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de Winter L, Jelsma A, Vermeulen JM, van Weeghel J, Hasson-Ohayon I, Mulder CL, Boonstra N, Veling W, de Haan L. Long-term Changes in Personal Recovery and Quality of Life Among Patients With Schizophrenia Spectrum Disorders and Different Durations of Illness: A Meta-analysis. Schizophr Bull 2024:sbae045. [PMID: 38613256 DOI: 10.1093/schbul/sbae045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
BACKGROUND AND HYPOTHESIS In schizophrenia spectrum disorders (SSD) personal recovery and subjective quality of life (S-QOL) are crucial and show conceptual overlap. There is limited knowledge about how these outcomes change over time. Therefore, we investigated changes in personal recovery or S-QOL for patients with SSD. We specifically focused on the influence of the patients' durations of illness (DOI) on changes in personal recovery and S-QOL. STUDY DESIGN We included 46 studies investigating longitudinal changes in quantitative assessments of personal recovery or S-QOL for patients with SSD. Outcomes were categorized in overall personal recovery, overall S-QOL connectedness, hope and optimism, identity, meaning in life, and empowerment. We evaluated effect sizes of change between baseline and follow-up assessments. We also evaluated potential moderating effects, including DOI on these changes in outcomes. STUDY RESULTS We found small improvements of overall personal recovery and S-QOL, but marginal or no improvement over time in the other more specific outcome domains. Patients without a schizophrenia diagnosis, a younger age, and more recent publications positively influenced these changes. We found no significant influence of DOI on the changes in any outcome domain. CONCLUSIONS Improvement in personal recovery or S-QOL of people with SSD is modest at best. However, these studies did not fully capture the personal narratives or nonlinear process of recovery of an individual. Future research should focus on how to shift from a clinical to more person-oriented approach in clinical practice to support patients in improving their personal process of recovery. REVIEW PROTOCOL REGISTRATION CRD42022377100.
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Affiliation(s)
- Lars de Winter
- Phrenos Center of Expertise, Utrecht, the Netherlands
- Department of Psychiatry, Amsterdam UMC location AMC, Amsterdam, the Netherlands
| | - Auke Jelsma
- Department of Psychiatry, Amsterdam UMC location AMC, Amsterdam, the Netherlands
| | - Jentien M Vermeulen
- Department of Psychiatry, Amsterdam UMC location AMC, Amsterdam, the Netherlands
| | | | | | - Cornelis L Mulder
- Epidemiological and Social Psychiatric Research Institute, Erasmus Medical Center, Rotterdam, the Netherlands
- Parnassia Psychiatric Institute, Rotterdam, the Netherlands
| | - Nynke Boonstra
- NHL Stenden University of Applied Science, Leeuwarden, the Netherlands
- University Medical Center Utrecht, Division Neuroscience, Utrecht, the Netherlands
| | - Wim Veling
- University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC location AMC, Amsterdam, the Netherlands
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Redublo T, Paul S, Joshi A, Arbour S, Murray R, Chiu M. We-Care-Well: exploring the personal recovery of mental health caregivers through Participatory Action Research. Front Public Health 2024; 12:1366144. [PMID: 38638483 PMCID: PMC11024292 DOI: 10.3389/fpubh.2024.1366144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
Family caregivers play a critical role in supporting the recovery journeys of their loved ones, yet the recovery journeys of family caregivers have not been well-explored. Using a Participatory Action Research approach, we explore the personal recovery journeys of family caregivers for individuals with mental illness. This case study involved piloting and exploring the impact of a novel online workshop series offered to mental health caregivers at Ontario Shores Center for Mental Health Sciences. Recovery courses and workshops conventionally engage patients living with mental health conditions. In the current case, the recovery model is adapted to the needs and experiences of their family caregivers, resulting in a pilot workshop series called "We Care Well". Through participant-led discussions, interactive and take-home activities, and experiential learning, caregivers co-created workshop content and engaged in peer-learning on seven personal recovery-oriented topics. This included: self-care, resilience-building, non-violent communication, storytelling, and mental health advocacy. Throughout the sessions, participants implemented their learnings into their caregiving roles, and shared their experiences with the group to progress through their own recovery journeys. The We Care Well series was found to be an effective intervention to adapt and apply the personal recovery framework to mental health caregivers. PAR, and co-design are viable approaches to engage caregivers in mental health research, and can facilitate knowledge exchange, as well as relationship building with peers and program facilitators.
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Affiliation(s)
- Tyler Redublo
- Research & Academics, Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sayani Paul
- Research & Academics, Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
| | - Anahita Joshi
- Research & Academics, Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
| | - Simone Arbour
- Research & Academics, Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
| | - Ross Murray
- Research & Academics, Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
| | - Mary Chiu
- Research & Academics, Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
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Kuramoto A, Saito S, Watanabe K. The Relationships among Internalized Stigma, Sense of Coherence, and Personal Recovery of Persons with Schizophrenia Living in the Community. Acta Med Okayama 2024; 78:171-184. [PMID: 38688835 DOI: 10.18926/amo/66926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
We investigated (i) the relationships among internalized stigma (IS), sense of coherence (SOC), and the personal recovery (PR) of persons with schizophrenia living in the community, and (ii) how to improve the support for these individuals. A questionnaire survey on IS, SOC, and PR was sent by mail to 270 persons with schizophrenia living in the community who were using psychiatric daycare services, of whom 149 responded and 140 were included in the analysis. We established a hypothetical model in which IS influences PR, and SOC influences IS and PR, and we used structural equation modeling to examine the relationships among these concepts. The goodness of fit was acceptable. Our findings suggest that rather than directly promoting PR, SOC promotes PR by mitigating the impact of IS. It is important for nurses/supporters to support individuals with schizophrenia living in the community so that they have opportunities to reflect on their own experiences through their activities and to share their experiences with peers. Nurses/supporters themselves should also reflect on their own support needs. Our findings suggest that this will lead to a reduction of IS and the improvement of SOC, which will in turn promote personal recovery.
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Affiliation(s)
- Aya Kuramoto
- Graduate School of Health Sciences, Okayama University
- School of Nursing, Faculty of Medicine, Kagawa University
| | - Shinya Saito
- Graduate School of Health Sciences, Okayama University
| | - Kumi Watanabe
- School of Nursing, Faculty of Medicine, Kagawa University
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Cugnetto ML, Morris EMJ, Bonfield SF, Gates J, Morrison I, Newman ER, Nicholls JD, Soares LM, Antonucci MT, Clemente JR, Garratt CLM, Goldstone E, Pavone DA, Farhall J. Group Acceptance and Commitment Therapy for Recovery From Psychosis: Protocol for a Single-Group Waitlist Trial. JMIR Res Protoc 2024; 13:e49849. [PMID: 38498035 PMCID: PMC10985603 DOI: 10.2196/49849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/19/2023] [Accepted: 01/09/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Psychological interventions, along with antipsychotic medications, are recommended for adults diagnosed with a psychotic disorder. While initially designed to mitigate positive symptoms, psychological interventions targeting personal recovery were developed and aligned with the recovery framework that many mental health services have adopted. Acceptance and Commitment Therapy (ACT) for psychosis is one such intervention that shows promise when delivered in an individual format. There is preliminary evidence that ACT for psychosis in a group format improves recovery. OBJECTIVE This trial aims to evaluate the effectiveness of the "Recovery ACT" group program on personal recovery among adults living with a psychotic disorder. METHODS Our unfunded study is a multiagency, prospective, nonrandomized, waitlist control, single-group trial of the Recovery ACT group program. The program involves 7 weekly group sessions of 90 minutes duration and a 90-minute booster session held 1 month later. We intend to recruit 160 adults living with a psychotic disorder who enroll in a group that is offered as a routine clinical service at participating public mental health services in Melbourne, Victoria, Australia. The 4 assessment time points are 4-6 weeks before the start of the group program, at the start of the group program, at the end of the group program, and at the booster session. There is an optional midgroup assessment and follow-up study. The primary outcome is personal recovery. Secondary outcomes include participants' well-being and psychological flexibility processes. Qualitative data are also collected from participants and facilitators. RESULTS Recruitment began in September 2019 and is ongoing until 2024, subsequent to a 24-month disruption due to the COVID-19 pandemic. As of the submission of this paper, 93 participants consented to the evaluation, 65 completed T1 measures, and 40 had a complete data set for the proposed analyses. CONCLUSIONS This is the first trial evaluating the effectiveness of the Recovery ACT group program on personal recovery for adults living with a psychotic disorder. Findings will contribute to knowledge about psychosocial interventions for adults living with psychosis. This trial may also serve as an example of a partnership between clinicians and academics that can facilitate the translation of research into practice. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12620000223932; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000223932. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49849.
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Affiliation(s)
- Marilyn L Cugnetto
- Mental Health Division, Northern Health, Epping, Victoria, Australia
- Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Eric M J Morris
- Mental Health Division, Northern Health, Epping, Victoria, Australia
- Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia
| | | | - Jesse Gates
- Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | | | - Ellie R Newman
- Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia
- Peninsula Health Mental Health Service, Frankston, Victoria, Australia
- Alfred Mental and Addiction Health, Melbourne, Victoria, Australia
| | - Julia D Nicholls
- Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia
- Alfred Mental and Addiction Health, Melbourne, Victoria, Australia
| | - Lisa M Soares
- NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | | | | | | | - Eliot Goldstone
- NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - David A Pavone
- Mental Health Division, Northern Health, Epping, Victoria, Australia
| | - John Farhall
- Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia
- NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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Bifarin O, Collier-Sewell F, Smith G, Moriarty J, Shephard H, Andrews L, Pearson S, Kasperska M. Standards of proficiency for registered nurses-To what end? A critical analysis of contemporary mental health nursing within the United Kingdom context. Nurs Inq 2024:e12630. [PMID: 38436620 DOI: 10.1111/nin.12630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Abstract
Against the backdrop of cultural and political ideals, this article highlights both the significance of mental health nursing in meeting population needs and the regulatory barriers that may be impeding its ability to adequately do so. Specifically, we consider how ambiguous notions of 'proficiency' in nurse education-prescribed by the regulator-impact the development of future mental health nurses and their mental health nursing identity. A key tension in mental health practice is the ethical-legal challenges posed by sanctioned powers to restrict patients' freedom at the same time as the desire (and obligation) to promote patients' self-determined recovery. The genericism of the UK's Future Nurse Standards do little to prepare mental health nurses to navigate the tensions that ensue. This has consequences for nurses and patients alike, as both risk experiencing the distress and dissonance that attends giving or receiving poor care. We argue that more needs to be done to enable mental health nurses to define and articulate the nuances of the profession as part of becoming critical, thoughtful and confident practitioners. Educators can contribute to this mission by aligning curriculum, pedagogy and assessment to create meaningful opportunities for mental health nursing students to engage with the complexities of mental health nursing practice. Without this, the credibility of the profession will continue to be questioned; its future uncertain.
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Affiliation(s)
- Oladayo Bifarin
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
- Research & Innovation, Mersey Care NHS FT, Liverpool, UK
| | - Freya Collier-Sewell
- Centre for Culture, Media and Society, Sheffield Hallam University, Sheffield, UK
| | - Grahame Smith
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
| | - Jo Moriarty
- NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London, London, UK
| | | | - Lauren Andrews
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
| | - Sam Pearson
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
| | - Mari Kasperska
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
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Simonsen C, Åsbø G, Slade M, Wold KF, Widing L, Flaaten CB, Engen MJ, Lyngstad SH, Gardsjord E, Bjella T, Romm KL, Ueland T, Melle I. A good life with psychosis: rate of positive outcomes in first-episode psychosis at 10-year follow-up. Psychol Med 2024:1-10. [PMID: 38389456 DOI: 10.1017/s0033291724000205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
BACKGROUND More knowledge about positive outcomes for people with first-episode psychosis (FEP) is needed. An FEP 10-year follow-up study investigated the rate of personal recovery, emotional wellbeing, and clinical recovery in the total sample and between psychotic bipolar spectrum disorders (BD) and schizophrenia spectrum disorders (SZ); and how these positive outcomes overlap. METHODS FEP participants (n = 128) were re-assessed with structured clinical interviews at 10-year follow-up. Personal recovery was self-rated with the Questionnaire about the Process of Recovery-15-item scale (total score ⩾45). Emotional wellbeing was self-rated with the Life Satisfaction Scale (score ⩾5) and the Temporal Experience of Pleasure Scale (total score ⩾72). Clinical recovery was clinician-rated symptom-remission and adequate functioning (duration minimum 1 year). RESULTS In FEP, rates of personal recovery (50.8%), life satisfaction (60.9%), and pleasure (57.5%) were higher than clinical recovery (33.6%). Despite lower rates of clinical recovery in SZ compared to BD, they had equal rates of personal recovery and emotional wellbeing. Personal recovery overlapped more with emotional wellbeing than with clinical recovery (χ2). Each participant was assigned to one of eight possible outcome groups depending on the combination of positive outcomes fulfilled. The eight groups collapsed into three equal-sized main outcome groups: 33.6% clinical recovery with personal recovery and/or emotional wellbeing; 34.4% personal recovery and/or emotional wellbeing only; and 32.0% none. CONCLUSIONS In FEP, 68% had minimum one positive outcome after 10 years, suggesting a good life with psychosis. This knowledge must be shared to instill hope and underlines that subjective and objective positive outcomes must be assessed and targeted in treatment.
