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Martinez A, Baumgartner JN, Kaaya S, Swai P, Lawala PS, Thedai B, Minja A, Headley J, Egger JR. Hopefulness among individuals living with schizophrenia and their caregivers in Tanzania: an actor-partner interdependence model. BMC Psychiatry 2023; 23:508. [PMID: 37442999 PMCID: PMC10339619 DOI: 10.1186/s12888-023-04990-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Hopefulness is a positive orientation or state of mind that can aid in the recovery and treatment of mental illness, as it can have significant impacts on clinical and psychosocial outcomes. As resource-constrained settings work to implement recovery-oriented care, there is a need to better understand hopefulness among people living with schizophrenia (PLWS) and caregivers in their extended family networks. This study seeks to examine the dyadic relationship of hopefulness and its associated correlates among PLWS attending outpatient psychiatric clinics and their caregivers in Tanzania. METHODS This study utilized baseline and immediate post-intervention data collected as part of a randomized controlled trial testing a culturally tailored model of Family Psychoeducation, KUPAA, in Tanzania. The Herth Hope Index was used to measure hopefulness among PLWS (n = 33) and their caregivers (n = 33) at baseline and immediate post-intervention. Univariable and multivariable regression models were conducted to determine correlates of hopefulness at baseline, while the Actor-Partner Interdependence Model (APIM) was employed to examine the longitudinal, dyadic relationship of hopefulness among and between PLWS and their caregivers. RESULTS Better family functioning was associated with higher levels of hopefulness in PLWS and their caregivers. Lower levels of stigma, lower symptom severity, and lower disability were associated with higher levels of hopefulness in PLWS. For PLWS and their caregivers, actor effects from the APIM model were less than one (PLWS, [Formula: see text]; caregivers, [Formula: see text]), indicating stability (within each person) in hopefulness over time. Regarding partner effects, a caregiver's baseline hopefulness had a positive effect on the hopefulness of their PLWS at follow-up ([Formula: see text]). This indicates that higher caregiver hope at time 0 is associated with higher levels of hope in PLWS at time 1. Baseline hopefulness levels for PLWS had a negative effect on caregivers' hopefulness at follow-up ([Formula: see text]). This suggests that higher hopefulness among PLWS at baseline is associated with lower levels of hope in caregivers at follow-up. CONCLUSION Hopefulness is important to consider in family or caregiver-based treatments for PLWS because caregiver hopefulness may influence improvements in hopefulness among PLWS over time. Future studies should further explore the longitudinal dyadic relationship of hopefulness for these populations, as hope is a non-pharmacological and modifiable mechanism of change that is underutilized in care and treatment plans for PLWS globally. TRIAL REGISTRATION Clinical Trials #NCT04013932, July 10, 2019.
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Affiliation(s)
- Alyssa Martinez
- Harvard Medical School, Department of Global Health & Social Medicine, Boston, MA, USA
| | - Joy Noel Baumgartner
- Duke Global Health Institute, Duke University, Durham, NC, USA
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sylvia Kaaya
- School of Medicine, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Praxeda Swai
- School of Medicine, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Paul S Lawala
- Mirembe National Mental Health Hospital, Dodoma, Tanzania
| | | | - Anna Minja
- School of Medicine, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | | | - Joseph R Egger
- Duke Global Health Institute, Duke University, Durham, NC, USA.
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Chen TT, Chueh KH, Chen KC, Chou CL, Yang JJ. The Satisfaction With Care of Patients With Schizophrenia in Taiwan: A Cross-Sectional Survey of Patient-Centered Care Domains. J Nurs Res 2023; 31:e268. [PMID: 36976539 DOI: 10.1097/jnr.0000000000000549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Pharmacological interventions combined with nonpharmacological treatments such as patient-centered care (PCC)-related activities are widely used to enhance outcomes in patients with schizophrenia. However, few studies have examined and identified the PCC factors essential to achieving better outcomes in patients with schizophrenia. PURPOSE This study was designed to identify the Picker-Institute-identified PCC domains associated with satisfaction and to determine which of these domains are most important in the context of schizophrenia care. METHODS Data were collected using patient surveys in outpatient settings and record reviews at two hospitals in northern Taiwan between November and December 2016. PCC data were collected in five domains: (a) support of patient autonomy; (b) goal setting; (c) collaboration and integration of healthcare services; (d) information, education, and communication; and (e) emotional support. The outcome measure was patient satisfaction. The study controlled for demographic factors, including age, gender, education, occupation, marriage, and urbanization level in the respondent's area of residence. Clinical characteristics included the Clinical Global Impressions severity and improvement index scores, previous admission, previous emergency department visit, and readmission within 1 year. Methods were adopted to prevent common method variance bias. Multivariable linear regression with stepwise selection and the generalized estimating equation were used to analyze the data. RESULTS After controlling for confounding factors, the generalized estimating equation model found only three PCC factors significantly associated with patient satisfaction, which differed slightly from the results of the multivariable linear regression. These three factors are as follows, in order of importance: information, education, and communication (parameter = 0.65 [0.37, 0.92], p < .001); emotional support (parameter = 0.52 [0.22, 0.81], p < .001); and goal setting (parameter = 0.31 [0.10, 0.51], p = .004). CONCLUSIONS The three critical PCC-related factors were evaluated in terms of enhancing patient satisfaction in patients with schizophrenia. Practicable strategies related to these three factors should also be developed for implementation in clinical settings.
