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Williamson PE, Hope J, Dixon C, Oades LG. Impact of Cofacilitated, Collaborative, Recovery-Oriented Practice Training on Clinical Mental Health Workforce Competencies. Psychiatr Serv 2023; 74:1052-1058. [PMID: 37096355 DOI: 10.1176/appi.ps.202100619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
OBJECTIVE The authors aimed to evaluate the impact of a staff development training program informed by the collaborative recovery model (CRM) on staff outcomes in the largest implementation of CRM undertaken by a public clinical mental health service. METHODS Implementation spanned community, rehabilitation, inpatient, and crisis programs for children and youths, adults, and older persons in metropolitan Melbourne, 2017-2018. The CRM staff development program was cofacilitated and coproduced by trainers with clinical and lived experience of recovery (including caregivers) and delivered to the mental health workforce (N=729, including medical, nursing, allied health, lived experience, and leadership staff). The 3-day training program was supplemented by booster training and coaching in team-based reflective practice. Pre- and posttraining measures assessed changes in self-reported CRM-related knowledge, attitudes, skills, and confidence and in the perceived importance of CRM implementation. Staff definitions of recovery were analyzed to understand changes in language related to collaborative recovery. RESULTS The staff development program significantly (p<0.001) improved self-rated knowledge, attitudes, and skills in applying CRM. At booster training, improvements in attitudes and self-confidence in implementing CRM were maintained. Ratings of the importance of CRM and confidence in the organization's implementation did not change. Definitions of recovery illustrated development of shared language throughout the large mental health program. CONCLUSIONS The cofacilitated CRM staff development program achieved significant changes in staff knowledge, attitudes, skills, and confidence and changes in language related to recovery. These results suggest that implementing collaborative, recovery-oriented practice in a large public mental health program is feasible and can result in broad and sustainable change.
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Affiliation(s)
- Phoebe E Williamson
- Centre for Mental Health Learning Victoria, Melbourne (Williamson); Mental Health Program, Eastern Health, Box Hill, Victoria, Australia (Williamson, Hope, Dixon); Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia (Hope); Centre for Wellbeing Science, University of Melbourne, Parkville, Victoria, Australia (Oades)
| | - Judith Hope
- Centre for Mental Health Learning Victoria, Melbourne (Williamson); Mental Health Program, Eastern Health, Box Hill, Victoria, Australia (Williamson, Hope, Dixon); Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia (Hope); Centre for Wellbeing Science, University of Melbourne, Parkville, Victoria, Australia (Oades)
| | - Christopher Dixon
- Centre for Mental Health Learning Victoria, Melbourne (Williamson); Mental Health Program, Eastern Health, Box Hill, Victoria, Australia (Williamson, Hope, Dixon); Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia (Hope); Centre for Wellbeing Science, University of Melbourne, Parkville, Victoria, Australia (Oades)
| | - Lindsay G Oades
- Centre for Mental Health Learning Victoria, Melbourne (Williamson); Mental Health Program, Eastern Health, Box Hill, Victoria, Australia (Williamson, Hope, Dixon); Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia (Hope); Centre for Wellbeing Science, University of Melbourne, Parkville, Victoria, Australia (Oades)
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Eiroa-Orosa FJ. Beyond recovery: toward rights-based mental health care - A cluster randomized wait-list controlled trial of a recovery and rights training for mental health professionals with or without first person accounts. Front Psychol 2023; 14:1152581. [PMID: 37780153 PMCID: PMC10539929 DOI: 10.3389/fpsyg.2023.1152581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/31/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Mental health models grounded in Recovery and Rights are driving the advancement of transformative care systems through multifaceted actions, which encompass Continuing Professional Development. The objective of this work is to evaluate a training activity developed through a participatory process that included people with lived experience of psychosocial distress, their relatives, and mental health professionals. Methods The training focused on alternatives to diagnosis, recovery principles, rights-based care, and peer support. The evaluation followed a cluster randomized wait-list controlled design. Four hundred eighty-eight health professionals from eight care centers were randomized to three experimental conditions: a wait list control, which underwent a one-month interval between the baseline assessment and the training activity, and two experimental groups, with or without first-person accounts, which accessed the training immediately after completing the baseline assessment. The dependent variables measured at all follow-ups were beliefs and attitudes toward mental health service users' rights. One hundred ninety-two professionals completed at least one follow-up and were included in the analyses. Results We observed different evolutions of experimental and control groups with statistically significant differences for tolerance to coercion and total beliefs and attitudes scores. No differences were observed between the groups with or who attended training activities with or without first person accounts. Upon receiving the training activity, the control group had an evolution equivalent to the experimental groups. Discussion The results of this evaluation project provide compelling evidence for the need to expand recovery and rights training activities to reach a larger audience of mental health professionals These training activities hold the potential to positively influence the beliefs and attitudes of mental health professionals, ultimately contributing toward a better future for individuals with lived experience of psychosocial distress.
