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Durocher K, Shin HD, Lo B, Chen S, Ma C, Strudwick G. Understanding the Role of Patient Portals in Fostering Interprofessional Collaboration Within Mental Health Care Settings: Mixed Methods Study. JMIR Hum Factors 2023; 10:e44747. [PMID: 37467024 PMCID: PMC10398557 DOI: 10.2196/44747] [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: 12/02/2022] [Revised: 06/06/2023] [Accepted: 06/17/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Patient portals are web-based systems through which patients can access their personal health information and communicate with their clinicians. The integration of patient portals into mental health care settings has been evolving over the past decade, as cumulated research to date has highlighted the potential role of portals in facilitating positive health outcomes. However, it is currently unknown whether portal use can foster interprofessional collaboration between clinicians and patients or whether the portal is a tool to support an already established collaborative relationship. OBJECTIVE This mixed methods study aimed to understand how the use of a patient portal within mental health settings can impact the level of interprofessional collaboration between clinicians and patients. METHODS This study was conducted in a large mental health care organization in Ontario, Canada. A convergent mixed methods design was used, where the primary data collection methods included questionnaires and semistructured interviews with patients who had experience using a portal for their mental health care. For the quantitative strand, participants completed the Health Care Communication Questionnaire and the Self-Empowerment subscale of the Mental Health Recovery Measure at 3 time points (baseline, 3 months of use, and 6 months of use) to measure changes in scores over time. For the qualitative strand, semistructured interviews were conducted at the 3-month time point to assess the elements of interprofessional collaboration associated with the portal. RESULTS For the quantitative strand, 113 participants completed the questionnaire. For the Health Care Communication Questionnaire scores, the raw means of the total scores at the 3 time points were as follows: baseline, 43.01 (SD 7.28); three months, 43.19 (SD 6.65); and 6 months, 42.74 (SD 6.84). In the univariate model with time as the only independent variable, the scores did not differ significantly across the 3 time points (P=.70). For the Mental Health Recovery Measure scores, the raw mean total scores at the 3 time points were as follows: baseline, 10.77 (SD 3.63); three months, 11.09 (SD 3.81); and 6 months, 11.10 (SD 3.33). In the univariate model with time as the only independent variable, the scores did not differ significantly across the 3 time points (P=.34). For the qualitative strand, 10 participants were interviewed and identified various elements of how interprofessional collaboration can be supplemented through the use of a patient portal, including improved team functioning, communication, and conflict resolution. CONCLUSIONS Although the quantitative data produced nonsignificant findings in interprofessional collaboration scores over time, the patients' narrative accounts described how the portal can support various interprofessional collaboration concepts, such as communication, leadership, and conflict resolution. This provides useful information for clinicians to support the interprofessional relationship when using a portal within a mental health setting. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2018-025508.
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Affiliation(s)
- Keri Durocher
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
- School of Health, Community Services, and Creative Design, Lambton College, Sarnia, ON, Canada
| | - Hwayeon Danielle Shin
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Brian Lo
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sheng Chen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Clement Ma
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Gillian Strudwick
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
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Walhout SJN, Zanten JV, DeFuentes-Merillas L, Sonneborn CKME, Bosma M. Patients With Autism Spectrum Disorder and Co-occurring Substance Use Disorder: A Clinical Intervention Study. Subst Abuse 2022; 16:11782218221085599. [PMID: 35465619 PMCID: PMC9019324 DOI: 10.1177/11782218221085599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/16/2022] [Indexed: 11/15/2022]
Abstract
Background: The prevalence of substance use disorders (SUD) in individuals with autism spectrum disorders (ASD) appears to be higher than previously described. Attention has been drawn to developing new treatment approaches for this patient population, as they appear to do less well with traditional addiction treatment. There is very little research addressing treatment outcome. This study aims to introduce and evaluate a manualized group treatment intervention developed specifically for patients with ASD and co-occurring SUD. Methods: We developed a group treatment based on cognitive behavioural therapy (CBT) and evaluated outcome measures at the end of treatment and 3-month follow-up. Fifty-seven patients with ASD and co-occurring SUD were included of which 30 completed the group intervention, 27 of them also participated at 3-month follow-up. Results: The findings suggest that group treatment can work for patients with ASD and co-occurring SUD. Lower levels of alcohol use ( t = 3.61, P = .002, d = 0.75), craving ( t = 2.65, P = .013, d = 0.51), passive coping styles ( t = 2.32, P = .030, d = 0.48), depression ( t = 3.48, P = .002, d = 0.67), anxiety ( t = 3.02, P = .006, d = 0.58), and stress ( t = 2.62, P = .015, d = 0.51) symptoms were reported after completing the group intervention, with even stronger effects at 3 months follow-up. Conclusions: The present study shows promising results of a tailor-made group intervention in a heterogeneous patient population with ASD and co-occurring SUD with positive effects on both symptoms of ASD and SUD.
