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Kerry E, Collett N, Gunn J. The impact of expert by experience involvement in teaching in a DClinPsych programme; for trainees and experts by experience. Health Expect 2023; 26:2098-2108. [PMID: 37448178 PMCID: PMC10485345 DOI: 10.1111/hex.13817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
INTRODUCTION There is a growing acknowledgement of the value of creating partnerships between those delivering and those accessing health services. Less is known about this in the context of clinical psychology doctoral training programmes. This study explores the models of involvement of experts by experience (EbEs) in teaching on a DClinPsych course in England; the impact of this both for EbEs and trainee clinical psychologists and whether improvements are required to better meet their needs. METHODS An audit of current involvement was conducted by reviewing course records. Two survey questionnaires designed around commonly used frameworks of participation and reflective learning were completed by EbEs and trainees. Thematic Analysis was used to evaluate the written feedback from the surveys. RESULTS Records of current EbE involvement were found to be lacking in detail and sometimes missing. Key themes extrapolated from the surveys highlighted the importance of EbE involvement in supporting the wellbeing of EbEs and the learning experiences of trainees. CONCLUSIONS Recommendations with regard to the processes for future involvement of EbEs in teaching are put forward. PATIENT OR PUBLIC CONTRIBUTION A carer of a service user was consulted about the design of the participant information sheet, consent form and the survey questionnaire which was sent to the EbEs. A trainee clinical psychologist was also consulted to provide a trainee perspective on the above forms and the survey questionnaire that was sent to trainees. Further to this, the first author's supervisor identifies as a user of physical and mental health services and provided continued supervision and support regarding the direction of the study including the research questions, design, methodology and interpretation of results.
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Affiliation(s)
- Ellie Kerry
- Oxford Institute for Clinical Psychology ResearchUniversity of OxfordOxfordUK
| | - Nicola Collett
- Oxford Institute for Clinical Psychology ResearchUniversity of OxfordOxfordUnited Kingdom
| | - Jason Gunn
- Oxford Institute for Clinical Psychology ResearchUniversity of OxfordOxfordUnited Kingdom
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Harris H, Clarkin C, Rovet J, Crawford A, Johnson A, Kirvan A, Gruszecki S, Wang S, Soklaridis S. Meaningful engagement through critical reflexivity: Engaging people with lived experience in continuing mental health professional development. Health Expect 2023; 26:1793-1798. [PMID: 37365844 PMCID: PMC10485329 DOI: 10.1111/hex.13798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Abstract
Engaging people with lived experience of mental health system encounters in the design and actualization of continuing professional development initiatives for mental health professionals can have transformative systemic impacts. Yet, despite evidence that involving people with lived experience benefits mental health professional education, far less focus has been placed on how to engage people with lived experience in continuing professional development initiatives. Tensions persist regarding the role of lived experience perspectives in continuing professional development, as well as how to establish people with lived experience as partners, educators and leaders in a thoughtful way. We propose that meaningful and equitable partnerships with people with lived experience can be realized by engaging in critical reflexivity and by systematically challenging assumptions. This paper explores three topics: (1) the current state of engagement with people with lived experience in continuing professional development initiatives; (2) barriers to meaningful engagement and (3) recommendations for using critical reflexivity to support the involvement and leadership of people with lived experience in continuing professional development for mental health professionals. PATIENT OR PUBLIC INVOLVEMENT: This viewpoint manuscript was co-designed and co-written by people with diverse lived and learned experiences. Each author's professional roles involve meaningfully and equitably partnering with and centring the perspectives of those with lived experience of mental health system encounters. In addition, approximately half of the authorship team identifies as having lived experience of accessing the psychiatric system and/or supporting family members who are navigating challenges related to mental health. These lived and learned experiences informed the conception and writing of this article.
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Affiliation(s)
- Holly Harris
- Department of EducationCentre for Addiction and Mental HealthTorontoOntarioCanada
| | - Chantalle Clarkin
- Talk Suicide CanadaCentre for Addiction and Mental HealthTorontoOntarioCanada
- Bloomberg Faculty of NursingUniversity of TorontoTorontoOntarioCanada
| | - Jordana Rovet
- Department of EducationCentre for Addiction and Mental HealthTorontoOntarioCanada
| | - Allison Crawford
- Talk Suicide CanadaCentre for Addiction and Mental HealthTorontoOntarioCanada
- Virtual Mental Health and OutreachCentre for Addiction and Mental HealthTorontoOntarioCanada
- Department of Psychiatry, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioUSA
| | - Andrew Johnson
- Department of EducationCentre for Addiction and Mental HealthTorontoOntarioCanada
| | - Anne Kirvan
- Talk Suicide CanadaCentre for Addiction and Mental HealthTorontoOntarioCanada
- Virtual Mental Health and OutreachCentre for Addiction and Mental HealthTorontoOntarioCanada
| | - Sam Gruszecki
- Department of EducationCentre for Addiction and Mental HealthTorontoOntarioCanada
| | - Stephanie Wang
- Department of EducationCentre for Addiction and Mental HealthTorontoOntarioCanada
- Virtual Mental Health and OutreachCentre for Addiction and Mental HealthTorontoOntarioCanada
- Health Out LoudTorontoOntarioCanada
| | - Sophie Soklaridis
- Department of EducationCentre for Addiction and Mental HealthTorontoOntarioCanada
- Department of Psychiatry, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioUSA
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Sagen JS, Smedslund G, Simonsen AE, Habberstad A, Kjeken I, Dagfinrud H, Moe RH. Patient engagement in the development and delivery of healthcare services: a systematic scoping review. BMJ Open Qual 2023; 12:e002309. [PMID: 37369560 PMCID: PMC10577732 DOI: 10.1136/bmjoq-2023-002309] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Patient engagement (PE) is required to improve future healthcare services. PE in the development and delivery of healthcare services is likely to be complex but is scarcely described. OBJECTIVES The objective of this scoping review was to summarise primary studies on mesolevel PE regarding structure, process and outcomes. More specifically, the aim was to explore barriers and facilitators to successful PE, how persons are engaged in the process and summarise reported consequences. METHOD A systematic scoping review was conducted, searching the MEDLINE, EMBASE, Cochrane and PsycINFO databases. Primary studies, published between 7 July 2005 and 4 October 2022, were considered for inclusion. Two reviewers extracted data about PE (eg, attributes of PE settings, facilitators and barriers, and outcomes to PE) and the first author coded the extracted data into structural, processual and outcome themes. RESULTS Of 8588 identified records, 37 studies were eligible. Most of the included studies were conducted in Europe (n=19; 51%) and North America (n=13; 35%). Structures that ensure sufficient stakeholder representativeness and PE knowledge through education may facilitate the PE process further, regardless of the environmental setting. Interpersonal relationships with uneven power dynamics were reported as noteworthy processual barriers to meaningful PE, while clearly described roles and tasks were reported as important facilitators. In contrast to hard outcomes with operationalised PE effects, the most noteworthy outcomes of PE were reported as soft processual consequences such as patient representatives improving their self-esteem and feeling valued. CONCLUSIONS Unfortunately, there is a dearth of studies exploring hard and operationalised PE outcomes on healthcare services and patients receiving healthcare. The PE process may be facilitated by dedicated finances to PE education and by ensuring sufficient stakeholder representativeness.