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Affiliation(s)
- Francisco José Eiroa-Orosa
- Section of Personality, Assessment and Psychological Treatment, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- First-Person Research Group, Veus, Catalan Federation of 1st Person Mental Health Organisations, Barcelona, Spain
- Yale Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, United States
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Kehoe M, Fossey E, Edan V, Chaffey L, Brophy L, Weller PJ, Shawyer F, Meadows G. Consumer Views and Experiences of Secondary-Care Services Following REFOCUS-PULSAR Staff Recovery-Oriented Practices Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105894. [PMID: 37239620 DOI: 10.3390/ijerph20105894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND The use of recovery-oriented practice (ROP) can be challenging to implement in mental health services. This qualitative sub-study of the Principles Unite Local Services Assisting Recovery (PULSAR) project explored how consumers perceive their recovery following community mental health staff undertaking specific ROP training. METHODS Using a qualitative participatory methodology, 21 consumers (aged 18-63 years) participated in one-on-one interviews. A thematic analysis was applied. RESULTS Four main themes were extracted: (1) connection, (2) supportive relationships, (3) a better life, and (4) barriers. Connections to community and professional staff were important to support consumers in their recovery journey. Many consumers were seeking and striving towards a better life that was personal and individual to each of them, and how they made meaning around the idea of a better life. Barriers to recovery primarily focused on a lack of choice. A minor theme of 'uncertainty' suggested that consumers struggled to identify what their recovered future might entail. CONCLUSION Despite staff undertaking the ROP training, all participants struggled to identify language and aspects of recovery in their interaction with the service, suggesting a need for staff to promote open, collaborative conversations around recovery. A specifically targeted recovery resource might facilitate such conversation.
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Affiliation(s)
- Michelle Kehoe
- Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Peninsula Campus Building G, 47-49 Moorooduc Hwy, Frankston, VIC 3199, Australia
- Alfred Health, Adult Mental and Addiction Health, 55 Commercial Road, Melbourne, VIC 3004, Australia
| | - Ellie Fossey
- Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Peninsula Campus Building G, 47-49 Moorooduc Hwy, Frankston, VIC 3199, Australia
| | - Vrinda Edan
- Centre for Mental Health Nursing, Department of Nursing, School of Health Sciences, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Lisa Chaffey
- Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Peninsula Campus Building G, 47-49 Moorooduc Hwy, Frankston, VIC 3199, Australia
| | - Lisa Brophy
- Social Work and Social Policy, Department of Community and Clinical Health School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
- The Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
| | | | - Frances Shawyer
- Southern Synergy, Monash Health, Dandenong, VIC 3175, Australia
| | - Graham Meadows
- The Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
- Southern Synergy, Monash Health, Dandenong, VIC 3175, Australia
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC 3168, Australia
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia
- School of Primary and Allied Health Care, Monash University, Melbourne, VIC 3168, Australia
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4
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Nyanyiwa S, Peters K, Murphy G. A scoping review: Treatment attitudes and adherence for adults with schizophrenia. J Clin Nurs 2022; 31:3060-3075. [PMID: 35043496 DOI: 10.1111/jocn.16219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/22/2021] [Accepted: 01/04/2022] [Indexed: 11/27/2022]
Abstract
AIM AND OBJECTIVES This scoping review presents an exploration of literature on the relationship between treatment attitudes and adherence in adults experiencing schizophrenia. BACKGROUND Strategies to address adherence and improve treatment outcomes are described in literature. However, adherence remains a challenge for people experiencing mental illness in practice. Transformational frameworks, evidence-based practice and patient-centred approaches have been established and implemented but non-adherence incidence rates continue to rise among people with schizophrenia. Moreover, the relationship between treatment attitudes and adherence in adults diagnosed with schizophrenia remains unclear. DESIGN A scoping review using the framework offered by Implementation Science, 5, 2010, 1. The PRISMA-ScR checklist was used to ensure integrity of the review. METHODS Four databases PsychINFO, Medline, Cochrane and CINAHL databases were searched for literature along with the reference lists of eligible sources. Original research, peer-reviewed articles published between 2010 and 2020 in English language were