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Lundqvist LO, Rytterström P, Rask M, Brunt D, Sellin T, Grim K, Rystedt I, Schröder A. Influence of mental health service provision on the perceived quality of life among psychiatric outpatients: associations and mediating factors. Front Psychiatry 2024; 14:1282466. [PMID: 38293591 PMCID: PMC10824987 DOI: 10.3389/fpsyt.2023.1282466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024] Open
Abstract
ObjectiveTo investigate the relationship between perceived mental health service provision and quality of life (QoL) as perceived by patients in psychiatric outpatient care.MethodsA total of 373 adult patients registered at 15 psychiatric outpatient clinics in three regions in central and southern Sweden were included in the study. Survey data were collected using a questionnaire on mental health service provision, symptom severity, recovery, clinical diagnosis, sociodemographics (serving as independent variables) and QoL (serving as the dependent variable). Three aspects of mental health service provision were used: patients’ perceived quality of care, perceived staff-patient interaction, and patient reported psychiatric treatments. Structural equation modelling was used to model the relationship among the variables.ResultsVariables in mental health service provision showed few direct associations with patients’ perceived QoL. Instead, the associations of mental health service provision on QoL were mainly mediated through symptom severity and recovery. These relationships were retained after adjusting for sociodemographic variables and clinical diagnoses. The final model achieved excellent goodness of fit (χ2 = 49.502, p = 0.230, RMSEA = 0.020, CFI = 0.997 and a SRMR = 0.024).ConclusionThis study shows that mental health service provision is associated with patients’ perceived QoL; however, this association is mostly indirect and mediated by reduced symptom severity and increased recovery. This finding can help inform the design of future interventions to enhance service provision to improve patients’ QoL.
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Affiliation(s)
- Lars-Olov Lundqvist
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Patrik Rytterström
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Mikael Rask
- School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - David Brunt
- School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Tabita Sellin
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Katarina Grim
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Ingrid Rystedt
- Division of Society and Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Agneta Schröder
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Nursing, Faculty of Health, Care and Nursing, Norwegian University of Science and Technology (NTNU), Gjövik, Norway
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Brolin R, Tjörnstrand C, Friis M, Argentzell E, Bejerholm U, Eklund M, Brunt D. "It's not just the residents who need to be motivated for activity": a qualitative study of the perspectives of staff on providing activity support for people with psychiatric disabilities in supported housing in Sweden. Front Psychiatry 2024; 14:1322859. [PMID: 38250283 PMCID: PMC10797039 DOI: 10.3389/fpsyt.2023.1322859] [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: 10/16/2023] [Accepted: 12/15/2023] [Indexed: 01/23/2024] Open
Abstract
Background The goals for staff in Supported Housing for people with psychiatric disabilities include helping to develop the residents' independence and self-confidence in activities. However, staff have expressed frustration about providing this type of support when motivating residents to engage in meaningful activities and also about the difficulty in finding suitable levels of independence within a housing setting with limitations. Objective The aim is to explore the views and experiences of housing staff in Supported Housing on how they can stimulate and support engagement in activities for people with psychiatric disabilities. Methods Twenty-six members of staff from 20 supported housing units in 10 municipalities in Sweden were interviewed in five focus groups. A semi-structured interview guide was used, and the transcribed material was analyzed using qualitative content analysis. Results Three main categories emerged from the analysis: Multi-faceted factors influencing the staff's provision of activity support, Staff's approach for supporting activities, and Staff's struggles to develop their work. Obstacles to participating in activities in the community were identified. Many contrasting factors were found, such as spontaneous or structured activities and individual or group activities, which affected the staff's ability to motivate to activity. Conclusion A broad approach encompassing in-house training including a focus on values, recruitment policies, staff supervision and interventions focusing on both residents and staff are ways to support staff in motivating residents toward being more active within Supported Housing.
