1
|
Iswanti DI, Nursalam N, Fitryasari R, Sarfika R, Saifudin IMMY. Effectiveness of an Integrative Empowerment Intervention for Families on Caring and Prevention of Relapse in Schizophrenia Patients. SAGE Open Nurs 2024; 10:23779608241231000. [PMID: 38333904 PMCID: PMC10851764 DOI: 10.1177/23779608241231000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/06/2023] [Accepted: 01/16/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction Patients with schizophrenia require extended treatment and recovery, leaving their families and support systems feeling helpless. Integrative empowerment is a strategy that utilizes outside-in and inside-out empowerment to increase the ability of families to care for their loved ones and prevent relapse. Objective This study aimed to investigate the impact of integrative empowerment intervention on enhancing the family's ability to care for and prevent relapse in patients with schizophrenia. Methods The study employed a quasi-experimental with a pre-test and post-test control group design. The research sample was comprised of 70 individuals from nuclear families residing in Semarang, all of whom were responsible for the care of individuals with schizophrenia. The participants were divided into two groups: the treatment group, consisting of 35 individuals, and the control group, also comprising 35 individuals. Participant selection was carried out using purposive sampling. Module and booklet were produced as an intervention tools. The integrative empowerment intervention program spanned a period of 5 weeks, involving one session per week, each lasting approximately 60-90 min. Data analysis was conducted through the utilization of the Wilcoxon and Mann-Whitney tests. The significance level for the study was set at p<.05. Results There was a significant change in the family's ability to care for patients with schizophrenia before and after the integrative empowerment intervention (p<.001), while there was no change in the control group's ability to care for patients with schizophrenia (p>.05). Integrative empowerment had a significant impact on increasing the family's ability to care for and prevent relapse in patients with schizophrenia (p<.001). Conclusions Nurses can help families strengthen their positive caregiving experiences through the home visit program by utilizing integrative empowerment. This study's findings highlight the importance of integrative empowerment in enhancing the family's ability to care for and prevent relapse in patients with schizophrenia.
Collapse
Affiliation(s)
- Dwi Indah Iswanti
- Department of Mental Health and Community, Faculty of Nursing and Health Science, Universitas Karya Husada Semarang, Semarang, Indonesia
| | | | | | - Rika Sarfika
- Department of Mental Health and Community, Faculty of Nursing, Universitas Andalas, Padang, West Sumatra, Indonesia
| | | |
Collapse
|
2
|
Khanthavudh C, Grealish A, Tzouvara V, Huang J, Leamy M. Implementation and evaluation of recovery-oriented practice interventions for people with mental illness in Asia: An integrative review. Int J Nurs Stud 2023; 147:104591. [PMID: 37708624 DOI: 10.1016/j.ijnurstu.2023.104591] [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: 04/20/2023] [Revised: 08/18/2023] [Accepted: 08/19/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Recovery is a process involving empowering individuals to take control of their lives and develop meaningful and purposeful life, regardless of whether their mental health symptoms persist. Recovery-oriented practice has been widely implemented, particularly in Anglophone countries, during the past two decades. Mental health recovery in Asia is also moving towards recovery-oriented practice. Little is known about how recovery-oriented interventions originating in the West have been implemented and evaluated in Asian contexts. OBJECTIVE This review aimed to identify 1) types of recovery-oriented practice interventions that have been implemented in Asia, 2) how they have been culturally adapted, 3) barriers and facilitators to implementation, and 4) how the interventions have been evaluated. DESIGN This is an integrative review. METHODS This integrative review followed Whittemore and Knafl's five-stage framework. Six electronic databases (e.g., PsycINFO, MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane Library) were systematically searched from their inception to January 2022 to identify eligible studies published in English language. The key search terms included "mental illness", "recovery-oriented intervention", and "Asia". Studies reporting on implementation and evaluation of recovery-focused interventions in Asian settings were eligible. Quality assessment and narrative synthesis were subsequently undertaken. RESULTS Thirty-eight studies were included. Seven main types of recovery-oriented intervention were identified: (1) peer programmes; (2) illness management and recovery; (3) individual placement and support; (4) strength model case management; (5) clubhouse model; (6) wellness recovery action plan and (7) psychiatric advance directive, alongside several novel recovery programmes. Studies reported cultural adaptations for language, content, cultural norms, religious beliefs, family, and local context. Barriers to implementation included a poor understanding of recovery concepts and inadequate organisational resources. A range of clinical and personal recovery outcome measures were reported. CONCLUSIONS Recovery-oriented interventions are increasing in Asia, with nearly half of reviewed studies featuring cultural adaptations. However, research is geographically skewed, and more rigorously conducted studies are needed across a wider range of Asian countries. REGISTRATION This review was registered with the PROSPERO International prospective register of systematic reviews (CRD42022310049). TWEETABLE ABSTRACT Recovery-oriented practice interventions for people with mental illness are on the rise in Asia @chonmananNN.