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Affiliation(s)
- Carmen Simonsen
- Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Gina Åsbø
- Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham NG7 2TU, UK
- Faculty of Nursing and Health Sciences, Health and Community Participation Division, Nord University, 7801 Namsos, Norway
| | - Kristin Fjelnseth Wold
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Line Widing
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Camilla Bärthel Flaaten
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Magnus Johan Engen
- Nydalen DPS, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Siv Hege Lyngstad
- Nydalen DPS, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Erlend Gardsjord
- Section for Treatment of Early Psychosis, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Thomas Bjella
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristin Lie Romm
- Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torill Ueland
- Department of Psychology, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Ferrara M, Zaffarami G, Simonelli G, Domenicano I, Vecchioni L, Toffanin T, Folesani F, Zotos S, Scrignoli C, Bertelli R, Carozza P, Grassi L. Dimensions and predictors of clinical and personal recovery in first-episode psychoses: Results from a cross-sectional study. Early Interv Psychiatry 2024. [PMID: 38318707 DOI: 10.1111/eip.13513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/18/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
INTRODUCTION First episode psychosis (FEP) services ensure higher recovery rates compared to usual care. The aim of this study was to investigate the different dimensions of recovery and its predictors. METHODS This cross-sectional study recruited within those admitted to the Ferrara FEP service since 2012 that at the time of analysis were still receiving psychiatric care. At admission, demographic, social and clinical information were collected. In September 2022, patients were assessed with the Health of the Nation Outcome Scale to evaluate clinical/functional recovery, the Recovery Assessment Scale to evaluate personal recovery, and the G12 item of the Positive and Negative Syndrome Scale to evaluate insight. Patients in recovery were compared to those not in recovery by bivariate analyses. Adjusted logistic regressions were performed to investigate predictors of recovery. RESULTS Within 141 admitted, and 105 still receiving care, 54 patients completed the assessment. Most (51.9%) were in clinical/functional, 61.1% in personal recovery, and 38.8% both. Psychiatric hospitalization positively predicted clinical/functional recovery, whereas being prescribed oral antipsychotics was a negative predictor. Personal recovery was predicted by male sex and showed a negative association with overall severity of symptomatology. Those in personal recovery were more likely to have been prescribed long-acting antipsychotics, but this was not significant in the multivariable analysis. Poor insight negatively predicted clinical/functional recovery but had no impact on personal recovery. CONCLUSION Our findings confirm that clinical/functional and personal recovery are semi-independent dimensions and not always overlap. Further research is needed to promote interventions targeted at all recovery dimensions.
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Affiliation(s)
- Maria Ferrara
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Giulia Zaffarami
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Gabriele Simonelli
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Ilaria Domenicano
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Ludovica Vecchioni
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Tommaso Toffanin
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Federica Folesani
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Spyridon Zotos
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Chiara Scrignoli
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Raffaella Bertelli
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Paola Carozza
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Luigi Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
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Jupille J, Harscoet YA, Duval M, Grall-Bronnec M, Moret L, Chirio-Espitalier M. "What makes you well?" Supports of well-being in bipolar disorder. A qualitative study. Int J Qual Stud Health Well-being 2023; 18:2244763. [PMID: 37660342 PMCID: PMC10478622 DOI: 10.1080/17482631.2023.2244763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
OBJECTIVE Subjective experience of people living with bipolar disorder is gaining attention in the field of research. Improving well-being could be as important as symptom remission, but this constitutes a vague concept. This study aimed at exploring the boundaries and the determinants of the well-being of people living with bipolar disorder in a French context. METHODS Individual semi-structured interviews were conducted with 16 patients by three professionals. Interviews were transcribed and analysed using the thematic analysis method. RESULTS Various dimensions emerged as contributing to well-being: daily routines, connectedness, regaining a positive identity, and self-awareness for self-management. CONCLUSIONS In addition to those common to the general population, this study highlighted specific determinants of well-being: the construction of a positive identity through acceptance of the diagnosis, the importance of self-awareness and self-management. They are highly intertwined with those of personal recovery and could help caregivers design interventions that directly target these goals. This study aimed to identify specific components of well-being for people living with bipolar disorder. Understanding the determinants of well-being enable caregivers to design tailored interventions that directly target quality of life and help improve bipolar disorder outcomes.
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Affiliation(s)
- Julien Jupille
- CRehab’S, Support Center for Psychosocial Rehabilitation in the Loire Region, Nantes University Hospital and Angevin Mental Health Center, Sainte Gemmes sur Loire, France
| | | | - Mélanie Duval
- Nantes Université, CHU Nantes, UIC Psychiatrie Et Santé Mentale, Nantes, France
| | - Marie Grall-Bronnec
- Nantes Université, CHU Nantes, UIC Psychiatrie Et Santé Mentale, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
| | - Leila Moret
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
- University Hospital Centre Nantes Department of Medical Information Evaluation and Public Health, Nantes, Pays de la Loire, France
| | - Marion Chirio-Espitalier
- Nantes Université, CHU Nantes, UIC Psychiatrie Et Santé Mentale, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
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Kraiss JT, Ten Klooster PM, Chrispijn M, Stevens A, Doornbos B, Kupka RW, Bohlmeijer ET. A multicomponent positive psychology intervention for euthymic patients with bipolar disorder to improve mental well-being and personal recovery: A pragmatic randomized controlled trial. Bipolar Disord 2023; 25:683-695. [PMID: 36856065 DOI: 10.1111/bdi.13313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVE Mental well-being and personal recovery are important treatment targets for patients with bipolar disorder (BD). The goal of this study was to evaluate the effectiveness of an 8-week group multicomponent positive psychology intervention (PPI) for euthymic patients with BD as an adjunct to treatment as usual (TAU) compared to TAU alone. METHODS Patients with BD were randomized to receive TAU (n = 43) or the PPI in addition to TAU (n = 54). The primary outcome was well being measured with the Mental Health Continuum-Short Form. Personal recovery was measured with the Questionnaire about the Process of Recovery. Data were collected at baseline, mid-treatment, post-treatment and 6- and 12-month follow-up. Life chart interviews were conducted at 12 months to retrospectively assess recurrence of depression and mania. RESULTS Significant group-by-time interaction effects for well-being and personal recovery were found favouring the PPI. At post-treatment, between-group differences were significant for well-being (d = 0.77) and personal recovery (d = 0.76). Between-group effects for well-being were still significant at 6-month follow-up (d = 0.72). Effects on well-being and personal recovery within the intervention group were sustained until 12-month follow-up. Survival analyses showed no significant differences in time to recurrence. CONCLUSIONS The multicomponent PPI evaluated in this study is effective in improving mental well-being and personal recovery in euthymic patients with BD and would therefore be a valuable addition to the current treatment of euthymic BD patients. The fact that the study was carried out in a pragmatic RCT demonstrates that this intervention can be applied in a real-world clinical setting.
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Affiliation(s)
- Jannis T Kraiss
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Peter M Ten Klooster
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | | | - Anja Stevens
- Centre for Bipolar Disorders, Dimence Mental Health, Deventer, The Netherlands
| | - Bennard Doornbos
- Department of Specialized Training, Psychiatric Hospital Mental Health Services Drenthe, Outpatient Clinics, Assen, The Netherlands
- Lentis Research, Lentis Psychiatric Institute, Groningen, The Netherlands
| | - Ralph W Kupka
- VU University Medical Center, Department of Psychiatry, Amsterdam Public Health research center, Amsterdam, The Netherlands
| | - Ernst T Bohlmeijer
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
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Huang LT, Liu YL, Pao CH, Chang YH, Chu RY, Hsu HM, Wei DR, Yang CY. The association of social support and hope with self-stigma and perceived recovery among people with schizophrenia: The serial mediation effect. J Adv Nurs 2023. [PMID: 38018027 DOI: 10.1111/jan.15980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/26/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND It is essential to assist individuals with a mental illness who have achieved clinical recovery in their personal recovery. Understanding the relationship between self-stigma and social support and the effects on perceived recovery can be valuable for clinical professionals in helping patients lead meaningful lives. AIM To examine the serial mediating roles of social support and perceived hope in self-stigma and the effects on perceived recovery. DESIGN A cross-sectional study. METHODS The study was conducted from September 2019 to June 2020. One hundred and fifty-seven patients with schizophrenia in seven chronic rehabilitation wards were enrolled. Each patient had a Positive and Negative Syndrome Scale score ≤ 60 points, and they regularly participated in occupational rehabilitation. Research tools included demographic data, the Internalized Stigma of Mental Illness Scale (ISMIS), Multidimensional Scale of Perceived Social Support (MSPSS), Herth Hope Index (HHI), and Perceived Recovery Inventory (PRI). IBM SPSS 24.0 was used to analyse the data. Pearson correlation was used to analyse the relationships between variables, and models 4 and 6 of PROCESS macro V3.4 for SPSS were used to examine the mediation model. RESULTS The results indicated that self-stigma and perceived recovery in patients with schizophrenia are negatively correlated, that peer support and perceived hope mediate the relationship between them, and that peer support and perceived hope also have a statistically significant serial mediating effect. CONCLUSION The serial mediation effect of peer support and perceived hope on the relationship between self-stigma and perceived recovery was statistically significant in this study. IMPACT This research delves into strategies to assist psychiatric patients in reducing self-stigma and achieving recovery. The findings underscore the heightened significance of peer support for patients in rehabilitative wards and offer valuable insights for medical staff. REPORTING METHOD STROBE checklist. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Li Ting Huang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya Ling Liu
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Che Hao Pao
- Yuanshan and Suao Branch, Taipei Veterans General Hospital, Yilan, Taiwan
| | - Yu Ho Chang
- Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Ru Ying Chu
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hui Min Hsu
- Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Dia Ru Wei
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Chiu Yueh Yang
- College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Versace J, Tazrin S, O'Connor E, Sekibo J, Morey E, Kasinopoulou A, O'Donoghue D, Simblett SK. The role of spirituality and identity formation in personal recovery from traumatic brain injury: A qualitative analysis through the personal experiences of survivors. Neuropsychol Rehabil 2023:1-31. [PMID: 38006578 DOI: 10.1080/09602011.2023.2274624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/04/2023] [Indexed: 11/27/2023]
Abstract
Traumatic brain injury (TBI) is a type of acquired brain injury (ABI) that happens when a sudden, external, physical assault damages the brain. TBI can cause long-term cognitive impairments and other lifestyle changes that may affect psychological wellbeing. Among the psychological challenges people recovering from TBI often face is the subjective loss of their pre-injury identity. Quantitative and qualitative research suggests that spirituality can play a positive role in recovery from TBI, increasing the quality of life and overall mental health. However, thus far, the research into this topic has not directly addressed the relationship between identity and spirituality after TBI. The present study sought to do this by thematically analyzing 22 public podcasts featuring interviews of people recovering from TBI telling their stories. The authors review the spiritual themes discussed in the podcasts and then propose a hypothesis about how, through a sense of connection to something self-transcendent, spirituality may enable people to test new meanings and identities, relatively free from the consequences of discrepancy in meaning and identity after TBI.
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Affiliation(s)
- J Versace
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S Tazrin
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - E O'Connor
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J Sekibo
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - E Morey
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A Kasinopoulou
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - D O'Donoghue
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S K Simblett
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Brasso C, Bellino S, Bozzatello P, Montemagni C, Nobili MGA, Sgro R, Rocca P. Second Generation Long-Acting Injectable Antipsychotics in Schizophrenia: The Patient's Subjective Quality of Life, Well-Being, and Satisfaction. J Clin Med 2023; 12:6985. [PMID: 38002600 PMCID: PMC10672596 DOI: 10.3390/jcm12226985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Schizophrenia (SZ) is among the twenty most disabling diseases worldwide. Subjective quality of life, well-being, and satisfaction are core elements to achieving personal recovery from the disorder. Long-acting injectable second-generation antipsychotics (SGA-LAIs) represent a valid therapeutic option for the treatment of SZ as they guarantee good efficacy and adherence to treatment. The aim of this rapid review is to summarize the evidence on the efficacy of SGA-LAIs in improving subjective quality of life, well-being, and satisfaction. The PubMed database was searched for original studies using SGA, LAI, risperidone, paliperidone, aripiprazole, olanzapine, SZ, and psychosis as keywords. Twenty-one studies were included: 13 clinical trials, 7 observational studies, and 1 post hoc analysis. It has been shown that SGA-LAIs bring an improvement to specific domains of subjective and self-rated quality of life, well-being, or satisfaction in prospective observational studies without a control arm and in randomized controlled trials versus placebo. The superiority of SGA-LAIs as compared with oral equivalents and haloperidol-LAI has been reported by some randomized controlled and observational studies. Although promising, the evidence is still limited because of the lack of studies and several methodological issues concerning the choice of the sample, the evaluation of the outcome variables, and the study design. New methodologically sound studies are needed.
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Affiliation(s)
- Claudio Brasso
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, Via Cherasco, 13, 10126 Turin, Italy; (S.B.); (P.B.); (C.M.); (M.G.A.N.); (R.S.); (P.R.)
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13
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Jagfeld G, Lobban F, Humphreys C, Rayson P, Jones SH. How People With a Bipolar Disorder Diagnosis Talk About Personal Recovery in Peer Online Support Forums: Corpus Framework Analysis Using the POETIC Framework. JMIR Med Inform 2023; 11:e46544. [PMID: 37962520 PMCID: PMC10662676 DOI: 10.2196/46544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 11/15/2023] Open
Abstract
Background Personal recovery is of particular value in bipolar disorder, where symptoms often persist despite treatment. We previously defined the POETIC (Purpose and Meaning, Optimism and Hope, Empowerment, Tensions, Identity, Connectedness) framework for personal recovery in bipolar disorder. So far, personal recovery has only been studied in researcher-constructed environments (eg, interviews and focus groups). Support forum posts can serve as a complementary naturalistic data resource to understand the lived experience of personal recovery. Objective This study aimed to answer the question "What can online support forum posts reveal about the experience of personal recovery in bipolar disorder in relation to the POETIC framework?" Methods By integrating natural language processing, corpus linguistics, and health research methods, this study analyzed public, bipolar disorder support forum posts relevant to the lived experience of personal recovery. By comparing 4462 personal recovery-relevant posts by 1982 users to 25,197 posts not relevant to personal recovery, we identified 130 significantly overused key lemmas. Key lemmas were coded according to the POETIC framework. Results Personal recovery-related discussions primarily focused on 3 domains: "Purpose and meaning" (particularly reproductive decisions and work), "Connectedness" (romantic relationships and social support), and "Empowerment" (self-management and personal responsibility). This study confirmed the validity of the POETIC framework to capture personal recovery experiences shared on the web and highlighted new aspects beyond previous studies using interviews and focus groups. Conclusions This study is the first to analyze naturalistic data on personal recovery in bipolar disorder. By indicating the key areas that people focus on in personal recovery when posting freely and the language they use, this study provides helpful starting points for formal and informal carers to understand the concerns of people diagnosed with a bipolar disorder and to consider how to best offer support.
