 193 (61%) of 319 individuals with mental illness, responses about benefit finding from 94 questionnaires was analyzed using content analysis (males: 57%; females: 43%; average age: 45 years). Each response about benefit finding was classified into one of three groups according to the stages of recovery by their RAS score (i.e. low, middle or high). RESULTS The group with higher recovery scores provided more examples of benefit finding, although almost a quarter of examples of benefit finding were provided by the low-RAS group. Different benefit finding characteristics were found between groups of people at different stages of recovery. CONCLUSION While individuals with higher recovery scores are likely to find a variety of benefits, even individuals with lower recovery scores are capable of benefit finding.
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Affiliation(s)
- Rie Chiba
- School of Nursing, Jichi Medical University , Tochigi , Japan
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27
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Percy ML, Bullimore P, Baker JA. Voice hearer's perceptions of recovery: findings from a focus group at the Second World Hearing Voices Festival and Congress. J Psychiatr Ment Health Nurs 2013; 20:564-8. [PMID: 23230997 DOI: 10.1111/jpm.12030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- M L Percy
- School of Nursing, Midwifery and Health Visiting, University of Manchester, Manchester, UK
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Chang YT, Tao SG, Lu CL. Qualitative inquiry into motivators for maintaining medication adherence among Taiwanese with schizophrenia. Int J Ment Health Nurs 2013; 22:272-8. [PMID: 22882876 DOI: 10.1111/j.1447-0349.2012.00864.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Medication non-adherence is associated with higher rates of relapse in persons with schizophrenia. Psychiatric nurses play a significant role in facilitating their medication adherence. The motivators which strengthen patients with schizophrenia to maintain their adherence to medication have seldom been explored. This study aims to explore what motivates persons with schizophrenia to consistently maintain their medication adherence. A qualitative approach was used to collect data from a psychiatric day-care centre at an armed forces hospital in Taiwan. Ten clients agreed to undergo an in-depth interview. The data was analyzed by a content analysis method. Four themes were identified: (i) the benefits of antipsychotic medication treatment; (ii) firm and ongoing family support; and the Chinese values of (iii) filial piety and (iv) hope for the future. These findings may provide psychiatric nurses with a better understanding of the motivators for medication adherence in persons with schizophrenia from the Chinese perspective. Nurses will then be able to adjust their practice to facilitate patients' medication adherence.
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Affiliation(s)
- Ying-Tzu Chang
- Department of Nursing, Buddhist Tzu Chi College of Technology, Hualien City, Taiwan.
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29
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O' Donnell H, Gormley K. Service user involvement in nurse education: perceptions of mental health nursing students. J Psychiatr Ment Health Nurs 2013; 20:193-202. [PMID: 22533371 DOI: 10.1111/j.1365-2850.2012.01917.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Increasingly providers of mental health nurse education are required to demonstrate user involvement in all aspects of these programmes including student selection, programme design and student assessment. There has been limited analysis of how nursing students perceive user involvement in nurse education programmes. The aim of this study has been to explore mental health nursing student's perceptions of involving users in all aspects of pre-registration mental health nursing programme. Researchers completed a number of focus group interviews with 12 ex-mental health nursing students who had been recruited by purposeful sampling. Each focus group interview was recorded and analysed using a series of data reduction, data display and verification methods. The study confirms many of the findings reported in earlier user participation in education studies. Three main themes related to user involvement have been identified: the protection of users, enhanced student learning and the added value benefits associated with user involvement.
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Affiliation(s)
- H O' Donnell
- School of Nursing and Midwifery, Queens University, Belfast, Medical Biology Centre, Belfast, UK.
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Mohr S, Borras L, Nolan J, Gillieron C, Brandt PY, Eytan A, Leclerc C, Perroud N, Whetten K, Pieper C, Koenig HG, Huguelet P. Spirituality and religion in outpatients with schizophrenia: a multi-site comparative study of Switzerland, Canada, and the United States. Int J Psychiatry Med 2013; 44:29-52. [PMID: 23356092 DOI: 10.2190/pm.44.1.c] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To assess the importance of spirituality and religious coping among outpatients with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder living in three countries. METHOD A total of 276 outpatients (92 from Geneva, Switzerland, 121 from Trois-Rivières, Canada, and 63 from Durham, North Carolina), aged 18-65, were administered a semi-structured interview on the role of spirituality and religiousness in their lives and to cope with their illness. RESULTS Religion is important for outpatients in each of the three country sites, and religious involvement is higher than in the general population. Religion was helpful (i.e., provided a positive sense of self and positive coping with the illness) among 87% of the participants and harmful (a source of despair and suffering) among 13%. Helpful religion was associated with better social, clinical and psychological status. The opposite was observed for the harmful aspects of religion. In addition, religion sometimes conflicted with psychiatric treatment. CONCLUSIONS These results indicate that outpatients with schizophrenia or schizoaffective disorder often use spirituality and religion to cope with their illness, basically positively, yet sometimes negatively. These results underscore the importance of clinicians taking into account the spiritual and religious lives of patients with schizophrenia.
