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Reinius M, Steinsaphir Å, Malmqvist Castillo M, Stenfors T. Patients' experiences of Daily Talks: a patient-driven intervention in inpatient mental healthcare. J Ment Health 2023:1-8. [PMID: 36840358 DOI: 10.1080/09638237.2023.2182420] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
BACKGROUND Recovery is known to be enhanced by meaningful interactions between patients and mental health staff. However, nurses may become distanced from patients, and patients may spend most of their time in inpatient mental health care alone. AIMS This study aimed to explore how patients experience the intervention Daily Talks, a patient-driven innovation intended to enhance meaningful interactions between patients and staff. METHODS Fourteen in-depth interviews were performed with patients who participated in Daily Talks. The interviews were analysed using reflexive thematic analysis. RESULTS The results of the participants' experiences of Daily Talks are presented in four themes: 1.Interpersonal and active interaction where individual factors matter 2.A patient-controlled space 3.A multi-use intervention and 4.A part of the daily healthcare structure. Participants stated that Daily Talks improved the relationship between patients and their nursing staff, and they stressed the importance of patients having control over both time and content in the Daily Talks. Daily Talks was used to vent emotions and thoughts, handle situations and create strategies, and become part of a helpful structure. CONCLUSIONS The results support the value of Daily Talks, indicating that Daily Talks may facilitate helpful structures and meaningful relationships between patients and nursing staff.
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Affiliation(s)
- Maria Reinius
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Stockholm, Sweden
| | - Åsa Steinsaphir
- User Involvement Coordinator, North Stockholm Psychiatry, Health Care Services Stockholm County, Stockholm, Sweden
| | - Moa Malmqvist Castillo
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Terese Stenfors
- Division of Learning, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Badu E, O'Brien AP, Mitchell R, Osei A. A qualitative study of evidence-based therapeutic process in mental health services in Ghana- context-mechanisms-outcomes. BMC Health Serv Res 2021; 21:1013. [PMID: 34563183 PMCID: PMC8466714 DOI: 10.1186/s12913-021-06993-1] [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] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 09/07/2021] [Indexed: 02/03/2023] Open
Abstract
Background Evidence-based clinical practice is an inherent component of mental health professional practice in developed countries. However, little is known about professional perspectives of evidence-based practice in mental in developing countries such as Ghana. This paper describes the processes involved in the delivery of best practice in Ghana. The paper reports on a realistic evaluation of mental health nurses and allied health professionals’ views on the evidence-based therapeutic process in Ghana. Methods A purposive sample of 30 mental health professionals (MHPs) was recruited to participate in semi-structured, in-depth interviews. Thematic analysis was used to analyse the data. A program theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis. Results The thematic analysis identified two contexts, mechanism and outcome configurations (themes): 1) technical competency stimulates evidence-based mental health services, and 2) therapeutic relationship building ensures effective interaction. The study demonstrates that contextual factors (technical competencies and therapeutic relationship building) together with mechanisms (intentional and unintentional) help to promote quality in mental health service provision. However, contextual factors such as a lack of sign language interpreters yielded unintended outcomes including barriers to communication with providers for consumers with hearing impairment and those from linguistic minority backgrounds. Conclusion Government stakeholders and policymakers should prioritise policies, periodic monitoring and adequate financial incentives to support the mechanisms that promote technical competence in MHPs and the building of therapeutic relationship. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06993-1.
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Affiliation(s)
- Eric Badu
- School of Nursing and Midwifery, Faculty Health and Medicine, The University of Newcastle, Callaghan, Australia.