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Affiliation(s)
- Sharon JN Walhout
- Department of Research & Development, Novadic-Kentron, Network for Addiction Treatment Services, Vught, The Netherlands
| | - Johan van Zanten
- Department of Research & Development, Novadic-Kentron, Network for Addiction Treatment Services, Vught, The Netherlands
| | - Laura DeFuentes-Merillas
- Department of Research & Development, Novadic-Kentron, Network for Addiction Treatment Services, Vught, The Netherlands
| | - Christina KME Sonneborn
- Department of Research & Development, Novadic-Kentron, Network for Addiction Treatment Services, Vught, The Netherlands
| | - Marc Bosma
- Department of Research & Development, Novadic-Kentron, Network for Addiction Treatment Services, Vught, The Netherlands
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Wang M, Wang J, Wang Y, Huang X, Huang Y, Huang J, Feng Y, Li X. Reliability and validity of the Mental Health Self-management Questionnaire among Chinese patients with mood and anxiety disorders. Front Psychiatry 2022; 13:952951. [PMID: 35966465 PMCID: PMC9372341 DOI: 10.3389/fpsyt.2022.952951] [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] [Received: 05/25/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Self-management plays an important role in promoting and restoring mental health for individuals with mental health issues. However, there is no valid and reliable Chinese tool assessing the self-management behaviors of people with mood and anxiety disorders. This study aimed to develop a Chinese version of the Mental Health Self-management Questionnaire (MHSQ-C) and to verify its psychometric properties. METHODS A total of 440 potential participants were recruited by convenience sampling from June to August 2020. Item analysis and analyses of internal consistency, test-retest reliability, content validity, construct validity and criterion validity were performed. RESULTS Data from 326 participants were used. Three factors obtained via principal component analysis and varimax rotation explained 53.68% of the total variance. The average content validity index was 0.99. The Cronbach's α coefficient (total: 0.874, clinical: 0.706, empowerment: 0.818, vitality: 0.830) and test-retest reliability (ICC: total: 0.783, 95% confidence interval (CI) [0.616, 0.882], clinical: 0.525, 95% CI [0.240, 0.725], empowerment: 0.786, 95% CI [0.622, 0.884], vitality: 0.748, 95% CI [0.564, 0.862]) were good. The MHSQ-C was well correlated with the Partners in Health scale and showed no floor or ceiling effect. DISCUSSION The MHSQ-C is a reliable and valid tool to evaluate the self-management strategies of patients with mood and anxiety disorders.
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Affiliation(s)
- Mengmeng Wang
- West China School of Nursing and West China Hospital, Sichuan University, Chengdu, China
| | - Jingjun Wang
- West China School of Nursing and West China Hospital, Sichuan University, Chengdu, China
| | - Ya Wang
- Department of Nursing, West China Hospital and West China School of Nursing, Sichuan University, Chengdu, China
| | - Xia Huang
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Yalin Huang
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Junqiang Huang
- Chengdu Dekang Hospital/Chengdu Psychiatric Hospital, Chengdu, China
| | - Yan Feng
- Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaolin Li
- West China School of Nursing and West China Hospital, Sichuan University, Chengdu, China
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4
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Jongkind A, Hendriks M, Grootens K, Beekman ATF, van Meijel B. Evaluation of a collaborative care program for patients with treatment-resistant schizophrenia: Protocol for a multiple case-study. (Preprint). JMIR Res Protoc 2021; 11:e35336. [PMID: 35700002 PMCID: PMC9237776 DOI: 10.2196/35336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/11/2022] [Accepted: 04/22/2022] [Indexed: 12/15/2022] Open
Abstract
Background Approximately one-third of all patients with schizophrenia are treatment resistant. Worldwide, undertreatment with clozapine and other effective treatment options exist for people with treatment-resistant schizophrenia (TRS). In this respect, it appears that regular health care models do not optimally fit this patient group. The Collaborative Care (CC) model has proven to be effective for patients with severe mental illness, both in primary care and in specialized mental health care facilities. The key principles of the CC model are that both patients and informal caregivers are part of the treatment team, that a structured treatment plan is put in place with planned evaluations by the team, and that the treatment approach is multidisciplinary in nature and uses evidence-based interventions. We developed a tailored CC program for patients with TRS. Objective In this paper, we provide an overview of the research design for a potential study that seeks to gain insight into both the process of implementation and the preliminary effects of the CC program for patients with TRS. Moreover, we aim to gain insight into the experiences of professionals, patients, and informal caregivers with the program. Methods This study will be underpinned by a multiple case study design (N=20) that uses a mixed methods approach. These case studies will focus on an Early Psychosis Intervention Team and 2 Flexible Assertive Community treatment teams in the Netherlands. Data will be collected from patient records as well as through questionnaires, individual interviews, and focus groups. Patient recruitment commenced from October 2020. Results Recruitment of participants commenced from October 2020, with the aim of enrolling 20 patients over 2 years. Data collection will be completed by the end of 2023, and the results will be published once all data are available for reporting. Conclusions The research design, framed within the process of developing and testing innovative interventions, is discussed in line with the aims of the study. The limitations in clinical practice and specific consequences of this study are explained. International Registered Report Identifier (IRRID) DERR1-10.2196/35336
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Affiliation(s)
- Amy Jongkind
- Reinier van Arkel, 's-Hertogenbosch, Netherlands
- Amsterdam University Medical Center (VUmc), Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | | | - Koen Grootens
- Reinier van Arkel, 's-Hertogenbosch, Netherlands
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Aartjan T F Beekman
- Amsterdam University Medical Center (VUmc), Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Berno van Meijel
- Amsterdam University Medical Center (VUmc), Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Inholland University of Applied Sciences, Department of Health, Sports & Welfare, Cluster Nursing, Amsterdam, Netherlands
- Parnassia Psychiatric Institute, Parnassia Academy, The Hague, Netherlands
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5