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Affiliation(s)
- Glorianna Jagfeld
- Division of Health Research, Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, United Kingdom
- UCREL Research Centre, School of Computing and Communications, Lancaster University, Lancaster, United Kingdom
| | - Fiona Lobban
- Division of Health Research, Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, United Kingdom
| | - Chloe Humphreys
- Faculty of Arts and Social Sciences, Department of Linguistics and English Language, Lancaster University, Lancaster, United Kingdom
| | - Paul Rayson
- UCREL Research Centre, School of Computing and Communications, Lancaster University, Lancaster, United Kingdom
| | - Steven Huntley Jones
- Division of Health Research, Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, United Kingdom
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van Sambeek N, Franssen G, van Geelen S, Scheepers F. Making meaning of trauma in psychosis. Front Psychiatry 2023; 14:1272683. [PMID: 38025479 PMCID: PMC10656619 DOI: 10.3389/fpsyt.2023.1272683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background Finding new meaning and identity in the aftermath of trauma has been identified as a key process of mental health recovery. However, research indicates that this meaning-making process is compromised in people with psychosis. Considering the high prevalence, yet under-treatment of trauma in people with psychosis, it is urgent to gain insight into how their meaning-making process can be supported. Aim To gain insight into how people with psychosis make meaning of trauma and identify barriers and facilitators in their meaning-making process. Methods Qualitative inquiry of N = 21 interviews transcripts from the Dutch Psychiatry Storybank. We included interviews of people who (a) lived through multiple psychotic episodes, and (b) spontaneously addressed traumatic experiences in a low-structured interview. Storyline analysis was performed to gain insight into the meaning-making of trauma within their self-stories. Psychosocial conceptualizations of narrative identity were used to inform the analysis. A data-validation session with four experts-by-experience was organized to check and improve the quality of our analysis. Results We identified four different story types: (1) Psychiatry as the wrong setting to find meaning; (2) The ongoing struggle to get trauma-therapy; (3) Exposure to trauma as a threat to a stable life, and (4) Disclosure as the key to resolving alienation. Each story type comprises a different plot, meaning of trauma withing the self-story, (lack of) integration and barriers and facilitators in the meaning-making process. Overall, barriers in the meaning-making process were mostly situated within mental healthcare and stigma-related. People felt particularly hindered by pessimistic ideas on their capacity to develop self-insight and cope with distress, resulting in limited treatment options. Their process of adaptive meaning-making often started with supportive, non-judgmental relationships with individuals or communities that offered them the safety to disclose trauma and motivated them to engage in a process of self-inquiry and growth. Conclusion The outcomes illuminate the social context of the meaning-making challenges that people with psychosis face and illustrate the devastating influence of stigma. Our outcomes offer guidance to remove barriers to adaptive meaning-making in people with psychosis, and can help clinicians to attune to differences in the meaning-making of trauma.
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Affiliation(s)
- Nienke van Sambeek
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Gaston Franssen
- Faculty of Humanities, University of Amsterdam, Amsterdam, Netherlands
| | | | - Floortje Scheepers
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
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Ohtake F, Noguchi-Watanabe M, Morita K. The Process of Home-Visiting Nurses Supporting People with Mental Disorders. Int J Environ Res Public Health 2023; 20:6965. [PMID: 37947523 PMCID: PMC10650724 DOI: 10.3390/ijerph20216965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/11/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023]
Abstract
The number of people with mental disorders (PMD) living in the community is increasing; however, it is unclear how home-visiting nurses (HVNs) supporting them in the community acquire their support skills. This study aimed to reveal the process of how HVNs learn support skills for PMD. Semi-structured interviews were conducted with 14 HVNs supporting PMD living in the community. The grounded theory approach was used for data analysis. As a result, two stages were present: "Explore the personal recovery of PMD" and "Believe in the potential of PMD and accompanying them". The first stage is further divided into two themes: "Overlapping the worlds of PMD and HVNs", and "Easing difficulty in living for PMD". In the first stage, HVNs gained a better understanding of PMD and obtained insight into the support they needed in their daily lives. In the second stage, HVNs became to provide the support that PMD truly needed. HVNs gained a deeper understanding of the reality of PMD through their support. After HVNs found the support PMD required, they sought to provide it, ultimately resulting in finding ways to facilitate the personal recovery of PMD.
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Affiliation(s)
- Fumi Ohtake
- Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (M.N.-W.); (K.M.)
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Dubreucq M, Thiollier M, Tebeka S, Fourneret P, Leboyer M, Viaux-Savelon S, Massoubre C, Dupont C, Dubreucq J. Toward recovery-oriented perinatal healthcare: A participatory qualitative exploration of persons with lived experience and health providers' views and experiences. Eur Psychiatry 2023; 66:e86. [PMID: 37860880 DOI: 10.1192/j.eurpsy.2023.2464] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Perinatal mental health disorders (PMHD) remain often undetected, undiagnosed, and untreated with variable access to perinatal mental health care (PMHC). To guide the design of optimal PMHC (i.e., coproduced with persons with lived experience [PLEs]), this qualitative participatory study explored the experiences, views, and expectations of PLEs, obstetric providers (OP), childcare health providers (CHPs), and mental health providers (MHPs) on PMHC and the care of perinatal depression. METHODS We conducted nine focus groups and 24 individual interviews between December 2020 and May 2022 for a total number of 84 participants (24 PLEs; 30 OPs; 11 CHPs; and 19 MHPs). The PLEs group included women with serious mental illness (SMI) or autistic women who had contact with perinatal health services. We recruited PLEs through social media and a center for psychiatric rehabilitation, and health providers (HPs) through perinatal health networks. We used the inductive six-step process by Braun and Clarke for the thematic analysis. RESULTS We found some degree of difference in the identified priorities between PLEs (e.g., personal recovery, person-centered care) and HPs (e.g., common culture, communication between providers, and risk management). Personal recovery in PMHD corresponded to the CHIME framework, that is, connectedness, hope, identity, meaning, and empowerment. Recovery-supporting relations and peer support contributed to personal recovery. Other factors included changes in the socio-cultural conception of the peripartum, challenging stigma (e.g., integrating PMH into standard perinatal healthcare), and service integration. DISCUSSION This analysis generated novel insights into how to improve PMHC for all users including those with SMI or autism.
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Affiliation(s)
- Marine Dubreucq
- Centre Referent de Rehabilitation Psychosociale, GCSMS REHACOOR 42, Saint-Étienne, France
- INSERM U1290, Research on Healthcare Performance (RESHAPE), University Lyon 1, Lyon, France
| | | | - Sarah Tebeka
- Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neurosciences, Team 1, Paris, France
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
| | - Pierre Fourneret
- Department of Psychopathology of Child and Adolescent Development, Hospices Civils de Lyon, Lyon, France
- Marc Jeannerod Institute of Cognitive Sciences UMR 5229, CNRS & Claude Bernard University, Lyon, France
| | - Marion Leboyer
- Fondation Fondamental, Créteil, France
- Université Paris Est Créteil, INSERM U955, IMRB, Translational NeuroPsychiatry, Créteil, France
- AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
| | - Sylvie Viaux-Savelon
- Marc Jeannerod Institute of Cognitive Sciences UMR 5229, CNRS & Claude Bernard University, Lyon, France
- Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Catherine Massoubre
- University Hospital of Saint-Étienne & EA 7423, Troubles du Comportement Alimentaire, Addictions et Poids Extrêmes (TAPE), Université Jean Monnet, Saint-Etienne, France
| | - Corinne Dupont
- University Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE) INSERM U1290 & AURORE Perinatal Network, Hospices Civils de Lyon, Croix-Rousse Hospital, Lyon, France
| | - Julien Dubreucq
- Marc Jeannerod Institute of Cognitive Sciences UMR 5229, CNRS & Claude Bernard University, Lyon, France
- Department of Child and Adolescent Psychiatry, University Hospital of Saint-Étienne, Saint-Etienne, France
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Raffin Bouchal DS, Ferguson AL, Green T, McAusland L, Kiss Z, Ramasubbu R. Personal recovery associated with deep brain stimulation for treatment-resistant depression: A constructivist grounded theory study. J Psychiatr Ment Health Nurs 2023; 30:1005-1018. [PMID: 37002931 DOI: 10.1111/jpm.12923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 02/07/2023] [Accepted: 02/28/2023] [Indexed: 06/19/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Major depressive disorder is the most prevalent of all mental illnesses. 10%-20% of patients with depression and 1% of the population overall have treatment-resistant depression (TRD). DBS is an emerging investigational treatment for TRD with documented clinical efficacy and safety. The framework of the recovery model includes both clinical and personal recovery. Personal recovery is a self-process in which hope, empowerment and optimism are embraced to overcome the impact of mental illness on one's sense of self. Although clinical and functional outcomes of DBS for TRD have been well documented in the previous studies, personal recovery as an outcome has been explored only in a handful of studies. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first qualitative study exploring personal recovery from DBS treatment specific to the target of subcallosal cingulate cortex in patients with TRD. Since the existing literature on personal recovery in DBS studies is limited, the contribution of this paper is crucial to this field. For individuals who responded to deep brain stimulation clinically, neither participants nor family believed it cured their depression, but rather there was a significant decrease in the severity of symptoms of depression. A holistic-oriented framework (that includes personal recovery) is significant for those individuals with TRD undergoing DBS. Personal and clinical recovery are two different constructs, and individuals may experience one or the other or both. The experience of participants who responded to deep brain stimulation recognized that the recovery from depression is a process of reconstructing self. This process involved a period of adjustment that evoked a deeper self-awareness, re-engagement with daily living and newfound gratitude in living. Individuals transitioned from an emotionally driven life to one where future goals were considered. Supportive relationships were instrumental in this process. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: A deep brain stimulation intervention for treatment-resistant depression offered individuals an opportunity for personal recovery where a reconstruction of self occurred. Personal recovery can be considered as an outcome in conjunction with clinical and functional outcomes in future DBS trials for TRD. The relevance of personal recovery in the prevention of relapses needs further investigation. To advocate for care and services that facilitate the process of recovery from depression, it is important to understand the personal dimensions and experience of recovery that may influence the process. To develop recovery-oriented interventions to help patients and families in recovery post-deep brain stimulation, further understanding of support and negotiating relationships during this life-altering experience is needed. ABSTRACT: Introduction Multiple trials of antidepressant treatments in patients with depression pose a major challenge to the mental health system. Deep brain stimulation (DBS) is an emerging and promising investigational treatment to reduce depressive symptoms in individuals with treatment-resistant depression (TRD). The clinical and functional outcomes of DBS for TRD have been well documented in previous studies; however, studies of personal recovery as an outcome of DBS specific to the target of subcallosal cingulate cortex in patients with TRD are limited. Aim To explore the processes of personal recovery in patients with treatment-resistant depression following subcallosal cingulate-deep brain stimulation. Method Participants were 18 patients with TRD who participated in the subcallosal cingulate (SCC)-DBS trial and 11 family members. They also participated in add-on individual cognitive behavioural therapy during the trial. A qualitative constructivist grounded theory approach was used to conceptualize the personal recovery process of patients and families. Results While every participant and their families' journey were unique following the deep brain stimulation intervention, a theoretical model of Balancing to Establish a Reconstructed Self emerged from the data. The themes underlying the model were (1) Balancing to Establish a Reconstructed Self: A Whole-Body Experience, (2) The Liminal Space in-between: Balancing with Cautious Optimism, (3) Hope: Transitioning from Emotion-Focussed Living to Goal-Oriented Planning and (4) Support: Negotiating Relationships. Discussion This is the first study examining recovery from patients' perspectives as an outcome of SCC-DBS intervention for TRD. The study shows that personal recovery is a gradual and continual process of reconstruction of the self, developing through supportive relationships. Clinical and personal recovery are two distinct constructs, and individuals may experience one or the other or both. Most patients who do respond clinically experience improvement in terms of having optimism and hope. Some patients, however, respond with significant symptom reduction but are not able to achieve personal recovery to experience joy or hope for improved quality of living. Implications for Practice Strategies for personal recovery for both patients and family need to be considered during and post deep brain stimulation intervention. Nurses working with these patients and families may benefit from education, training and support to assess and engage in conversations about their recovery process.
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Affiliation(s)
- Donna S Raffin Bouchal
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, T2N 1N4, Alberta, Canada
| | - Angela L Ferguson
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, T2N 1N4, Alberta, Canada
| | - Theresa Green
- Faculty of Health & Behavioural Sciences, School of Nursing, Midwifery & Social Work, University of Queensland, St Lucia, 4072, Queensland, Australia
| | - Laina McAusland
- Department of Psychiatry and Clinical Neurosciences and Hotchkiss Brain Institute, Mathison Centre for Mental Health Research and Education, Cumming School of Medicine, University of Calgary, TRW 4D64, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Alberta, Canada
| | - Zelma Kiss
- Department of Psychiatry and Clinical Neurosciences and Hotchkiss Brain Institute, Mathison Centre for Mental Health Research and Education, Cumming School of Medicine, University of Calgary, TRW 4D64, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Alberta, Canada
| | - Rajamannar Ramasubbu
- Department of Psychiatry and Clinical Neurosciences and Hotchkiss Brain Institute, Mathison Centre for Mental Health Research and Education, Cumming School of Medicine, University of Calgary, TRW 4D64, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Alberta, Canada
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Cano-Prieto I, Prat-Vigué G, Vilanova-Masana R, Guillaume-Cornet A, Giralt Palou R, Lana-Francos G, Simó-Algado S. MOSAIC, an example of comprehensive and integrated social and health care: care and practices oriented towards personal recovery. Front Health Serv 2023; 3:1174594. [PMID: 37600925 PMCID: PMC10437109 DOI: 10.3389/frhs.2023.1174594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023]
Abstract
Background The Mosaic project is a socio-health integration model that promotes the personal recovery of people with severe mental illness in a territory of Central Catalonia: the Bages region. The recovery approach in mental health care promotes meaningful activities and social inclusion for people with mental health disorders. The aim of this study is to examine the relationship between the level of meaningful activities and other factors associated with the mental health recovery model. Methods A cross-sectional design was used. Participants (n = 59) signed an informed consent and completed the following standardized instruments: Engagement in Meaningful Activities Survey; The Connor-Davidson Resilience Scale; Hert Hope Scale; and Recovery Assessment Scale. Results A Pearson correlation test was performed between the level of meaningful activities and life satisfaction, resilience, hope, and recovery. These data indicate that the amount of meaningful activities are strongly associated with variables related to the personal recovery process from mental health problems. Conclusions The integration process of MOSAIC confirms the need to accompany the recovery processes through significant occupations.