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Affiliation(s)
- Sylvia Mohr
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Switzerland.
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31
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Pietruch M, Jobson L. Posttraumatic growth and recovery in people with first episode psychosis: an investigation into the role of self-disclosure. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2012. [DOI: 10.1080/17522439.2011.608434] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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32
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Stein-Parbury J, Gallagher R, Chenoweth L, Luscombe GM. Factors associated with good self-management in older adults with a schizophrenic disorder compared with older adults with physical illnesses. J Psychiatr Ment Health Nurs 2012; 19:146-53. [PMID: 22070648 DOI: 10.1111/j.1365-2850.2011.01767.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The number of older people living with a schizophrenic disorder (SD) is increasing yet little attention paid has been paid to the needs of this population relative to people with other chronic illnesses. In order to achieve optimal functioning people with a SD need to manage their illness and its impact; therefore, this study set out to determine the factors associated with self-management in this population. The illness management of people over 50 years of age and living with schizophrenia (n= 84) was compared with their peers who were diagnosed with a chronic physical illness (n= 216). Participants completed a survey that included an illness management inventory, self-rated health and sense of coherence. The results demonstrated that participants with a SD had lower illness management levels, particularly for understanding their symptoms and taking appropriate actions in relation to health care. Poor self-rated health and the presence of comorbid conditions had a pervasive negative effect on self-management factors in the SD group, whereas being married, having a greater sense of coherence and being voluntary to treatment had a positive effect. Nurses need to develop strategies to address general health and self-management in older adults living with a SD.
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Affiliation(s)
- J Stein-Parbury
- Faculty of Nursing, Midwifery and Health, University of Technology Sydney, Lindfield, Australia.
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33
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Webb M, Charbonneau AM, McCann RA, Gayle KR. Struggling and enduring with God, religious support, and recovery from severe mental illness. J Clin Psychol 2011; 67:1161-76. [PMID: 22072528 DOI: 10.1002/jclp.20838] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVES People with severe mental illnesses may achieve varying degrees of recovery, including symptom reduction and community integration. Research also indicates that religiosity facilitates coping with psychological disorders. In this study, we assessed the relationship between religiosity and recovery from severe mental illnesses. DESIGN Self-report data were collected from 81 participants with severe mental illnesses. We measured recovery, religious support, and participants' struggle or endurance with faith. RESULTS Religious support and enduring with faith were positively associated with recovery. Struggling was negatively associated with recovery, and that relationship was mediated by religious support. CONCLUSIONS Religious variables, including religious support and spiritual struggle, might affect recovery from severe mental illnesses.
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Affiliation(s)
- Marcia Webb
- Seattle Pacific University, Seattle, Washington 98119, USA.
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34
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Differences in self-reported importance of elements of health and subjectively experienced health among outpatients in community mental health services. Arch Psychiatr Nurs 2011; 25:e19-26. [PMID: 21978810 DOI: 10.1016/j.apnu.2011.04.002] [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] [Received: 10/23/2010] [Revised: 03/23/2011] [Accepted: 04/02/2011] [Indexed: 11/20/2022]
Abstract
Positive dimensions of mental health are strong protective factors against physical and mental illness in general population. A cross-sectional study including a randomly selected sample of 141 outpatients was performed to explore differences in patients' self-reported importance of elements of health and subjective experiences of health related to sociodemographic background variables. The examination of differences in self-reported importance of elements of health showed differences regarding gender, and the analyses of subjectively experienced health showed differences regarding age and diagnosis. Clinical interventions aiming at strengthening positive dimensions of health are required in community mental health services to meet the patients' individual needs of enhanced health.