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Beentjes TAA, Teerenstra S, Vermeulen H, Goossens PJJ, der Sanden MWGNV, van Gaal BGI. Identifying the minimal important difference in patient-reported outcome measures in the field of people with severe mental illness: a pre-post-analysis of the Illness Management and Recovery Programme. Qual Life Res 2021; 30:1723-1733. [PMID: 33594528 PMCID: PMC8178137 DOI: 10.1007/s11136-021-02779-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 11/30/2022]
Abstract
Purpose Complementary interventions for persons with severe mental illness (SMI) focus on both personal recovery and illness self-management. This paper aimed to identify the patient-reported outcome measures (PROMs) associated with the most relevant and meaningful change in persons with SMI who attended the Illness Management and Recovery Programme (IMR). Methods The effect of the IMR was measured with PROMs concerning recovery, illness self-management, burden of symptoms and quality of life (QoL). From the QoL measures, an anchor was chosen based on the most statistically significant correlations with the PROMs. Then, we estimated the minimal important difference (MID) for all PROMs using an anchor-based method supported by distribution-based methods. The PROM with the highest outcome for effect score divided by MID (the effect/MID index) was considered to be a measure of the most relevant and meaningful change. Results All PROMs showed significant pre–post-effects. The QoL measure ‘General Health Perception (Rand-GHP)’ was identified as the anchor. Based on the anchor method, the Mental Health Recovery Measure (MHRM) showed the highest effect/MID index, which was supported by the distribution-based methods. Because of the modifying gender covariate, we stratified the MID calculations. In most MIDs, the MHRM showed the highest effect/MID indexes. Conclusion Taking into account the low sample size and the gender covariate, we conclude that the MHRM was capable of showing the most relevant and meaningful change as a result of the IMR in persons with SMI.
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Affiliation(s)
- Titus A A Beentjes
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.
- Center for Nursing Research, Saxion University of Applied Science, Deventer/Enschede, The Netherlands.
- Dimence Group Mental Health Care Centre, Deventer, The Netherlands.
| | - Steven Teerenstra
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department for Health Evidence, Group Biostatistics, Nijmegen, The Netherlands
| | - Hester Vermeulen
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands
| | - Peter J J Goossens
- Dimence Group Mental Health Care Centre, Deventer, The Netherlands
- University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Betsie G I van Gaal
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands
- HAN University of Applied Sciences, Faculty of Health and Social Studies, Nijmegen, The Netherlands
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6
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McPherson P, Lloyd-Evans B, Dalton-Locke C, Killaspy H. A Systematic Review of the Characteristics and Efficacy of Recovery Training for Mental Health Staff: Implications for Supported Accommodation Services. Front Psychiatry 2021; 12:624081. [PMID: 34054593 PMCID: PMC8160251 DOI: 10.3389/fpsyt.2021.624081] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/09/2021] [Indexed: 11/13/2022] Open
Abstract
Evidence suggests a link between recovery-oriented practise and service user outcomes in supported accommodation settings. Current clinical guidelines recommend recovery training for supported accommodation staff, however evidence relating to the effectiveness of this type of training is unclear. This review aimed to describe and compare the characteristics and efficacy of existing recovery training packages for mental health staff. The appropriateness and applicability of the interventions was considered in relation to UK supported accommodation services. Initial search processes returned 830 papers. After duplicate removal, inclusion and exclusion criteria were applied to 489 papers, leaving a final sample of seven papers. Data were reviewed using a narrative synthesis approach. The reviewed papers showed variation in the aims, frequency, and duration of the training interventions, although all included content consistent with the five-domains of the CHIME model. All interventions used direct, in-person teaching, and prioritised interactive, experiential learning, however a number were limited by the absence of feedback, the use of one-off, rather than repeated/follow-up sessions, and a reliance on classroom-based, rather than in-vivo, training. There was limited evidence to suggest a consistent effect of training on staff or service user outcomes, and there was no clear association between the delivery and design characteristics of the interventions and reported outcomes. In considering the development of recovery training for supported accommodation staff, little guidance can be taken from the reviewed literature. Any training package must be developed with consideration of the unique contextual and organisational characteristics of these services. The authors recommend viewing training as one component of a broader goal of service transformation.
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Vogel JS, Bruins J, Halbersma L, Lieben RJ, de Jong S, van der Gaag M, Castelein S. Measuring personal recovery in people with a psychotic disorder based on CHIME: A comparison of three validated measures. Int J Ment Health Nurs 2020; 29:808-819. [PMID: 32147933 PMCID: PMC7586981 DOI: 10.1111/inm.12711] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2020] [Indexed: 11/27/2022]
Abstract
Living well in spite of residual symptoms of mental illness is measured with the construct of personal recovery. The CHIME framework might be suitable to evaluate personal recovery measures and guide instrument choice. Three validated measures were evaluated in Dutch patients with a psychotic disorder (N = 52). We compared the Recovery Assessment Scale (RAS), the Mental Health Recovery Measure (MHRM), and the Netherlands Empowerment List (NEL). The measures were assessed on six criteria: content validity (based on CHIME), convergent validity with a social support measure, internal consistency, floor and ceiling effects, item interpretability, and ease of administration. The MHRM scored high on content validity with a balanced distribution of items covering the CHIME framework. The MHRM and the NEL showed moderate convergent validity with social support. In all three measures, internal consistency was moderate and floor and ceiling effects were absent. The NEL scores demonstrated a high degree of item interpretability. Ease of administration was moderate for all three measures. Finally, the CHIME framework demonstrated good utility as a framework in guiding instrument choice and evaluation of personal recovery measures. The MHRM showed the best overall result. However, differences between measures were minimal. Generalization of the results is limited by cultural and linguistic factors in the assessment for the subjective measures (i.e. content validity and item interpretability). The broad and multidimensional construct of personal recovery might lead to ambiguous interpretations. Scientific consensus on a well-defined personal recovery construct is needed.