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Affiliation(s)
- Ivan Cano-Prieto
- Grup de Recerca en Innovació en Salut Mental i Benestar Emocional (ISaMBeS), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), Vic, Spain
| | - Gemma Prat-Vigué
- Grup de Recerca en Innovació en Salut Mental i Benestar Emocional (ISaMBeS), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), Vic, Spain
- Divisió de Salut Mental, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Spain
- Facultat de Medicina. Universitat de Vic-Central de Catalunya (UVIC-UCC), Vic, Spain
| | - Rut Vilanova-Masana
- Divisió de Salut Mental, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Spain
| | - Aida Guillaume-Cornet
- Divisió de Salut Mental, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Spain
| | - Rosa Giralt Palou
- Divisió de Salut Mental, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Spain
| | - Gemma Lana-Francos
- Divisió de Salut Mental, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Spain
| | - Salvador Simó-Algado
- Grup de Recerca en Innovació en Salut Mental i Benestar Emocional (ISaMBeS), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IRIS-CC), Vic, Spain
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Moeller SB, Gondan M, Austin SF, Slade M, Simonsen S. National norms of mental health for Denmark. Nord J Psychiatry 2023; 77:617-623. [PMID: 37129238 DOI: 10.1080/08039488.2023.2202637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 03/01/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
INTRODUCTION To facilitate interpretation and clinical utility of patient-reported outcomes, normative data provide a reference for a person's score on a particular outcome in relation to the general population. This study reports Danish general population norms for four mental health indicators, assessing social functioning (Sheehan Disability Scale, SDS) personal recovery (Brief INSPIRE-O), symptom burden (Symptom Check List-10, SCL-10) and subjective well-being (WHO-5). METHODS The study was a cross-sectional survey study organized by the State's statistical authority among the general population of adult Danish residents in Denmark, ranging in age between 18 to 79 years. RESULTS A total of 8003 citizens were contacted including reminders from 2 March 2019 to 11 April 2019 by electronic letters, resulting in 2819 (35%) citizens providing complete responses. Female gender, higher age, Danish origin and living with a partner were associated with increased participation, and decreased participation was observed in male immigrants. We found a mean score of subjective well-being slightly lower than the population norm typically found in Danish general population studies. Elderly persons, Danes, and persons living with a partner reported better subjective mental health. Subjective well-being and personal recovery were positively correlated with social contacts and self-reported general health rating, and negatively correlated with social functioning and symptoms of depression and anxiety. CONCLUSION This normative data provides a reference for interpreting mental health status. Our findings indicate slightly poorer subjective mental health than previously found. There is a need for special attention to engaging male immigrants in studies on mental health in the general population.
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Affiliation(s)
- Stine Bjerrum Moeller
- Psychotherapy Research Unit, Mental Health Centre Stolpegaard, Capital Region Psychiatry, Denmark
- Southern Denmark Psychiatry, Department of Trauma and Torture survivors, Odense, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | | | - Stephen F Austin
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Psychiatric Research Unit, Psychiatry Region Zealand, Denmark
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, UK
- Nord University, Namsos, Norway
| | - Sebastian Simonsen
- Psychotherapy Research Unit, Mental Health Centre Stolpegaard, Capital Region Psychiatry, Denmark
- Department of Psychology, University of Copenhagen, Denmark
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Smit D, Miguel C, Vrijsen JN, Groeneweg B, Spijker J, Cuijpers P. The effectiveness of peer support for individuals with mental illness: systematic review and meta-analysis. Psychol Med 2023; 53:5332-5341. [PMID: 36066104 PMCID: PMC10476060 DOI: 10.1017/s0033291722002422] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/05/2022] [Accepted: 07/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The benefits of peer support interventions (PSIs) for individuals with mental illness are not well known. The aim of this systematic review and meta-analysis was to assess the effectiveness of PSIs for individuals with mental illness for clinical, personal, and functional recovery outcomes. METHODS Searches were conducted in PubMed, Embase, and PsycINFO (December 18, 2020). Included were randomized controlled trials (RCTs) comparing peer-delivered PSIs to control conditions. The quality of records was assessed using the Cochrane Collaboration Risk of Bias tool. Data were pooled for each outcome, using random-effects models. RESULTS After screening 3455 records, 30 RCTs were included in the systematic review and 28 were meta-analyzed (4152 individuals). Compared to control conditions, peer support was associated with small but significant post-test effect sizes for clinical recovery, g = 0.19, 95% CI (0.11-0.27), I2 = 10%, 95% CI (0-44), and personal recovery, g = 0.15, 95% CI (0.04-0.27), I2 = 43%, 95% CI (1-67), but not for functional recovery, g = 0.08, 95% CI (-0.02 to 0.18), I2 = 36%, 95% CI (0-61). Our findings should be considered with caution due to the modest quality of the included studies. CONCLUSIONS PSIs may be effective for the clinical and personal recovery of mental illness. Effects are modest, though consistent, suggesting potential efficacy for PSI across a wide range of mental disorders and intervention types.
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Affiliation(s)
- Dorien Smit
- Pro Persona Mental Health Care, Pro Persona Research, Depression Expertise Center, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Clara Miguel
- Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Janna N. Vrijsen
- Pro Persona Mental Health Care, Pro Persona Research, Depression Expertise Center, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bart Groeneweg
- Dutch Depression (Patient) Association, Amersfoort, The Netherlands
| | - Jan Spijker
- Pro Persona Mental Health Care, Pro Persona Research, Depression Expertise Center, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Concerto C, Rodolico A, Mineo L, Ciancio A, Marano L, Romano CB, Scavo EV, Spigarelli R, Fusar-Poli L, Furnari R, Petralia A, Signorelli MS. Exploring Personal Recovery in Schizophrenia: The Role of Mentalization. J Clin Med 2023; 12:4090. [PMID: 37373783 DOI: 10.3390/jcm12124090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Recovery is a broadly debated concept in the field of psychiatry research and in schizophrenia. Our study aims to understand the correlation between personal recovery from schizophrenia and factors such as mentalization, disability, quality of life, and antipsychotic side effects; Methods: Participants with schizophrenia (according to DSM-5 criteria) were consecutively recruited from the Psychiatry Unit of the University of Catania, Italy. Participants were assessed with the Recovery Assessment Scale (RAS), the Multidimensional Mentalizing Questionnaire (MMQ), the brief version of the WHO Disability Assessment Schedule (WHO-DAS), the EuroQoL-5 dimensions-5 levels, the Insight Orientation Scale (IOS) and the Glasgow Antipsychotic Side Effect Scale (GASS); Results: 81 patients were included. Our findings showed a positive correlation between RAS total scores and MMQ scores, especially in "good mentalizing" subdomains. IOS scores also had a positive association with RAS and MMQ scores. In contrast, poor mentalizing abilities negatively correlated with WHO-DAS 2.0 scores. While antipsychotic side effects influenced functioning, they did not impact perceived recovery. Conclusions: The study's results identified potential predictors of personal recovery from schizophrenia. These findings could contribute to creating tailored interventions to facilitate the recovery process.
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Affiliation(s)
- Carmen Concerto
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Alessandro Rodolico
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Ludovico Mineo
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Alessia Ciancio
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Leonardo Marano
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Carla Benedicta Romano
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Elisa Vita Scavo
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Riccardo Spigarelli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Laura Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
| | - Rosaria Furnari
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Antonino Petralia
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Maria Salvina Signorelli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
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22
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Kunita K, Morimoto T, Kotake R, Sato-Nakamura S, Nakamura-Kukuminato N. Effect of combining motivational interviewing with cognitive remediation on personal recovery in patients with schizophrenia. Hong Kong J Occup Ther 2023; 36:20-30. [PMID: 37332296 PMCID: PMC10273794 DOI: 10.1177/15691861231167504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 03/18/2023] [Indexed: 09/20/2023] Open
Abstract
Background/objective We have been practising the Neuropsychological and Educational Approach to Remediation (NEAR) as cognitive remediation (CR) in a psychiatric hospital and have implemented it in combination with regular interviews based on Motivational Interviewing (MI) approximately 2 years after launching NEAR. In this study, we investigated whether combining MI with CR affected completion of the programme, cognitive functions, global functioning, and personal recovery of patients with schizophrenia by analysing medical records. Methods In this retrospective observational study, 14 participants were assigned to the NEAR group and 12 participants were assigned to the NEAR + MI group. Fifteen participants in the NEAR group (n = 6) and NEAR + MI group (n = 9) completed the programme. First, the difference in the completion rate between the groups was examined using the chi-squared test. Second, measures of cognitive functions, global functioning, and personal recovery pre-and post-intervention were examined using the Wilcoxon signed-rank tests for those in each group who completed the programme. Third, therapeutic responses for each group were compared using the Mann-Whitney U tests. Results There were no statistically significant differences in completion rates between the groups. In the NEAR group, verbal memory and overall cognition improved after the intervention. On the other hand, not only cognitive functions but also global functioning and personal recovery improved in the NEAR + MI group. Moreover, changes in global functioning and personal recovery were significantly higher in the NEAR + MI group. Conclusion Study findings indicated that combining MI with CR improves cognitive functions, global functioning, and personal recovery in patients with schizophrenia.
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Affiliation(s)
- Koji Kunita
- Department of Rehabilitation, Hayashishita Hospital, Sapporo, Japan
- Forensic Psychiatry Center, Hokkaido University Hospital, Sapporo, Japan
| | - Takafumi Morimoto
- Department of Rehabilitation, Hayashishita Hospital, Sapporo, Japan
- Department of Occupational Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Reiko Kotake
- Department of Rehabilitation, Hayashishita Hospital, Sapporo, Japan
- Hokudai-dori Mental Health Clinic, Sapporo, Japan
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23
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Kehoe M, Fossey E, Edan V, Chaffey L, Brophy L, Weller PJ, Shawyer F, Meadows G. Consumer Views and Experiences of Secondary-Care Services Following REFOCUS-PULSAR Staff Recovery-Oriented Practices Training. Int J Environ Res Public Health 2023; 20:ijerph20105894. [PMID: 37239620 DOI: 10.3390/ijerph20105894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND The use of recovery-oriented practice (ROP) can be challenging to implement in mental health services. This qualitative sub-study of the Principles Unite Local Services Assisting Recovery (PULSAR) project explored how consumers perceive their recovery following community mental health staff undertaking specific ROP training. METHODS Using a qualitative participatory methodology, 21 consumers (aged 18-63 years) participated in one-on-one interviews. A thematic analysis was applied. RESULTS Four main themes were extracted: (1) connection, (2) supportive relationships, (3) a better life, and (4) barriers. Connections to community and professional staff were important to support consumers in their recovery journey. Many consumers were seeking and striving towards a better life that was personal and individual to each of them, and how they made meaning around the idea of a better life. Barriers to recovery primarily focused on a lack of choice. A minor theme of 'uncertainty' suggested that consumers struggled to identify what their recovered future might entail. CONCLUSION Despite staff undertaking the ROP training, all participants struggled to identify language and aspects of recovery in their interaction with the service, suggesting a need for staff to promote open, collaborative conversations around recovery. A specifically targeted recovery resource might facilitate such conversation.
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Affiliation(s)
- Michelle Kehoe
- Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Peninsula Campus Building G, 47-49 Moorooduc Hwy, Frankston, VIC 3199, Australia
- Alfred Health, Adult Mental and Addiction Health, 55 Commercial Road, Melbourne, VIC 3004, Australia
| | - Ellie Fossey
- Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Peninsula Campus Building G, 47-49 Moorooduc Hwy, Frankston, VIC 3199, Australia
| | - Vrinda Edan
- Centre for Mental Health Nursing, Department of Nursing, School of Health Sciences, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Lisa Chaffey
- Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Peninsula Campus Building G, 47-49 Moorooduc Hwy, Frankston, VIC 3199, Australia
| | - Lisa Brophy
- Social Work and Social Policy, Department of Community and Clinical Health School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
- The Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
| | | | - Frances Shawyer
- Southern Synergy, Monash Health, Dandenong, VIC 3175, Australia
| | - Graham Meadows
- The Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
- Southern Synergy, Monash Health, Dandenong, VIC 3175, Australia
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC 3168, Australia
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia
- School of Primary and Allied Health Care, Monash University, Melbourne, VIC 3168, Australia
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24
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Tari-Keresztes N, Armstrong N, Smith JA, Gupta H, Goding S, Endemann SA. "You Don't Get That from Professionals": A Consumer-Led Peer Recovery Program for Families and Friends of Individuals with Alcohol and Other Drugs Use Issues in Darwin. Int J Environ Res Public Health 2023; 20:ijerph20085514. [PMID: 37107795 PMCID: PMC10138685 DOI: 10.3390/ijerph20085514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 05/11/2023]
Abstract
While there has been a reduction in alcohol consumption among Australians aged 18 years and above, about 25% of people still drink above the recommended limit. The use of alcohol and other drugs is a substantial issue in the Northern Territory; however, there have been significant investments in alcohol reforms over the past few years. This paper reports on a pilot study that involved co-designing, implementing, and evaluating the Circles of Support consumer-led recovery and empowerment program for families and friends of individuals with alcohol and other drugs use issues. The evaluation comprised a mixed-methods approach; however, this article only presents the qualitative component (n = 7). Interview data were thematically analysed, and four main themes were identified: (1) the value of a peer-to-peer approach; (2) facing challenges and distress; (3) adopting self-care strategies; and (4) the development of valuable skills. Participants enjoyed the program content and learning. This involved self-care and communication strategies, boundary setting, service navigation, the concept of post-traumatic growth, the circles of control, and the stages of change model for families. Our findings strongly support the scaling up of the program in Darwin and other locations across the Northern Territory and future program adaptation for different vulnerable target audiences.