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35
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Walker S, Kelly M. The introduction of an early warning signs journal in an adolescent inpatient unit. J Psychiatr Ment Health Nurs 2011; 18:563-8. [PMID: 21848589 DOI: 10.1111/j.1365-2850.2011.01705.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Early warning signs are considered to be one of the many tools utilized by specialist early intervention practitioners and other mental health professionals to assist young people how to recognize a deterioration in their mental state or if a relapse is indicated. This article focuses on the role that early warning signs recognition has played in a Child and Adolescent inpatient setting in the form of a journal that is used to record a young person's personal journey by recording early warning signs to prevent a future relapse. Feedback on the use of the journal has been positive from the young people who have utilized the journal and it has also been viewed as a useful and practical framework to identify key symptoms that may potentiate a relapse into illness.
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Affiliation(s)
- S Walker
- Dorset Healthcare University NHS Foundation Trust, University Department of Mental Health, Dorset, UK.
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36
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Romano D, McCay E, Boydell K. The use of material objects in understanding the process of recovery from a first episode of schizophrenia. Arts Health 2011. [DOI: 10.1080/17533015.2011.584882] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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37
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Holm AL, Severinsson E. Struggling to recover by changing suicidal behaviour: narratives from women with borderline personality disorder. Int J Ment Health Nurs 2011; 20:165-73. [PMID: 21492357 DOI: 10.1111/j.1447-0349.2010.00713.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Borderline personality disorder (BPD) is described as the most lethal of psychiatric disorders, with suicide rates of 3-9.5%, a rate almost 50 times higher than that of the general population. The struggle to recover by changing suicidal behaviour is not well described in relation to people with BPD. The most common reason given for suicide attempts was to escape or obtain relief from situations of extreme distress. The aim of this study was to explore how a recovery process facilitated changes in suicidal behaviour in a sample of women with BPD. An exploratory design was used. Data were collected by means of in-depth interviews (n = 13), and a thematic analysis was employed. The findings revealed two themes: 'struggling to assume responsibility for self and others' and 'struggling to stay alive by enhancing self-development'. The first theme comprised three subthemes: 'the desire to recover by searching for strength', 'the struggle to be understood as the person you are', and 'recovering by refusing to be violated'. The second theme comprised one subtheme: 'recovering by feeling safe and trusted'. The main finding of this study suggests that women with BPD who exhibit suicidal behaviour can change when they feel confirmed, safe, and trusted.
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Affiliation(s)
- Anne Lise Holm
- Department of Nursing Education, Stord/Haugesund University College, Haugesund, Norway.
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38
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Chiba R, Kawakami N, Miyamoto Y. Quantitative relationship between recovery and benefit-finding among persons with chronic mental illness in Japan. Nurs Health Sci 2011; 13:126-32. [PMID: 21481122 DOI: 10.1111/j.1442-2018.2011.00589.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study quantitatively examined the association between recovery and benefit-finding among persons with a chronic mental illness in Japan. A cross-sectional questionnaire survey was conducted, with responses from 237 (74%) of 319 individuals (≥ 20 years old) with a chronic mental illness in community and inpatient ward settings. The data of 120 questionnaires were analyzed (men, 64%; average age, 41 years). The questionnaire included the Recovery Assessment Scale (RAS) and Self-identified Stage of Recovery Parts A and B (SISR-A and SISR-B) for assessing recovery and the Perceived Positive Change Scale (PPCS) for assessing benefit-finding. The total RAS and SISR-B scores strongly and positively correlated with the PPCS score. The PPCS score significantly differed among the recovery stages, as classified by the SISR-A, with higher scores at higher stages; the association was almost linear. The study confirmed the theoretically expected relationship between recovery and benefit-finding among these individuals. Benefit-finding might be associated not only with a higher stage of recovery but also with each step from one stage to another.
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Affiliation(s)
- Rie Chiba
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Japan.
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39
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Piat M, Sabetti J, Fleury MJ, Boyer R, Lesage A. "Who believes most in me and in my recovery": the importance of families for persons with serious mental illness living in structured community housing. JOURNAL OF SOCIAL WORK IN DISABILITY & REHABILITATION 2011; 10:49-65. [PMID: 21360400 PMCID: PMC4835237 DOI: 10.1080/1536710x.2011.546310] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this article, the authors report on qualitative findings on the role of family in supporting recovery for mental health consumers living in structured, community housing in a large Canadian city. Despite living separately from families and relying heavily on formal services, residents identified their families more often than mental health professionals, friends, and residential caregivers as those who most believe in them and their recovery. Families supported recovery by providing affection and belonging, offering emotional and instrumental support, and by staying actively involved with residents. Families are a vital, untapped resource for social workers in promoting independent living.
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Affiliation(s)
- Myra Piat
- Douglas Mental Health University Institute, Montréal, Québec, Canada.