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Affiliation(s)
- Jelle Sjoerd Vogel
- Lentis Psychiatric Institute, Groningen, The Netherlands.,Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands.,Rob Giel Research Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jojanneke Bruins
- Lentis Psychiatric Institute, Groningen, The Netherlands.,Rob Giel Research Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Levi Halbersma
- Lentis Psychiatric Institute, Groningen, The Netherlands
| | | | - Steven de Jong
- Lentis Psychiatric Institute, Groningen, The Netherlands.,Rob Giel Research Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology, VU University, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Stynke Castelein
- Lentis Psychiatric Institute, Groningen, The Netherlands.,Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands.,Rob Giel Research Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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8
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Roosenschoon BJ, Kamperman AM, Deen ML, van Weeghel J, Mulder CL. Determinants of clinical, functional and personal recovery for people with schizophrenia and other severe mental illnesses: A cross-sectional analysis. PLoS One 2019; 14:e0222378. [PMID: 31532805 PMCID: PMC6750648 DOI: 10.1371/journal.pone.0222378] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 08/29/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To analyze the relationships between insight, medication adherence, addiction, coping and social support-components of Illness Management and Recovery (IMR)-as determinants of clinical, functional and personal recovery in patients with schizophrenia and other severe mental illnesses. Our rationale lay in the interrelations between these concepts suggested in a conceptual framework of IMR. METHODS The cross-sectional design used baseline data of outpatient participants in a randomized clinical trial on IMR (N = 187). We used structural equation modeling (SEM) to describe pathways between degrees of insight, medication adherence, addiction, coping and social support, and degree of clinical, functional and personal recovery. We also explored whether clinical recovery mediated functional and personal recovery. RESULTS Our final model showed that coping was associated with clinical, functional and personal recovery. Direct associations between coping and functional and personal recovery were stronger than indirect associations via clinical recovery. Although SEM also showed a significant but weak direct pathway between social support and functional recovery, there were no significant pathways either between social support and clinical or personal recovery, or between insight, medication adherence, addiction and any type of recovery. CONCLUSIONS Coping may be a determinant of all three types of recovery, and social support a determinant of functional recovery. Clinical recovery appears not to be a prerequisite for functional or personal recovery. While our results also suggest the relevance of improving coping skills and of enhancing social support, they only partially support the conceptual framework of IMR.
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Affiliation(s)
- Bert-Jan Roosenschoon
- ESPRI Epidemiological and Social Psychiatric Research Institute, Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
- Parnassia Psychiatric Institute, The Hague, the Netherlands
- * E-mail:
| | - Astrid M. Kamperman
- ESPRI Epidemiological and Social Psychiatric Research Institute, Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Mathijs L. Deen
- Parnassia Psychiatric Institute, The Hague, the Netherlands
- Faculty of Social and Behavioral Sciences, Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Jaap van Weeghel
- Parnassia Psychiatric Institute, The Hague, the Netherlands
- Tilburg University, Department of Social and Behavioral Sciences, TRANZO Scientific Center for Care and Welfare, Tilburg, the Netherlands
| | - Cornelis L. Mulder
- ESPRI Epidemiological and Social Psychiatric Research Institute, Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
- Parnassia Psychiatric Institute, Antes/Bavo Europoort, Rotterdam, the Netherlands
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9
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Recovery-oriented training programmes for mental health professionals: A narrative literature review. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.mhp.2019.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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10
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Beentjes TAA, Goossens PJJ, Vermeulen H, Teerenstra S, Nijhuis-van der Sanden MWG, van Gaal BGI. E-IMR: e-health added to face-to-face delivery of Illness Management & Recovery programme for people with severe mental illness, an exploratory clustered randomized controlled trial. BMC Health Serv Res 2018; 18:962. [PMID: 30541536 PMCID: PMC6292084 DOI: 10.1186/s12913-018-3767-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 11/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND E-mental health holds promise for people with severe mental illness, but has a limited evidence base. This study explored the effect of e-health added to face-to-face delivery of the Illness Management and Recovery Programme (e-IMR). METHOD In this multi-centre exploratory cluster randomized controlled trial, seven clusters (n = 60; 41 in intervention group and 19 in control group) were randomly assigned to e-IMR + IMR or IMR only. Outcomes of illness management, self-management, recovery, symptoms, quality of life, and general health were measured at baseline (T0), halfway (T1), and at twelve months (T2). The data were analysed using mixed model for repeated measurements in four models: in 1) we included fixed main effects for time trend and group, in 2) we controlled for confounding effects, in 3) we controlled for interaction effects, and in 4) we performed sub-group analyses within the intervention group. RESULTS Notwithstanding low activity on e-IMR, significant effects were present in model 1 analyses for self-management (p = .01) and recovery (p = .02) at T1, and for general health perception (p = .02) at T2, all in favour of the intervention group. In model 2, the confounding covariate gender explained the effects at T1 and T2, except for self-management. In model 3, the interacting covariate non-completer explained the effects for self-management (p = .03) at T1. In model 4, the sub-group analyses of e-IMR-users versus non-users showed no differences in effect. CONCLUSION Because of confounding and interaction modifications, effectiveness of e-IMR cannot be concluded. Low use of e-health precludes definite conclusions on its potential efficacy. Low use of e-IMR calls for a thorough process evaluation of the intervention. TRIAL REGISTRATION The Dutch Trial Register ( NTR4772 ).