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Affiliation(s)
- Noemi Tari-Keresztes
- Rural and Remote Health, College of Medicine & Public Health, Flinders University, Casuarina, NT 0815, Australia
- Correspondence:
| | - Noelene Armstrong
- Northern Territory Lived Experience Network, Darwin, NT 0820, Australia
| | - James A. Smith
- Rural and Remote Health, College of Medicine & Public Health, Flinders University, Casuarina, NT 0815, Australia
| | - Himanshu Gupta
- Rural and Remote Health, College of Medicine & Public Health, Flinders University, Casuarina, NT 0815, Australia
| | - Sam Goding
- Northern Territory Lived Experience Network, Darwin, NT 0820, Australia
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25
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Eklund M, Lund K, Argentzell E. The impact of the BEL intervention on levels of motivation, engagement and recovery in people who attend community mental health services. Scand J Occup Ther 2023. [PMID: 36867590 DOI: 10.1080/11038128.2023.2184717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
BACKGROUND Community-based day centres (DC) in Sweden provide support to people with severe mental health problems. The role of DC motivation for outcomes in terms of occupational engagement and personal recovery is yet unknown. AIMS To compare two groups who received DC services, one of which also received the 16-week Balancing Everyday Life (BEL) intervention. The focus was motivation for DC services at baseline and after 16 weeks of services, while also investigating the importance of DC motivation for the selected outcomes and service satisfaction. MATERIAL AND METHODS Sixty-five DC attendees were randomised to BEL (n = 27) or standard support (n = 38) and responded to questionnaires about motivation, the selected outcomes and satisfaction with DC services. RESULTS The groups did not differ on any measured aspects of motivation; nor were changes seen over time. The BEL group, but not those receiving standard support, improved from baseline to 16 weeks on occupational engagement and recovery. Motivation for attending the DC was related to service satisfaction. CONCLUSION The BEL program could be a viable enrichment tool in the DC context and boost occupational engagement and personal recovery among the attendees. SIGNIFICANCE The study provided knowledge of importance when developing community-based services while enhancing motivation.
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Affiliation(s)
- Mona Eklund
- Department of Health Sciences, the Mental Health, Activity and Participation (MAP) Group, Lund University, Lund, Sweden
| | - Kristine Lund
- Department of Health Sciences, the Mental Health, Activity and Participation (MAP) Group, Lund University, Lund, Sweden
| | - Elisabeth Argentzell
- Department of Health Sciences, the Mental Health, Activity and Participation (MAP) Group, Lund University, Lund, Sweden
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Kuek JHL, Raeburn T, Liang AG, Wand T. Mental health professionals' perspectives regarding how recovery is conceptualized in Singapore: a constructivist grounded theory study. J Ment Health 2023. [PMID: 36866589 DOI: 10.1080/09638237.2023.2182431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
BACKGROUND Mental health recovery has shifted from clinical conceptualizations to more personal ones. However, much of the lived experience literature has focused on people living with mental health conditions, and less attention has been placed on various mental health professionals, especially in Asian countries, where the personal recovery literature base is in its nascent stage. AIM We sought to contribute to a growing body of work by exploring recovery from the lens of different mental health professionals in Singapore. METHODS Mental health professionals in Singapore were invited to participate in an online interview through social media. The recordings were transcribed verbatim and analyzed using a constructive grounded theory approach. RESULTS Nineteen participants were interviewed. A single core category, "living in society once more", and three categories, "An ongoing process", "Regaining ability to function in society", and "A normality report card" were identified from our data. CONCLUSIONS Recovery within the Singapore mental health professional perspective focuses on helping individuals return to society and function productively while considering existing societal norms such as the highly competitive and pragmatic culture in Singapore. Future research can explore in greater depth the impact of these factors on the recovery process.
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Affiliation(s)
- Jonathan Han Loong Kuek
- Susan Wakil School of Nursing and Midwifery
- Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Toby Raeburn
- Faculty of Nursing and Midwifery, Health Sciences & Physiotherapy, The University of Notre Dame, Australia
| | | | - Timothy Wand
- Susan Wakil School of Nursing and Midwifery
- Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Australia
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Abstract
Despite its seeming breadth and diversity, the bulk of the personal (mental health) recovery literature has remained strangely 'silent' about the impact of various socio-structural inequalities on the recovery process. Such an inadequacy of the empirical literature is not without consequences since the systematic omission or downplaying, at best, of the socio-structural conditions of living for persons with lived experience of mental health difficulties may inadvertently reinforce a reductionist view of recovery as an atomised, individualised phenomenon. Motivated by those limitations in extant scholarship, a critical literature review was conducted to identify and critique relevant research to problematise the notion of personal recovery in the context of socio-structural disadvantage such as poverty, homelessness, discrimination and inequalities. The review illuminates the scarcity of empirical research and the paucity of sociologically-informed theorisation regarding how recovery is shaped by the socio-structural conditions of living. Those inadequacies are especially pertinent to homelessness research, whereby empirical investigations of personal recovery have remained few and undertheorised. The gaps in the research and theorising about the relational, contextual and socio-structural embeddedness of recovery are distilled. The critical review concludes that personal recovery has remained underresearched, underproblematised and undertheorised, especially in the context of homelessness and other forms of socio-structural disadvantage. Understanding how exclusionary social arrangements affect individuals' recovery, and the coping strategies that they deploy to negotiate those, is likely to inform anti-oppressive interventions that could eventually remove the structural constraints to human emancipation and flourishing.
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Affiliation(s)
- Dimitar Karadzhov
- Dimitar Karadzhov, Centre for
Health Policy, University of Strathclyde, 16 Richmond Street, Glasgow,
G1 1XQ, UK.
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Sánchez-Guarnido AJ, Ruiz-Granados MI, Herruzo-Cabrera J, Herruzo-Pino C. The Effectiveness of Day Hospitals in the Personal Recovery of Mental Disorder Patients during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:413. [PMID: 36766988 PMCID: PMC9913925 DOI: 10.3390/healthcare11030413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/24/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND In recent years, a new recovery model has gained ground in which recovery is understood as a process of change where individuals are able to improve their health and wellbeing, lead self-sufficient lives and strive to achieve their maximum potential (personal recovery). Despite the existence of data regarding the effectiveness of mental health day hospitals (MHDHs) in reducing relapses in terms of hospital admissions and emergencies, no studies have to date assessed how this change affected the new personal recovery model. OBJECTIVES To verify the effectiveness of MHDHs in improving personal recovery processes among people with mental disorders (MDs). METHODS A prospective cohort study. A group of patients receiving follow-up at MHDHs was compared with another group of patients receiving follow-up in other therapeutic units over a period of three months. RESULTS Patient recovery at the MHDHs, assessed using the Individual Recovery Outcomes Counter (I.ROC), was found to be significantly better than that of patients attended in other units. CONCLUSIONS MHDHs can contribute to the recovery of people with MDs. This is particularly important at a time when some patients may have experienced impediments to their recovery processes due to the pandemic.
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Affiliation(s)
| | | | | | - Carlos Herruzo-Pino
- Facultad de Ciencias de la Educación, Universidad de Córdoba, 14071 Córdoba, Spain
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29
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He L, Petrakis M. Spiritual Diversity in Personal Recovery from Mental Health Challenges: A Qualitative Study from Chinese-Australian Service Users' Perspectives. Int J Environ Res Public Health 2023; 20:2210. [PMID: 36767577 PMCID: PMC9915160 DOI: 10.3390/ijerph20032210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/20/2023] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
Spiritual diversity and the positive role of spirituality in personal recovery have received growing attention in mental health literature. However, the spiritual experiences and views of service users from cultural communities, particularly the Chinese community, are understudied in Australia. This research explores Chinese service users' spiritual identities and their views and perspectives on the roles of spirituality in their mental health recovery and attempts to provide inspiration for practitioners to engage with service users' spirituality in non-clinical mental health practice. A qualitative exploratory approach guided this study. Semi-structured interviews were employed with four Chinese participants with spiritual identities, who were recruited through the community Psychosocial Support Service in Victoria. The template analysis method supported the data analysis. The results indicate that spirituality has a positive impact on the mental health recovery of participants, primarily through coping, self-regulatory, and social support mechanisms. The findings also present that Chinese service users' understanding and approaches to spirituality are shaped by both original and Australian Cultures. These findings suggest that practitioners should provide a creative understanding and cultural awareness when discussing with service users their spiritual identities, perspectives, and spirituality in the wider context. The research fills a gap in the spiritual views and perspectives of service users accessing a non-clinical mental health service from the Chinese community.
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Affiliation(s)
- Ling He
- Psychosocial Support Service, Wellways Australia, Melbourne, VIC 3132, Australia
- Department of Social Work, Monash University, Melbourne, VIC 3145, Australia
| | - Melissa Petrakis
- Department of Social Work, Monash University, Melbourne, VIC 3145, Australia
- Mental Health Service, St. Vincent’s Hospital Melbourne, Melbourne, VIC 3065, Australia
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30
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Israel P, Ruud T, Weimand B. Carer involvement in the assessment of personal recovery: A naturalistic study of assertive community treatment in Norway. Front Psychiatry 2023; 14:1135135. [PMID: 37051169 PMCID: PMC10083239 DOI: 10.3389/fpsyt.2023.1135135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 02/22/2023] [Indexed: 04/14/2023] Open
Abstract
Background The user and carer movements have come a long way in becoming embedded in mainstream mental health services for individuals with serious mental illness. However, implementing recovery-oriented practice continues to be plagued by an individualistic clinical focus. The carers do not feel integrated despite policies and best intentions. The implementation of Assertive Community Treatment (ACT) provided an opportunity to involve the carers and compare their assessment of personal recovery with the users. Aims The aims of this study were to examine (i) how family carers and users differed in their assessment of personal recovery, (ii) whether familial and personal relationships influenced how carers assess personal recovery of users, and (iii) if the experience of family carers with the ACT team was associated with personal recovery. Methods The naturalistic, explorative study recruited 69 users and 36 family carers from 12 Norwegian ACT teams. The users and carers assessed the user's personal recovery. Family carers also reported their experience and satisfaction with the ACT teams. Analyses included independent and paired sample T-tests and correlation analysis. Results Family carers were significantly more conservative than the users' assessment of the intrapsychic and interpersonal subscales of personal recovery. The pattern held true whether the family carers were matched to the users or part of the total sample. Lastly, there was a significant negative correlation between the family carer's experience of cooperation with the ACT team and their assessment of the user's intrapersonal process of recovery. Conclusions The results of our study were consistent with previous research on carer involvement in MHS. However, it is the first study that engaged carers and assessed personal recovery of the users of ACT services. Discrepancy between carers and users is the rule. Clinicians are encouraged to embrace the discrepancy and diversity carers bring and learn the methodology of multi-informant assessments. There also is a need to address, update, and integrate the personal, familial, and relational aspects of recovery. Modification of recovery measures such as QPR and their creative use with carers has the potential to generate valuable third-party information and to involve them meaningfully in mental health services.
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Affiliation(s)
- Pravin Israel
- Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
- *Correspondence: Pravin Israel
| | - Torleif Ruud
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health, Department of Special Psychiatry, Akershus University Hospital, Lørenskog, Norway
| | - Bente Weimand
- Division of Mental Health, Department of Special Psychiatry, Akershus University Hospital, Lørenskog, Norway
- Department of Health, Social, and Welfare Studies, University of South-Eastern Norway, Kongsberg, Norway
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Granholm Valmari E, Melander M, Hariz GM, Naesström M, Lindström M. Translation and linguistic validation of the Swedish recovering quality of life (ReQoL) - A brief research report. Front Psychiatry 2023; 14:1059406. [PMID: 36824668 PMCID: PMC9941141 DOI: 10.3389/fpsyt.2023.1059406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/18/2023] [Indexed: 02/10/2023] Open
Abstract
In research and among clinicians, the focus has shifted from mainly symptom reduction and increasing functionality to a more recovery-oriented focus. Although there are instruments measuring recovery, there has been a lack of instruments sensitive enough to measure the quality of life for people with severe mental health disorders. Therefore, this study aimed to obtain a Swedish version of the Recovering Quality of Life (ReQoL) questionnaire adhering to best practice guidelines using various steps of translation, linguistic validation, and cognitive debriefing. The cognitive debriefing was conducted with seven participants, and all felt the items in the questionnaire were relevant to their health, apprehensible, and easy to complete. However, some issues were raised regarding wording and the concepts behind certain items. All feedback was considered, and some items were revised in response to criticism after continuous discussions. A Swedish version of ReQoL now exists, and although there is a need for ReQoL in different clinical research settings in Sweden, further research is required to psychometrically test the construct validity as well as reliability of the Swedish version in Sweden.
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Affiliation(s)
- Elin Granholm Valmari
- Occupational Therapy Unit, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Marianne Melander
- Psychiatric Unit, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Gun-Marie Hariz
- Occupational Therapy Unit, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.,Department of Clinical Science, Neurosciences, Umeå University, Umeå, Sweden
| | - Matilda Naesström
- Psychiatric Unit, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Maria Lindström
- Occupational Therapy Unit, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
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Dallinger VC, Krishnamoorthy G, du Plessis C, Pillai-Sasidharan A, Ayres A, Waters L, Groom Y, Alston O, Anderson L, Burton L. Utilisation of Digital Applications for Personal Recovery Amongst Youth with Mental Health Concerns. Int J Environ Res Public Health 2022; 19:16818. [PMID: 36554700 PMCID: PMC9779003 DOI: 10.3390/ijerph192416818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
There is an increasing population of youths that report mental health issues. Research has shown that youths are reluctant to seek help for various reasons. A majority of those who do seek help are using digital mental health supports. Subsequently, efforts to promote youth mental health have focused on the use of digital applications as a means of overcoming barriers related to factors including stigma and lack of available services. The worldwide move toward recovery-oriented care led to emerging research on personal recovery amongst youths with mental health concerns. This study sought to address the need for recovery-oriented digital resources for youths. It utilised a qualitative design methodology to develop a rich interpretation of how youths are using digital interventions to support their mental health recovery journey. It sought to understand how existing digital applications are useful for youth recovery and identified characteristics associated with recovery and engagement. The content analysis generated five categories that represent facilitators of youth recovery and the thematic analysis identified key elements of digital applications that support youth recovery. The results offer complimentary support and guidance for recovery-oriented care and the use of digital mental health interventions in the promotion of personal recovery amongst youths.