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Affiliation(s)
- Joachim Støren Sagen
- NKRR, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Oslo Metropolitan University, Faculty of Health Sciences, Oslo, Norway
| | - Geir Smedslund
- NKRR, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Andreas Habberstad
- The Norwegian Federation of Organisations of Disabled People, Oslo, Norway
| | - Ingvild Kjeken
- NKRR, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Oslo Metropolitan University, Faculty of Health Sciences, Oslo, Norway
| | - Hanne Dagfinrud
- NKRR, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Rikke Helene Moe
- NKRR, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
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Cox R, Molineux M, Kendall M, Tanner B, Miller E. 'Learning and growing together': exploring consumer partnerships in a PhD, an ethnographic study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:8. [PMID: 36918951 PMCID: PMC10014401 DOI: 10.1186/s40900-023-00417-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Consumer and community involvement (CCI) in health research is increasingly recognised as best practice and is closely linked with calls for epistemic justice and more transparent university collaborations with consumers. Given doctoral candidates play a key role in the future of co-production, examination of consumer partnerships in PhDs is important. This study aimed to describe and evaluate consumer partnerships in a PhD from the perspective of the consumer co-researchers, the PhD candidate, and the academic supervisors including optimal approaches, impacts, and benefits and challenges. METHODS This prospective, co-produced ethnographic study was conducted over 33 months. Data collection included field notes, a monthly online log of partnership experiences and time spent, interviews or a focus group every six months, and a PhD student reflexive diary. Qualitative data were analysed using reflexive thematic analysis. RESULTS The student, two academics, and four consumer co-researchers were involved. A mean of 11.10 h per month were spent on CCI. The student spent the most time (mean 15.86 h per month). Preparation for dissemination of findings was the most frequent partnership activity. The two overarching themes emphasised that a PhD promotes a rich partnership ethos with the student at the centre and that the partnership was a worthwhile but challenging process. The four sub-themes highlighted that developing a collegial and supportive environment with regular meetings combined with a multi-faceted and responsive co-learning approach were core to success. Additionally, there were benefits for individuals, research processes and outcomes, and for driving change in consumer-academic research partnerships. Recruiting to and forming the partnership, maintaining the collaboration through inevitable changes and challenges, and an ethical and supportive closure of the research team were critical. CONCLUSIONS This longitudinal ethnographic study demonstrated that doctoral research can create a rich ethos for research and knowledge co-production which evolved over time. Equalising power dynamics through relationship building and co-learning was critical. Additionally, a focus on supportively ending the partnership was essential, and CCI may reduce PhD student isolation and procrastination. Enhanced university incentivisation of co-production in health research is recommended to address gaps in consumer remuneration and student support.
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Affiliation(s)
- Ruth Cox
- Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Corner Kessels and Troughton Roads, Coopers Plains, QLD, 4108, Australia.
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia.
| | - Matthew Molineux
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Melissa Kendall
- Acquired Brain Injury Outreach Service and Transitional Rehabilitation Program, Princess Alexandra Hospital, Buranda, QLD, Australia
- School of Health Sciences and Social Work, Griffith University, Meadowbrook, QLD, Australia
| | - Bernadette Tanner
- Consumer Co-Researcher C/O Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Coopers Plains, QLD, Australia
| | - Elizabeth Miller
- Consumer Co-Researcher C/O Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Coopers Plains, QLD, Australia
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Merner B, Schonfeld L, Virgona A, Lowe D, Walsh L, Wardrope C, Graham-Wisener L, Xafis V, Colombo C, Refahi N, Bryden P, Chmielewski R, Martin F, Messino NM, Mussared A, Smith L, Biggar S, Gill M, Menzies D, Gaulden CM, Earnshaw L, Arnott L, Poole N, Ryan RE, Hill S. Consumers' and health providers' views and perceptions of partnering to improve health services design, delivery and evaluation: a co-produced qualitative evidence synthesis. Cochrane Database Syst Rev 2023; 3:CD013274. [PMID: 36917094 PMCID: PMC10065807 DOI: 10.1002/14651858.cd013274.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Partnering with consumers in the planning, delivery and evaluation of health services is an essential component of person-centred care. There are many ways to partner with consumers to improve health services, including formal group partnerships (such as committees, boards or steering groups). However, consumers' and health providers' views and experiences of formal group partnerships remain unclear. In this qualitative evidence synthesis (QES), we focus specifically on formal group partnerships where health providers and consumers share decision-making about planning, delivering and/or evaluating health services. Formal group partnerships were selected because they are widely used throughout the world to improve person-centred care. For the purposes of this QES, the term 'consumer' refers to a person who is a patient, carer or community member who brings their perspective to health service partnerships. 'Health provider' refers to a person with a health policy, management, administrative or clinical role who participates in formal partnerships in an advisory or representative capacity. This QES was co-produced with a Stakeholder Panel of consumers and health providers. The QES was undertaken concurrently with a Cochrane intervention review entitled Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation. OBJECTIVES 1. To synthesise the views and experiences of consumers and health providers of formal partnership approaches that aimed to improve planning, delivery or evaluation of health services. 2. To identify best practice principles for formal partnership approaches in health services by understanding consumers' and health providers' views and experiences. SEARCH METHODS We searched MEDLINE, Embase, PsycINFO and CINAHL for studies published between January 2000 and October 2018. We also searched grey literature sources including websites of relevant research and policy organisations involved in promoting person-centred care. SELECTION CRITERIA We included qualitative studies that explored consumers' and health providers' perceptions and experiences of partnering in formal group formats to improve the planning, delivery or evaluation of health services. DATA COLLECTION AND ANALYSIS Following completion of abstract and full-text screening, we used purposive sampling to select a sample of eligible studies that covered a range of pre-defined criteria, including rich data, range of countries and country income level, settings, participants, and types of partnership activities. A Framework Synthesis approach was used to synthesise the findings of the sample. We appraised the quality of each study using the CASP (Critical Appraisal Skill Program) tool. We assessed our confidence in the findings using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. The Stakeholder Panel was involved in each stage of the review from development of the protocol to development of