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Affiliation(s)
- Titus A A Beentjes
- Titus Beentjes, IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500, HB, Nijmegen, the Netherlands. .,Center for Nursing Research, Saxion University of Applied Science, Deventer/Enschede, the Netherlands. .,Dimence Group Mental Health Care Centre, Deventer, the Netherlands.
| | - Peter J J Goossens
- Dimence Group Mental Health Care Centre, Deventer, the Netherlands.,Department of Public Health, Faculty of Medicine and Health Sciences, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Hester Vermeulen
- Titus Beentjes, IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500, HB, Nijmegen, the Netherlands
| | - Steven Teerenstra
- Department for Health Evidence, Radboud University Medical Center, Radboud Institute for Health Sciences, Group Biostatistics, Nijmegen, the Netherlands
| | - Maria W G Nijhuis-van der Sanden
- Titus Beentjes, IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500, HB, Nijmegen, the Netherlands
| | - Betsie G I van Gaal
- Titus Beentjes, IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, PO Box 9101, 6500, HB, Nijmegen, the Netherlands.,Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, the Netherlands
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11
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Van Eck RM, Burger TJ, Schenkelaars M, Vellinga A, de Koning MB, Schirmbeck F, Kikkert M, Dekker J, de Haan L. The impact of affective symptoms on personal recovery of patients with severe mental illness. Int J Soc Psychiatry 2018; 64:521-527. [PMID: 29992846 DOI: 10.1177/0020764018784610] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Clinical recovery is often defined as remission of symptoms. Personal recovery is described as growing beyond the catastrophic effects of mental illness, sometimes despite ongoing symptoms. AIMS To examine the relationship between the severity of clinical symptom domains and personal recovery in patients with severe mental illness (SMI). METHODS Symptom severity and personal recovery of 105 outpatients with SMI at Mentrum, part of Arkin Institute for Mental Health in Amsterdam, the Netherlands, were assessed using the Brief Psychiatric Rating Scale-Expanded Version (BPRS-E) and the Mental Health Recovery Measure (MHRM). Correlation and regression analyses were used to investigate the associations. RESULTS The multiple regression analysis showed that only affective symptoms significantly predicted personal recovery, whereas neither positive nor negative symptom severity added to the explained variance in the model. CONCLUSION The association between affective symptoms and personal recovery in patients with SMI implies that treatment of affective symptoms may advance personal recovery, and/or support of personal recovery may improve mood, whereas focussing on treatment of psychotic symptoms might not be the key to personal recovery. More research is needed to elucidate causal interrelations.
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Affiliation(s)
- Robin Michael Van Eck
- 1 Mentrum, part of Arkin Institute for Mental Health, Amsterdam, The Netherlands.,2 Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Thijs Jan Burger
- 2 Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,3 Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | | | - Astrid Vellinga
- 1 Mentrum, part of Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | | | - Frederike Schirmbeck
- 2 Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,3 Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | - Martijn Kikkert
- 3 Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | - Jack Dekker
- 3 Arkin Institute for Mental Health, Amsterdam, The Netherlands.,5 Department of Clinical Psychology, Free University, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- 2 Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,3 Arkin Institute for Mental Health, Amsterdam, The Netherlands
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12
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Strudwick G, Kuziemsky C, Booth RG, Collins S, Chyjek A, Sakal M, Harris A, Strauss J. Engaging patients and family members in the evaluation of a mental health patient portal: protocol for a mixed-methods study. BMJ Open 2018; 8:e025508. [PMID: 30139909 PMCID: PMC6112388 DOI: 10.1136/bmjopen-2018-025508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Twenty per cent of Canadians will experience a mental illness in any year. Mental health patient portals have been developed to support these individuals in taking more control over their own mental health and care. This may be done through electronic access to their health records and other supportive functions like completion of online self-assessments. To date, there has been limited research into the value that these portals may provide within mental health contexts. This study will identify what value mental health patient portals may offer to patients and their family members. METHODS AND ANALYSIS This study will use a mixed-methods design. Patients will complete a survey consisting of validated instruments at the time of enrolment in the portal, and at 3 and 6 months of portal use. Patient and family member focus groups will be conducted. Portal usage data will be collected to identify if there are differences in outcomes based on usage. The study will be done at Canada's largest mental health and addiction teaching hospital, and will be conducted using a patient and family-oriented research approach, engaging these important representatives in all stages of the research process. The primary data analysis for the survey portion of the study will be done using linear mixed-effect models, assessing the differences between patients with different portal usage levels. A thematic analysis will be conducted of the focus group transcripts. ETHICS AND DISSEMINATION Approval from the study site's Research Ethics Board has been obtained. The dissemination of findings of this study will be done through presentations at conferences, as well as a formal peer-reviewed journal article. Additionally, the research team will work with a group of patients and family members to identify opportunities to complete knowledge translation and dissemination activities in non-traditional venues.