included. Articles were included if study participants were adults with a diagnosis of schizophrenia or related psychosis. Methodological quality was evaluated using a quality assessment checklist, the Critical Appraisal Skills Programme tool. RESULTS Ten articles were included in the study. Five main themes about treatment adherence emerged from the literature: (i) severity of symptoms, (ii) side effects, (iii) beliefs and attitudes, (iv) insight and (v) support and relationships. CONCLUSIONS This scoping review concluded that attitude influenced adherence to medication in people with schizophrenia. The five main themes reported directly influenced attitude, impacting on treatment adherence in people experiencing schizophrenia. This review makes recommendations for a person-centred and recovery framework that aims to improve adherence. RELEVANCE TO CLINICAL PRACTICE Nurses in all healthcare settings could use evidence-based strategies to enhance treatment adherence in people with a range of physical and mental health conditions.
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Affiliation(s)
- Simehlani Nyanyiwa
- School of Nursing & Midwifery, Western Sydney University, Sydney, New South Wales, Australia.,South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Kath Peters
- School of Nursing & Midwifery, Western Sydney University, Sydney, New South Wales, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
| | - Gillian Murphy
- School of Nursing & Midwifery, Western Sydney University, Sydney, New South Wales, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
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Hawsawi T, Stein-Parbury J, Orr F, Roche M, Gill K. Exploring recovery-focused educational programmes for advancing mental health nursing: An integrative systematic literature review. Int J Ment Health Nurs 2021; 30 Suppl 1:1310-1341. [PMID: 34231293 DOI: 10.1111/inm.12908] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2021] [Indexed: 01/10/2023]
Abstract
Recovery-focused educational programmes have been implemented in mental health services in an attempt to transform care from a purely biomedical orientation to a more recovery-oriented approach. Mental health nurses have identified the need for enhancing their abilities and confidence in translating recovery knowledge into mental health nursing practice. However, recovery-focused educational programmes have not fully address nurses' learning needs. Therefore, this review synthesized the evidence of the effectiveness of recovery-focused educational programmes for mental health nurses. A systematic search of electronic databases and hand-searched references was conducted. It identified 35 programmes and 55 educational materials within 39 studies. Synthesizing the literature revealed three themes and nine subthemes. The first theme, a framework for understanding and supporting consumers' recovery, had four subthemes: consumers' involvement, multidisciplinary approach, profession-specific training, and performance indicators. The second theme, contents of educational materials, included the subthemes: knowledge development and recovery-focused care planning. The final theme, nurses' learning experiences, included the subthemes: understanding recovery, the positive effects of recovery-focused educational programmes, and implementation of recovery-oriented practices. Based on these findings, a mental health nursing recovery-focused educational programme framework is proposed. Further research should investigate the effectiveness of the framework, especially in relation to recovery-focused care planning and consumer and carer involvement in the development, delivery, participation, and evaluation of these educational programmes.
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Affiliation(s)
- Tahani Hawsawi
- Faculty of Nursing, King Abdul-Aziz University, Jeddah, Saudi Arabia
| | - Jane Stein-Parbury
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Fiona Orr
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Michael Roche
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
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Baek S. Ecological Predictors of Recovery-Oriented Practices Among Psychiatric Nurses in South Korea. J Psychosoc Nurs Ment Health Serv 2021; 58:37-47. [PMID: 33119120 DOI: 10.3928/02793695-20201013-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/08/2020] [Indexed: 11/20/2022]
Abstract
Using hierarchical multiple regression analysis, the current study aimed to investigate ecological predictors of recovery-oriented practices among 230 psychiatric nurses in South Korea. Intrapersonal predictors associated with recovery-oriented practice were educational level, type of workplace, and attitudes regarding recovery. Extent of nursing practice environment recognized by nurses at the organizational level was also significant. Recovery-oriented practices were associated with intrapersonal and organizational factors. Therefore, it is necessary to provide multi-level considerations to improve recovery-oriented practices among psychiatric nurses. [Journal of Psychosocial Nursing and Mental Health Services, 58(11), 37-47.].