the best practice principles. MAIN RESULTS We found 182 studies that were eligible for inclusion. From this group, we selected 33 studies to include in the final synthesis. These studies came from a wide range of countries including 28 from high-income countries and five from low- or middle-income countries (LMICs). Each of the studies included the experiences and views of consumers and/or health providers of partnering in formal group formats. The results were divided into the following categories. Contextual factors influencing partnerships: government policy, policy implementation processes and funding, as well as the organisational context of the health service, could facilitate or impede partnering (moderate level of confidence). Consumer recruitment: consumer recruitment occurred in different ways and consumers managed the recruitment process in a minority of studies only (high level of confidence). Recruiting a range of consumers who were reflective of the clinic's demographic population was considered desirable, particularly by health providers (high level of confidence). Some health providers perceived that individual consumers' experiences were not generalisable to the broader population whereas consumers perceived it could be problematic to aim to represent a broad range of community views (high level of confidence). Partnership dynamics and processes: positive interpersonal dynamics between health providers and consumers facilitated partnerships (high level of confidence). However, formal meeting formats and lack of clarity about the consumer role could constrain consumers' involvement (high level of confidence). Health providers' professional status, technical knowledge and use of jargon were intimidating for some consumers (high level of confidence) and consumers could feel their experiential knowledge was not valued (moderate level of confidence). Consumers could also become frustrated when health providers dominated the meeting agenda (moderate level of confidence) and when they experienced token involvement, such as a lack of decision-making power (high level of confidence) Perceived impacts on partnership participants: partnering could affect health provider and consumer participants in both positive and negative ways (high level of confidence). Perceived impacts on health service planning, delivery and evaluation: partnering was perceived to improve the person-centredness of health service culture (high level of confidence), improve the built environment of the health service (high level of confidence), improve health service design and delivery e.g. facilitate 'out of hours' services or treatment closer to home (high level of confidence), enhance community ownership of health services, particularly in LMICs (moderate level of confidence), and improve consumer involvement in strategic decision-making, under certain conditions (moderate level of confidence). There was limited evidence suggesting partnering may improve health service evaluation (very low level of confidence). Best practice principles for formal partnering to promote person-centred care were developed from these findings. The principles were developed collaboratively with the Stakeholder Panel and included leadership and health service culture; diversity; equity; mutual respect; shared vision and regular communication; shared agendas and decision-making; influence and sustainability. AUTHORS' CONCLUSIONS Successful formal group partnerships with consumers require health providers to continually reflect and address power imbalances that may constrain consumers' participation. Such imbalances may be particularly acute in recruitment procedures, meeting structure and content and decision-making processes. Formal group partnerships were perceived to improve the physical environment of health services, the person-centredness of health service culture and health service design and delivery. Implementing the best practice principles may help to address power imbalances, strengthen formal partnering, improve the experiences of consumers and health providers and positively affect partnership outcomes.
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Affiliation(s)
- Bronwen Merner
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Lina Schonfeld
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Ariane Virgona
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Dianne Lowe
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
- Child and Family Evidence, Australian Institute of Family Studies, Melbourne, Australia
| | - Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Cheryl Wardrope
- Clinical Governance, Metro South Hospital and Health Service, Eight Mile Plains, Australia
| | | | - Vicki Xafis
- The Sydney Children's Hospitals Network, Sydney, Australia
| | - Cinzia Colombo
- Laboratory for medical research and consumer involvement, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Nora Refahi
- Consumer Representative, Melbourne, Australia
| | - Paul Bryden
- Consumer Representative, Caboolture, Australia
| | - Renee Chmielewski
- Planning and Patient Experience, The Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | | | | | | | - Lorraine Smith
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Susan Biggar
- Consumer Representative, Melbourne, Australia
- Australian Health Practitioner Regulation Agency (AHPRA), Melbourne, Australia
| | - Marie Gill
- Gill and Wilcox Consultancy, Melbourne, Australia
| | - David Menzies
- Chronic Disease Programs, South Eastern Melbourne Primary Health Network, Heatherton, Australia
| | - Carolyn M Gaulden
- Detroit Wayne County Authority Health Residency Program, Michigan State University, Providence Hospital, Southfield, Michigan, USA
| | | | | | - Naomi Poole
- Strategy and Innovation, Australian Commission on Safety and Quality in Health Care, Sydney, Australia
| | - Rebecca E Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
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Fusco F, Marsilio M, Guglielmetti C. Co-creation in healthcare: framing the outcomes and their determinants. JOURNAL OF SERVICE MANAGEMENT 2023. [DOI: 10.1108/josm-06-2021-0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PurposeUnderstanding the outcomes of co-creation (CC) in healthcare is increasingly gaining multidisciplinary scientific interest. Although more and more service management scholars have pointed out the benefits of cross-fertilization between the various research fields, the literature on this topic is still scattered and poorly integrated. This study aims to summarize and integrate multiple strands of extant knowledge CC by identifying the outcomes of health CC and the determinants of these outcomes and their relationships.Design/methodology/approachA structured literature review was conducted per PRISMA guidelines. A total of 4,189 records were retrieved from the six databases; 1,983 articles were screened, with 161 included in the qualitative thematic analysis.FindingsThis study advances a comprehensive framework for healthcare CC based on a thorough analysis of the outcomes and their determinants, that is, antecedents, management activities and institutional context. Extant research rarely evaluates outcomes from a multidimensional and systemic perspective. Less attention has been paid to the relationship among the CC process elements.Research limitations/implicationsThis study offers an agenda to guide future studies on healthcare CC. Highlighting some areas of integration among different disciplines further advances service literature.Practical implicationsThe framework offers an operational guide to better shape managerial endeavors to facilitate CC, provide direction and assess multiple outcomes.Originality/valueThis is the first extensive attempt to synthesize and integrate multidisciplinary knowledge on CC outcomes in healthcare settings by adopting a systematic perspective on the overall process.