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Affiliation(s)
| | - Craig Kuziemsky
- Telfer School of Management, University of Ottawa, Ottawa, Canada
| | - Richard G Booth
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Sarah Collins
- Department of Biomedical Informatics and Nursing, Columbia University, New York, USA
| | - Anna Chyjek
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Moshe Sakal
- Hong Fook Mental Health Association, Toronto, Ontario, Canada
| | | | - John Strauss
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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13
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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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14
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Bitter NA, Roeg DPK, van Nieuwenhuizen C, van Weeghel J. Identifying profiles of service users in housing services and exploring their quality of life and care needs. BMC Psychiatry 2016; 16:419. [PMID: 27881159 PMCID: PMC5120432 DOI: 10.1186/s12888-016-1122-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 11/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Housing services aim to support people with mental illness in their daily life and recovery. As the level of recovery differs between service users, the quality of life and care needs also might vary. However, the type and amount of care and support that service users receive do not always match their recovery. In order to improve the quality of care, this study aims to explore whether subgroups of service users exist based on three dimensions of recovery and to examine and compare the quality of life and care needs of the persons in these subgroups. METHODS Latent class analysis was performed with data from 263 service users of housing services in the Netherlands. Classes were based on three variables: personal recovery (Mental Health Recovery Measure), social recovery (Social Functioning Scale), and clinical recovery (Brief Symptom Inventory). Subsequently, the quality of life (MANSA) and care needs (CANSAS) of the different classes were analysed by the use of descriptive and inferential statistics. RESULTS Three classes could be distinguished. Class 1 (45%) comprised of people who score the highest of the three classes in terms of personal and social recovery and who experience the least number of symptoms. People in class 2 (44%) and class 3 (11%) score significantly lower on personal and social recovery, and they experience significantly more symptoms compared to class 1. The distinction between class 2 and 3 can be made on the significantly higher number of symptoms in class 3. All three classes differ significantly on quality of life and unmet needs. CONCLUSIONS The quality of life of service users of housing services needs improvement, as even persons in the best-recovered subgroup have a lower quality of life than the average population. Workers of housing services need to be aware of the recovery of a client and what his or her individual needs and goals are. Furthermore, better care (allocation) concerning mental and physical health and rehabilitation is needed. Care should be provided on all dimensions of recovery at the same time, therefore mental health care organisations should work together and integrate their services. TRIAL REGISTRATION ISRCTN registry ISRCTN77355880 retrospectively registered 05/07/2013.
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Affiliation(s)
- Neis A. Bitter
- Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
| | - Diana P. K. Roeg
- Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, 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
- Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, 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
- Department of Social and Behavioral 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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15
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Roosenschoon BJ, van Weeghel J, Bogaards M, Deen ML, Mulder CL. Illness Management & Recovery (IMR) in the Netherlands; a naturalistic pilot study to explore the feasibility of a randomized controlled trial. BMC Psychiatry 2016; 16:391. [PMID: 27829392 PMCID: PMC5103352 DOI: 10.1186/s12888-016-1096-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 10/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Illness Management & Recovery (IMR) is a curriculum-based program for people with severe and persistent mental illness. To date, four randomized controlled trials (RCTs) have been published on it. As these produced mixed results, we conducted a pilot study to test the feasibility of conducting a new RCT in a Dutch psychiatric institute. Because our primary objective was to evaluate support for implementing IMR on a broader scale, we examined participant recruitment, client outcomes, and clients' and clinicians' satisfaction. Secondary objectives were to evaluate fidelity, trainers' training and supervision, and to explore program duration, dropout, and client characteristics related to dropout. For reporting, we used the checklist for pilot studies adopted from the CONSORT Statement. METHODS This program evaluation included a process-evaluation and an outcome evaluation with a One Group Pre-Posttest Design (N = 81). Interviews and internal reports were used to monitor participant numbers, program duration, dropout, and completers' characteristics. Clients' and clinicians' satisfaction and provision of trainers' training and supervision were assessed through interviews. Fidelity was assessed on the IMR Fidelity Scale; client outcomes were assessed on the IMR scale (client and clinician versions) and the Recovery Markers Questionnaire (RMQ). RESULTS Eighty-one participants were recruited of 167 people who were assessed for eligibility. Completers and clinicians were satisfied, and scores for completers improved significantly on the IMR scale (clinician version) (d = 0.84) and RMQ (d = 0.52), and not significantly on the IMR scale client version (d = 0.41). Mean fidelity was good, but three groups had only moderate fidelity. Our feasibility criterion for trainers' education and supervision was partly attained. Dropout from treatment was 51 %; female participants and people who scored higher on both IMR-scales at baseline had a significantly lower chance of dropping out. The duration of IMR varied (M = 12.7 months, SD = 2.87). CONCLUSIONS Results suggested that feasibility of conducting an RCT on IMR was good. Special attention is required to fidelity, IMR duration, trainers' education and supervision, and dropout, especially of men. One study limitation was our inability to conduct follow-up measurements of non-completers.