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Fleury MJ, Sabetti J, Bamvita JM. Modeling Relationships Involving Perceived Recovery Orientation of Mental Health Teams Among Quebec Mental Health Professionals. J Behav Health Serv Res 2020; 46:434-449. [PMID: 29511938 DOI: 10.1007/s11414-018-9591-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
While mental health (MH) services are expected to support client recovery, very little is known about services provided by MH teams in relation to this goal. This study explored relationships between a comprehensive collection of team effectiveness variables and the perspectives of MH professionals regarding the recovery orientation of their teams. A model developed by path analysis revealed eight team-related variables that were significantly and positively associated with recovery-oriented teams: primary care versus specialized MH services; greater proportions of clients with severe mental disorders or with suicide ideation on caseloads; knowledge sharing and knowledge production among team members; team climate; work role performance; and trust in coworkers. Results underline the importance of building knowledge and professional competence on MH teams, and the need for a positive team climate that offers flexibility and innovation for addressing the complex needs of people in MH recovery living in the community.
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Affiliation(s)
- Marie-Josée Fleury
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada. .,Douglas Mental Health University Institute Research Centre, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada.
| | - Judith Sabetti
- Douglas Mental Health University Institute Research Centre, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada.,School of Social Work, McGill University, 3506 University Street, Montreal, QC, H3A 2A7, Canada
| | - Jean-Marie Bamvita
- Douglas Mental Health University Institute Research Centre, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada
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8
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Recovery-oriented training programmes for mental health professionals: A narrative literature review. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.mhp.2019.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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9
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Bitter N, Roeg D, Van Nieuwenhuizen C, Van Weeghel J. Training professionals in a recovery-oriented methodology: a mixed method evaluation. Scand J Caring Sci 2019; 33:457-466. [PMID: 30653692 DOI: 10.1111/scs.12644] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 11/27/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Several studies have reported difficulties concerning the implementation of recovery-oriented interventions. In this study, the effect of training in the Comprehensive Approach to Rehabilitation (CARe) on daily practice was evaluated. Additionally, we aimed to acquire insight into the experiences with the implementation process involving professionals, management and trainers. METHODS Fourteen teams for sheltered and supported housing in the Netherlands participated in this study. As part of a cluster-randomised controlled trial (RCT) design, eight teams received training in the CARe methodology. Model fidelity (using the CARe fidelity audit) and professionals' knowledge of recovery (using the Recovery Knowledge Inventory) were measured for all teams until 20 months after the start. Afterwards, an evaluation meeting with participating stakeholders was organised in which barriers and facilitators of the implementation of the CARe methodology were inventoried. RESULTS Ten months after the training, the intervention teams scored higher than the control teams on the fidelity subscales: 'recovery', 'strengths orientation' and 'amount of training and coaching'. Twenty months after the training, only the effect of 'amount of coaching and training' remained. Additionally, 'methodological working' clearly differed between the groups after 20 months in favour of the intervention teams. In all teams, model fidelity was moderate at both measurements. The knowledge of recovery of the trained teams was slightly and significantly higher at 10 and 20 months after training. Although professionals were positive about recovery and strength-oriented working, they experienced several organisational and societal barriers. CONCLUSION Training in the CARe methodology improved the fidelity and knowledge of recovery among professionals. However, the differences were small, and fidelity decreased over time. More in-depth knowledge is needed on which barriers professionals experience in practice so that tailored training and implementation strategies can be developed. Furthermore, more attention is needed for professional development and the translation of theory into practice.