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Affiliation(s)
- Vicki C. Dallinger
- School of Psychology and Wellbeing, University of Southern Queensland (UniSQ), Darling Heights, QLD 4350, Australia
| | - Govind Krishnamoorthy
- School of Psychology and Wellbeing, University of Southern Queensland (UniSQ), Darling Heights, QLD 4350, Australia
| | - Carol du Plessis
- School of Psychology and Wellbeing, University of Southern Queensland (UniSQ), Darling Heights, QLD 4350, Australia
| | - Arun Pillai-Sasidharan
- Child and Youth Mental Health, Children’s Health Queensland, Queensland Health, Queensland Government, Brisbane, QLD 4000, Australia
| | - Alice Ayres
- Child and Youth Mental Health, Children’s Health Queensland, Queensland Health, Queensland Government, Brisbane, QLD 4000, Australia
| | - Lillian Waters
- Child and Youth Mental Health, Children’s Health Queensland, Queensland Health, Queensland Government, Brisbane, QLD 4000, Australia
| | - Yasmin Groom
- Child and Youth Mental Health, Children’s Health Queensland, Queensland Health, Queensland Government, Brisbane, QLD 4000, Australia
| | - Olivia Alston
- School of Psychology and Wellbeing, University of Southern Queensland (UniSQ), Darling Heights, QLD 4350, Australia
| | - Linda Anderson
- School of Psychology and Wellbeing, University of Southern Queensland (UniSQ), Darling Heights, QLD 4350, Australia
| | - Lorelle Burton
- School of Psychology and Wellbeing, University of Southern Queensland (UniSQ), Darling Heights, QLD 4350, Australia
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McLeod B, Meyer C, Meyer D, Nunan C, Murray G, Farhall J, Thomas N. Do recovery-oriented messages improve self-efficacy and positive emotions amongst people with lived experience of psychosis? Experimental investigation. Psychol Psychother 2022; 95:1003-1017. [PMID: 35906746 PMCID: PMC9796912 DOI: 10.1111/papt.12415] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/25/2022] [Accepted: 06/29/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Recovery-oriented perspectives have become accepted worldwide as an alternative to the biomedical approach to conceptualizing and managing severe mental health problems. It has been proposed that one advantage of this is to support self-efficacy amongst people with a lived experience of psychosis, especially when recovery messages are presented by lived experience peers. The aim of the present study was to investigate the proposed psychological benefits of the recovery paradigm, by testing for possible differential impacts of recovery versus biomedical messages on self-efficacy beliefs and positive emotional state amongst people with experience of psychosis. It was hypothesized that (1) recovery-oriented messages, when presented by lived experience peers, would generate improvements in self-efficacy and positive emotions relative to biomedical messages presented by a professional and (2) recovery-oriented messages delivered by a professional would generate improvements in self-efficacy and positive emotions relative to biomedical messages delivered by a professional. We also explored whether recovery-oriented messages were more impactful when delivered by a lived experience peer versus a professional. DESIGN Experimental design with three within-subject video-based conditions. METHODS Fifty-three participants with lived experience of psychosis viewed three videos: (i) people with lived experience sharing their experiences of recovery; (ii) mental health professionals presenting traditional biomedical conceptualizations of psychosis; and (iii) mental health professionals presenting recovery perspectives. Participants provided baseline clinical and demographic information, and post-viewing ratings of experienced changes in self-efficacy and emotional state. RESULTS Hypothesis 1 was supported: both self-efficacy and positive emotions were significantly increased by a video of peers sharing personal recovery stories relative to professionals presenting biomedical messages. Hypothesis 2 was partially supported: when comparing videos of recovery versus biomedical messages delivered by professionals, significant relative benefits were found for positive emotions, but not self-efficacy. CONCLUSIONS This experimental investigation generated a pattern of findings broadly supportive of the assumed psychological benefits of the recovery paradigm for people with lived experiences of psychosis. Findings must be interpreted with caution given the limitations of the present design, but encourage further experimental research to directly test the interpersonal impacts of the recovery paradigm.
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Affiliation(s)
- Bronte McLeod
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Catherine Meyer
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Denny Meyer
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Cassy Nunan
- Wellways AustraliaMelbourneVictoriaAustralia
| | - Greg Murray
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - John Farhall
- La Trobe UniversityMelbourneVictoriaAustralia,NorthWestern Mental HealthMelbourneVictoriaAustralia
| | - Neil Thomas
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia,Alfred HospitalMelbourneVictoriaAustralia
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Chao PY, Hsieh WL, Yeh ST, Hsieh CJ, Liu CY, Liu WI. Factors associated with personal recovery among psychiatric nursing home residents. J Psychiatr Ment Health Nurs 2022; 29:852-860. [PMID: 34957650 DOI: 10.1111/jpm.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/29/2021] [Accepted: 12/17/2021] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: Poor recovery will cause harm to the quality of life and well-being of residents and that the scope of influence includes the self, family and society. No study to date has investigated empowerment and the other multiple factors associated with personal recovery among psychiatric nursing home residents. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The factors associated with personal recovery are empowerment, social support and global functioning. This pioneer study contributes new evidence that personal recovery is mainly predicted by empowerment, social support and global function, with empowerment exhibiting the highest predictive value. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Strengthening empowerment in mental health nursing may contribute more to the personal recovery of psychiatric nursing home residents than improving global function or social support. Mental health professionals should shift to empowerment-oriented care to improve individuals' personal recovery, such as offering more opportunities to achieve autonomy, encouraging individuals' involvement in decision-making and promoting individuals' motivation for achieving their goals. ABSTRACT: Introduction Individuals diagnosed with mental illness have a need for recovery. No study to date has investigated empowerment and the other multiple factors associated with personal recovery among psychiatric nursing home residents. Aim The study aimed to identify the factors associated with personal recovery among psychiatric nursing home residents. Methods This was a cross-sectional study with convenience sampling. Participants were recruited from a psychiatric nursing home in Northern Taiwan between April and June 2018. Data were collected through self-reported, structured questionnaires with verified reliability and validity. Descriptive and hierarchical regression analyses were performed. The present study followed the STROBE guidelines. Results The study included 158 participants. The factors associated with recovery according to bivariate associations were religious belief, psychotic symptoms, global function, social support and empowerment. In the hierarchical regression, empowerment, social support and global function were the main predictive factors of recovery, with the explained variation reaching 40.8%. Empowerment exhibited the highest predictive value for the recovery. Implications for clinical practice Strengthening empowerment in mental health nursing may contribute more to the personal recovery of psychiatric nursing home residents than improving global function or social support.
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Affiliation(s)
- Pei-Yi Chao
- Department of nursing, Bali Psychiatric Center, New Taipei City, Taiwan
| | - Wen Ling Hsieh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Shin Ting Yeh
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
| | - Chia Jung Hsieh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
| | - Chieh-Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
| | - Wen-I Liu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
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Sokol Y, Levin C, Linzer M, Rosensweig C, Hubner S, Gromatsky M, Walsh S, Dixon L, Goodman M. Theoretical model of recovery following a suicidal episode (COURAGE): scoping review and narrative synthesis. BJPsych Open 2022; 8:e200. [PMID: 36384945 PMCID: PMC9707512 DOI: 10.1192/bjo.2022.599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite a significant need, there are currently no rigorously developed empirically based models for what personal recovery from a suicidal episode looks like. AIMS To develop a theoretical model of personal recovery after a suicidal episode, based on a comprehensive literature review and stakeholder feedback. METHOD A scoping review of all empirical studies on this topic was conducted, followed by a thematic analysis to create a preliminary framework. Consultation-based revisions were then made based on feedback from a stakeholder panel to develop the final theoretical model. RESULTS The final model comprised seven themes: choosing life, optimising identity, understanding oneself, rediscovering meaning, acceptance, growing connectedness and empowerment (acronym 'COURAGE'). Although there are some similarities between COURAGE and other models of personal recovery, there are components, such as 'choosing life' and 'understanding oneself', that are specific to recovery after an acute suicidal episode. CONCLUSIONS To our knowledge, this is the first study to use a comprehensive literature review with stakeholder feedback to develop a conceptual model of personal recovery after an acute suicidal episode. This model has important implications for both researchers and clinicians to consider. Looking ahead, COURAGE can inform the reconceptualisation of assessment, research and clinical care of individuals who have experienced a suicidal episode.
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Affiliation(s)
- Yosef Sokol
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Psychology, School of Health Sciences, Touro University, New York, New York, USA; and VISN 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, New York, New York, USA
| | - Chynna Levin
- VISN 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, New York, New York, USA; and Teacher's College, Columbia University, New York, New York, USA
| | - Mairav Linzer
- VISN 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, New York, New York, USA; and School of Health Professions and Nursing, Long Island University, New York, New York, USA
| | - Chayim Rosensweig
- VISN 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, New York, New York, USA; and Ferkauf Graduate School of Psychology, Yeshiva University, New York, New York, USA
| | - Shifra Hubner
- VISN 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, New York, New York, USA; and School of Health Sciences, Touro College, New York, New York, USA
| | - Molly Gromatsky
- VISN 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, New York, New York, USA; and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Samantha Walsh
- Levy Library, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lisa Dixon
- New York State Psychiatric Institute, New York, New York, USA; Vagelos College of Physicians and Surgeons, Columbia University/New York-Presbyterian, New York, New York, USA
| | - Marianne Goodman
- VISN 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, New York, New York, USA; and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Ibrahim N, Newby C, Thomas N, Slade M. Measuring recovery in Arabic countries: Translation of the self-efficacy for personal recovery scale. Int J Soc Psychiatry 2022; 68:1428-1434. [PMID: 34176354 DOI: 10.1177/00207640211028604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM To translate the Self-Efficacy for Personal Recovery Scale (SEPRS) into Arabic and evaluate the psychometric properties of the Arabic version. METHODS An established translation methodology was employed, involving back-translation, comparison, forward-translation, comparison, and piloting. The pre-final version of the Arabic translated scale was tested for clarity with young people with a primary diagnosis of mental health problem. The final Arabic version and standardized measures of hope and loneliness were administered to 119 young people in two rounds. RESULTS Internal consistency was adequate (Cronbach's alpha = 0.87 in round 1, 0.91 in round 2). Consistent with the English version, a one-factor solution best fitted the data. The correlation between SEPRS and hope was R = 0.60 (round 1) and R = 0.61 (round 2), indicating convergent validity. The correlation between SEPRS and loneliness was R = -0.52 (round 1) and R = -0.60 (round 2). Correlation between test and retest was R = -0.998 indicated adequate test-retest reliability. Minimal floor and ceiling effects were detected. CONCLUSION The use of the Arabic SEPRS with Arabic-speaking samples is supported. Further research to investigate divergent validity is warranted.
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Affiliation(s)
- Nashwa Ibrahim
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | | | - Neil Thomas
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
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Austin SF, Hjorthøj C, Baagland H, Simonsen E, Dam J. Investigating personal and clinical recovery processes in people with first episode psychosis. Early Interv Psychiatry 2022; 16:1102-1111. [PMID: 34825487 DOI: 10.1111/eip.13258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 10/04/2021] [Accepted: 11/07/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Schizophrenia is a serious mental illness characterized by a range of symptoms such as distortions in reality, emotional abnormalities and deficits in cognition. Recovery from severe mental illness can be conceptualized in a number of ways. Clinical recovery has a focus on symptoms and functioning whilst personal recovery describes the process of developing new meaning and purpose in life beyond mental illness. OBJECTIVE This longitudinal study examined the relationship between clinical and personal recovery processes within a group of people with first episode psychosis (FEP) receiving early intervention treatment over a period of up to 2 years. METHODS The study sequentially recruited people with FEP that accepted into early intervention treatment. Participants were evaluated at baseline, 12 months and completion of treatment for clinical and personal recovery. RESULTS A total of 51 participants were recruited, completed treatment and assessments. Modest but significant correlations (r = 0.38-0.51) were found between personal recovery and certain aspects of clinical recovery (negative symptoms and functioning). Improvements in functioning (vocational and social activities) predicted both personal and clinical recovery whilst negative symptoms predicted attaining clinical recovery. Reductions in negative symptoms (global, apathy and anhedonia) during treatment were associated with moving towards personal recovery. Psychotic symptoms were not significantly associated with the attainment of clinical or personal recovery. CONCLUSIONS Results indicated that clinical and personal recovery are interdependent and complementary processes. Mental health services may need implement interventions that simultaneously target clinical and personal recovery processes in order to meet the treatment needs of people with psychosis.
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Affiliation(s)
- Stephen F Austin
- Psychiatric Research Unit, Psychiatry Region Zealand, Denmark.,Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Erik Simonsen
- Psychiatric Research Unit, Psychiatry Region Zealand, Denmark.,Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Dam
- Psychiatric Center North Zealand, Hillerød, Denmark
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Farhall J, Castle D, Constantine E, Foley F, Kyrios M, Rossell S, Arnold C, Leitan N, Villagonzalo KA, Brophy L, Fossey E, Meyer D, Mihalopoulos C, Murray G, Nunan C, Sterling L, Thomas N. Using a digital personal recovery resource in routine mental health practice: feasibility, acceptability and outcomes. J Ment Health 2022; 32:567-574. [PMID: 36072983 DOI: 10.1080/09638237.2022.2118688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Digital technologies enable the dissemination of multimedia resources to support adults with serious mental illness in their self-management and personal recovery. However, delivery needs to accommodate engagement and accessibility challenges. AIMS We examined how a digital resource, designed for mental health workers and consumers to use together in session, would be used in routine practice. METHODS Thirty consumers and their workers participated. The web-based resource, Self-Management And Recovery Technology (SMART), was available to use within and between sessions, for a 6-month period. Workers initiated in-session use where relevant. Feasibility was explored via uptake and usage data; and acceptability and impact via questionnaires. A pre-post design assessed recovery outcomes for consumers and relationship outcomes for consumers and workers. RESULTS In participating mental health practitioner-consumer dyads, consumers gave strong acceptability ratings, and reported improved working relationships. However, the resource was typically used in one-third or fewer appointments, with consumers expressing a desire for greater in-session use. Improvements in self-rated personal recovery were not observed, possibly contributed to by low usage. CONCLUSIONS In-session use was found helpful by consumers but may be constrained by other demands in mental health care delivery: collaborative use may require dedicated staff time or more formal implementation.
