1
|
Zomer L, van der Meer L, van Weeghel J, Widdershoven G, de Jong I, Voskes Y. Recovery-oriented care in Teams Working with the ART Model in long-term Mental Health care: A Qualitative Study on the Experiences of Service Users and Their Significant Others. Community Ment Health J 2024; 60:1177-1190. [PMID: 38619696 PMCID: PMC11199278 DOI: 10.1007/s10597-024-01269-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/16/2024] [Indexed: 04/16/2024]
Abstract
The Active Recovery Triad (ART) model provides a framework for recovery-oriented care in long-term mental health settings. The aim of this study is to gain insight into the experiences and views of service users and their significant others regarding care and support they receive from teams working with the ART model. Semi-structured interviews were performed with nineteen service users and five significant others of teams operating in Dutch long-term mental health care. Data were analyzed using thematic analysis. The three core principles of the ART model formed the deductive basis of the analysis and for every principle themes were identified inductively. Under the principle 'Active', service users mentioned that they feel motivated, work actively on personal recovery goals and have dreams for the future. Service users valued the service as a safe environment, but several service users also preferred to live more independently. Under the principle 'Recovery', participants reported how the dimensions of recovery (health, personal identity, daily life and community functioning) were addressed in care and support. Also, specific conditions for recovery-oriented care were identified, for example regarding specific expertise of care providers. Under the principle 'Triad' the support from significant others, contact with care workers and with other service users were identified as important. The insights regarding what is important for service users and their significant others may contribute to the improvement of care and support in long-term mental health care. In addition, the findings of this study provide directions for the further development of the ART model.
Collapse
Affiliation(s)
- Lieke Zomer
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands.
- Altrecht GGz, Zeist, the Netherlands.
| | - Lisette van der Meer
- Department of Clinical & Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
- Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, the Netherlands
| | - Jaap van Weeghel
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, the Netherlands
| | - Guy Widdershoven
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
| | - Isa de Jong
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
| | - Yolande Voskes
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, the Netherlands
- Impact Care Group, GGz Breburg, Tilburg, the Netherlands
| |
Collapse
|
2
|
Jesus TS, Stern BZ, Struhar J, Deutsch A, Heinemann AW. The use of patient experience feedback in rehabilitation quality improvement and codesign activities: Scoping review of the literature. Clin Rehabil 2022; 37:261-276. [DOI: 10.1177/02692155221126690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To characterize the literature, reported enablers, and gaps on the use of patient experience feedback for person-centered rehabilitation quality improvement and codesign activities. Design Scoping Review. Data sources Scientific databases (PubMed, CINAHL, Rehabdata, Scopus, Web of Science, ProQuest), website searches (e.g. Beryl Institute), snowballing, and key-informant recommendations. Methods Two independent reviewers performed title and abstract screenings and full-text reviews. Eligibility focused on English-language, peer-reviewed (all time) and gray literature (last five years) that used patient experience feedback in rehabilitation improvement activities. The aims, settings, methods, findings, implications, and reported limitations were extracted, followed by content analyses identifying reported enablers and gaps. Results Among the 901 unique references and 52 full texts reviewed, ten were included: four used patient experience surveys for improving patient experiences; six used codesign methodologies to engage patient feedback in service improvement activities. Implementation enablers included securing managerial support, having a structured methodology and facilitator, using efficient processes, engaging staff experiences, and using appreciative inquiry. Reported study gaps included limited follow-up, low sample sizes, analytical limitations, lack of reported limitations, or narrow range of perspectives (e.g. not from people with severe impairments). Conclusion Few examples of the use of patient experience feedback in quality improvement or codesign activities were found in the rehabilitation literature. Patient experience improvement activities relied exclusively on retrospective survey data, which were not combined with often more actionable forms (e.g. qualitative, real time) of patient experience feedback. Further research might consider design of activities that collect and use patient experience feedback for rehabilitation service improvements.
Collapse
Affiliation(s)
- TS Jesus
- Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - BZ Stern
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Struhar
- Nerve, Muscle + Bone Innovation Center & Oncology Innovation Center, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - A Deutsch
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- RTI International, Chicago, IL, USA
| | - AW Heinemann
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| |
Collapse
|
3
|
Sharing Visual Narratives of Diabetes on Social Media and Its Effects on Mental Health. Healthcare (Basel) 2022; 10:healthcare10091748. [PMID: 36141360 PMCID: PMC9498624 DOI: 10.3390/healthcare10091748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/26/2022] [Accepted: 09/08/2022] [Indexed: 11/16/2022] Open
Abstract
Diabetes is a chronic illness affecting over six percent of the global population. Visual social media sites such as Tumblr provide a unique opportunity to understand visual illness narratives of type 1 and type 2 diabetes and its effects on mental health. We qualitatively analyze 259 Tumblr images with a “diabetes” hashtag. The results provide rich insights into the lives of diabetes patients, including personal and social life interactions, visual narratives portraying one’s acceptance and maintenance of diabetes, difficulty in social interactions, and how patients’ identity and beliefs are shaped by the daily struggles and failures of living with diabetes. We discuss the findings in the context of the chaos, quest, and restitution narratives of illness proposed by Arthur Frank. The results have implications for the visual representation of chronic diseases on social media and for improving patient–provider interactions and treatment of type 1 and type 2 diabetes patients.
Collapse
|
4
|
Chinn D. 'I Have to Explain to him': How Companions Broker Mutual Understanding Between Patients with Intellectual Disabilities and Health Care Practitioners in Primary Care. QUALITATIVE HEALTH RESEARCH 2022; 32:1215-1229. [PMID: 35435768 DOI: 10.1177/10497323221089875] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
People with intellectual disabilities (ID) experience marked health inequalities. This is attributable, at least in part, to suboptimal healthcare communication with health care practitioners (HCPs) whereby patients with ID and HCPs struggle to understand each other. Companions who attend healthcare appointments with patients with ID can support the communicative exchange between patient and HCP, but their involvement can have unintended consequences. This article uses Conversation Analysis (CA) to analyse video-recorded data from primary care health checks involving 24 patients with ID. This method shows that companions use their linguistic and experiential resources to intervene as 'brokers' to address real or potential threats to mutual understanding between patients with ID and HCPs. Their interventions can fill in the gaps in knowledge and understanding of the other parties, but also run the risk of deskilling the others in the interaction, by relieving them of the obligation to address communication breakdown directly themselves.
Collapse
Affiliation(s)
- Deborah Chinn
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
| |
Collapse
|
5
|
Miller AL, Frye D, Green T, Mitchell C, Garcia G, Huereña J, Moore T, Turnage V. (Re)defining their place at the table: Frank discussions by adults with disabilities on contemporary self‐advocacy. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:777-788. [DOI: 10.1111/jar.12981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/22/2021] [Accepted: 12/02/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Amanda L. Miller
- College of Education Wayne State University Detroit Michigan USA
| | - David Frye
- Self Advocacy Resource and Technical Assistance Center Maineville OHIO USA
| | - Thelma Green
- Self Advocacy Resource and Technical Assistance Center Maineville OHIO USA
| | - Cheri Mitchell
- Self Advocacy Resource and Technical Assistance Center Maineville OHIO USA
| | | | | | | | | |
Collapse
|