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Affiliation(s)
- Neis Bitter
- Department of Social and Behavioural Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, Tilburg, The Netherlands
| | - Diana Roeg
- Department of Social and Behavioural Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, Tilburg, The Netherlands.,GGzE Institute for Mental Health Care, Eindhoven, The Netherlands
| | - Chijs Van Nieuwenhuizen
- Department of Social and Behavioural Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, Tilburg, The Netherlands.,GGzE Institute for Mental Health Care, Eindhoven, The Netherlands
| | - Jaap Van Weeghel
- Department of Social and Behavioural Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, Tilburg, The Netherlands.,Phrenos Centre of Expertise, Utrecht, The Netherlands.,Dijk en Duin Mental Health Centre, Parnassia Group, Castricum, The Netherlands
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10
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Jas E, Wieling M. Providers' competencies positively affect personal recovery of involuntarily admitted patients with severe mental illness: A prospective observational study. Int J Soc Psychiatry 2018; 64:145-155. [PMID: 29277105 DOI: 10.1177/0020764017749864] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE There is limited research on the patient-provider relationship in inpatient settings. The purpose of this study was to measure the effect of mental healthcare providers' recovery-promoting competencies on personal recovery in involuntarily admitted psychiatric patients with severe mental illness. METHODS In all, 127 Dutch patients suffering from a severe mental illness residing in a high-secure psychiatric hospital reported the degree of their personal recovery (translated Questionnaire about Processes of Recovery questionnaire (QPR)) and the degree of mental healthcare providers' recovery-promoting competence (Recovery Promoting Relationship Scale (RPRS)) at two measurement points, 6 months apart. ANALYSES (Mixed-effects) linear regression analysis was used to test the effect of providers' recovery-promoting competence on personal recovery, while controlling for the following confounding variables: age, gender drug/alcohol problems, social relationships, activities of daily living, treatment motivation and medication adherence. RESULTS Analyses revealed a significant positive effect of providers' recovery-promoting competencies on the degree of personal recovery ( t = 8.4, p < .001) and on the degree of change in personal recovery over time ( ts > 4, p < .001). CONCLUSION This study shows that recovery-promoting competencies of mental healthcare providers are positively associated with (a change in) personal recovery of involuntarily admitted patients. Further research is necessary on how to organize recovery-oriented care in inpatient settings and how to enhance providers' competencies in a sustainable way.
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Affiliation(s)
- Ellen Jas
- 1 Institute of Mental Health Care, GGZ Drenthe, Assen, The Netherlands
| | - Martijn Wieling
- 2 Center for Language and Cognition Groningen, University of Groningen, Groningen, The Netherlands
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Walsh FP, Meskell P, Burke E, Dowling M. Recovery-based Training in Mental Health: Effects on Staff Knowledge and Attitudes to Recovery. Issues Ment Health Nurs 2017; 38:886-895. [PMID: 28745921 DOI: 10.1080/01612840.2017.1346014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This longitudinal study describes the effects of recovery-based training on staff knowledge and attitudes to recovery. Mental health staff (n = 101) completed the study questionnaire (the Recovery Knowledge Inventory (RKI-20) and Recovery Attitudes' Questionnaire (RAQ-16)) before training and after six months. On the RKI, significant changes between pre- and post-training scores (p < 0.01) were found. On the RAQ, the scores showed significant changes in Factors 1 (p < 0.001) and 2 (p < 0.009). The results indicate a significant difference in confidence using a recovery model of care following training suggesting that recovery-based training positively affects staff knowledge and attitudes to recovery overall.
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Affiliation(s)
| | - Pauline Meskell
- b School of nursing , University College Limerick , Limerick , Ireland
| | - Emer Burke
- c School of Nursing , National University of Ireland , Galway , Ireland
| | - Maura Dowling
- d School of Nursing and Midwifery , National University of Ireland , Galway , Ireland
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Roux P, Passerieux C, Fleury MJ. Mediation analysis of severity of needs, service performance and outcomes for patients with mental disorders. Br J Psychiatry 2016; 209:511-516. [PMID: 27758837 DOI: 10.1192/bjp.bp.116.184010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 06/14/2016] [Accepted: 06/20/2016] [Indexed: 12/27/2022]
Abstract
BACKGROUND Needs and service performance assessment are key components in improving recovery among individuals with mental disorders. AIMS To test the role of service performance as a mediating factor between severity of patients' needs and outcomes. METHOD A total of 339 adults with mental disorders were interviewed. A mediation analysis between severity of needs, service performance (adequacy of help, continuity of care and recovery orientation of services) and outcomes (personal recovery and quality of life) was carried out using structural equation modelling. RESULTS The structural equation model provided a good fit with the data. An increase in needs was associated with lower service performance and worse outcomes, whereas higher service performance was associated with better outcomes. Service performance partially mediated the effect of patient needs on outcomes. CONCLUSIONS Poorer service performance has a negative impact on outcomes for patients with the highest needs. Ensuring more efficient services for patients with high needs may help improve their recovery and quality of life.