| | | | - Rebecca Mitchell
- Macquarie Business School, Macquarie University, Sydney, Australia
| | - Akwasi Osei
- Ghana Mental Health Authority, Ghana Health Services, Accra, Ghana
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Fekete OR, Langeland E, Larsen TMB, Davidson L, Kinn LG. Recovery at the Clubhouse: challenge, responsibility and growing into a role. Int J Qual Stud Health Well-being 2021; 16:1938957. [PMID: 34126865 PMCID: PMC8208115 DOI: 10.1080/17482631.2021.1938957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: To explore how people with mental illness experience recovery in the Clubhouse context, and which ingredients of the model they find active in promoting recovery. Methods: Hermeneutic–phenomenological design. Individual, semi-structured interviews with 18 Norwegian Clubhouse members. Systematic text condensation was used in analysis. Results: Three main themes emerged: “Balancing unlimited support with meeting challenges”, with two sub-themes: “Unlimited membership: space for self-agency or hindering development?” and “Becoming a Clubhouse member: concerns and positive experiences”. The second main theme was: “Learning how to build new skills and roles in the community”. The third main theme was: “Getting better through and for work”, with two sub-themes: “Work at the Clubhouse as a means to recovery” and “Preparing for a working life in society”. Overall, participants experienced improved mental and social wellbeing and work readiness. Conclusions: Recovery in the Clubhouse context requires members’ personal initiative, thus people having poor mental health might struggle with utilizing the Clubhouse. However, participants reported that lack of challenges within the community thwarted their recovery. Based on Salutogenesis, conscious application of challenge in Clubhouse activities might enhance members’ recovery. Furthermore, participants’ all-round involvement in their recovery journeys suggests the importance of shared decision-making in recovery-oriented services.
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Affiliation(s)
- Orsolya Reka Fekete
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Eva Langeland
- Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Torill M B Larsen
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Larry Davidson
- Yale Program for Recovery and Community Health, Yale University, New Haven, CT, USA
| | - Liv Grethe Kinn
- Department of Welfare and Participation, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Piat M, Wainwright M, Sofouli E, Vachon B, Deslauriers T, Préfontaine C, Frati F. Factors influencing the implementation of mental health recovery into services: a systematic mixed studies review. Syst Rev 2021; 10:134. [PMID: 33952336 PMCID: PMC8101029 DOI: 10.1186/s13643-021-01646-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 03/22/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Countries around the world have committed in policy to transforming their mental health services towards a recovery orientation. How has mental health recovery been implemented into services for adults, and what factors influence the implementation of recovery-oriented services? METHODS This systematic mixed studies review followed a convergent qualitative synthesis design and used the best-fit framework synthesis method. Librarians ran searches in Ovid- MEDLINE, Ovid-EMBASE, Ovid-PsycInfo, EBSCO-CINAHL Plus with Full Text, ProQuest Dissertations and Theses, Cochrane Library, and Scopus. Two reviewers independently screened studies for inclusion or exclusion using DistillerSR. Qualitative, quantitative, and mixed methods peer-reviewed studies published since 1998 were included if they reported a new effort to transform adult mental health services towards a recovery orientation, and reported findings related to implementation experience, process, or factors. Data was extracted in NVivo12 to the 38 constructs of the Consolidated Framework for Implementation Research (CFIR). The synthesis included a within-case and a cross-case thematic analysis of data coded to each CFIR construct. Cases were types of recovery-oriented innovations. RESULTS Seventy studies met our inclusion criteria. These were grouped into seven types of recovery-oriented innovations (cases) for within-case and cross-case synthesis. Themes illustrating common implementation factors across innovations are presented by CFIR domain: Intervention Characteristics (flexibility, relationship building, lived experience); Inner Setting (traditional biomedical vs. recovery-oriented approach, the importance of organizational and policy commitment to recovery-transformation, staff turnover, lack of resources to support personal recovery goals, information gaps about new roles and procedures, interpersonal relationships), Characteristics of Individuals (variability in knowledge about recovery, characteristics of recovery-oriented service providers); Process (the importance of planning, early and continuous engagement with stakeholders). Very little data from included studies was extracted to the outer setting domain, and therefore, we present only some initial observations and note that further research on outer setting implementation factors is needed. CONCLUSION The CFIR required some adaptation for use as an implementation framework in this review. The common implementation factors presented are an important starting point for stakeholders to consider when implementing recovery-oriented services.