Collapse
Affiliation(s)
- Chonmanan Khanthavudh
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom; Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Annmarie Grealish
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom; Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Vasiliki Tzouvara
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
| | - Jing Huang
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
| | - Mary Leamy
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
| |
Collapse
|
3
|
Jay EK, Patterson C, Fernandez R, Moxham L. Experiences of recovery among adults with a mental illness using visual art methods: A systematic review. J Psychiatr Ment Health Nurs 2023; 30:361-374. [PMID: 36305611 DOI: 10.1111/jpm.12882] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/20/2022] [Accepted: 10/18/2022] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Arts-based research is an established and accepted research approach and systematic reviews have been published on this methodology. There are many possible data collection techniques and study designs within arts-based research, which have been implemented but not yet systematically reviewed. Rationales and challenges for arts-based research have covered participants' experiences of being in arts-based studies in health service research. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The main results of this systematic review are that mental health recovery concepts are effectively communicated by visual arts-based research and participation in these studies is progressive and connecting for mental health consumers. This paper adds new knowledge about participants' experiences specifically in visual arts-based studies, where the participants are mental health consumers. The results are significant because they support visual arts-based research in its development and popularity, both as a research approach and as an empowerment intervention. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The results of this systematic review can enhance the fields of qualitative research methods and mental health nursing. Recommendations for professional development can be advanced from consumers' ideas and experiences of recovery reported in this review. Nurse scientists and consumer researchers can take into consideration visual arts-based data collection techniques for use as research and empowerment interventions with mental health consumer participants. ABSTRACT INTRODUCTION: Art creation has been found to be therapeutic to mental health consumers, making the prospect of art creation's conceivable benefits as a mental health research strategy worthy of consideration. AIM This systematic review aims to explore experiences of recovery among adults with a mental illness using visual art methods. METHOD Following a comprehensive database search, 14 suitable studies were identified. These involved adult participants with a formal mental health diagnosis, or who self-identify as having a mental illness. The studies employed arts-based methodologies with participant-created, visual art as their data. Articles underwent data extraction and quality appraisal with the JBI-QARI (Qualitative Assessment and Review Instrument). RESULTS Results were categorised and further aggregated into two synthesised findings according to Joanna Briggs Institute (JBI) guidelines. The synthesised findings are: (1) Creative artmaking enables the use of visual metaphors which can aid expression of feelings, externalisation of identity, and personal learning, and (2) Interpersonal and self-connectedness through inclusion in community, receiving support when needed, and progressing through loss, are beneficial for mental health recovery. DISCUSSION These findings are comparable to those already existing in the literature, and suggest that visual arts-based research methods are as dependable as other qualitative research methods. Additionally, this systematic review reveals that when conducting research studies, there are benefits for mental health consumer participants when visual arts-based methods are used. IMPLICATIONS FOR PRACTICE A visual arts-based research intervention can be concluded to have the effect of an empowerment intervention, as well as being a credible research method.