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40
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Svanberg J, Gumley A, Wilson A. How do social firms contribute to recovery from mental illness? A qualitative study. Clin Psychol Psychother 2010; 17:482-96. [DOI: 10.1002/cpp.681] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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41
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MacNeela P, Morris R, Scott A, Treacy MP, Hyde A. Seen as core: a Delphi consensus study of essential elements of mental health nursing care in Ireland. Arch Psychiatr Nurs 2010; 24:339-48. [PMID: 20851325 DOI: 10.1016/j.apnu.2010.02.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 01/24/2010] [Accepted: 02/03/2010] [Indexed: 12/11/2022]
Abstract
Continued ambiguity about the scope of mental health nursing is harmful to the discipline's identity and to patients' interests. Using a Delphi survey design, consensus was achieved on a set of 70 items representing core elements of mental health nursing among a sample of 150 mental health nurses working in Ireland. Items achieving consensus in Round 3 of the survey were composed of 28 clinical phenomena (framed as client problems), 18 direct and 12 indirect nursing interventions, and 12 nursing-sensitive outcomes of care. Mental health nurses accepted responsibility across a broad range of outcomes apart from those linked to physical care, the one domain of care rejected by participants. The findings portray mental health nursing as a psychosocial enterprise, encompassing both phenomenological and diagnosis-related elements.
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42
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Van Lith T, Fenner P, Schofield M. The lived experience of art making as a companion to the mental health recovery process. Disabil Rehabil 2010; 33:652-60. [DOI: 10.3109/09638288.2010.505998] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Theresa Van Lith
- Department of Counselling and Psychological Health, La Trobe University, Melbourne, Australia
| | - Patricia Fenner
- Department of Counselling and Psychological Health, La Trobe University, Melbourne, Australia
| | - Margot Schofield
- Department of Counselling and Psychological Health, La Trobe University, Melbourne, Australia
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Abstract
PURPOSE To call attention to attention deficit hyperactivity disorder (ADHD) as a psychiatric disorder that can limit women's potential and overall well-being. CONCLUSION ADHD, a legitimate neurobiological disorder that is often hidden, ignored, or misdiagnosed among women, causes them to struggle in silence. Proper interventions for women with ADHD that provide significant attention to context mitigate challenges across psychological, academic, occupational, and social domains. This should amend the diagnosis du jour concept, thereby supporting mechanisms to improve early intervention and positive outcomes. PRACTICE IMPLICATIONS Primary care practitioners play a central role in recognition, intervention, and recovery of women with ADHD.
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Affiliation(s)
- Roberta Waite
- Drexel University, Interdisciplinary Research Unit, Philadelphia, Pennsylvania, USA.
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44
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Kamper SJ, Stanton TR, Williams CM, Maher CG, Hush JM. How is recovery from low back pain measured? A systematic review of the literature. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2010; 20:9-18. [PMID: 20552378 DOI: 10.1007/s00586-010-1477-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 04/29/2010] [Accepted: 06/03/2010] [Indexed: 10/19/2022]
Abstract
Recovery is commonly used as an outcome measure in low back pain (LBP) research. There is, however, no accepted definition of what recovery involves or guidance as to how it should be measured. The objective of the study was designed to appraise the LBP literature from the last 10 years to review the methods used to measure recovery. The research design includes electronic searches of Medline, EMBASE, CINAHL, Cochrane database of clinical trials and PEDro from the beginning of 1999 to December 2008. All prospective studies of subjects with non-specific LBP that measured recovery as an outcome were included. The way in which recovery was measured was extracted and categorised according to the domain used to assess recovery. Eighty-two included studies used 66 different measures of recovery. Fifty-nine of the measures did not appear in more than one study. Seventeen measures used pain as a proxy for recovery, seven used disability or function and seventeen were based on a combination of two or more constructs. There were nine single-item recovery rating scales. Eleven studies used a global change scale that included an anchor of 'completely recovered'. Three measures used return to work as the recovery criterion, two used time to insurance claim closure and six used physical performance. In conclusion, almost every study that measured recovery from LBP in the last 10 years did so differently. This lack of consistency makes interpretation and comparison of the LBP literature problematic. It is likely that the failure to use a standardised measure of recovery is due to the absence of an established definition, and highlights the need for such a definition in back pain research.
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Affiliation(s)
- Steven J Kamper
- The George Institute for International Health, University of Sydney, Missenden Road, Sydney, NSW 2050, Australia.