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Affiliation(s)
- Tsung-Tai Chen
- PhD, Associate Professor, Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - Ke-Hsin Chueh
- PhD, RN, Associate Professor, Department of Nursing, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - Kao-Chen Chen
- MS, Case Manager Supervisor, Department of Health, New Taipei City Government, New Taipei, Taiwan
| | - Chi-Ling Chou
- BSN, RN, Head Nurse, Department of Community Psychiatry & Addition Psychiatry, Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei, Taiwan
| | - Jing-Jung Yang
- MS, MD, Attending Physician, Department of Psychiatry, Cardinal Tien Hospital, and Adjunct Instructor, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
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McNeely HE, Letts L, Martin ML, Strong S. Participants' Evaluation and Outcomes following Integration of Self-Management Support into Outpatient Schizophrenia Case Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3035. [PMID: 36833727 PMCID: PMC9964489 DOI: 10.3390/ijerph20043035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Self-management is advocated as a feasible, effective intervention to support individuals to actively manage the impact of illness and live healthier lives. We sought to evaluate a piloted self-management model, SET for Health, tailored for individuals living with schizophrenia embedded within ambulatory case management. (2) Methods: A mixed-methods design engaged 40 adults living with schizophrenia in the SET for Health protocol. Functional and symptomatic outcomes were measured by self-report and clinician ratings at baseline and completion of self-management plans, on average one year later. Semi-structured qualitative client interviews invited evaluations of personal experiences with the intervention. (3) Results: Significant improvements were found concerning client illness severity, social and occupational functioning, illness management and functional recovery with reductions in emergency visits and days in hospital. Clients endorsed the value of the intervention. Baseline clinical characteristics did not predict who benefited. Participation contributed to motivational gains and quality of life. (4) Conclusions: Results confirmed self-management support embedded within traditional case management improved clients' clinical and functional status, and contributed to quality of life. Clients engaged in their recovery and actively used self-management strategies. Self-management can be successfully adopted by clients with schizophrenia regardless of age, gender, education, illness severity or duration.
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Affiliation(s)
- Heather E. McNeely
- Schizophrenia and Community Integration Service, St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada
| | - Lori Letts
- School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada
| | - Mary-Lou Martin
- Forensic Service, St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada
- School of Nursing, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Susan Strong
- Schizophrenia and Community Integration Service, St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada
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ŞAHİN ALTUN Ö, ÖZER D, OKANLİ A, ASİ KARAKAŞ S, ÖZTÜRK Z, KAYAOĞLU K. Validity and Reliability of Turkish version of the Schizophrenia Hope Scale. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2022. [DOI: 10.18863/pgy.1168790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This study aimed to evaluate the validity and reliability of the Turkish version of the Schizophrenia Hope Scale (SHS). This methodological study was carried out with 214 participants diagnosed with schizophrenia who were followed up in the psychiatry outpatient clinics of a university hospital between August 2021 and August 2022. Data were collected using an Information Form and the Schizophrenia Hope Scale (SHS). Language and content validity, exploratory and confirmatory factor analyses, item-total correlation, Cronbach alpha coefficient, and test-retest reliability methods were used in the validity and reliability analysis of the scale. As a result of the exploratory factor analysis, no item was excluded from the scale and it was determined that the scale has nine items and a single-factor structure. The single-factor structure of the scale was confirmed with the confirmatory factor analysis. The Cronbach Alpha coefficient of the scale was 0.901 and the factor loads ranged between 0.70 and 1.0. The test-retest correlation coefficient was r=0.959. The Turkish version of the scale was found to be valid and reliable. SCH is important since it represents the subjective meaning of hope from schizophrenic patients’ perspective and allows an easier measurement of the level of hope in this population. Mental health professionals can use SHS to determine or increase the level of hope of schizophrenia patients in their studies.