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Affiliation(s)
- John Farhall
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,NorthWestern Mental Health, Melbourne, Australia
| | - David Castle
- Department of Psychiatry, St Vincent's Hospital and The University of Melbourne, Melbourne, Australia
| | | | - Fiona Foley
- Centre for Mental Health Swinburne University of Technology, Melbourne, Australia
| | - Michael Kyrios
- Órama Institute for Mental Health & Wellbeing Flinders University, Adelaide, Australia
| | - Susan Rossell
- Centre for Mental Health Swinburne University of Technology, Melbourne, Australia.,Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
| | - Chelsea Arnold
- Centre for Mental Health Swinburne University of Technology, Melbourne, Australia
| | - Nuwan Leitan
- Centre for Mental Health Swinburne University of Technology, Melbourne, Australia
| | | | - Lisa Brophy
- School of Allied Health Human Services and Sport, La Trobe University and the Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Ellie Fossey
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia.,Living with Disability Research Centre La Trobe University, Melbourne, Australia
| | - Denny Meyer
- Centre for Mental Health Swinburne University of Technology, Melbourne, Australia
| | - Cathrine Mihalopoulos
- Deakin Health Economics Institute for Health Transformation Deakin University, Geelong, Australia
| | - Greg Murray
- Centre for Mental Health Swinburne University of Technology, Melbourne, Australia
| | | | - Leon Sterling
- Centre for Design Innovation Swinburne University of Technology, Melbourne, Australia
| | - Neil Thomas
- Centre for Mental Health Swinburne University of Technology, Melbourne, Australia.,Alfred Health, Melbourne, Australia
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Lawn S, Brooks H, Sutton K, Vicary E, Isaacs AN. Editorial: Non-clinical Approaches to Improve Outcomes in Persons With Mental Disorders. Front Sociol 2022; 7:967508. [PMID: 35865267 PMCID: PMC9294626 DOI: 10.3389/fsoc.2022.967508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Sharon Lawn
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Helen Brooks
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Keith Sutton
- Monash Rural Health, Monash University, Clayton, VIC, Australia
| | - Emily Vicary
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Anton N. Isaacs
- Monash Rural Health, Monash University, Clayton, VIC, Australia
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Ennals P, Lessing K, Spies R, Egan R, Hemus P, Droppert K, Tidhar M, Wood T, van Dijk C, Bride R, Asche A, Bendall S, Simmons M. Co-producing to understand what matters to young people living in youth residential rehabilitation services. Early Interv Psychiatry 2022; 16:782-791. [PMID: 34494354 DOI: 10.1111/eip.13222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 06/03/2021] [Accepted: 08/15/2021] [Indexed: 11/30/2022]
Abstract
AIM Residential group care is an important service for vulnerable young people experiencing mental health, substance abuse and/or behavioural challenges. Yet little is written about specific models and their outcomes, especially from the perspectives of the young people who use these services. This project aimed to explore what matters to young people living in a 12-month voluntary residential program for young people aged 16-25. METHODS This participatory action research study was co-produced with Youth Residential Rehabilitation Service residents and staff as co-researchers. A steering group comprising residents, staff and researchers oversaw all research stages. 18 young people and 17 staff members participated in either individual or group interviews to discuss what was important in Youth Residential Rehabilitation Services. Data analysis drew on grounded theory techniques; subsequent codes and themes were refined in the steering group. RESULTS We identified the 'change work' that young people were expected to do, and the milieu factors that created a supportive environment. As young people were figuring out their directions and learning new skills, they needed to be understood as the developing expert of their own lives. Real relationships with staff and other young people created a culture of belonging, safety and feeling known. These findings are metaphorically captured in the image of an egg. CONCLUSIONS Our study highlights that real relationships between all Youth Residential Rehabilitation Service community members are central to creating the atmosphere of safety and belonging that enables healing and self-development to occur.
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Affiliation(s)
| | | | | | | | | | | | | | - Tom Wood
- Neami National, Preston, Victoria, Australia
| | | | | | | | - Sarah Bendall
- Orygen, National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Magenta Simmons
- Orygen, National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
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Spies R, Ennals P, Egan R, Hemus P, Gonzales R, Droppert K, Tidhar M, McMullan S, Lessing K, Wood T, Bride R, Bendall S, Simmons M. Introducing the youth residential rehabilitation service: An operational and experiential overview of a psychosocial residential support option for young people experiencing mental health challenges. Early Interv Psychiatry 2022; 16:444-452. [PMID: 34464497 DOI: 10.1111/eip.13217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 06/03/2021] [Accepted: 08/15/2021] [Indexed: 11/26/2022]
Abstract
AIM A range of residential supports is available for young people experiencing mental health challenges. One Australian example is the Youth Residential Rehabilitation Service, which provides up to 12 months of intensive psychosocial support in a residential setting to young people aged 16-25 experiencing serious mental health challenges. This paper aimed to add to the scant literature on these services, describing the experiences of young people and staff members across the duration of a stay. METHODS This study drew on collaborative autoethnography to engage and centre the direct lived experience of young people who had lived, and staff who had worked, in a Youth Residential Rehabilitation Service. RESULTS We identified three phases that young people typically journey through during their stay at the service. The Arriving phase was marked by appropriate referrals, a warm welcome, a period of settling in and the development of trusting relationships. The Discovering phase saw young people identifying and enacting their strengths, hopes and values. Community connections were a focus of the Continuing phase as lives after service exit were envisioned and created. CONCLUSIONS Drawing on collaborative autoethnography methods represents one approach to amplify the voice of young people in service design and evaluation. This paper richly described some of the possibilities and complexities of the Youth Residential Rehabilitation Service experience, which can be used to inform the service's pacing and structure of support.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Tom Wood
- Neami National, Preston, Victoria, Australia
| | | | - Sarah Bendall
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Magenta Simmons
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Schoppmann S, Balensiefen J, Nienaber A, Rogge S, Hachtel H. The perspective of staff members of two forensic psychiatric clinics in German-speaking Switzerland on the introduction of recovery orientation: An explorative study. Front Psychiatry 2022; 13:946418. [PMID: 36699488 PMCID: PMC9870309 DOI: 10.3389/fpsyt.2022.946418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 12/09/2022] [Indexed: 01/11/2023] Open
Abstract
Recovery orientation (RO) is directed at living a worthwhile life despite being impaired by the constraints of mental illness. Although being quite common in general psychiatry in Switzerland, the dual mission of forensic psychiatry-safeguarding and therapy-challenges the idea of establishing RO as a work philosophy in this context. This explorative study qualitatively investigates baseline expectations and professional perspectives of forensic staff members concerning the idea of establishing RO in Swiss forensic psychiatric wards. Thereby, three central themes were worked out, namely "challenges associated with recovery," "expected barriers," and "possible recovery-oriented interventions." From a general point of view, the staff members were uncertain whether RO interventions could be introduced at all, and if so, to what extent. This, on the one hand, had to do with structural obstacles such as security requirements; however, personal obstacles in the form of different, sometimes contradictory attitudesand ideals and fearful anticipations-such as the loss of authority and power-also played a central role. As forensic psychiatric wards are non-existent in Latin-speaking Switzerland, the study does only refer to the German-speaking language region.
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Affiliation(s)
- Susanne Schoppmann
- Department of Education, Research and Practice Development, Universitäre Psychiatrische Kliniken (UPK) Basel, Basel, Switzerland
| | - Joachim Balensiefen
- Department of Education, Research and Practice Development, Universitäre Psychiatrische Kliniken (UPK) Basel, Basel, Switzerland
| | - André Nienaber
- Nursing Directorate, Universitäre Psychiatrische Kliniken (UPK) Basel, Basel, Switzerland.,Zentralinstitut für Seelische Gesundheit (ZI) Mannheim, Mannheim, Germany
| | - Stefan Rogge
- Forensic Department, Universitäre Psychiatrische Kliniken (UPK) Basel, Basel, Switzerland
| | - Henning Hachtel
- Forensic Department, Faculty of Medicine, Universitäre Psychiatrische Kliniken (UPK) Basel, University of Basel, Basel, Switzerland
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Prat Vigué G, Cano Prieto I, Del Río Sáez R, Vilanova Masana R, Simó Algado S. Training Peer Support Workers in Mental Health Care: A Mixed Methods Study in Central Catalonia. Front Psychiatry 2022; 13:791724. [PMID: 35463525 PMCID: PMC9023875 DOI: 10.3389/fpsyt.2022.791724] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/25/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION A mental health peer support program was implemented at two reference institutions in Central Catalonia. The program culturally and contextually adapted successful international projects by training people with experience of mental health problems and ensuring their employment in multidisciplinary health care teams. This study explores the influence of peer interventions in mental health on the three groups of participants: peer support workers, service users, and mental health professionals. METHODS A mixed observational method design included pre-, inter-, and post-experimental components and a qualitative description of the impact. The triangulation of the qualitative and quantitative findings showed its coherence and facilitated the understanding of the results. Outcomes and measures were as follows: self-stigma (Self-Stigma Questionnaire); life satisfaction (Scale of Satisfaction with Life); participation in relevant activities (Engagement in Meaningful Activities Survey); personal recovery (Scale-revised Recovery Assessment); occupational performance (Canadian Occupational Performance Measure); and attitudes toward mental illness (Community Attitudes toward Mental Illness). RESULTS The program showed beneficial effects on peer support workers' (PSW) perceptions of occupational performance, specifically on the ability to find work (p = 0.038), work as a peer support worker (p = 0.016), give to the community (p = 0.011), and satisfaction in the ability to find work (p = 0.031). The assessment made by the three groups of participants was very positive: the PSWs showed an increase in self-esteem and a feeling of usefulness; users of the service described the experience as a source of hope and optimism in their recovery process; and professionals described the program as a positive step in their professional growth. DISCUSSION The peer-to-peer strategy is a source of hope in the personal recovery process, providing meaning to life for the PSWs while providing an extra source of support to service users in their process of personal recovery. The results offer us lines of improvement for future implementations. PSW's final emphasis has us reflecting on improvements to enhance their own wellness in mental health care services. The findings show the importance of working on life projects and their impact on the recovery process.
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Affiliation(s)
- Gemma Prat Vigué
- Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain
| | - Ivan Cano Prieto
- Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain
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Chirio-Espitalier M, Schreck B, Duval M, Hardouin JB, Moret L, Bronnec MG. Exploring the Personal Recovery Construct in Bipolar Disorders: Definition, Usage and Measurement. A Systematic Review. Front Psychiatry 2022; 13:876761. [PMID: 35815013 PMCID: PMC9263970 DOI: 10.3389/fpsyt.2022.876761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/30/2022] [Indexed: 11/25/2022] Open
Abstract
Personal recovery from psychiatric disorders is a journey toward a satisfying and hopeful life despite the possible persistence of symptoms. This concept has gained interest and become an increasingly important goal in mental health care programmes. Personal Recovery is well described in the context of severe mental illnesses in general, but little is known about this journey in bipolar disorders and the factors underlying it. A systematic review was conducted according to the PRISMA recommendations, focusing on studies exploring personal recovery in bipolar disorder specifically. The latter have integrated a comprehensive approach to the concept, the existing means of measurement or have explored the levers of recovery in care. Twenty-four articles were selected, including seven qualitative, 12 observational, and five interventional studies. The Bipolar Recovery Questionnaire was the only scale developed de novo from qualitative work with bipolar people. Personal recovery did not correlate very closely with symptomatology. Some elements of personal recovery in bipolar disorder were similar to those in other severe mental illnesses: meaning in life, self-determination, hope, and low self-stigma. Specific levers differed: mental relationships with mood swings, including acceptance and decrease in hypervigilance, and openness to others, including trust and closeness. The studies highlighted the role of caregiver posture and the quality of communication within care, as well as the knowledge gained from peers. The choice to exclude articles not focused on bipolar disorder resulted in the provision of very specific information, and the small number of articles to date may limit the scope of the evidence. New components of personal recovery in bipolar disorder emerged from this review; these components could be taken into account in the construction of care tools, as well as in the caregiving posture. Strengthening skills of openness to others could also be a central target of recovery-focused care.
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Affiliation(s)
- Marion Chirio-Espitalier
- Nantes University, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France.,Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
| | - Benoit Schreck
- Nantes University, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France.,Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
| | - Melanie Duval
- Department of Public Health, University Hospital of Nantes, Nantes, France
| | - Jean-Benoit Hardouin
- Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
| | - Leila Moret
- Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France.,Department of Public Health, University Hospital of Nantes, Nantes, France
| | - Marie Grall Bronnec
- Nantes University, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France.,Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
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Hofmann LA, Lau S, Kirchebner J. Maintaining social capital in offenders with schizophrenia spectrum disorder-An explorative analysis of influential factors. Front Psychiatry 2022; 13:945732. [PMID: 36339835 PMCID: PMC9631923 DOI: 10.3389/fpsyt.2022.945732] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/06/2022] [Indexed: 11/25/2022] Open
Abstract
The importance of "social capital" in offender rehabilitation has been well established: Stable family and community relationships offer practical assistance in the resettlement process after being released from custody and can serve as motivation for building a new sense of self off the criminal past, thus reducing the risk of re-offending. This also applies to offenders with severe mental disorders. The aim of this study was to identify factors that promote or hinder the establishment or maintenance of social relationships upon release from a court-ordered inpatient treatment using a modern statistical method-machine learning (ML)-on a dataset of 369 offenders with schizophrenia spectrum disorder (SSD). With an AUC of 0.73, support vector machines (SVM) outperformed all the other ML algorithms. The following factors were identified as most important for the outcome in respect of a successful re-integration into society: Social integration and living situation prior to the hospitalization, a low risk of re-offending at time of discharge from the institution, insight in the wrongfulness of the offense as well as into the underlying psychiatric illness and need for treatment, addressing future perspectives in psychotherapy, the improvement of antisocial behavior during treatment as well as a detention period of less than 1 year emerged as the most predictive out of over 500 variables in distinguishing patients who had a social network after discharge from those who did not. Surprisingly, neither severity and type of offense nor severity of the psychiatric illness proved to affect whether the patient had social contacts upon discharge or not. The fact that the majority of determinants which promote the maintenance of social contacts can be influenced by therapeutic interventions emphasizes the importance of the rehabilitative approach in forensic-psychiatric therapy.