Collapse
Affiliation(s)
- Elissa-Kate Jay
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, New South Wales, Australia
| | - Christopher Patterson
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, New South Wales, Australia
| | - Ritin Fernandez
- Australia Centre for Research in Nursing and Health, St George Hospital, Kogarah, New South Wales, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Wollongong, New South Wales, Australia
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, Australia
- JBI Centre of Excellence, University of Wollongong, Wollongong, New South Wales, Australia
| |
Collapse
|
4
|
Hsieh WL, Li IH, Liu WI. Effects of empowerment-based illness management on the medication adherence and recovery of persons with schizophrenia: A systematic review and meta-analysis. Int J Ment Health Nurs 2023. [PMID: 36788653 DOI: 10.1111/inm.13123] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/18/2022] [Accepted: 01/16/2023] [Indexed: 02/16/2023]
Abstract
Medication adherence and recovery rates are <50% among persons with schizophrenia; therefore, this health concern needs attention. Empowerment is a vital element for behavioural change, but previous studies have presented different results and lack specific connotations about empowerment. Therefore, this study systematically reviewed and meta-analysed the effects of empowerment-based illness management on the medication adherence and recovery of persons with schizophrenia. The databases searched included the PROSPERO registration network, Cochrane Library, PubMed, Embase, CINAHL, PsycAricle, and Airiti Library. The research steps were based on PRISMA. RoB 2.0 was used for article quality evaluation, the effect size was calculated using RevMan software, and the random-effect model and standardized mean differences (SMD) were established. Eight randomized controlled trials (RCTs) involving 859 participants were used to investigate the effect of empowerment on medication adherence. The trials involved the use of effective strategies as inducing medication motivation, promoting self-medication management, and providing support resources. A moderate effect was observed (SMD = 0.58, 95% CI 0.18-0.99). Ten RCTs involving 1473 participants were used to investigate the effect of empowerment on recovery. These trials involved the use of such effective strategies as using self-strength, connecting external forces, understanding personal needs, and overcoming self-stigma. A moderate effect was observed (SMD = 0.55, 95% CI 0.10-0.99). Empowerment in illness management can effectively promote the medication adherence and recovery of persons with schizophrenia. In the future, nurses can use self-strength care to promote medication motivation and connect internal and external forces to assist a person's medication adherence and recovery.
Collapse
Affiliation(s)
- Wen-Ling Hsieh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan.,Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - I-Hsien Li
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan.,Cardinal Tien Junior College of Healthcare and Management, New Taipei City, Taiwan
| | - Wen-I Liu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| |
Collapse
|
5
|
Töbelmann L, Hahne I, Schulze T, Bergmann N, Fuchs L, Zierhut M, Hahn E, Böge K. Mechanisms of action and processes of yoga-based group intervention for inpatients with schizophrenia spectrum disorders-A longitudinal qualitative study. Front Psychiatry 2023; 14:1086468. [PMID: 36824673 PMCID: PMC9941680 DOI: 10.3389/fpsyt.2023.1086468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/16/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Research exploring the effects of yoga therapy (YT) on individuals with schizophrenia spectrum disorders (SSD) is scarce. Therefore, the current study aimed to explore possible mechanisms of actions and processes, as well as adverse effects of a novel yoga-based group intervention (YoGI) for in-patients with SSD in a German university hospital setting. MATERIAL AND METHODS A longitudinal qualitative study was integrated into a rater-blinded randomized controlled trial, exploring the impact of a 4-week YoGI as add-on treatment. In-depth interviews were conducted with participants receiving YoGI (n = 19) in addition to treatment as usual (TAU) and a control group (n = 14) which only received TAU. Interviews were conducted at baseline (n = 33) and 4 weeks post-intervention (N = 28) to assess the participant's experiences and how they changed over time. The interviews (N = 61) were audio-taped, translated, coded, and analyzed by means of inductive thematic analysis. Separate case summaries were prepared for each participant to analyze longitudinal changes within subjects. The research team members collaboratively discussed the final list of themes and subcodes. Rater-based questionnaires, such as the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Personal and Social Performance Scale (PSP) were administered at baseline to assess clinical outcomes. RESULTS At baseline, participants reported a desire to improve their stress- and symptom management. A minority of participants expressed reservations toward yoga, and several psychosocial barriers were named, including worries about symptom exacerbation. At post-intervention, four mechanisms of change became evident from the interviews: (1) acquiring competence in relaxation, (2) increased interoceptive awareness, (3) feeling connected, and (4) a sense of spiritual wellbeing. A small number of participants reported difficulties with YoGI. CONCLUSION Generally, YoGI positively influenced participants' experiences of their inpatient stay, regarding distress, self- and body awareness, social connectedness, and spiritual wellbeing. However, participants also illuminated necessary adjustments to improve the intervention. YoGI will therefore be adapted and further developed in an iterative process based on a participant involvement approach. The efficacy regarding outcomes and processes needs to be investigated in a future larger-scaled randomized controlled trial.