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Affiliation(s)
- Özlem ŞAHİN ALTUN
- ., Ataturk University, Faculty of Nursing, Department of Psychiatric Nursing, Erzurum, Turkey
| | - Duygu ÖZER
- Sağlık Bilimleri Üniversitesi, Sultan Abdülhamid Han Eğitim ve Araştırma Hastanesi, İstanbul
| | | | - Sibel ASİ KARAKAŞ
- ., Ataturk University, Faculty of Nursing, Department of Psychiatric Nursing, Erzurum, Turkey
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Üşenmez TY, Budak FK, Ayhan MO. The Effect of Psychological Resilience on Hope in Individuals With Schizophrenia. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20220919-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lai DWL, Chan KC, Daoust GD, Xie XJ. Hopes and Wishes of Clients with Mentally Illness in Hong Kong. Community Ment Health J 2021; 57:1556-1565. [PMID: 33507470 PMCID: PMC7841978 DOI: 10.1007/s10597-021-00779-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 01/12/2021] [Indexed: 11/24/2022]
Abstract
Recovery is a progressive process involving support to people with mental illness to take control of their life through the enhancement of motivation, self-drive, and responsibility. Drawing on qualitative interviews with 61 patients with mental illness aged between 40 and 75 in the community or residential settings, this study examined the wishes and hopes of clients who were in recovery. Participants described wishes and hopes for autonomy and independence in finances, accommodation, and health; stable housing or accommodation; meaningful occupation or employment; 'giving back' to society by serving others; intimate relationships; and gaining back 'lost time.' Wishes and hopes were motivating factors contributing to physical, mental, and social health over time, motivating clients with mental illness to live happily. To foster recovery, mental health practitioners should consider the identification and fulfilment of wishes and hopes in health and social care programs for this unique client group.
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Affiliation(s)
- Daniel W L Lai
- Faculty of Social Sciences, Hong Kong Baptist University, Room 1325, 13/F Academic and Administration Building, Baptist University Road Campus, Hong Kong, China.
| | - K C Chan
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
| | - G D Daoust
- Department of International Relations, The University of Sussex, Brighton, UK
| | - X J Xie
- International Social Service Hong Kong Branch, 130 Hennessy Rd, Wan Chai, Hong Kong, China
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Golubinski V, Wild EM. Factors associated with patient activation in a socially deprived population: Evidence from Germany. PATIENT EDUCATION AND COUNSELING 2021; 104:2791-2802. [PMID: 33863586 DOI: 10.1016/j.pec.2021.03.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/25/2021] [Accepted: 03/28/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Patient activation has been identified as a crucial determinant of health, but little is known about its own determinants, particularly in low socioeconomic status populations. To address this research gap, we analyzed factors that might explain variation in patient activation in such a population. METHODS We conducted a cross-sectional patient survey (n = 582) in a low socioeconomic status urban district in Germany in 2017. Using multivariate linear regressions, we examined the association between patient activation and a range of psychological, sociodemographic, and health-related factors. To assess the relative importance of these factors, we used dominance analysis. RESULTS Our results suggest that age, employment status, linguistic acculturation, health status, and self-efficacy were significantly associated with patient activation. Dominance analysis indicated that self-efficacy was the most important factor explaining variation in patient activation. CONCLUSIONS Age, employment status, linguistic acculturation, health status, and self-efficacy are important determinants of patient activation. PRACTICE IMPLICATIONS Our results can inform decision makers about approaches for more targeted and effective interventions to improve patient activation in low socioeconomic status populations. Much might be gained by investing in interventions that focus on age, employment status, linguistic acculturation, and health status. Interventions that improve self-efficacy may represent a particularly promising approach.
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Affiliation(s)
- Veronika Golubinski
- Department of Health Care Management, Hamburg Center for Health Economics (HCHE), University of Hamburg, Esplanade 36, 20354 Hamburg, Germany
| | - Eva-Maria Wild
- Department of Health Care Management, Hamburg Center for Health Economics (HCHE), University of Hamburg, Esplanade 36, 20354 Hamburg, Germany.
