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McGeechan GJ, Moore H, Le Sauvage N, Smith J, Giles EL. Considerations for peer research and implications for mental health professionals: learning from research on food insecurity and severe mental illness. J Psychiatr Ment Health Nurs 2024; 31:966-971. [PMID: 38528678 DOI: 10.1111/jpm.13050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/13/2024] [Accepted: 03/20/2024] [Indexed: 03/27/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT Peer research methodologies and methods are increasingly used in research, particularly to benefit from lived experiences. The experiences of peer researchers with severe mental illness are less common, including the impact on them of conducting peer-led research. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE This paper shares the experience of peer research and suggests in the context of food insecurity, that it is not well understood by some healthcare professionals. WHAT ARE THE IMPLICATIONS FOR PRACTICE Implications include considerations around trauma-informed care and the need for screening for food insecurity in mental healthcare settings. Research implications include providing training for peer research and needing to consider longevity of peer researcher relationships. ABSTRACT Introduction Food insecurity means that a person does not have access to sufficient nutritious food for normal growth and health. This can lead to health problems such as obesity, heart disease, diabetes and other long term chronic health conditions. People living with a severe mental illness are more likely to experience food insecurity than people without a severe mental illness. Aim The aim of this paper is to present a lived experience narrative of two peer researchers. Peer researchers conducted interviews with adults with severe mental illness from Northern England as part of a funded research project. These interviews discussed experiences of food insecurity and strategies to tackle it and were conducted between March and December 2022. Thesis The following paper does not discuss the results of the interviews themselves. Rather the narrative begins with an overview of peer research, before sharing the experiences of the two peer researchers in undertaking this project. Implications for Practice This includes healthcare professionals understanding food insecurity, what it is and what it is not, thinking about trauma-informed care, and screening for food insecurity. Peer research implications centre on adequate support and training, considerations to longevity of peer research relationships and reducing unnecessary research burden for peer researchers.
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Affiliation(s)
- Grant J McGeechan
- Centre for Applied Psychological Science, School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK
| | | | | | - Jo Smith
- Tees, Esk and Wear Valley NHS Foundation Trust, Flatts Lane Centre, Middlesbrough, UK
- School of Health and Life Sciences, Centuria Building South, Teesside University, Middlesbrough, UK
| | - Emma L Giles
- School of Health and Life Sciences, Centuria Building South, Teesside University, Middlesbrough, UK
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2
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Friesinger JG, Topor A, Lindvig GR, Larsen IB. Micropolitics of Mental Health Recovery: An Assemblage Analysis of People's Experiences of Becoming Well. Community Ment Health J 2024:10.1007/s10597-024-01311-5. [PMID: 38922508 DOI: 10.1007/s10597-024-01311-5] [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: 07/02/2023] [Accepted: 06/08/2024] [Indexed: 06/27/2024]
Abstract
Mental health recovery takes place in a social and material world. However, socio-material contexts have often been absent from recovery studies. The present study was conducted in Norway, a Scandinavian welfare country. We interviewed people at meeting places who had experiences as service users, focusing on their experiences of becoming well, and analyzed their recovery stories using an assemblage framework. Our analysis identified four constitutive dimensions that promote mental health recovery: an atmosphere of togetherness, doings as more than the act, personal development, and integration in society. We discuss how these dimensions might be seen as social, relational, and material forces that create important micropolitics that challenge the individualistic professionalization of the recovery concept.
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Affiliation(s)
| | - Alain Topor
- Department of Psychosocial Health, University of Agder, Grimstad, Norway
| | | | - Inger Beate Larsen
- Department of Psychosocial Health, University of Agder, Grimstad, Norway
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Jørgensen K, Søren Hansen M, Bjerrum M, Hansen M, Watson E, Karlsson B. Healthcare Professionals' Experiences of Recovery-Oriented Collaboration Between Mental Health Centres and Municipalities: A Qualitative Study. Issues Ment Health Nurs 2024; 45:264-273. [PMID: 38232186 DOI: 10.1080/01612840.2023.2286477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Collaboration within mental health centres and with municipalities in Western European healthcare has presented challenges due to structural and cultural disparities. The Danish healthcare system faces obstacles that impact mental healthcare services, particularly in cross-sectorial cooperation. Our aim was to investigate healthcare professionals' experiences of recovery-oriented collaboration within a mental healthcare setting across hospitals and municipalities to gather a deeper understanding of this issue. Twenty-four employees were purposively sampled from mental health centres in Copenhagen and focus group interviews were conducted to explore their perceptions of working together. Inductive content analysis was used to analyse the data and identify themes and categories. The participants emphasised challenges in communication and coordination to improve collaboration within across the two sectors. This study can contribute to a greater understanding of collaboration between mental health centres and municipalities. It aims to inspire improvements in communication, coordination, and the optimisation of mental health service delivery across sectors.