Collapse
Affiliation(s)
- Laura Töbelmann
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Inge Hahne
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Theresa Schulze
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Niklas Bergmann
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Lukas Fuchs
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Marco Zierhut
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
6
|
Chao PY, Hsieh WL, Yeh ST, Hsieh CJ, Liu CY, Liu WI. Factors associated with personal recovery among psychiatric nursing home residents. J Psychiatr Ment Health Nurs 2022; 29:852-860. [PMID: 34957650 DOI: 10.1111/jpm.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/29/2021] [Accepted: 12/17/2021] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: Poor recovery will cause harm to the quality of life and well-being of residents and that the scope of influence includes the self, family and society. No study to date has investigated empowerment and the other multiple factors associated with personal recovery among psychiatric nursing home residents. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The factors associated with personal recovery are empowerment, social support and global functioning. This pioneer study contributes new evidence that personal recovery is mainly predicted by empowerment, social support and global function, with empowerment exhibiting the highest predictive value. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Strengthening empowerment in mental health nursing may contribute more to the personal recovery of psychiatric nursing home residents than improving global function or social support. Mental health professionals should shift to empowerment-oriented care to improve individuals' personal recovery, such as offering more opportunities to achieve autonomy, encouraging individuals' involvement in decision-making and promoting individuals' motivation for achieving their goals. ABSTRACT: Introduction Individuals diagnosed with mental illness have a need for recovery. No study to date has investigated empowerment and the other multiple factors associated with personal recovery among psychiatric nursing home residents. Aim The study aimed to identify the factors associated with personal recovery among psychiatric nursing home residents. Methods This was a cross-sectional study with convenience sampling. Participants were recruited from a psychiatric nursing home in Northern Taiwan between April and June 2018. Data were collected through self-reported, structured questionnaires with verified reliability and validity. Descriptive and hierarchical regression analyses were performed. The present study followed the STROBE guidelines. Results The study included 158 participants. The factors associated with recovery according to bivariate associations were religious belief, psychotic symptoms, global function, social support and empowerment. In the hierarchical regression, empowerment, social support and global function were the main predictive factors of recovery, with the explained variation reaching 40.8%. Empowerment exhibited the highest predictive value for the recovery. Implications for clinical practice Strengthening empowerment in mental health nursing may contribute more to the personal recovery of psychiatric nursing home residents than improving global function or social support.
Collapse
Affiliation(s)
- Pei-Yi Chao
- Department of nursing, Bali Psychiatric Center, New Taipei City, Taiwan
| | - Wen Ling Hsieh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Shin Ting Yeh
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
| | - Chia Jung Hsieh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
| | - Chieh-Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
| | - Wen-I Liu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei city, Taiwan
| |
Collapse
|
7
|
Vilamala S, Puig M, Ochoa S, Martín-Martínez JR, Hernández A, Balsera J, Verdaguer-Rodríguez M, Villellas R, Arenas O, García-Franco M. Assessment of the treatment needs of community recovery Services in Spain: From the perspective of service users, families, and mental health professionals. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5819-e5830. [PMID: 36073979 DOI: 10.1111/hsc.14013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 07/19/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
Profile of Community Recovery Services users has changed over the years and has become more diverse. To explore the evolution of treatment needs, this study aimed to identify users' needs, from the point of view of different agents implicated in the recovery process. We explored the consistency between the agents using the focus group technique. We defined four groups (n = 58): service users, family members, professionals, and referring professionals. We pre-identified topics related to recovery, such as illness-related losses, imaginary of CRS, expectations, activities, and life goals. All agents recognised losses related to the mental illness, the need for carrying activities out of the Community Recovery Services, and for including families in the recovery process. The groups differed in some areas, such as the identification of activities that should be encouraged, or the importance of promoting vital expectations. Our findings suggest that it is important to identify the needs of different agents involved in the recovery process. There is consistency in the service users' needs, but there are some differences that need to be considered. Interventions should be personalised, covering functional, cognitive, and relational losses related to the mental illness.