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Keen A, Lu Y, Oruche UM, Mazurenko O, Draucker CB. Activation in persons with mental health disorders: An integrative review. J Psychiatr Ment Health Nurs 2021; 28:873-899. [PMID: 34311508 DOI: 10.1111/jpm.12789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 07/07/2021] [Accepted: 07/19/2021] [Indexed: 11/26/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Evidence indicates a strong relationship between patient activation (i.e. confidence, knowledge and skills to self-manage health) and positive health behaviours and outcomes in a variety of clinical populations. Because persons with mental health disorders experience significant disease burden but often underutilize mental health treatment or experience poor treatment outcomes, they would likely benefit from increases in activation. No systematic reviews have been conducted to summarize and synthesize research on patient activation in persons with mental health disorders. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: To our knowledge, this is the first comprehensive review to identify factors associated with activation and interventions that have shown to be effective in persons with mental health disorders. This integrative review indicates that better health status, less depression, positive health attitudes and behaviours, and higher quality therapeutic relationships may be associated with higher levels of activation in persons with mental health disorders. This review also indicates that a variety of interventions, most notably educational programs, are effective in increasing levels of patient activation in persons with mental health disorders. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Psychiatric mental health nurses and other clinicians should consider routine assessment of patient activation to inform individualized treatment plans for their clients. Clinicians should aim to form high-quality therapeutic relationships with clients as a way to promote higher levels of activation. Interventions that have been found to be effective in improving activation could be offered in a variety of mental health settings. ABSTRACT: Introduction Patient activation is understanding one's role in the healthcare process and having confidence, knowledge, and skills to self-manage one's health and health care. Researchers have begun to investigate patient activation in persons with mental health disorders, but no systematic reviews have been conducted to summarize and synthesize this research. For psychiatric mental health nurses and other clinicians to develop strategies to increase patient activation in this population, more information is needed about factors associated with activation and interventions that increase activation. Review Questions (1) What factors are associated with levels of activation in persons diagnosed with mental health disorders? (2) What interventions have shown to be effective at increasing levels of activation in persons diagnosed with mental health disorders? Method A 5-stage integrative review as described by Whittemore & Knafl. Results Twenty-nine articles were included in the review. Ten provided correlations between activation and other factors, and 20 examined the effects of interventions on activation. Some studies revealed significant correlations between a variety of health and treatment-related factors, and others revealed that some interventions, most notably educational programs, were shown to increase activation. Discussion The findings of this comprehensive review can inform psychiatric mental health nurses and other clinicians in developing strategies to increase activation in the patients with whom they work. More research is needed to provide a deeper understanding of the role of activation in the recovery and treatment of persons with mental health disorders. Implications for Practice Psychiatric nurses and other clinicians should assess for patient activation and incorporate strategies to increase levels of activation in patients in their practice. Positive therapeutic relationships likely enhance activation in persons with mental health disorders.
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Affiliation(s)
- Alyson Keen
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Yvonne Lu
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Ukamaka M Oruche
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Olena Mazurenko
- Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana, USA
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Özdemir AA, Kavak Budak F. The Effects of Mindfulness-Based Stress Reduction Training on Hope, Psychological Well-Being, and Functional Recovery in Patients with Schizophrenia. Clin Nurs Res 2021; 31:183-193. [PMID: 34382427 DOI: 10.1177/10547738211039069] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study tested the effects of mindfulness-based stress reduction (MBSR) training on multiple outcomes in patients with schizophrenia. We compared MBSR, psychoeducation, and control groups in a randomized controlled research design. Outcome measures assessed hope, psychological wellbeing, and functional recovery over three time points in 137 participants. The results of this study indicate that MBSR training was more effective in terms of increasing the level of hope, psychological well-being, and functional recovery of schizophrenia patients when compared with psychoeducation and control patients.
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Barello S, Guida E, Leone S, Previtali E, Graffigna G. Does patient engagement affect IBD patients' health-related quality of life? Findings from a cross-sectional study among people with inflammatory bowel diseases. Health Qual Life Outcomes 2021; 19:77. [PMID: 33678181 PMCID: PMC7938585 DOI: 10.1186/s12955-021-01724-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 03/01/2021] [Indexed: 01/19/2023] Open
Abstract
Background Patients diagnosed with inflammatory bowel disease (IBD) are required to deal with the unpredictability of this clinical condition, which is associated with poorer health-related quality of life (HRQoL) compared to other clinical conditions. Patient engagement is currently demonstrated to relate with chronic patients’ HRQoL, but few studies have been conducted among this population. Methods A cross-sectional study was conducted among 1176 IBD patients. Data were collected on participants’ HRQoL (SIBD-Q) and patient engagement (PHE-s®). Regression analysis was used to examine the effects of patient engagement on HRQoL. Results About the half of the sample (47%) reported a low patient engagement level. 30% of the sample reported a low level of HRQoL. Psycho-emotional functioning resulted to be the aspect of HRQoL most impacted in the 37% of the sample. The regression model showed that PHE-s® is significantly related to the SIBD-Q total score (B = .585; p < .001; R squared = .343) and to the subscales’ scores—systemic symptoms (B = .572; p < .001; R squared = .327), bowel symptoms (B = .482; p < .001; R squared = .232), social (B = .485; p < .001; R squared = .234) and psycho-emotional (B = .607; p < .001; R squared = .369) functioning. Conclusions Patients who are engaged in their IBD care pathway are more likely to report higher level of HRQoL, thus offering clues to potential therapeutic approaches to ameliorating IBD patients’ wellbeing. As this is a modifiable factor, screening for patient health engagement levels, coupled with appropriate interventions, could improve care, and ultimately improve HRQoL outcomes among IBD patients.