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Waxell A, Wiklund Gustin L. "Walking Together Towards Freedom." Patients' Lived Experiences of Participation in Outpatient Forensic Care. Issues Ment Health Nurs 2022; 43:455-462. [PMID: 34762558 DOI: 10.1080/01612840.2021.1998262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
There is a general agreement regarding the significance of patient participation in care. In forensic psychiatric care, however, this appears to be troublesome because of the paradoxical nature of having responsibility; to give person-centered, recovery-oriented psychiatric care and to protect society from potentially dangerous individuals. The aim of this study was to describe patients' lived experiences of participation in outpatient forensic psychiatric care. Data were collected by means of individual interviews with five patients. The phenomenological hermeneutical analysis shed light on patient participation as having two dimensions. The outer dimension focuses on participation as "doing" and as a means of developing the understanding and skills necessary for being discharged from forensic care, while the inner dimension is related to "being" and experiences of acceptance and inclusion in communion with other people. This emphasises the importance of supporting patients' experiences of being involved in everyday life together with others, even in periods when patients' possibilities to affect decisions regarding their care are limited.
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Affiliation(s)
- Anni Waxell
- Division of Psychiatry, Region Vastmanland, Västerås, Sweden
| | - Lena Wiklund Gustin
- School of Health, Care and Social Welfare, Mälardalen University Sweden, Västerås, Sweden.,Department of Health and Care Sciences, UiT/The Arctic University of Norway, Tromsø, Norway
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8
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Mountjoy M, Vertommen T, Denhollander R, Kennedy S, Majoor R. Effective engagement of survivors of harassment and abuse in sport in athlete safeguarding initiatives: a review and a conceptual framework. Br J Sports Med 2022; 56:232-238. [PMID: 35110362 DOI: 10.1136/bjsports-2021-104625] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2021] [Indexed: 11/04/2022]
Abstract
Sport, as a microcosm of society, is not immune to the abuse of its stakeholders. Attention to abuse in sport has recently become a priority for sport organisations following several high-profile cases of athlete abuse from different sports around the world. Resulting from this increased awareness, many sport organisations have commenced work in the field of athlete safeguarding including the development of policy, educational programmes, reporting pathways, investigation mechanisms and research initiatives. One mechanism adopted by many sport organisations to support their safeguarding efforts is the engagement of survivors of abuse in sport: typically, as guest speakers at conferences or educational events. Unfortunately, many sport organisations do not have the knowledge or trauma-informed expertise to engage survivors safely and effectively; and in doing so, may unintentionally retraumatise the survivor if erroneous methods of engagement are employed. For some survivors, this experience may compound the original harms, and thus it also represents an area of vulnerability for the organising entity. The purpose of this paper is to explore the rationale for partnering with survivors of abuse in sport in safeguarding initiatives and to propose a living conceptual framework to support effective and safe survivor engagement in safeguarding initiatives. We will explore the underpinning scientific background, as well as the 'why', and 'how' of survivor engagement to inform sport organisations, research scientists, policy-makers, conference organisers, safeguarding officers, sport medicine clinicians and survivors themselves.
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Affiliation(s)
- Margo Mountjoy
- Family Medicine, McMaster University Michael G DeGroote School of Medicine, Waterloo, Ontario, Canada .,International Research Network on Violence and Integrity in Sport, IRNOVIS, Antwerp, Belgium
| | - Tine Vertommen
- International Research Network on Violence and Integrity in Sport, IRNOVIS, Antwerp, Belgium.,Medicine and Health Sciences, Universiteit Antwerpen, Antwerpen, Belgium
| | | | | | - Renald Majoor
- Breaking the Silence Foundation, Wehl, The Netherlands
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Owen E, Massazza A, Roberts B, Lokot M, Fuhr DC. “Nothing about us, without us”? A qualitative study of service user involvement in the development of lay-delivered psychological interventions in contexts affected by humanitarian crises. J Migr Health 2022; 5:100087. [PMID: 35243462 PMCID: PMC8885574 DOI: 10.1016/j.jmh.2022.100087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/28/2022] Open
Abstract
Background : Service user involvement has become increasingly prioritised within health research, and more recently, within mental health and psychosocial support (MHPSS). However, there is limited exploration of service user involvement in the development of lay-delivered MHPSS psychological interventions. The aim of this research was to investigate how service users have been involved in the development of lay-delivered psychological interventions for populations affected by humanitarian crises. Methods : Thirteen semi-structured interviews were conducted with respondents involved in randomized controlled trials (RCTs) of lay-delivered MHPSS psychological interventions, either as principal investigators or as focal points for service user involvement. Thematic data analysis used was used to analyse the data. Results : There was a common perception that service user involvement is vital to the development of lay-delivered psychological interventions, but there was concern about how that happened in practice. Respondents desired to increase service user involvement, but they either did not know how to do this into practice or felt that they lacked the resources to do so. Recommendations were made for strengthening involvement, such as employing service users onto research teams. However, legal difficulties in compensating service users for their work were raised. Conclusion : Service user involvement was viewed as vital in the development of lay delivered psychological interventions, but remains predominantly tokenistic, partly due to limited guidance, time, and finances. Guidelines could support more meaningful and ethical service user involvement in lay-delivered psychological interventions in areas affected by humanitarian crises.