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Affiliation(s)
- Lena A Hofmann
- Department of Forensic Psychiatry, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Steffen Lau
- Department of Forensic Psychiatry, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Johannes Kirchebner
- Department of Forensic Psychiatry, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
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Leendertse P, Hirzalla F, van den Berg D, Castelein S, Mulder CL. Facilitating and hindering factors of personal recovery in the context of Soteria-A qualitative study among people with (early episode) psychosis. Front Psychiatry 2022; 13:1051446. [PMID: 36683984 PMCID: PMC9848445 DOI: 10.3389/fpsyt.2022.1051446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/23/2022] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE The objective of this study was to gain insight into patients' experiences of how personal recovery (PR) is facilitated or hindered in the context of an early episode psychosis setting (Soteria). We thereby aimed to contribute to the understanding of how care settings may promote or hinder the process of PR in people with (acute) psychosis. METHOD This study used a qualitative method, consisting of semi-structured in-depth interviews with people who had been admitted to a Soteria house in the Netherlands. Interview transcripts were analyzed following the Grounded Theory approach. RESULTS Five themes emerged from the data illustrating how Soteria facilitated or impeded PR. The experience of togetherness in contact with staff and peers, feeling at home, and being active facilitated PR, while the emphasis put on medication by staff was experienced as hindering, and attention to spirituality was missed. CONCLUSION In addition to the literature that identified factors associated with PR in psychosis, the current study gives a sense of how this can be put into practice. By offering treatment within a normalizing, holding environment, with emphasis on equality, close contact, optimism, active structured days, open-mindedness toward spirituality, and the role of medication, PR can be facilitated without detracting from guideline-based treatment aimed at symptomatic recovery. Similarities with existing concepts are discussed.
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Affiliation(s)
- Pien Leendertse
- Emergis, Institute for Mental Healthcare, Kloetinge, Netherlands.,Department of Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Fadi Hirzalla
- Department of Public Administration and Sociology, Erasmus School of Social and Behavioural Sciences, Erasmus University, Rotterdam, Netherlands
| | - David van den Berg
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Research and Innovation, Parnassia Psychiatric Institute, The Hague, Netherlands
| | - Stynke Castelein
- Lentis Research, Lentis Psychiatric Institute, Groningen, Netherlands.,Faculty of Behavioral and Social Sciences, Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
| | - Cornelis Lambert Mulder
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands.,Antes, Institute for Mental Healthcare, Parnassia Psychiatric Institute, Rotterdam, Netherlands
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Abstract
Support from caregivers is an important element of mental health recovery. However, the mechanisms by which social support influences the recovery of persons with depressive, anxiety, or bipolar disorders are less understood. In this study, we describe the social support mechanisms that influence mental health recovery. A cross-sectional qualitative study was undertaken in Québec (Canada) with 15 persons in recovery and 15 caregivers-those having played the most significant role in their recovery. A deductive thematic analysis allowed for the identification and description of different mechanisms through a triangulation of perspectives from different actors. Regarding classic social support functions, several of the support mechanisms for mental health recovery were identified (emotional support, companionship, instrumental support, and validation). However, informational support was not mentioned. New mechanisms were also identified: presence, communication, and influence. Social support mechanisms evoke a model containing a hierarchy as well as links among them.
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Affiliation(s)
| | - Janie Houle
- Université du Québec à Montréal, Montréal, Québec, Canada
- Janie Houle, Department of Psychology, Université du Québec à Montréal, 100 Rue Sherbrooke Ouest, Montréal, Québec, Canada H2X 3P2.
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Dubreucq J, Gabayet F, Godin O, Andre M, Aouizerate B, Capdevielle D, Chereau I, Clauss-Kobayashi J, Coulon N, D’Amato T, Dorey JM, Dubertret C, Faraldo M, Laouamri H, Leigner S, Lancon C, Leboyer M, Llorca PM, Mallet J, Misdrahi D, Passerieux C, Rey R, Pignon B, Schorr B, Urbach M, Schürhoff F, Szoke A, Fond G, Berna F. Overlap and Mutual Distinctions Between Clinical Recovery and Personal Recovery in People With Schizophrenia in a One-Year Study. Schizophr Bull 2021; 48:382-394. [PMID: 34718808 PMCID: PMC8886587 DOI: 10.1093/schbul/sbab114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Recovery is a multidimensional construct that can be defined either from a clinical perspective or from a consumer-focused one, as a self-broadening process aimed at living a meaningful life beyond mental illness. We aimed to longitudinally examine the overlap and mutual distinctions between clinical and personal recovery. Of 1239 people with schizophrenia consecutively recruited from the FondaMental Advanced Centers of Expertise for SZ network, the 507 present at one-year did not differ from those lost to follow-up. Clinical recovery was defined as the combination of clinical remission and functional remission. Personal recovery was defined as being in the rebuilding or in the growth stage of the Stages of Recovery Instrument (STORI). Full recovery was defined as the combination of clinical recovery and personal recovery. First, we examined the factors at baseline associated with each aspect of recovery. Then, we conducted multivariable models on the correlates of stable clinical recovery, stable personal recovery, and stable full recovery after one year. At baseline, clinical recovery and personal recovery were characterized by distinct patterns of outcome (i.e. better objective outcomes but no difference in subjective outcomes for clinical recovery, the opposite pattern for personal recovery, and better overall outcomes for full recovery). We found that clinical recovery and personal recovery predicted each other over time (baseline personal recovery for stable clinical recovery at one year; P = .026, OR = 4.94 [1.30-23.0]; baseline clinical recovery for stable personal recovery at one year; P = .016, OR = 3.64 [1.31-11.2]). In short, given the interaction but also the degree of difference between clinical recovery and personal recovery, psychosocial treatment should target, beyond clinical recovery, subjective aspects such as personal recovery and depression to reach full recovery.
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Affiliation(s)
- Julien Dubreucq
- Fondation FondaMental, Créteil, France,Centre Référent de Réhabilitation psychosociale et de Remédiation cognitive (C3R), CH Alpes Isère, Saint Egrève, France,To whom correspondence should be addressed to: Centre Référent de Réhabilitation psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, 8 place du Conseil National de la Résistance, 38400 Saint Martin d’Hères, France; tel: (33 4) 56 58 88 00, e-mail:
| | - Franck Gabayet
- Fondation FondaMental, Créteil, France,Centre Référent de Réhabilitation psychosociale et de Remédiation cognitive (C3R), CH Alpes Isère, Saint Egrève, France
| | - Ophélia Godin
- Fondation FondaMental, Créteil, France,Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, Créteil, France
| | - Myrtille Andre
- Fondation FondaMental, Créteil, France,IGF, University of Montpellier, CNRS, INSERM, Montpellier, France,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHU Montpellier, France
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France,Centre Hospitalier Charles Perrens, Université de Bordeaux, Bordeaux, France,INRA, NutriNeuro, University of Bordeaux, Bordeaux, France
| | - Delphine Capdevielle
- Fondation FondaMental, Créteil, France,IGF, University of Montpellier, CNRS, INSERM, Montpellier, France,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHU Montpellier, France
| | - Isabelle Chereau
- Fondation FondaMental, Créteil, France,Université Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
| | - Julie Clauss-Kobayashi
- Fondation FondaMental, Créteil, France,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Nathalie Coulon
- Fondation FondaMental, Créteil, France,Centre Référent de Réhabilitation psychosociale et de Remédiation cognitive (C3R), CH Alpes Isère, Saint Egrève, France
| | - Thierry D’Amato
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 team, Lyon, France,Centre Hospitalier le Vinatier, Centre Expert Dépression Résistante, Lyon, France
| | - Jean-Michel Dorey
- INSERM U1028, CNRS, UMR 5292, Lyon Neuroscience Research Center, EDUWELL Team, Lyon 2 University, Lyon, France,Centre Hospitalier le Vinatier, Pôle PsyPA, Lyon, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France,AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, Service de Psychiatrie et Addictologie. Hôpital Louis Mourier, Colombes, France,Université de Paris INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - Mégane Faraldo
- Fondation FondaMental, Créteil, France,Centre Référent de Réhabilitation psychosociale et de Remédiation cognitive (C3R), CH Alpes Isère, Saint Egrève, France
| | | | - Sylvain Leigner
- Fondation FondaMental, Créteil, France,Centre Référent de Réhabilitation psychosociale et de Remédiation cognitive (C3R), CH Alpes Isère, Saint Egrève, France
| | - Christophe Lancon
- Fondation FondaMental, Créteil, France,AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, Service de Psychiatrie et Addictologie. Hôpital Louis Mourier, Colombes, France,Université de Paris INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France,Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, Créteil, France,AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d’Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Créteil, France,Université Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
| | - Jasmina Mallet
- Fondation FondaMental, Créteil, France,AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, Service de Psychiatrie et Addictologie. Hôpital Louis Mourier, Colombes, France,Université de Paris INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - David Misdrahi
- Fondation FondaMental, Créteil, France,Pôle de psychiatrie Générale et Universitaire, Centre Hospitalier Charles Perrens, Université de Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France,Service Universitaire de Psychiatrie d’Adultes et d’Addictologie, Centre Hospitalier de Versailles, Le Chesnay, France,DisAP-DevPsy-CESP, INSERM UMR1018, Université Paris-Saclay, Université Versailles Saint-Quentin-En-Yvelines, Villejuif, France
| | - Romain Rey
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 team, Lyon, France,Centre Hospitalier le Vinatier, Centre Expert Dépression Résistante, Lyon, France
| | - Baptiste Pignon
- Fondation FondaMental, Créteil, France,Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, Créteil, France,AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d’Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris, France
| | - Benoit Schorr
- Fondation FondaMental, Créteil, France,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Mathieu Urbach
- Fondation FondaMental, Créteil, France,Service Universitaire de Psychiatrie d’Adultes et d’Addictologie, Centre Hospitalier de Versailles, Le Chesnay, France,DisAP-DevPsy-CESP, INSERM UMR1018, Université Paris-Saclay, Université Versailles Saint-Quentin-En-Yvelines, Villejuif, France
| | - Franck Schürhoff
- Fondation FondaMental, Créteil, France,Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, Créteil, France,AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d’Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris, France
| | - Andrei Szoke
- Fondation FondaMental, Créteil, France,Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, Créteil, France,AP-HP, Hôpitaux Universitaires Henri Mondor, Département Médico-Universitaire de Psychiatrie et d’Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris, France
| | | | - Guillaume Fond
- Fondation FondaMental, Créteil, France,AP-HM, Aix-Marseille Univ, School of medicine—La Timone Medical Campus, EA 3279: CEReSS—Health Service Research and Quality of Life Center, Marseille, France
| | - Fabrice Berna
- Fondation FondaMental, Créteil, France,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
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Dreyer RP, Pavlo AJ, Horne A, Dunn R, Danvers K, Brush J, Slade M, Davidson L. Conceptual Framework for Personal Recovery in Patients With Acute Myocardial Infarction. J Am Heart Assoc 2021; 10:e022354. [PMID: 34581198 PMCID: PMC8649153 DOI: 10.1161/jaha.121.022354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Although there has been movement in cardiology to advance patient-centered approaches to postacute myocardial infarction (AMI) care, work remains to be done in aligning patient preferences with clinical care. Our objective was to characterize patients' experience of AMI and treatment to develop a new conceptual framework of patient-centered recovery in cardiology. Methods and Results We conducted in-depth interviews with people who previously experienced an AMI (2016-2019). The interview focused on participants' experiences of their recovery, which were audio-recorded, transcribed verbatim, and analyzed using a phenomenological framework. The overarching theme described by the 42 participants was feeling like a "different person" after the AMI. This shift manifested itself in both losses and gains, each of which posed new challenges to everyday life. The experience appeared to be an active process requiring people to take responsibility for their health. In terms of loss, participants describe how the AMI threatened their sense of safety and security and led to social isolation, fragility, uncertainty about the future, and difficulty expressing emotions accompanied this new fear. A conceptual framework describing the relationship between AMI, identity change, and functioning was developed. Conclusions Participants experienced the AMI as an unexpected disruption in their lives that had far-reaching effects on their daily functioning, and were resolved in numerous ways. The conceptual framework may assist in providing a theoretical basis for future interventions in cardiology that not only engage and retain patients in care but also improve long-term adherence to secondary prevention and other aspects of self-care.
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Affiliation(s)
- Rachel P Dreyer
- Center for Outcomes Research and Evaluation (CORE) New Haven CT.,Department of Emergency Medicine Yale School of Medicine New Haven CT
| | - Anthony J Pavlo
- Department of Psychiatry Yale School of Medicine New Haven CT.,Yale Program for Recovery and Community Health (PRCH) New Haven CT
| | - Anna Horne
- Department of Psychiatry Yale School of Medicine New Haven CT.,Yale Program for Recovery and Community Health (PRCH) New Haven CT
| | - Robert Dunn
- Department of Psychiatry Yale School of Medicine New Haven CT.,Yale Program for Recovery and Community Health (PRCH) New Haven CT
| | - Karina Danvers
- Department of Psychiatry Yale School of Medicine New Haven CT.,Yale Program for Recovery and Community Health (PRCH) New Haven CT
| | - John Brush
- Sentara Healthcare and Eastern Virginia Medical School Norfolk VA
| | - Mike Slade
- School of Health Sciences Institute of Mental Health University of Nottingham United Kingdom
| | - Larry Davidson
- Department of Psychiatry Yale School of Medicine New Haven CT.,Yale Program for Recovery and Community Health (PRCH) New Haven CT
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