Collapse
Affiliation(s)
- Sonia Vilamala
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat Institut de Recerca Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain
| | - Marta Puig
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat Institut de Recerca Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat Institut de Recerca Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Ana Hernández
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat Institut de Recerca Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain
| | - Joaquin Balsera
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat Institut de Recerca Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain
| | - Marina Verdaguer-Rodríguez
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat Institut de Recerca Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain
| | - Raul Villellas
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat Institut de Recerca Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain
| | | | - Mar García-Franco
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat Institut de Recerca Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain
| |
Collapse
|
8
|
L’empowerment des usagers en santé mentale. Satisfaction du club thérapeutique : quel lien avec la qualité de vie et le soutien social perçus ? ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2022. [DOI: 10.1016/j.amp.2022.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
9
|
Effectiveness of personal recovery facilitators in adults with schizophrenia and other psychoses: A systematic review of reviews and narrative synthesis. Schizophr Res 2022; 246:132-147. [PMID: 35777151 DOI: 10.1016/j.schres.2022.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/14/2022] [Accepted: 06/19/2022] [Indexed: 01/12/2023]
Abstract
This review aimed to examine the evidence base for the use of personal recovery facilitators [non-psychopharmacological approaches] for adults with a diagnosis of schizophrenia and other psychoses. A systematic review (umbrella review) was conducted of reviews published in English between January 2010 and February 2022, which examined the effectiveness of personal recovery facilitators to support aspects of personal recovery as defined by the CHIME framework (connectedness, hope and optimism, identity, meaning and purpose, and empowerment). Twenty-one systematic reviews on thirteen different types of personal recovery facilitators [PRFs] were included in this umbrella review. Only one review sought to directly measure personal recovery processes according to the CHIME framework. Outcome measures mostly aligned with the processes of hope (21 reviews) and connectedness (19 reviews). Those related to empowerment (2 reviews), identity (5 reviews) and meaning and purpose (1 review) were less frequently the focus of PRFs. Yoga and music therapy showed the most promise as PRFs. Vocational treatments and integrated supported employment show good potential as personal recovery facilitators. However, together with narrative photovoice, art making and exhibition, they require further robust research to fully examine their impact. Personal recovery is only beginning to be considered as an intended outcome of interventions for persons with schizophrenia and other psychoses. This may be due in part to the continued predominance of the biomedical model approach to recovery within statutory services. Future evaluations of PRFs should include outcome measures that directly assess personal recovery according to the CHIME framework or other measures developed in consultation with recipients of these approaches. Review registration number and date: PROSPERO 2020 CRD42020215471: 10/11/20.
Collapse
|
10
|
Lee KT, Lee SK, Lu MJ, Hsieh WL, Liu WI. Mediating effect of empowerment on the relationship between global function and personal recovery among community-dwelling patients with schizophrenia: a cross-sectional study. BMC Psychiatry 2021; 21:241. [PMID: 33962596 PMCID: PMC8103620 DOI: 10.1186/s12888-021-03239-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Functional degradation among community-dwelling patients with schizophrenia can negatively influence their recovery. Given the importance of patient empowerment during recovery, this study examined the mediating effect of empowerment on the relationship between global function and personal recovery among community-dwelling patients with schizophrenia. METHODS This cross-sectional study recruited community-dwelling patients with schizophrenia from northern and central Taiwan. Questionnaires with verified reliability and validity were provided and collected on site by trained nurses. Global function, empowerment, and personal recovery were measured using the Global Assessment of Functioning (developed by the American Psychiatric Association), Empowerment Scale, and Questionnaire on the Process of Recovery, respectively. The causal steps approach proposed by Baron and Kenny and the Sobel test were utilized to verify the mediation effect. The causal steps approach tested the four following pathways (regression coefficients): global function on empowerment (Path a), global function and empowerment as predictors of personal recovery (Path b), global function on personal recovery (Path c), and global function and empowerment on personal recovery (Path c'). RESULTS A total of 373 participants completed the survey. After controlling for factors associated with recovery, Paths a (β = .24, p < .001), b (β = .68, p < .001), and c (β = .19, p < .001) were found to be significant; however, Path c' was not significant (β = .03, p = .452). Empowerment was determined to exert "full mediation" over the effects of global function on personal recovery, and the Sobel test indicating significant mediation (Z = 3.61, p < .001). CONCLUSIONS Empowerment fully mediates the association between global function and personal recovery. This study suggested that offering empowerment-oriented care services may be more effective than global function improvement in recovery among these patients.