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Affiliation(s)
- Emily Owen
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, London, UK
| | - Alessandro Massazza
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, London, UK
| | - Bayard Roberts
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, London, UK
| | - Michelle Lokot
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, London, UK
| | - Daniela C. Fuhr
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, London, UK
- Corresponding author.
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10
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Wiklund Gustin L. " Being mutually involved in recovery". A hermeneutic exploration of nurses' experiences of patient participation in psychiatric care. Int J Qual Stud Health Well-being 2021; 16:2001893. [PMID: 34823447 PMCID: PMC8843384 DOI: 10.1080/17482631.2021.2001893] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/30/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE This study aims at exploring how psychiatric nurses' experiences of patient participation could be understood from a caring science perspective. METHODS The design was inspired by clinical application research., which is a hermeneutic approach developed within caring science research. . In this study data were co-created during four reflective group dialogues where five participants' experiences of patient participation were reflected on in the light of caring science theory and research. The transcribed dialogues were subjected to a thematic, hermeneutic interpretation. RESULTS The interpretation gave rise to three themes; giving room for the patient to find his/her own pathway, strengthening personhood, and being in a balanced communion. From these themes an underlying pattern of the meaning of participation as being mutually involved in the patients' process of recovery arose. CONCLUSION From a caring science perspective the meaning of psychiatric nurses experiences of patient participation could be understood as an interpersonal process reflecting the reciprocity in human relationships. This means a shift in understanding of patient participation from procedures related to the planning of nursing care, to understanding participation as a process focusing on the mutual involvement of patients and nurses in the patients' process of recovery.
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Affiliation(s)
- Lena Wiklund Gustin
- School of Health, Care and Social Welfare, Mälardalen University Sweden, Västerås, Sweden
- Department of Health and Care Sciences, UiT/The Arctic University of Norway, Tromsø, Norway
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11
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Cox R, Molineux M, Kendall M, Tanner B, Miller E. Co-produced capability framework for successful patient and staff partnerships in healthcare quality improvement: results of a scoping review. BMJ Qual Saf 2021; 31:134-146. [PMID: 34253682 PMCID: PMC8784995 DOI: 10.1136/bmjqs-2020-012729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 06/23/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Internationally, patient and public involvement (PPI) is core policy for health service quality improvement (QI). However, authentic QI partnerships are not commonplace. A lack of patient and staff capability to deliver successful partnerships may be a barrier to meaningful QI collaboration. OBJECTIVES The research questions for this scoping review were: What is known regarding the capabilities required for healthcare staff and patients to effectively partner in QI at the service level?; and What is known regarding the best practice learning and development strategies required to build and support those capabilities? METHODS A six-stage scoping review was completed. Five electronic databases were searched for publications from January 2010 to February 2020. The database searches incorporated relevant terms for the following concepts: capabilities for PPI in healthcare QI; and best practice learning and development strategies to support those capabilities. Data were analysed using descriptive statistics and qualitative content analysis. RESULTS Forty-nine papers were included. Very little peer-reviewed literature focused explicitly on capabilities for QI partnerships and thus implicit paper content was analysed. A Capability framework for successful partnerships in healthcare quality improvement was developed. It includes knowledge, skills and attitudes across three capability domains: Personal Attributes; Relationships and Communication; and Philosophies, Models and Practices, and incorporates 10 capabilities. Sharing power and leadership was discussed in many papers as fundamental and was positioned across all of the domains. Most papers discussed staff and patients' co-learning (n=28, 57.14%). Workshops or shorter structured training sessions (n=36, 73.47%), and face-to-face learning (n=34, 69.38%) were frequently reported. CONCLUSION The framework developed here could guide individualised development or learning plans for patient partners and staff, or could assist organisations to review learning topics and approaches such as training content, mentoring guidelines or community of practice agendas. Future directions include refining and evaluating the framework. Development approaches such as self-reflection, communities of practice, and remote learning need to be expanded and evaluated.
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Affiliation(s)
- Ruth Cox
- Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia .,Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Queensland, Australia
| | - Matthew Molineux
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Queensland, Australia
| | - Melissa Kendall
- School of Health Sciences and Social Work, Griffith University, Queensland, Queensland, Australia.,Acquired Brain Injury Outreach Service and Transitional Rehabilitation Program, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Bernadette Tanner
- Consumer Co-Researcher C/O Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia
| | - Elizabeth Miller
- Consumer Co-Researcher C/O Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia
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12
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Marsilio M, Fusco F, Gheduzzi E, Guglielmetti C. Co-Production Performance Evaluation in Healthcare. A Systematic Review of Methods, Tools and Metrics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3336. [PMID: 33804862 PMCID: PMC8037812 DOI: 10.3390/ijerph18073336] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/12/2021] [Accepted: 03/19/2021] [Indexed: 12/29/2022]
Abstract
Co-produced practices and publications in the healthcare sector are gaining momentum, since they can be a useful tool in addressing the sustainability and resilience challenges of health systems. However, the investigation of positive and, mainly, negative outcomes is still confused and fragmented, and above all, a comprehensive knowledge of the metrics used to assess these outcomes is lacking. To fill this gap, this study aims to systematically review the extant literature to map the methods, tools and metrics used to empirically evaluate co-production in health services. The search took place in six databases: Scopus, Web of Science, Psych INFO, PubMed, Cochrane and CINAHL. A total of 2311 articles were screened and 203 articles were included in the analysis, according to PRISMA guidelines. Findings show that outcomes are mainly investigated through qualitative methods and from the lay actor or provider perspective. Moreover, the detailed categorisation of the quantitative measures found offers a multidimensional performance measurement system and highlights the impact areas where research is needed to develop and test new measures. Findings should also promote improvements in empirical data collection on the multiple faceted co-produced activities and spur the consciousness of the adoption of sustainable co-productive initiatives.