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45
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Chiba R, Kawakami N, Miyamoto Y, Andresen R. Reliability and validity of the Japanese version of the Self-Identified Stage of Recovery for people with long term mental illness. Int J Ment Health Nurs 2010; 19:195-202. [PMID: 20550643 DOI: 10.1111/j.1447-0349.2009.00656.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Self-Identified Stage of Recovery (SISR) is a two-part scale assessing both the stage of recovery (SISR-A) and the component processes of recovery (SISR-B) for people with mental illness. This study aimed to develop a Japanese version of the SISR and to examine its reliability and validity. The Japanese versions of the SISR-A and SISR-B were developed through focus group cognitive interviews and the translation-back translation procedure. A cross-sectional questionnaire survey was conducted of 223 participants who had long term mental illness, were aged 20 years or older, and currently living in communities and inpatient ward settings; 59.2% were males and the average age was 47.6 years. The questionnaire also included the 24-item Recovery Assessment Scale, Herth Hope Index, Empowerment Scale, and Resilience Scale. Cronbach's alpha coefficient, intraclass correlation coefficient, and weighted kappas were generally fair to high, and the SISR-A and SISR-B scores were positively correlated with other relevant scales. This study supported the reliability and validity of the Japanese versions of the SISR-A and SISR-B among people with long term mental illness in Japan.
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Affiliation(s)
- Rie Chiba
- Departments of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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46
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Chiba R, Miyamoto Y, Kawakami N. Reliability and validity of the Japanese version of the Recovery Assessment Scale (RAS) for people with chronic mental illness: Scale development. Int J Nurs Stud 2010; 47:314-22. [DOI: 10.1016/j.ijnurstu.2009.07.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Revised: 07/17/2009] [Accepted: 07/19/2009] [Indexed: 10/20/2022]
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47
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Byrne R, Davies L, Morrison AP. Priorities and preferences for the outcomes of treatment of psychosis: A service user perspective. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2010. [DOI: 10.1080/17522430903456913] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Rory Byrne
- a Greater Manchester West NHS Foundation Trust , UK
- b University of Manchester , Manchester , UK
| | | | - Anthony P. Morrison
- a Greater Manchester West NHS Foundation Trust , UK
- b University of Manchester , Manchester , UK
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48
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Abstract
BACKGROUND Researchers have identified the reestablishment of self-identity as a key part of recovery in individuals with schizophrenia. Previous studies have increased scholars' understanding about how and when identity changes occur in those with schizophrenia; less is understood about the process by which individuals with schizophrenia reconstruct their self-identity. OBJECTIVE The objective of this study is to describe the process of self-identity reconstruction in people with schizophrenia. STUDY DESIGN A grounded theory study was conducted with 10 purposively selected participants and 4 significant others; 19 semistructured interviews were completed. RESULTS Constant comparative analysis led to a theory of a six-stage process of self-recovery in those with schizophrenia. For some participants, the successful struggle to care for a new self led to the refinement and eventual recovery of self-identity. CONCLUSIONS Individuals with schizophrenia experience a process of distinct changes in self-identity occurring between engulfment by a severe mental illness and emergence of a new self.
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Affiliation(s)
- Joyce M Shea
- Fairfield University School of Nursing, Fairfield, CT,
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49
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Piat M, Sabetti J. The Development of a Recovery-Oriented Mental Health System in Canada: What the Experience of Commonwealth Countries Tells Us. CANADIAN JOURNAL OF COMMUNITY MENTAL HEALTH = REVUE CANADIENNE DE SANTE MENTALE COMMUNAUTAIRE 2009; 28:17-33. [PMID: 27099409 PMCID: PMC4835232 DOI: 10.7870/cjcmh-2009-0020] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This article examines how the recovery concept has been introduced into national mental health policies in New Zealand, Australia and the England. Five overall themes are identified as critical in shifting to a recovery-oriented system: restructuring of mental health services; promoting mental health and preventing mental illness, developing and training the workforce; cultivating consumer participation and leadership and establishing outcome-oriented and measurable practices. These issues are vital in the uptake of recovery and should guide the overall direction of the Canadian Mental Health Commission's mental health strategy.
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Affiliation(s)
- Myra Piat
- Douglas Mental Health University Institute, Montreal, Canada
- McGill University, Montreal, Canada
| | - Judith Sabetti
- Douglas Mental Health University Institute, Montreal, Canada
- McGill University, Montreal, Canada
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50
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Walton DM, Macdermid JC, Nielson W. Recovery from acute injury: Clinical, methodological and philosophical considerations. Disabil Rehabil 2009; 32:864-74. [DOI: 10.3109/09638280903349511] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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