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Affiliation(s)
- Serena Barello
- EngageMinds Hub, Consumer, Food and Health Engagement Research Center, Faculty of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.
| | - Elena Guida
- EngageMinds Hub, Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | | | - Guendalina Graffigna
- EngageMinds Hub, Consumer, Food & Health Engagement Research Center, Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Piacenza, Italy
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Feasibility of the Schizophrenia Hope Scale-9: A Psychometric Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228635. [PMID: 33233757 PMCID: PMC7699933 DOI: 10.3390/ijerph17228635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 11/16/2022]
Abstract
Hope is essential in rehabilitating persons with schizophrenia, though scales to measure hope are not appropriate for this population. The purpose of this cross-sectional study was to identify the psychometric properties of the Schizophrenia Hope Scale-9 (SHS-9) using data from 83 people with schizophrenia in four mental health centers and 762 healthy persons from two universities in South Korea. The total SHS-9 score is calculated by adding all items’ scores and ranges from 0 to 18. The mean (standard deviation) SHS-9 score of the participants with schizophrenia and healthy participants was 11.53 (SD = 4.78) and 14.78 (SD = 3.19), respectively. Lower scores indicate a lower level of hope. The Cronbach’s alpha coefficient was 0.92 with a four-week test-retest reliability of 0.89. Criterion-related construct validity was established by examining the correlation between the SHS-9 and the State-Trait Hope Inventory scores. Divergent validity was identified through a negative relationship of SHS-9 with the Beck Hopelessness Scale. In persons with schizophrenia and healthy college students, Bartlett’s test of sphericity yielded χ2 = 465.03 (p < 0.001) and χ2 = 2679.24 (p < 0.001) respectively. The values of the Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy were 0.89 and 0.90, respectively. The construct validity of the SHS-9 was confirmed through principal component analysis with extraction methods, which resulted in a one-factor solution, accounting for 61.83% of the total item variance. This study provides evidence for the validity and reliability of the SHS-9; therefore, it could be used to study the relationships between hope and other variables (e.g., depression and recovery) in persons with schizophrenia and measure the effect of psychosocial interventions on their hope.
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Budak FK, Yildirim T, Özdemir A. The effect of negative automatic thoughts on hope in patients with schizophrenia. Perspect Psychiatr Care 2020; 57:936-940. [PMID: 33090516 DOI: 10.1111/ppc.12637] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 01/17/2023] Open
Abstract
PURPOSE The purpose of this study is to determine the effect of negative automatic thoughts on hope in patients with schizophrenia. DESIGN AND METHODS The sample size of the study was calculated to be 94 patients through the power analysis. The study was completed with 115 patients who met the inclusion criteria. "descriptive characteristics form," "automatic thoughts questionnaire-negative," and "dispositional hope scale" were used to collect the data. FINDINGS In the study, it was found that there was a negative strong correlation between negative automatic thoughts and hope levels. In addition, the negative automatic thoughts of the patients had a statistical significance in accounting for hope (p < .05) and the negative automatic thoughts predicted the hope by 66%. PRACTICE IMPLICATIONS In the study, it was found that the patients had high negative automatic thoughts and moderate level of hopes. As negative automatic thoughts increased, hope decreased.
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Affiliation(s)
- Funda Kavak Budak
- Department of Psychiatric Nursing, Inonu Unıversıty, Malatya, Turkey
| | - Tülay Yildirim
- Department of Psychiatric Nursing, Dıcle Unıversıty, Diyarbakır, Turkey
| | - Aysel Özdemir
- Department of Psychiatric Nursing, Fırat Unıversıty, Elazığ, Turkey
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Golubinski V, Oppel EM, Schreyögg J. A systematic scoping review of psychosocial and psychological factors associated with patient activation. PATIENT EDUCATION AND COUNSELING 2020; 103:2061-2068. [PMID: 32534814 DOI: 10.1016/j.pec.2020.05.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Patient activation has been identified as an important predictor of how patients manage their own health, but little is known about its determinants. In this scoping review, we aim to address this research gap by (1) identifying literature on psychosocial/psychological factors associated with patient activation, and (2) extracting and synthesizing major results reported on that relationship. METHODS Using a systematic search of four electronic databases (Web of Science, PubMed, PsychInfo, CINAHL), our search algorithm combined related terms for "psychosocial factors" or "psychological factors" and "patient activation". RESULTS Of the 1128 records identified, we included 13 studies in this scoping review. In these, we identified 21 psychosocial/psychological factors that were significantly associated with patient activation. The four most frequently investigated factors were depression, self-efficacy, hope, and health status. Overall, the methodological quality of studies was low. The majority were cross sectional in design, and only one assessed causality. CONCLUSIONS Our results suggest that psychosocial/psychological factors explain variations in patient activation. However, further research is needed to identify causal relationships between psychosocial/psychological factors and patient activation. PRACTICE IMPLICATIONS The insights from our review could be used for designing and evaluating interventions to improve patient activation.