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Affiliation(s)
- Marta Marsilio
- Department of Economics, Management and Quantitative Methods (DEMM), Università degli Studi di Milano, via Conservatorio, 7, 20122 Milan, Italy; (F.F.); (C.G.)
| | - Floriana Fusco
- Department of Economics, Management and Quantitative Methods (DEMM), Università degli Studi di Milano, via Conservatorio, 7, 20122 Milan, Italy; (F.F.); (C.G.)
| | - Eleonora Gheduzzi
- School of Management, Politecnico di Milano, via Lambruschini 4, 20156 Milan, Italy;
| | - Chiara Guglielmetti
- Department of Economics, Management and Quantitative Methods (DEMM), Università degli Studi di Milano, via Conservatorio, 7, 20122 Milan, Italy; (F.F.); (C.G.)
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13
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Horgan A, Manning F, Donovan MO, Doody R, Savage E, Bradley SK, Dorrity C, O'Sullivan H, Goodwin J, Greaney S, Biering P, Bjornsson E, Bocking J, Russell S, MacGabhann L, Griffin M, van der Vaart KJ, Allon J, Granerud A, Hals E, Pulli J, Vatula A, Ellilä H, Lahti M, Happell B. Expert by experience involvement in mental health nursing education: The co-production of standards between Experts by Experience and academics in mental health nursing. J Psychiatr Ment Health Nurs 2020; 27:553-562. [PMID: 31989758 DOI: 10.1111/jpm.12605] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/13/2020] [Accepted: 01/23/2020] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT Expert by Experience (EBE) involvement in mental health nursing education has demonstrated benefits, including enhancing understanding of holistic and recovery-focused practice and enhanced application of interpersonal skills. Structure and support for EBE involvement is lacking; often resulting in inadequate preparation and debriefing and tokenistic involvement. Service user involvement in mental health nursing education should be underpinned by lived experience perspectives. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE An exploration of EBE involvement in nursing education from the perspective of those with lived experience. The development of standards designed to provide structure to better support future EBEs involved in higher education. An exemplar for co-production of standards between EBE and nurse academics which has applicability for other contexts. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The standards could potentially strengthen EBE involvement in mental health nursing education, enhance their confidence and increase the retention of EBEs by creating an inclusive working culture. By increasing support for EBEs, the benefits to mental health nursing practice are likely to be maximized. ABSTRACT Introduction Involving people with lived experience of mental distress in mental health nursing education has gained considerable traction yet broader implementation remains ad hoc and tokenistic. Effective involvement requires curricula be informed by lived experience of service use. Aim To develop standards to underpin expert by experience involvement in mental health nursing education based on lived experience of service use. Methods Phase one used qualitative descriptive methods, involving focus groups with service users (n = 50) from six countries to explore perceptions of service user involvement in mental health nursing education. Phase two utilized these findings through consensus building to co-produce standards to support Experts by Experience involvement in mental health nursing education. Results Three themes emerged in Phase one: enablers and barriers, practical and informational support, and emotional and appraisal support. These themes underpinned development of the standards, which reflect nine processes: induction and orientation, external supervision, supportive teamwork, preparation for teaching and assessing, "intervision," mutual mentorship, pre- and post-debriefing, role clarity and equitable payment. Conclusions These standards form the framework entitled; Standards for Co-production of Education (Mental Health Nursing) (SCo-PE [MHN]). Implications for Practice The standards aim to support implementation of Expert by Experience roles in mental health nursing education.
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Affiliation(s)
- Aine Horgan
- School of Nursing and Midwifery, ENGAGE: Interdisciplinary Clinical Mental health Research Network, University College Cork, Cork, Ireland
| | - Fionnuala Manning
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Moira O Donovan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Rory Doody
- School of Nursing and Midwifery, ENGAGE: Interdisciplinary Clinical Mental health Research Network, University College Cork, Cork, Ireland
| | - Eileen Savage
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | | | - Claire Dorrity
- School of Applied Social Sciences, University College Cork, Cork, Ireland
| | - Hazel O'Sullivan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - John Goodwin
- School of Nursing and Midwifery, ENGAGE: Interdisciplinary Clinical Mental health Research Network, University College Cork, Cork, Ireland
| | - Sonya Greaney
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Pall Biering
- Department of Nursing, University of Iceland, Reykjavik, Iceland
| | - Einar Bjornsson
- Department of Nursing, University of Iceland, Reykjavik, Iceland
| | - Julia Bocking
- ANU Medical School, College of Health and Medicine, The Australian National University, Woden, Canberra, Australia
| | - Siobhan Russell
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland
| | - Liam MacGabhann
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland
| | - Martha Griffin
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland
| | | | - Jerry Allon
- 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
| | - Elisabeth Hals
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Hedmark, Norway
| | - Jarmo Pulli
- Faculty of Medicine, Department of Nursing Science, Turku University, Turku University of Applied Sciences, Turku, Finland
| | - Annaliina Vatula
- Faculty of Medicine, Department of Nursing Science, Turku University, Turku University of Applied Sciences, Turku, Finland
| | - Heikki Ellilä
- Faculty of Medicine, Department of Nursing Science, Turku University, Turku University of Applied Sciences, Turku, Finland
| | - Mari Lahti
- Faculty of Medicine, Department of Nursing Science, Turku University, Turku University of Applied Sciences, Turku, Finland
| | - Brenda Happell
- School of Nursing and Midwifery, Health and Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
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14
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Scheffelaar A, Bos N, de Jong M, Triemstra M, van Dulmen S, Luijkx K. Lessons learned from participatory research to enhance client participation in long-term care research: a multiple case study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:27. [PMID: 32518688 PMCID: PMC7268743 DOI: 10.1186/s40900-020-00187-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 03/26/2020] [Indexed: 06/04/2023]
Abstract
BACKGROUND Although participatory research is known to have advantages, it is unclear how participatory research can best be performed. This study aims to report on lessons learned in collaboration with service users involved as co-researchers in three participatory teams in long-term care. METHODS A multiple case study design was chosen to explore the collaboration in three teams, each covering one specific client group receiving long-term care: physically or mentally frail elderly people, people with mental health problems or people with intellectual disabilities. RESULTS A good working environment and a good collaboration were found to be crucial requirements for participatory research. A good working environment was developed by discussing reasons for engagement and wishes, formulating basic rules, organizing training sessions, offering financial appreciation, and the availability of the researcher to give travel support. The actual collaboration was established by developing a bond and equal positioning, deciding on the role division, holding on to transparency and a clear structure, and have sufficient time for the collaboration. Moreover, the motivations and unique contributions of the co-researchers and differences between the teams were reported. The motivations of co-researchers ranged from individual goals - such as personal development, creating a new social identity and belonging to a social group - to more external goals, such as being valuable for other service users and increasing the quality of care. An inclusive collaboration required valuing the individual contributions of co-researchers and adjustment to team differences. CONCLUSIONS The results showed the importance of developing a good working environment and establishing a good collaboration for participatory research. Furthermore, the study shows that individual and team differences should be taken into account. These results can be used by researchers for designing and shaping future research projects in long-term care in collaboration with co-researchers.