Collapse
Affiliation(s)
- Kuen Tai Lee
- grid.412146.40000 0004 0573 0416National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shih Kai Lee
- grid.454740.6Department of Nursing, Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou, Taiwan
| | - Mei Jou Lu
- Shu-Zen Junior College of Medicine and Management, Kaohsiung City, Taiwan
| | - Wen Ling Hsieh
- grid.412146.40000 0004 0573 0416National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Wen I. Liu
- grid.412146.40000 0004 0573 0416National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| |
Collapse
|
11
|
Sabatello M, Chen Y, Herrera CF, Brockhoff E, Austin J, Appelbaum PS. Teenagers and Precision Psychiatry: A Window of Opportunity. Public Health Genomics 2021; 24:14-25. [PMID: 33503628 PMCID: PMC7920903 DOI: 10.1159/000512475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 10/16/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Precision medicine raises hope for translating genetic-based knowledge about psychiatric risks into mental health benefits by motivating health-related, risk-reducing behaviors. Teenagers (ages 14-17) are an important age-group to engage in preventive efforts but, their views about psychiatric genetics are understudied. METHOD An online survey with a nationally representative sample of teenagers (n = 417) was conducted. Participants were randomly assigned to receive 1 of 2 handouts, 1 emphasizing the genetic underpinnings of psychiatric conditions; the other agency-oriented and focusing on gene-environment interactions. Survey questions queried their views about behavioral changes in response to psychiatric genetic risk information and expressed willingness to undertake them. Participants' decision-making characteristics (i.e., self-efficacy, empowerment, intolerance of uncertainty, and sensation-seeking) were assessed at baseline. RESULTS Teenagers strongly valued the information provided and its potential usefulness for their mental health. Information about psychiatric genetics alone impacted views about the causes of mental illness. Contrary to our hypothesis, the type of handout did not impact participants' expressed willingness to make behavioral changes to reduce their risk of developing a psychiatric condition, but their sense of empowerment played a key role in their responses. CONCLUSION Educating teenagers about gene-environment interactions may help facilitate the translational efforts of precision psychiatry. Research with teenagers across racial/ethnic groups, especially those with family histories, is needed to better understand the factors that impact teenagers' empowerment in psychiatric genomic settings and to identify measures, including the best enablers of empowerment (e.g., educators, parents), which would allow them to reap the benefits of precision psychiatry.
Collapse
Affiliation(s)
- Maya Sabatello
- Department of Medicine, Columbia University, New York, New York, USA,
- Department of Medical Humanities and Ethics, Columbia University, New York, New York, USA,
| | - Ying Chen
- New York State Psychiatric Institute, New York, New York, USA
| | | | | | - Jehannine Austin
- Department of Psychiatry and Medical genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paul S Appelbaum
- Department of Psychiatry, Columbia University, New York, New York, USA
| |
Collapse
|
12
|
Leendertse JCP, Wierdsma AI, van den Berg D, Ruissen AM, Slade M, Castelein S, Mulder CL. Personal Recovery in People With a Psychotic Disorder: A Systematic Review and Meta-Analysis of Associated Factors. Front Psychiatry 2021; 12:622628. [PMID: 33708145 PMCID: PMC7940758 DOI: 10.3389/fpsyt.2021.622628] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/13/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Personal recovery (PR) is a subjective, multidimensional concept, and quantitative research using PR as an outcome is rapidly increasing. This systematic review is intended to support the design of interventions that contribute to PR in psychotic disorders, by providing an overview of associated factors and their weighted importance to PR: clinical factors, social factors, and socio-demographic characteristics are included, and factors related to the concept of PR (organized into CHIME dimensions). Methods: A systematic literature search was conducted from inception to March 2020. Quantitative studies that had used a validated questionnaire assessing the concept of PR were included. Mean effect sizes for the relationship between PR-scale total scores and related factors were calculated using meta-analyses. Sources of heterogeneity were examined using meta-regression tests. Results: Forty-six studies, that used (a total of) eight PR measures, showed that in clinical factors, affective symptoms had a medium negative association with PR-scale total scores (r = -0.44, 95%CI -0.50 to -0.37), while positive, negative and general symptoms had small negative correlations. No association was found with neuro-cognition. Social factors (support, work and housing, and functioning) showed small positive correlations. Gender and age differences had barely been researched. Large associations were found for PR-scale total scores with the CHIME dimensions hope (r = 0.56, 95%CI 0.48-0.63), meaning in life (r = 0.48, 95%CI 0.38-0.58) and empowerment (r = 0.53, 95%CI 0.42-0.63); while medium associations were found with connectedness (r = 0.34, 95%CI 0.43-0.65) and identity (r = 0.43, 95%CI 0.35-0.50). Levels of heterogeneity were high, sources included: the variety of PR measures, variations in sample characteristics, publication bias, variations in outcome measures, and cultural differences. Discussion: Most interventions in mental healthcare aim to reduce symptoms and improve functioning. With regard to stimulating PR, these interventions may benefit from also focusing on enhancing hope, empowerment, and meaning in life. The strength of these findings is limited by the challenges of comparing separate CHIME dimensions with questionnaires assessing the concept of PR, and by the high levels of heterogeneity observed. Future research should focus on the interaction between elements of PR and clinical and social factors over time.