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Affiliation(s)
- Bert-Jan Roosenschoon
- Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus University Medical Centre, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. .,Parnassia Psychiatric Institute, Parnassia Academy, Kiwistraat 32, 2552, DH, Den Haag, The Netherlands.
| | - Jaap van Weeghel
- Tilburg School of Social and Behavioral Sciences, Department of TRANZO, Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands ,Parnassia Psychiatric Institute, Dijk en Duin, Oude Parklaan 125, 1901 ZZ Castricum, The Netherlands
| | - Moniek Bogaards
- Parnassia Psychiatric Institute, Bavo-Europoort, Prins Constantijnweg 48-54, 3066 TA Rotterdam, The Netherlands
| | - Mathijs L. Deen
- Parnassia Psychiatric Institute, Parnassia Academy, Kiwistraat 32, 2552 DH Den Haag, The Netherlands ,Faculty of Social and Behavioral Sciences, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - Cornelis L. Mulder
- Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus University Medical Centre, ‘s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands ,Parnassia Psychiatric Institute, Bavo-Europoort, Prins Constantijnweg 48-54, 3066 TA Rotterdam, The Netherlands
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Oliveira-Maia AJ, Mendonça C, Pessoa MJ, Camacho M, Gago J. The Mental Health Recovery Measure Can Be Used to Assess Aspects of Both Customer-Based and Service-Based Recovery in the Context of Severe Mental Illness. Front Psychol 2016; 7:1679. [PMID: 27857698 PMCID: PMC5093119 DOI: 10.3389/fpsyg.2016.01679] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 10/12/2016] [Indexed: 12/20/2022] Open
Abstract
Within clinical psychiatry, recovery from severe mental illness (SMI) has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here, we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs and quality of life. The study was conducted in 101 patients suffering from SMI, recruited from a rural community mental health setting in Portugal. Customer-based recovery and function-related service-based recovery were assessed, respectively, using a shortened version of the Mental Health Recovery Measure (MHRM-20) and the Global Assessment of Functioning score. The Camberwell Assessment of Need scale was used to objectively assess needs, while subjective quality of life was measured with the TL-30s scale. Using multiple linear regression models, we found that the Global Assessment of Functioning score was incrementally predictive of the MHRM-20 score, when added to a model including only clinical and demographic factors, and that this model was further incremented by the score for quality of life. However, in an alternate model using the Global Assessment of Functioning score as the dependent variable, while the MHRM-20 score contributed significantly to the model when added to clinical and demographic factors, the model was not incremented by the score for quality of life. These results suggest that, while a more global concept of recovery from SMI may be assessed using measures for service-based and customer-based recovery, the latter, namely the MHRM-20, also provides information about subjective well-being. Pending confirmation of these findings in other populations, this instrument could thus be useful for comprehensive assessment of recovery and subjective well-being in patients suffering from SMI.
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Affiliation(s)
- Albino J Oliveira-Maia
- Champalimaud Clinical Centre, Champalimaud Centre for the UnknownLisboa, Portugal; Champalimaud Research, Champalimaud Centre for the UnknownLisboa, Portugal; Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa OcidentalLisboa, Portugal; Department of Psychiatry and Mental Health, NOVA School of Medicine - Faculdade de Ciências Médicas, Universidade Nova de LisboaLisboa, Portugal
| | - Carina Mendonça
- Department of Psychiatry and Mental Health, Centro Hospitalar Cova da Beira Covilhã, Portugal
| | - Maria J Pessoa
- Department of Psychiatry and Mental Health, Centro Hospitalar Cova da Beira Covilhã, Portugal
| | - Marta Camacho
- Champalimaud Research, Champalimaud Centre for the Unknown Lisboa, Portugal
| | - Joaquim Gago
- Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa OcidentalLisboa, Portugal; Department of Psychiatry and Mental Health, NOVA School of Medicine - Faculdade de Ciências Médicas, Universidade Nova de LisboaLisboa, Portugal
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17
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Roosenschoon BJ, Mulder CL, Deen ML, van Weeghel J. Effectiveness of illness management and recovery (IMR) in the Netherlands: a randomised clinical trial. BMC Psychiatry 2016; 16:73. [PMID: 26995361 PMCID: PMC4799598 DOI: 10.1186/s12888-016-0774-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 03/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Illness Management and Recovery (IMR) is intended to provide a structured psychosocial programme that helps to manage the disabling effects of severe mental illnesses such as schizophrenia and bipolar disorders. It is curriculum based and aims to improve different aspects of illness management and recovery through interventions such as goal-setting, psycho-education, coping and social skills training. Its overall aim is to improve illness outcomes and support subjective and objective recovery. To date there have been four RCTs on IMR; as these yielded mixed results, further research is needed. Our hypotheses aim to test the interrelatedness assumed in Mueser's Conceptual Framework for IMR for the many aspects of illness management, illness management outcomes and recovery. METHODS/DESIGN This randomised multi-centre, single-blinded clinical trial is intended to compare IMR with treatment as usual for 200 outpatient clients with a severe and persistent mental illness (SMI). We will investigate whether IMR leads to better illness management, fewer symptoms and fewer relapses, and also to better subjective and objective recovery. The primary outcome measure is the score on the client version of the Illness Management and Recovery Scale. Secondary outcome measures are the clinician version of the Illness Management and Recovery scale, measures of illness management, coping, symptoms, the number of relapses, and measures of recovery. Measurement will take place before randomisation, and 12 and 18 months after randomisation. DISCUSSION Overall, our study has the following strengths: 1.) our use of an RCT design in a country where the earlier RCTs on IMR were not conducted; 2.) the fact that participants will consist not only of people with a diagnosis of schizophrenia, but also of those with various types of SMI; 3.) our inclusion of 200 participants; and 4.) the fact that we will explore the working mechanisms described in Mueser's Conceptual Framework for IMR. Finally, 5.) because the RCT will be conducted in everyday clinical practice, we believe that the generalisability of our results will be good. TRIAL REGISTRATION The Netherlands National Trial Register (identifier: NTR 5033 ). Date registered: 13 January 2015.