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Affiliation(s)
- Veronika Golubinski
- Hamburg Center for Health Economics (HCHE), University of Hamburg, Hamburg, Germany
| | - Eva-Maria Oppel
- Hamburg Center for Health Economics (HCHE), University of Hamburg, Hamburg, Germany.
| | - Jonas Schreyögg
- Hamburg Center for Health Economics (HCHE), University of Hamburg, Hamburg, Germany
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Sleep disturbance and quality of life in clinically stable inpatients with schizophrenia in rural China. Qual Life Res 2020; 29:2759-2768. [DOI: 10.1007/s11136-020-02541-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2020] [Indexed: 01/20/2023]
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Green AL, Lambert MC, Hurley KD. Measuring Activation in Parents of Youth with Emotional and Behavioral Disorders. J Behav Health Serv Res 2020; 46:306-318. [PMID: 29956072 DOI: 10.1007/s11414-018-9627-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
For parents of youth with emotional and behavioral disorders, activation, or having the knowledge, skills, and confidence to access and engage in appropriate services for their children, is important for managing their child's mental health care. The Parent Activation Measure (PAM) was modified to create the Parent Patient Activation Measure-Mental Health (P-PAM-MH) to measure activation as part of a randomized controlled trial of a peer parent support intervention for parents of youth with emotional and behavioral problems. Results from this study provide initial support for use of the P-PAM-MH as a measure of activation in this population and for the reliability and validity of the measure. Implications of the findings from this study for research and practice in behavioral health are discussed.
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Affiliation(s)
- Amy L Green
- University of South Florida - Tampa, 13301 Bruce B. Downs Blvd., Tampa, FL, 33612, USA.
| | - Matthew C Lambert
- University of Nebraska - Lincoln, 247E Barkley Memorial Center, Lincoln, NE, 68583-0732, USA
| | - Kristin Duppong Hurley
- University of Nebraska - Lincoln, 247E Barkley Memorial Center, Lincoln, NE, 68583-0732, USA
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Işık I, Ergün G. Hope and belonging in patients with schizophrenia: A phenomenological study. Perspect Psychiatr Care 2020; 56:235-242. [PMID: 31313318 DOI: 10.1111/ppc.12418] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/17/2019] [Accepted: 06/28/2019] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The aim of this study was to examine in depth the senses of hope and belonging in patients with schizophrenia and factors which affect these. DESIGN AND METHODS The data were collected through the phenomenological interview method and interpreted using Strauss and Corbin's approach to qualitative data analysis. FINDINGS Patients with schizophrenia reported that having hope and feeling a sense of belonging were very important to them and patients with the same diagnosis, and that being accepted by society, being employed and being productive increased their senses of both hope and belonging. PRACTICE IMPLICATIONS For the rehabilitation of patients with schizophrenia, which is a chronic disease, psychiatric nurses should carry out activities which increase their senses of hope and belonging.
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Affiliation(s)
- Işıl Işık
- Department of Nursing, Faculty of Health Sciences, Yeditepe University, Istanbul, Turkey
| | - Gül Ergün
- Department of Nursing, Faculty of Health Sciences, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
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Wang W, Zhou Y, Chai N, Liu D. Cognitive-behavioural therapy for personal recovery of patients with schizophrenia: A systematic review and meta-analysis. Gen Psychiatr 2019; 32:e100040. [PMID: 31552381 PMCID: PMC6738704 DOI: 10.1136/gpsych-2018-100040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 07/03/2019] [Accepted: 07/17/2019] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND To date, cognitive-behavioural therapy (CBT) trials have primarily focused on clinical recovery; however, personal recovery is actually the fundamental aspect of the recovery process. The aim of this study was to summarise and synthesise the existing evidence regarding the effectiveness of CBT for personal recovery in patients with schizophrenia. AIM This study aimed to determine the effectiveness of CBT for personal recovery in patients with schizophrenia. METHODS A systematic search of the literature in PsycINFO, PubMed, Cochrane (CENTRAL), Embase and Web of Science (SCI) was conducted to identify randomised controlled trials reporting the impact of CBT interventions on personal recovery in patients with schizophrenia. The estimated effect sizes of the main study outcomes were calculated to estimate the magnitude of the treatment effects of CBT on personal recovery. We also evaluated the CBT's effect size at the end-of-treatment and long-term (follow-up) changes in some aspects of personal recovery. RESULTS Twenty-five studies were included in the analysis. The effect of CBT on personal recovery was 2.27 (95% CI 0.10 to 4.45; I2=0%; p=0.04) at post-treatment and the long-term effect size was 2.62 (95% CI 0.51 to 4.47; I2=0%; p=0.02). During the post-treatment period, the pooled effect size of CBT was 0.01 (95% CI -0.12 to 0.15; I2=33.0%; p>0.05) for quality of life (QoL), 0.643 (95% CI 0.056 to 1.130; I2=30.8%; p<0.01) for psychological health-related QoL, -1.77 (95% CI -3.29 to -0.25; I2=40%; p=0.02) for hopelessness and 1.85 (95% CI 0.69 to 3.01; I2=41%; p<0.01) for self-esteem. We also summarised the effects of CBT on QoL (subscale scores not included in the evaluation of the pooled effect size), self-confidence and connectedness, and all results corresponded to positive effects. However, there was insufficient evidence regarding the long-term effects of CBT on personal recovery. CONCLUSIONS CBT is an effective therapy with meaningful clinical effect sizes on personal recovery and some aspects of personal recovery of schizophrenia after treatment. However, the effect is relatively immediate and rapidly decreases as time progresses. Therefore, in the future, more studies should focus on the mechanism of CBT for personal recovery and the factors that influence the long-term effects of CBT. TRIAL REGISTRATION NUMBER CRD42018085643.