Collapse
Affiliation(s)
- J C P Leendertse
- Emergis Institute for Mental Healthcare, Kloetinge, Netherlands.,Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - A I Wierdsma
- Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - D van den Berg
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,Research and Innovation, Parnassia Psychiatric Institute, The Hague, Netherlands
| | - A M Ruissen
- Emergis Institute for Mental Healthcare, Kloetinge, Netherlands.,Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands.,Department of Psychiatry, Haaglanden Medical Centre, The Hague, Netherlands
| | - M Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - S Castelein
- Lentis Research, Lentis Psychiatric Institute, Groningen, Netherlands.,Faculty of Behavioural and Social Sciences, Clinical Psychology, University of Groningen, Groningen, Netherlands
| | - C L Mulder
- Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, Netherlands.,Research and Innovation, Parnassia Psychiatric Institute, The Hague, Netherlands
| |
Collapse
|
13
|
Asadi M, Tabari F, Haghani S, Heidari ME. The impact of empowerment model-based education on quality of life of transgender people under hormone therapy: A randomized clinical trial. J Family Med Prim Care 2020; 9:2794-2800. [PMID: 32984128 PMCID: PMC7491847 DOI: 10.4103/jfmpc.jfmpc_1201_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/26/2020] [Accepted: 03/02/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction: Gender identity disorder is a complex psychological problem and people with this disorder are at risk of many problems, including reduced quality of life. Empowerment intervention is one of the methods that can be used to improve the quality of life of people. The present study aimed to investigate the effect of empowerment model-based training on the quality of life of transgender people undergoing hormone therapy. Methods: The present study is a randomized clinical trial that was conducted in 2012 on 81 transgender people at Tehran Welfare Center. The study samples were randomly assigned into two groups of intervention and control. The intervention group received training based on the empowerment model (threat perception, problem-solving, educational participation, and evaluation) and the control group received routine treatment. Results: According to the findings, after the intervention, a statistically significant difference was found between the two groups in terms of the mean level of overt anxiety (P = 0.045) and aspects of emotional health (P = 0.030), the general perception of health (P = 0.007), mental health (P = 0.008), and overall quality of life (P = 0.005). Also, although there was a statistically significant difference in the aspect emotional well-being in the intervention group before and after the intervention (P = 0.034), this difference was not significant between the two groups (P = 0.274). Conclusion: The results showed that the empowerment-based training program had a significant relationship with the improvement in aspects of emotional health, the overall perception of health, mental health, emotional well-being and overall quality of life.
Collapse
Affiliation(s)
- Maryam Asadi
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Tabari
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Haghani
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Eghbal Heidari
- Student's Scientific Research Center, Nursing and Midwifery University, Tehran University Medical Science, Tehran, Iran
| |
Collapse
|
14
|
Faith LA, Collins JO, Decker J, Grove A, Jarvis SP, Rempfer MV. Experiences of empowerment in a community cognitive enhancement therapy program: an exploratory qualitative study. PSYCHOSIS 2019. [DOI: 10.1080/17522439.2019.1632920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Laura A. Faith
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Jen O. Collins
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Jenna Decker
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Amber Grove
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Stephen P. Jarvis
- Truman Medical Center Behavioral Health, Kansas City, MO, USA
- Department of Psychiatry, University of Missouri, Kansas City, MO, USA
| | - Melisa V. Rempfer
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| |
Collapse
|
15
|
The challenge of well-being and quality of life: A meta-analysis of psychological interventions in schizophrenia. Schizophr Res 2019; 208:16-24. [PMID: 30833133 DOI: 10.1016/j.schres.2019.01.040] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 11/08/2018] [Accepted: 01/27/2019] [Indexed: 02/03/2023]
Abstract
Well-being is a critical outcome in the recovery from psychosis and the prevention of symptoms. Previous reviews of the effectiveness of psychological interventions have focused on psychotic symptoms and general psychopathology, not recognising well-being as an essential outcome. This study conducted a meta-analysis of the effects of psychological interventions on the well-being and quality of life (QoL) of people with schizophrenia and analysed some critical moderating factors. A systematic literature search was conducted yielding 12986 published reports, 2043 of which were clinical trials. After a detailed review, 36 articles were included in the analyses. Measures of related concepts, well-being and quality of life were included in the present meta-analysis to reflect the current state of the literature and to ensure the representativeness of RCTs that have evaluated the effect of psychological interventions on the extent to which people with schizophrenia experience a good life. Our findings reflect a significant, small, treatment effect on the outcomes of well-being. Subgroup analysis also suggested a significant moderating effect when the primary aim of the intervention was well-being. These findings suggest that symptom or functional improvement does not necessarily lead to an improvement in well-being and would imply the need to focus specifically on those. We recommend psychological interventions that target well-being as a complementary strategy in mental health promotion and treatment. In addition, we stress the need to include well-being outcome measure in RCT as well as to clearly identify the different domains of well-being being measured.