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Affiliation(s)
- Aukelien Scheffelaar
- Nivel (Netherlands Institute for Health Services Research), PO Box 1568, 3500 BN Utrecht, The Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Nanne Bos
- Nivel (Netherlands Institute for Health Services Research), PO Box 1568, 3500 BN Utrecht, The Netherlands
| | | | - Mattanja Triemstra
- Nivel (Netherlands Institute for Health Services Research), PO Box 1568, 3500 BN Utrecht, The Netherlands
| | - Sandra van Dulmen
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Katrien Luijkx
- Tranzo Academic Centre for Transformation in Care and Welfare, Tilburg University, Tilburg, The Netherlands
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15
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Happell B, Waks S, Horgan A, Greaney S, Bocking J, Manning F, Goodwin J, Scholz B, Jan van der Vaart K, Allon J, Hals E, Granerud A, Doody R, Wai-Chi Chan S, Platania-Phung C, Griffin M, Russell S, MacGabhann L, Pulli J, Vatula A, Lahti M, Ellilä H, Browne G, Bjornsson E, Biering P. Expert by Experience Involvement in Mental Health Nursing Education: Nursing Students' Perspectives on Potential Improvements. Issues Ment Health Nurs 2019; 40:1026-1033. [PMID: 31498007 DOI: 10.1080/01612840.2019.1631417] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Expert by experience involvement in mental health education for health professional programmes has increased in recent decades. The related literature has articulated the benefits, and changes in attitudes have been measured in some studies. Less attention has been devoted to ways this learning approach could be improved. The aim of this paper is to present the nursing students perspectives on how Expert by Experience input into nursing curricula could be enhanced. Qualitative exploratory research was undertaken, involving focus groups with students who had completed a mental health learning module co-produced by Experts by Experience and nurse academics. Results show two main themes: getting the structure right, and changes to content and approach. Some student responses could directly influence changes to the learning module. In other instances, responses indicate the need to better prepare students of the value of lived experience knowledge in its own right, rather than adjunct to more traditional methods of education. These findings are important in encouraging reflection on how future learning modules co-produced by Experts by Experience and Mental Health Nursing academics can be refined and better articulated.
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Affiliation(s)
- Brenda Happell
- University of Newcastle, Callaghan, New South Wales, Australia
| | - Shifra Waks
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Aine Horgan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Sonya Greaney
- Southern Area Mental Health Services, School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Julia Bocking
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Fionnuala Manning
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - John Goodwin
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Brett Scholz
- ANU Medical School, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | | | - 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
| | - Arild Granerud
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Hedmark, Norway
| | - Rory Doody
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Sally Wai-Chi Chan
- University of Newcastle Singapore Operation, Singapore.,Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | | | - Martha Griffin
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland
| | - Siobhan Russell
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland
| | - Liam MacGabhann
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland
| | - Jarmo Pulli
- Turku University of Applied Sciences, Turku, Finland.,Department of Nursing Science, Faculty of Medicine, Turku University, Turku, Finland
| | - Annaliina Vatula
- Turku University of Applied Sciences, Turku, Finland.,Department of Nursing Science, Faculty of Medicine, Turku University, Turku, Finland
| | - Mari Lahti
- Turku University of Applied Sciences, Turku, Finland.,Department of Nursing Science, Faculty of Medicine, Turku University, Turku, Finland
| | - Heikki Ellilä
- Turku University of Applied Sciences, Turku, Finland.,Department of Nursing Science, Faculty of Medicine, Turku University, Turku, Finland
| | - Graeme Browne
- School of Nursing & Midwifery, University of Newcastle, Port Macquarie, Australia
| | - Einar Bjornsson
- Department of Nursing, University of Iceland, Reykjavik, Iceland
| | - Pall Biering
- Department of Nursing, University of Iceland, Reykjavik, Iceland
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16
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Happell B, Platania-Phung C, Scholz B, Bocking J, Horgan A, Manning F, Doody R, Hals E, Granerud A, Lahti M, Pullo J, Vatula A, Ellilä H, van der Vaart KJ, Allon J, Griffin M, Russell S, MacGabhann L, Bjornsson E, Biering P. Nursing student attitudes to people labelled with 'mental illness' and consumer participation: A survey-based analysis of findings and psychometric properties. NURSE EDUCATION TODAY 2019; 76:89-95. [PMID: 30776534 DOI: 10.1016/j.nedt.2019.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 01/15/2019] [Accepted: 02/05/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Understanding student attitudes towards people diagnosed with mental illness is central to realising evidence-based nursing education and policy at an international level. Redressing stigmatised views can assist in preparing nursing students to work in mental health settings and support the active involvement of consumers in all aspects of mental health service delivery (known as: consumer participation) at individual and systemic levels. Accurate research on nursing student attitudes is dependent on the availability of valid and reliable measures. OBJECTIVES Using data from and international study, this research sought to: (1) evaluate two measures of nurse student attitudes, and (2) explore whether attitudes to people labelled with a diagnosis of mental illness and who use mental health services is associated with more positive attitudes to consumer participation in mental health services. DESIGN Self-report quantitative data gained via the Consumer Participation Questionnaire (CPQ) and Mental Health Nurse Education Survey (MHNES). SETTING AND PARTICIPANTS University nursing students in Australia and Western Europe. DATA Pooled CPQ and MHNES data from Australia, Ireland, Finland, Norway and the Netherlands. METHODS The MHNES and CPQ were evaluated via exploratory factor analysis and Rasch modelling. Hierarchical regression was applied to see whether attitudes to mental illness and mental health practice relate to attitudes to consumer participation after addressing demographic differences. RESULTS Refined MHNES scales demonstrated overall fit on Rasch models. Reliabilities for MHNES ranged from 0.82 to 0.73. Perceived value of mental health nursing to consumers and lower negative stereotypes were associated with positive attitudes to consumer participation independent of age, gender and country [F (9, 381) = 15.78, p < .001]. Students who considered mental health nursing made a valuable contribution represented the strongest association with a positive attitude towards consumer participation. CONCLUSIONS Differences in openness to consumer participation are partly attributable to views about people diagnosed with mental illness and the perception that mental health practice makes a positive difference to these people within health service contexts.