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Affiliation(s)
- Paul Roux
- Paul Roux, MD, PhD, Department of Psychiatry, McGill University, Douglas Mental Health University Institute Research Centre, Montreal, Canada, Service Universitaire de Psychiatrie d'adultes, Centre Hospitalier de Versailles, Le Chesnay, Laboratoire HandiRESP, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux and Fondation Fondamental, Créteil, France; Christine Passerieux, MD, PhD, Service Universitaire de Psychiatrie d'adultes, Centre Hospitalier de Versailles, Le Chesnay, Laboratoire HandiRESP, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux and Fondation Fondamental, Créteil, France; Marie-Josée Fleury, PhD, Department of Psychiatry, McGill University, Douglas Mental Health University Institute Research Centre, Montreal, Canada
| | - Christine Passerieux
- Paul Roux, MD, PhD, Department of Psychiatry, McGill University, Douglas Mental Health University Institute Research Centre, Montreal, Canada, Service Universitaire de Psychiatrie d'adultes, Centre Hospitalier de Versailles, Le Chesnay, Laboratoire HandiRESP, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux and Fondation Fondamental, Créteil, France; Christine Passerieux, MD, PhD, Service Universitaire de Psychiatrie d'adultes, Centre Hospitalier de Versailles, Le Chesnay, Laboratoire HandiRESP, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux and Fondation Fondamental, Créteil, France; Marie-Josée Fleury, PhD, Department of Psychiatry, McGill University, Douglas Mental Health University Institute Research Centre, Montreal, Canada
| | - Marie-Josée Fleury
- Paul Roux, MD, PhD, Department of Psychiatry, McGill University, Douglas Mental Health University Institute Research Centre, Montreal, Canada, Service Universitaire de Psychiatrie d'adultes, Centre Hospitalier de Versailles, Le Chesnay, Laboratoire HandiRESP, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux and Fondation Fondamental, Créteil, France; Christine Passerieux, MD, PhD, Service Universitaire de Psychiatrie d'adultes, Centre Hospitalier de Versailles, Le Chesnay, Laboratoire HandiRESP, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux and Fondation Fondamental, Créteil, France; Marie-Josée Fleury, PhD, Department of Psychiatry, McGill University, Douglas Mental Health University Institute Research Centre, Montreal, Canada
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13
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Heard CP, Scott J, Yeo S. Walking the Labyrinth: Considering Mental Health Consumer Experience, Meaning Making, and the Illumination of the Sacred in a Forensic Mental Health Setting. THE JOURNAL OF PASTORAL CARE & COUNSELING : JPCC 2015; 69:240-250. [PMID: 26631524 DOI: 10.1177/1542305015616102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The purpose of this study is to explore the unique meaning and experience associated with walking a unicursal seven circuit outdoor Chartress Labyrinth and 11 circuit indoor Chartress Labyrinth for persons residing at a forensic mental health care facility. Over the past several decades labyrinths have enjoyed something of a renaissance and are often utilized by spiritual care practitioners and health care clinicians in order to support reflection, stress reduction, and the exploration of personal wellness in a sacred setting. Labyrinths are used in many settings including places of worship, hospitals, long-term care facilities, and parks. While labyrinths are becoming more prevalent, an understanding of their impact, particularly in the mental health context, is limited. This qualitative study supports a novel investigation of the meaning associated with participation in walking a labyrinth for persons residing at a forensic mental health care facility. The study design is a qualitative methodology involving transcribed interviews with 12 individuals resident at the Southwest Centre for Forensic Mental Health Care who participated in the 'Walking the Labyrinth' program as facilitated by spiritual care staff. A standardized interview protocol was utilized and the collected data was coded for themes. Several methods were employed to establish trustworthiness including triangulation by analyst and by theory/perspective. Member checking was also utilized in order to further validate the themes. Recommendations related to potential health care applications for labyrinths are identified. These include a focus upon the linkage between mental health care planning and labyrinth participation.
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Affiliation(s)
| | - Jared Scott
- Southwest Centre for Forensic Mental Health Care, Ontario, Canada
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