Collapse
|
16
|
Andrade MCR, Slade M, Bandeira M, Evans-Lacko S, Martin D, Andreoli SB. Need for information in a representative sample of outpatients with schizophrenia disorders. Int J Soc Psychiatry 2018; 64:476-481. [PMID: 29783875 DOI: 10.1177/0020764018776350] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Providing adequate information and involving patients in treatment have become an essential component of mental health care. Despite this, research regarding the extent to which this need has been met in clinical services is still scarce. AIMS To investigate the need for information about psychiatric condition and treatment among outpatients with schizophrenia disorders and how this need is associated with service use, adjusting for sociodemographic and clinical characteristics. METHODS Need for information about condition and treatment, using the corresponding domain in the Camberwell Assessment of Need (CAN), in a representative sample of 401 schizophrenia outpatients in Santos, Brazil was assessed. Hierarchical logistic regression was used to investigate the association of information as a reported need and as an unmet need with service use variables, adjusting for sociodemographic and clinical characteristics. RESULTS Need for information was reported by 214 (53.4%) patients, being met in 101 (25.2%) and unmet in 113 (28.2%). Hierarchical regression indicated a significant association of a reported need with higher age of onset, family monitoring medication use last year and lower education level, which was only associated with an unmet need. CONCLUSION Information was a commonly reported need and which was often unmet, showing no significant association with service use. Greater attention should be given by mental health services to information provision.
Collapse
Affiliation(s)
- Mário César Rezende Andrade
- 1 Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,2 Department of Psychology, Universidade Federal de São João del-Rei (UFSJ), São João del-Rei, Brazil
| | - Mike Slade
- 3 Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Marina Bandeira
- 2 Department of Psychology, Universidade Federal de São João del-Rei (UFSJ), São João del-Rei, Brazil
| | - Sara Evans-Lacko
- 4 Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Denise Martin
- 5 Department of Preventive Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,6 Universidade Católica de Santos (UNISANTOS), Santos, Brazil
| | - Sérgio Baxter Andreoli
- 1 Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,6 Universidade Católica de Santos (UNISANTOS), Santos, Brazil
| |
Collapse
|
17
|
Abstract
PURPOSE OF REVIEW Schizophrenia has a heterogeneous range of end states, from severe cases requiring repeated hospitalization to cases in which a single illness episode is followed by complete remission. The purpose of the present review is to examine recent literature on recovery in schizophrenia, focusing on the predictive factors and on the possibility to achieve it. RECENT FINDINGS Roughly half of schizophrenia patients recovered or significantly improved over the long term, suggesting that functional remission is possible. Several factors predict the course of schizophrenia, including demographic, clinical, and treatment characteristics, as well as socioeconomic variables. Antipsychotics are a fundamental element of schizophrenia treatment, although the available antipsychotics have significant limitations. In this context, psychosocial interventions are supported by substantial evidence of efficacy in many outcome measures and rehabilitation interventions should be considered as an evidence-based practice and need to become a part of the standard treatment of schizophrenia. SUMMARY As recovery is a multidimensional concept, some authors suggested that at least two areas should be taken into account: clinical remission and social functioning. Functional outcome should be a priority target for therapeutic interventions in schizophrenia and in this perspective measuring treatment response, remission and functional recovery is essential. Only an integrated and multifaceted approach involving pharmacotherapy, psychosocial interventions, and attention to environmental circumstances can improve outcome in schizophrenia.
Collapse
|