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Affiliation(s)
- Rosita Brolin
- School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Carina Tjörnstrand
- Department of Health Sciences/Mental Health, Activity and Participation, Lund University, Lund, Sweden
| | - Mette Friis
- Department of Health Sciences/Mental Health, Activity and Participation, Lund University, Lund, Sweden
| | - Elisabeth Argentzell
- Department of Health Sciences/Mental Health, Activity and Participation, Lund University, Lund, Sweden
| | - Ulrika Bejerholm
- Department of Health Sciences/Mental Health, Activity and Participation, Lund University, Lund, Sweden
| | - Mona Eklund
- Department of Health Sciences/Mental Health, Activity and Participation, Lund University, Lund, Sweden
| | - David Brunt
- School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
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Argentzell E, Tjörnstrand C, Brunt D, Eklund M, Bejerholm U. Opportunities and barriers for occupational engagement among residents in supported housing. Scand J Occup Ther 2023; 30:125-135. [PMID: 36345116 DOI: 10.1080/11038128.2022.2141315] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Opportunities and barriers for occupational engagement among residents in supported housing. BACKGROUND Research shows that people with psychiatric disabilities view supported housing (SH) as a possibility for social contact, but also as entailing a risk of deprived self-determination. There is, however, little research on the target group's engagement in everyday occupations. AIM To explore SH residents' opportunities and barriers for occupational engagement. MATERIALS AND METHODS Sixteen participants were interviewed, and data was analysed using content analysis. RESULTS An overarching theme, Struggling to create meaning and seeking affection, and three underlying categories, emerged. Finding meaning through self-chosen occupations and support focussed on receiving support, doing self-chosen occupations, and having social contacts. Feeling neglected and insecure limits engagement in occupations was related to feelings of not being seen by staff, and insecurity, which hampered daily life. The third theme was Having a negative self-image and low level of ability hinders an active life. CONCLUSION Residents' self-view and ability to create an inner drive for being active was important for occupational engagement, which was linked to social connectedness. Occupational based interventions and a personal recovery approach is warranted in order to facilitate needs for meaningful occupations. SIGNIFICANCE The results from the study can be used to further develop optimal support within SH units.
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Affiliation(s)
- Elisabeth Argentzell
- Department of Health Sciences, Mental Health, Activity and Participation (MAP), Lund university, Lund, Sweden
| | - Carina Tjörnstrand
- Department of Health Sciences, Mental Health, Activity and Participation (MAP), Lund university, Lund, Sweden
| | - David Brunt
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Mona Eklund
- Department of Health Sciences, Mental Health, Activity and Participation (MAP), Lund university, Lund, Sweden
| | - Ulrika Bejerholm
- Department of Health Sciences, Mental Health, Activity and Participation (MAP), Lund university, Lund, Sweden
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Harrison M, Forsyth K, Murray AL, Angarola R, Henderson S, Irvine Fitzpatrick L, Fisher G. Establishing the measurement properties of the Residential Environment Impact Scale (Version 4.0). Scand J Occup Ther 2022:1-10. [PMID: 36490204 DOI: 10.1080/11038128.2022.2143891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Developed as an environment assessment informed by the Model of Human Occupation, the Residential Environment Impact Survey considered the physical, social and activity features of the environment, evaluating the impact of the environment on resident's quality of life. Clinicians reported that the Residential Environment Impact Survey was a useful tool; however, it had not been structured to be a measurement tool and did not have established psychometric properties. AIMS/OBJECTIVES This study examines the psychometric properties of the restructured Residential Environment Impact Scale Version 4.0 (REIS), which measures the level of environment support provided to residents. MATERIAL AND METHODS The REIS was completed across residential sites for people with complex mental health needs. A many facets Rasch analysis was conducted to establish the reliability and validity of the REIS. RESULTS The REIS demonstrated reasonable psychometric properties, with items demonstrating internal scale validity and scale items following an expected pattern of increasingly challenging environment support. CONCLUSIONS AND SIGNIFICANCE Initial evidence suggests that the REIS provides a valid and reliable measure of environment support, providing a detailed assessment of how physical, social and activity elements of the environment support or inhibit participation and can be applied across a range of living environments.
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Affiliation(s)
- Michele Harrison
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Kirsty Forsyth
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Aja Louise Murray
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland.,School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, Scotland
| | - Rocco Angarola
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland.,Midlothian Health and Social Care Partnership, Dalkeith, Scotland
| | - Shona Henderson
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | | | - Gail Fisher
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL, USA
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Rask M, Lundqvist LO, Schröder A, Brunt D. Psychometric Properties of the Verbal and Social Interaction Questionnaire for Psychiatric Outpatient Care (VSI-OP), Staff and Patient Versions. Issues Ment Health Nurs 2022; 43:936-943. [PMID: 35580349 DOI: 10.1080/01612840.2022.2072549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this paper is to investigate the psychometric properties of the Verbal and Social Interaction questionnaire for psychiatric outpatient care (VSI-OP) by using a confirmatory factor analysis. A further aim is to present the patient and staff perceptions of the frequency of these interactions in this context. The factor structure of the VSI-OP could be explained by three factors for both the staff and the patient versions. The three factors are: 'Inviting the patient to establish a relationship', 'Showing interest in the patients' feelings, experiences and behaviour' and 'Helping the patients to establish structure and routines in their everyday life'. The two first factors were the most frequently occurring actions according to the staff and the patients.