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Affiliation(s)
- Weiliang Wang
- School of Nursing, Daqing Campus of Harbin Medical University, Daqing, Heilongjiang, China
| | - Yuqiu Zhou
- School of Nursing, Daqing Campus of Harbin Medical University, Daqing, Heilongjiang, China
| | - Nannan Chai
- School of Nursing, Chifeng University, Chifeng, Inner Mongolia Autonomous Region, China
| | - Dongwei Liu
- School of Nursing, Daqing Campus of Harbin Medical University, Daqing, Heilongjiang, China
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18
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Chen TT, Yang JJ, Hsueh YSA, Wang V. The effects of a schizophrenia pay-for-performance program on patient outcomes in Taiwan. Health Serv Res 2019; 54:1119-1125. [PMID: 31131891 DOI: 10.1111/1475-6773.13174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To examine the effects of a schizophrenia pay-for-performance (P4P) program on the health outcomes of patients in Taiwan. DATA SOURCES Seven years (2007-2013) of data from the National Health Insurance Administration (NHIA) databases were examined. STUDY DESIGN P4P patients included those who were treated at participating facilities and consecutively included in the regular group (classified by the NHIA). Non-P4P patients were treated at nonparticipating facilities and never included in the regular group. The caliper matching method and a generalized estimating equation were used to estimate difference-in-differences models (baseline year 2009) and examine the short- and long-term effects of the P4P program on adverse outcomes. PRINCIPAL FINDINGS The schizophrenia P4P program was associated with decreases in unscheduled outpatient visits (OR: 0.69, P < 0.001) and compulsory admissions (incidence rate ratio: 0.33, P < 0.05). However, this program was not associated with decreases in other outcomes including emergency department visits for any disease, admissions to an acute psychiatric ward, and readmission within 6 months. CONCLUSIONS Although the disease management component of the P4P program can be beneficial for compulsory admissions, more sophisticated activities, such as health promotion targeting disadvantaged patients, could be implemented to reduce the occurrence of complicated adverse outcomes.
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Affiliation(s)
- Tsung-Tai Chen
- Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, R.O.C
| | - Jing-Jung Yang
- Department of Psychiatry, Cardinal Tien Hospital, New Taipei City, Taiwan, R.O.C.,School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, R.O.C
| | - Ya-Seng Arthur Hsueh
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Vinchi Wang
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, R.O.C.,Department of Neurology, Neurological Center, Cardinal Tien Hospital, New Taipei City, Taiwan, R.O.C
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19
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Zisman-Ilani Y, Roe D, Elwyn G, Kupermintz H, Patya N, Peleg I, Karnieli-Miller O. Shared Decision Making for Psychiatric Rehabilitation Services Before Discharge from Psychiatric Hospitals. HEALTH COMMUNICATION 2019; 34:631-637. [PMID: 29393685 DOI: 10.1080/10410236.2018.1431018] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Shared decision making (SDM) is an effective health communication model designed to facilitate patient engagement in treatment decision making. In mental health, SDM has been applied and evaluated for medications decision making but less for its contribution to personal recovery and rehabilitation in psychiatric settings. The purpose of this pilot study was to assess the effect of SDM in choosing community psychiatric rehabilitation services before discharge from psychiatric hospitalization. A pre-post non-randomized design with two consecutive inpatient cohorts, SDM intervention (N = 51) and standard care (N = 50), was applied in two psychiatric hospitals in Israel. Participants in the intervention cohort reported greater engagement and knowledge after choosing rehabilitation services and greater services use at 6-to-12-month follow-up than those receiving standard care. No difference was found for rehospitalization rate. Two significant interaction effects indicated greater improvement in personal recovery over time for the SDM cohort. SDM can be applied to psychiatric rehabilitation decision making and can help promote personal recovery as part of the discharge process.