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Affiliation(s)
- Myra Piat
- Douglas Mental Health University Institute, 6875, boul. LaSalle, Montréal, Québec, H4H 1R3, Canada. .,McGill University, Québec, Canada.
| | - Megan Wainwright
- Douglas Mental Health University Institute, 6875, boul. LaSalle, Montréal, Québec, H4H 1R3, Canada.,Department of Anthropology, Durham University, Durham, Canada
| | - Eleni Sofouli
- Douglas Mental Health University Institute, 6875, boul. LaSalle, Montréal, Québec, H4H 1R3, Canada.,McGill University, Québec, Canada
| | - Brigitte Vachon
- School of Rehabilitation, Université de Montréal, C.P. 6128, succursale Centre-ville, Montreal, Québec, H3C 3J7, Canada
| | - Tania Deslauriers
- School of Rehabilitation, Université de Montréal, 7077 avenue du Parc, Montreal, QC, H3N 1X7, Canada
| | - Cassandra Préfontaine
- Université du Québec à Trois-Rivières, 3351 Boulevard des Forges, Trois-Rivières, QC, G8Z 4M3, Canada
| | - Francesca Frati
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, 809, Sherbrooke W, Montreal, Québec, H3A 0C9, Canada
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Fekete OR, Langeland E, Larsen TMB, Kinn LG. "Finally, I belong somewhere I can be proud of" - Experiences of being a Clubhouse member in Norway. Int J Qual Stud Health Well-being 2020; 15:1703884. [PMID: 31877109 PMCID: PMC6968664 DOI: 10.1080/17482631.2019.1703884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2019] [Indexed: 11/06/2022] Open
Abstract
Purpose: The number of psychosocial Clubhouses is growing rapidly in Norway. However, more knowledge is needed about the subjective experience of Clubhouse members in terms of their recuperation processes and experiences in the Clubhouse context. Therefore, this qualitative study explored what it is like to be a Clubhouse member in Norway, and further discuss it in light of the theory of Salutogenesis on successful pathways to coping and well-being.Methods: Using a hermeneutic-phenomenological approach, the present study included in-depth, semi-structured individual interviews with 18 Clubhouse members from three accredited Norwegian Clubhouses. Analysis was conducted using systematic text condensation.Results: Three main themes emerged from the analysis: "Finally, I belong somewhere I can be proud of," "I feel more like an ordinary citizen, just different," and "I feel somewhat equal to others." Overall, the participants experienced improved mental and social well-being owing to their membership of a Clubhouse.Conclusions: Our findings correspond with previous international research. Owing to the positive effect participation in the Clubhouse seem to have on members' motivation, Salutogenesis might help explain helpful processes within the model. Moreover, the model might be a relevant example for policy and service development in mental health care and the labour market.
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Affiliation(s)
- Orsolya Reka Fekete
- Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Eva Langeland
- Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Torill M B Larsen
- Department of Health Promotion and Development Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Liv Grethe Kinn
- Department of Welfare and Participation, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Fekete OR, Kinn LG, Larsen TMB, Langeland E. Salutogenesis as a theoretical framework for psychosocial rehabilitation: the case of the Clubhouse model. Int J Qual Stud Health Well-being 2020; 15:1748942. [PMID: 32249690 PMCID: PMC7170324 DOI: 10.1080/17482631.2020.1748942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose: This study explored whether the holistic theory of salutogenesis may be a suitable theoretical framework for the Clubhouse model of psychosocial rehabilitation, a pioneer among psychosocial rehabilitation programmes. Methods: A systematic examination of elements of the Clubhouse model, as prescribed by the Clubhouse standards, was performed within the context of the theory of salutogenesis including its basic salutogenic orientation and the main concepts of sense of coherence and resistance resources. Results: We found that several standards and practices within the Clubhouse model can be understood as applications of salutogenesis. We have hypothesized that the Clubhouse model promotes peoples’ sense of coherence and mental health. However, our investigation also showed that, to enhance the recovery of Clubhouse members, more explicitly incorporating some salutogenic principles, such as “appropriate challenges” and “active adaptation as the ideal in treatment”, may benefit Clubhouse practice. Conclusions: The Clubhouse model of psychosocial rehabilitation is very consistent with the salutogenic orientation and main salutogenic concepts. The present study suggests that salutogenesis may be a suitable theoretical framework for the Clubhouse model and possibly in the psychosocial rehabilitation field in general.