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Affiliation(s)
- Mikael Rask
- School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Lars-Olov Lundqvist
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Agneta Schröder
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Department of Nursing, Faculty of Health, Care and Nursing, Norwegian University of Science and Technology (NTNU), Gjövik, Norway
| | - David Brunt
- School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
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Jose AL, Harrison M, Roy AS, Fitzpatrick LI, Forsyth K. The level of formal support received by people with severe mental illness living in supported accommodation and participation: A systematic review. Int J Soc Psychiatry 2021; 67:854-866. [PMID: 33487055 PMCID: PMC8559179 DOI: 10.1177/0020764020988576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM The review aimed to identify and explore the association of level of support received by people with severe mental illness in supported accommodation and participation. METHOD The authors conducted a systematic search in MEDLINE, PsychINFO, PsychARTICLES, CINAHL Plus and ASSIA. Searches were restricted to articles published in English and participants aged 18 years and over with severe mental illness. Articles were included based on level of support received in mental health supported accommodation, classified according to the Simple Taxonomy for Supported Accommodation, and three factors of participation: social participation, daily living functioning and personal empowerment. Studies of in-patient settings and nursing homes were excluded. The review protocol is registered on PROSPERO (registration number: CRD42019161808). RESULTS Six articles were included in the review from USA, Australia, Sweden and Taiwan. Factors of participation for people living in accommodation with moderate support and accommodation with high support were explored. Data indicated an association between level of support and participation showing that people living in accommodation with moderate support had increased participation compared to people living in accommodation with high support. CONCLUSION This review identified an association between level of formal support and participation. People with SMI living in accommodation with medium support participated in more community occupations, more activities and had a higher level of personal empowerment than people living in accommodation with high support.
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Affiliation(s)
- Akkara Lionel Jose
- School of Health Sciences, Queen
Margaret University, Queen Margaret University Drive, Edinburgh, UK
| | - Michele Harrison
- School of Health Sciences, Queen
Margaret University, Edinburgh, UK
| | - Anusua Singh Roy
- School of Health Sciences, Queen
Margaret University, Edinburgh, UK
| | - Linda Irvine- Fitzpatrick
- Strategic Programme Manager, Mental
Health and Wellbeing, City of Edinburgh Health and Social Care Partnership,
Edinburgh, UK
| | - Kirsty Forsyth
- School of Health Sciences, Queen
Margaret University, Edinburgh, UK
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Gunnarsson AB, Brunt D, Tjörnstrand C, Argentzell E, Bejerholm U, Eklund M. Navigating in a Misty Landscape - Perceptions of Supporting a Relative Residing in Supported Housing for People with a Psychiatric Disability. Issues Ment Health Nurs 2020; 41:1038-1046. [PMID: 32605419 DOI: 10.1080/01612840.2020.1756012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim was to explore informal carers' perceptions of supporting the everyday life of a relative who has a psychiatric disability and resides in supported housing (SH). A qualitative study based on interviews with 12 informal carers was performed, and the data was analyzed with qualitative content analysis. The theme "Navigating in a misty landscape when striving to support a relative with a psychiatric disability" was identified, encompassing four categories pertaining to residents' needs, collaboration, environmental issues and the carer's situation. SH services can be enhanced by addressing informal carers' experiences and developing greater collaboration involving informal carers, residents and staff.
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Affiliation(s)
- A Birgitta Gunnarsson
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Department of Research and Development, Region Kronoberg, Växjö Sweden
| | - David Brunt
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | | | | | | | - Mona Eklund
- Department of Health Sciences, Lund University, Lund, Sweden
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Eklund M, Argentzell E, Bejerholm U, Brunt D, Tjörnstrand C. Outcomes of the Active in My Home (AiMH) intervention for people with psychiatric disabilities in supported housing: A longitudinal pilot and feasibility study. Br J Occup Ther 2019. [DOI: 10.1177/0308022619888872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mona Eklund
- Department of Health Sciences, Lund University, Lund, Sweden
| | | | | | - David Brunt
- Department of Health and Caring Sciences, Linneaus University, Växjö, Sweden
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