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Affiliation(s)
- Yaara Zisman-Ilani
- a Department of Rehabilitation Sciences , College of Public Health, Temple University
| | - David Roe
- b Department of Community Mental Health, Faculty of Social Welfare & Health Sciences , University of Haifa
| | - Glyn Elwyn
- c The Dartmouth Institute for Health Policy & Clinical Practice, Geisel Medical School, Dartmouth College
| | - Haggai Kupermintz
- d Department of Learning, Instruction, and Teaching, Faculty of Education , University of Haifa
| | - Noa Patya
- e Shalvata Mental Health Center , Hod HaSharon
| | | | - Orit Karnieli-Miller
- g Department of Medical Education, Sackler Faculty of Medicine , Tel Aviv University
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Horgan A, Manning F, Bocking J, Happell B, Lahti M, Doody R, Griffin M, Bradley SK, Russell S, Bjornsson E, O'Donovan M, MacGabhann L, Savage E, Pulli J, Goodwin J, van der Vaart KJ, O'Sullivan H, Dorrity C, Ellila H, Allon J, Hals E, Sitvast J, Granerud A, Biering P. 'To be treated as a human': Using co-production to explore experts by experience involvement in mental health nursing education - The COMMUNE project. Int J Ment Health Nurs 2018; 27:1282-1291. [PMID: 29377483 DOI: 10.1111/inm.12435] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 12/17/2017] [Indexed: 12/30/2022]
Abstract
Increasingly, experts as deemed by personal experience or mental health service use, are involved in the education of nurses; however, accompanying research is limited and focuses primarily on opinions of nurse educators and students. The aim of this study was to develop an understanding of the potential contribution to mental health nursing education by those with experience of mental health service use. The research was part of the international COMMUNE (Co-production of Mental Health Nursing Education) project, established to develop and evaluate co-produced mental health content for undergraduate nursing students. A qualitative descriptive design was adopted with data collected through focus group interviews in seven sites across Europe and Australia. Experts by experience (people with experience of distress, service use, and recovery) co-produced the project in partnership with nursing academics. Co-production enriched the process of data collection and facilitated the analysis of data from multiple perspectives. Two themes are presented in this paper. The first focuses on how experts by experience can enhance students' understanding of recovery by seeing the strengths inherent in the 'human' behind the diagnostic label. The second highlights the importance of communication and self-reflection on personal values, where students can explore their own thoughts and feelings about mental distress alongside those with lived experience. Interacting with experts by experience in the classroom can assist in challenging stigmatizing attitudes prior to nursing placements. These findings can be used to inform international nursing curricula by increasing the focus on nursing skills valued by those who use the services.
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Affiliation(s)
- Aine Horgan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Fionnuala Manning
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Julia Bocking
- SYNERGY: Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Canberra, Australian Capital Territory, Australia
| | - Brenda Happell
- SYNERGY: Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Canberra, Australian Capital Territory, Australia
| | - Mari Lahti
- Turku University of Applied Sciences, Turku, Finland.,Faculty of Medicine, Department of Nursing Science, Turku University, Turku, Finland
| | - Rory Doody
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Martha Griffin
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Stephen K Bradley
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Siobhan Russell
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Einar Bjornsson
- Department of Nursing, University of Iceland, Reykjavik, Iceland
| | - Moira O'Donovan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Liam MacGabhann
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Eileen Savage
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Jarmo Pulli
- Turku University of Applied Sciences, Turku, Finland
| | - John Goodwin
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | | | - Hazel O'Sullivan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Claire Dorrity
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Heikki Ellila
- Turku University of Applied Sciences, Turku, Finland
| | - Jerry Allon
- Institute for Nursing Studies, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Elisabeth Hals
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Hedmark, Norway
| | - Jan Sitvast
- Institute for Nursing Studies, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Arild Granerud
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Hedmark, Norway
| | - Pall Biering
- Department of Nursing, University of Iceland, Reykjavik, Iceland
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21
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Language and hope in schizophrenia-spectrum disorders. Psychiatry Res 2016; 245:8-14. [PMID: 27526311 DOI: 10.1016/j.psychres.2016.08.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 07/17/2016] [Accepted: 08/04/2016] [Indexed: 11/21/2022]
Abstract
Hope is integral to recovery for those with schizophrenia. Considering recent advancements in the examination of clients' lexical qualities, we were interested in how clients' words reflect hope. Using computerized lexical analysis, we examined social, emotion, and future words' relations to hope and its pathways and agency components. Forty-five clients provided detailed narratives about their life and mental illness. Transcripts were analyzed using the Linguistic Inquiry and Word Count program (LIWC), which assigns words to categories (e.g., "anxiety") based on a pre-existing dictionary. Correlations and linear multiple regression were used to examine relationships between lexical qualities and hope. Hope and its subcomponents had significant or trending bivariate correlations in expected directions with several emotion-related word categories (anger and sadness) but were not associated with expected categories such as social words, positive emotions, optimism, achievement, and future words. In linear multiple regressions, no LIWC variable significantly predicted hope agency, but anger words significantly predicted both total hope and hope pathways. Our findings indicate lexical analysis tools can be used to investigate recovery-oriented concepts such as hope, and results may inform clinical practice. Future research should aim to replicate our findings in larger samples.
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