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Affiliation(s)
- Brenda Happell
- School of Nursing and Midwifery, University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia.
| | - Chris Platania-Phung
- School of Nursing and Midwifery, University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia.
| | - Brett Scholz
- ANU Medical School, College of Health and Medicine, The Australian National University, Woden, Canberra, Australia.
| | - Julia Bocking
- School of Health Sciences, University of Canberra, Faculty of Health, Australia.
| | - Aine Horgan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland.
| | - Fionnuala Manning
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Rory Doody
- School of Nursing and Midwifery, University College Cork, Cork, Ireland.
| | - Elisabeth Hals
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Hedmark, Norway.
| | - Arild Granerud
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Hedmark, Norway.
| | - Mari Lahti
- Turku University of Applied Sciences, Turku, Finland; Faculty of Medicine, Department of Nursing Science, Turku University, Turku, Finland.
| | - Jarmo Pullo
- Turku University of Applied Sciences, Turku, Finland; Faculty of Medicine, Department of Nursing Science, Turku University, Turku, Finland
| | - Annaliina Vatula
- Turku University of Applied Sciences, Turku, Finland; Faculty of Medicine, Department of Nursing Science, Turku University, Turku, Finland
| | - Heikki Ellilä
- Turku University of Applied Sciences, Turku, Finland; Faculty of Medicine, Department of Nursing Science, Turku University, Turku, Finland.
| | | | - Jerry Allon
- Institute for Nursing Studies, University of Applied Sciences Utrecht, Utrecht, the Netherlands.
| | - Martha Griffin
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland.
| | - Siobhan Russell
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland.
| | - Liam MacGabhann
- School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland.
| | - Einar Bjornsson
- Department of Nursing, University of Iceland, Reykjavik, Iceland.
| | - Pall Biering
- Department of Nursing, University of Iceland, Reykjavik, Iceland.
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17
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Abayneh S, Lempp H, Alem A, Alemayehu D, Eshetu T, Lund C, Semrau M, Thornicroft G, Hanlon C. Service user involvement in mental health system strengthening in a rural African setting: qualitative study. BMC Psychiatry 2017; 17:187. [PMID: 28521749 PMCID: PMC5437561 DOI: 10.1186/s12888-017-1352-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Accepted: 05/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is essential to involve service users in efforts to expand access to mental health care in integrated primary care settings in low- and middle-income countries (LMICs). However, there is little evidence from LMICs to guide this process. The aim of this study was to explore barriers to, and facilitators of, service user/caregiver involvement in rural Ethiopia to inform the development of a scalable approach. METHODS Thirty nine semi-structured interviews were carried out with purposively selected mental health service users (n = 13), caregivers (n = 10), heads of primary care facilities (n = 8) and policy makers/planners/service developers (n = 8). The interviews were audio-recorded and transcribed in Amharic, and translated into English. Thematic analysis was applied. RESULTS All groups of participants supported service user and caregiver involvement in mental health system strengthening. Potential benefits were identified as (i) improved appropriateness and quality of services, and (ii) greater protection against mistreatment and promotion of respect for service users. However, hardly any respondents had prior experience of service user involvement. Stigma was considered to be a pervasive barrier, operating within the health system, the local community and individuals. Competing priorities of service users included the need to obtain adequate individual care and to work for survival. Low recognition of the potential contribution of service users seemed linked to limited empowerment and mobilization of service users. Potential health system facilitators included a culture of community oversight of primary care services. All groups of respondents identified a need for awareness-raising and training to equip service users, caregivers, service providers and local community for involvement. Empowerment at the level of individual service users (information about mental health conditions, care and rights) and the group level (for advocacy and representation) were considered essential, alongside improved, accessible mental health care and livelihood interventions. CONCLUSION As Ethiopia increases access to mental health care, a fundamental barrier to service user involvement is beginning to be addressed. Our study identified further barriers that need to be tackled, including a supportive political climate, and receptiveness amongst stakeholders. The findings will inform the development of a model of service user involvement, which will be piloted and evaluated.
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Affiliation(s)
- Sisay Abayneh
- Department of Psychiatry, University College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Heidi Lempp
- 0000 0001 2322 6764grid.13097.3cKing’s College London, Academic Rheumatology, Weston Education Centre, 10, Cutcombe Rd., London, SE5 9RJ UK
| | - Atalay Alem
- Department of Psychiatry, University College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Daniel Alemayehu
- Department of Psychiatry, University College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Tigist Eshetu
- Department of Psychiatry, University College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
| | - Crick Lund
- 0000 0004 1937 1151grid.7836.aDepartment of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Rondebosch, Cape Town, 7700 South Africa ,0000 0001 2322 6764grid.13097.3cKing’s College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, London, UK
| | - Maya Semrau
- 0000 0001 2322 6764grid.13097.3cHealth Service and Population Research Department, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Graham Thornicroft
- 0000 0001 2322 6764grid.13097.3cHealth Service and Population Research Department, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Charlotte Hanlon
- Department of Psychiatry, University College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia. .,King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, London, UK.
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