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Affiliation(s)
- Bert-Jan Roosenschoon
- Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus University Medical Centre, 's-Gravendijkwal 230, Rotterdam, CE, 3015, The Netherlands. .,Parnassia Psychiatric Institute The Hague, Kiwistraat 32, Den Haag, 2552 DH, The Netherlands.
| | - Cornelis L. Mulder
- Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus University Medical Centre, ‘s-Gravendijkwal 230, Rotterdam, CE 3015 The Netherlands ,Parnassia Psychiatric Institute, Bavo-Europoort, Prins Constantijnweg 48-54, Rotterdam, 3066 TA The Netherlands
| | - Mathijs L. Deen
- Parnassia Psychiatric Institute The Hague, Kiwistraat 32, Den Haag, 2552 DH The Netherlands ,Faculty of Social and Behavioral Sciences, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - Jaap van Weeghel
- Tilburg School of Social and Behavioral Sciences, Department of TRANZO, Tilburg University, Warandelaan 2, Tilburg, 5037 AB The Netherlands ,Parnassia Psychiatric Institute, Dijk en Duin, Oude Parklaan 125, Castricum, 1901 ZZ The Netherlands
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18
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Beentjes TAA, van Gaal BGI, Goossens PJJ, Schoonhoven L. Development of an e-supported illness management and recovery programme for consumers with severe mental illness using intervention mapping, and design of an early cluster randomized controlled trial. BMC Health Serv Res 2016; 16:20. [PMID: 26782620 PMCID: PMC4717621 DOI: 10.1186/s12913-016-1267-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 03/31/2015] [Accepted: 01/12/2016] [Indexed: 11/13/2022] Open
Abstract
Background E-mental health is a promising medium to keep mental health affordable and accessible. For consumers with severe mental illness the evidence of the effectiveness of e-health is limited. A number of difficulties and barriers have to be addressed concerning e-health for consumers with severe mental illness. One possible solution might be to blend e-health with face-to-face delivery of a recovery-oriented treatment, like the Illness Management & Recovery (IMR) programme. This paper describes the development of an e-health application for the IMR programme and the design of an early clustered randomized controlled trial. Method/Design We developed the e-IMR intervention according to the six-step protocol of Intervention Mapping. Consumers joined the development group to address important and relevant issues for the target group. Decisions during the six-step development process were based on qualitative evaluations of the Illness Management & Recovery programme, structured interviews, discussion in the development group, and literature reviews on qualitative papers concerning consumers with severe mental illness, theoretical models, behavioural change techniques, and telemedicine for consumers with severe mental illness. The aim of the e-IMR intervention is to help consumers with severe mental illness to involve others, manage achieving goals, and prevent relapse. The e-IMR intervention consists of face-to-face delivery of the Illness Management & Recovery programme and an e-health application containing peer-testimonials on videos, follow up on goals and coping strategies, monitoring symptoms, solving problems, and communication opportunities. We designed an early cluster randomized controlled trial that will evaluate the e-IMR intervention. In the control condition the Illness Management & Recovery programme is provided. The main effect-study parameters are: illness management, recovery, psychiatric symptoms severity, self-management, quality of life, and general health. The process of the IMR program will be evaluated on fidelity and feasibility in semi-structured interviews with participants and trainers. Discussion Intervention Mapping provided a systematic procedure for the development of this e-health intervention for consumers with severe mental illness and the preparation of an early randomized controlled trial. Trial Registration The trial is registered in the Dutch Trial Register: NTR4772 .
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Affiliation(s)
- Titus A A Beentjes
- Radboud university medical center, Radboud Institute for Health Sciences, IQ healthcare, Geert Groteplein 21, PO Box 9101, 6500, HB, Nijmegen, The Netherlands. .,Saxion University of Applied Science, School of Health, Deventer, The Netherlands. .,Dimence Group Mental Health Care Centre, Deventer, The Netherlands.
| | - Betsie G I van Gaal
- Radboud university medical center, Radboud Institute for Health Sciences, IQ healthcare, Geert Groteplein 21, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Peter J J Goossens
- Radboud university medical center, Radboud Institute for Health Sciences, IQ healthcare, Geert Groteplein 21, PO Box 9101, 6500, HB, Nijmegen, The Netherlands.,Dimence Group Mental Health Care Centre, Deventer, The Netherlands.,University Centre for Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,GGZ-VS, Institute for Education of Clinical Nurse Specialist in Mental Health, Utrecht, The Netherlands
| | - Lisette Schoonhoven
- Radboud university medical center, Radboud Institute for Health Sciences, IQ healthcare, Geert Groteplein 21, PO Box 9101, 6500, HB, Nijmegen, The Netherlands.,Faculty of Health Sciences, University of Southampton, Southampton, UK
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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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