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Affiliation(s)
- Orsolya Reka Fekete
- Department of Welfare and Participation, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences and Department of Health Promotion and Development Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Liv Grethe Kinn
- Department of Welfare and Participation, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Torill M B Larsen
- Department of Health Promotion and Development Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Eva Langeland
- Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Facial Emotion Recognition: Virtual Reality Program for Facial Emotion Recognition—A Trial Program Targeted at Individuals With Schizophrenia. REHABILITATION COUNSELING BULLETIN 2019. [DOI: 10.1177/0034355219847284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
People with severe mental illness (SMI), schizophrenia in particular, show considerable functional impairment in emotional recognition and social perception, which negatively affects interpersonal relationships and social functioning. Owing to its ecological validity, virtual reality (VR) has been observed to improve both assessment and training of emotional recognition skills of people with SMI. This article includes two studies: (a) a descriptive study on the Virtual Reality program for Facial Emotion Recognition (VR-FER) and (b) an empirical study that presents the results of the application of the VR-FER’s first module. For the second study, data were collected using two samples: a group of 12 people with schizophrenia and a reference group of 12 people who were mentally healthy. Data analysis comprised descriptive (mean, standard deviation) and inferential statistics (Mann–Whitney U test). Results showed that the first group presented a lower number of correct answers and a higher number of incorrect answers compared with the second group regarding facial emotion recognition (FER), thereby confirming the need to develop strategies to improve emotional recognition and social perception in people with schizophrenia. VR-FER is regarded a strategic training program for FER, using latest technology and following rehabilitation guidelines for SMI.
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Topor A, Ljungberg A. “Everything is so relaxed and personal” – The construction of helpful relationships in individual placement and support. AMERICAN JOURNAL OF PSYCHIATRIC REHABILITATION 2016. [DOI: 10.1080/15487768.2016.1255276] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Alain Topor
- Department of Social Work, Stockholm University, Stockholm, Sweden
- Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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Ljungberg A, Denhov A, Topor A. Non-helpful relationships with professionals - a literature review of the perspective of persons with severe mental illness. J Ment Health 2015; 25:267-77. [PMID: 27150468 DOI: 10.3109/09638237.2015.1101427] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The relationship with professionals has proved to be important with regard to outcome for persons with severe mental illness (SMI). The understanding of non-helpful relationships is important complementary knowledge to that regarding helpful relationships. AIM To review the available qualitative research providing knowledge of non-helpful relationships from the perspective of persons with SMI. METHOD A review of qualitative studies, based on an earlier systematic search, analyzed through thematic analysis. RESULTS The main themes were "non-helpful professionals", "organization versus relation" and "the consequences of non-helpful relationships with professionals". Examples of professionals described as non-helpful were pessimistic and uncaring professionals who were paternalistic and disrespectful. Discontinuity, insufficient time and coercion were some of the contextual factors described as non-helpful. These sorts of relationships were non-helpful because they hindered helpful relationships from developing and contributed to further suffering, instilling hopelessness and hindering personal growth. CONCLUSIONS Non-helpful relationships with professionals can be understood as impersonal relationships that contain no space for negotiation of the relationship nor of the support and treatment provided through it. It is important that organizations provide professionals with favorable conditions to negotiate the organizational framework and to treat persons with SMI as whole human beings.
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Affiliation(s)
- Amanda Ljungberg
- a Research and Development Unit , Psychiatry South Stockholm , Stockholm , Sweden
| | - Anne Denhov
- a Research and Development Unit , Psychiatry South Stockholm , Stockholm , Sweden .,b Department of Social Work , Stockholm University , Stockholm , Sweden , and
| | - Alain Topor
- a Research and Development Unit , Psychiatry South Stockholm , Stockholm , Sweden .,b Department of Social Work , Stockholm University , Stockholm , Sweden , and.,c Faculty of Health and Sport Sciences , University of Agder , Grimstad , Norway
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