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Affiliation(s)
- Kim Jørgensen
- Department of People and Technology, Roskilde University, Roskilde, Denmark
| | | | - Merete Bjerrum
- Research Unit of Nursing and Healthcare, Institute of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Emma Watson
- Nottinghamshire Healthcare NHS Foundation Trust, Learning & Development, People and Culture Services, Nottingham, UK
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Soronen K. Acting as a Mental Health Expert by Experience and Its Impact on Social Identity. Community Ment Health J 2024; 60:179-190. [PMID: 37976006 PMCID: PMC10799801 DOI: 10.1007/s10597-023-01207-w] [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: 04/20/2023] [Accepted: 11/04/2023] [Indexed: 11/19/2023]
Abstract
This study was conducted to examine the construction of social identity among mental health experts by experience working in Finnish municipal mental healthcare services. The construction of social identity is approached as an ongoing lifelong process that is significantly affected by lived experiences with mental health problems and recovery from them. The research data consist of focus group discussions, and the analysis is based on a thematic design that is initially material-driven. As a result, four categories are formed to describe the effect of acting as an expert by experience on social identity and the importance of the issue. Experts by experience have to consider profound questions about their identity and future in their new life situation. The individual meanings of acting as an expert by experience are considered particularly important. The support provided by group members builds confidence in one's chances of success and thereby supports the development of social identity. Social identities of experts by experience are partially built in encounters with professionals representing the mental health care system. This creates opportunities for new roles for those who act as experts by experience.
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Affiliation(s)
- Kari Soronen
- Faculty of Social Sciences, University of Lapland, Rovaniemi, Finland.
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Hansen BW, Pedersen HA, Berring LL, Josephsson S. Creative activities as intervention - Exploring occupational therapists' narrative reasoning. Scand J Occup Ther 2024; 31:2394212. [PMID: 39192624 DOI: 10.1080/11038128.2024.2394212] [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: 02/21/2024] [Revised: 08/13/2024] [Accepted: 08/15/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND Creative activities as intervention (CaI) in mental health promotes recovery and is an important part of occupational therapy practice. Yet few studies have explored occupational therapists' reasoning about using CaI to trace tacit knowledge. AIMS/OBJECTIVES The aim of this study was to explore occupational therapists' reasoning on rationale and motives in co-creating a model (the CreActivity model) for CaI as a resource in mental health rehabilitation. MATERIAL AND METHODS Co-operative inquiry and narrative theory provided the methodology for exploring eight occupational therapists' narrative reasoning in the process of co-creating a model. Data were generated via ethnographic methods from seven co-operative inquiry group meetings and analysed through narrative analysis. RESULTS The occupational therapists' reasoning in using creative activities comprised building relationships and opportunity for activity. Motivating and engagement by finding 'cracks' and stories bridging action with the past and future using creative activities were used to create reflection, development, and empowerment. CONCLUSIONS AND SIGNIFICANCE Identifying the narrative layers of occupational therapists' reasoning on achieving core dimensions of occupational therapy may enable and support occupational therapists in the use of creative activities as intervention.
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Affiliation(s)
- Bodil Winther Hansen
- Department of Regional Health Research, University of Southern Denmark, Værløse, Denmark
- University College Copenhagen, Copenhagen, Denmark
| | | | - Lene Lauge Berring
- Psychiatric Research Unit, Region Zealand Psychiatry, Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Casey H, Johnston J, Dillon M, Nolan C. "Kickstart to Recovery": An Irish Football Program for Mental Health Service Users. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:637-644. [PMID: 37350190 PMCID: PMC10486149 DOI: 10.1177/15394492231177281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
The "Kickstart to Recovery" program is a collaboration between Irish mental health occupational therapists and the Football Association of Ireland. This pilot study aimed to investigate whether participants experienced changes in quality of life, recovery, social gains, and the meaning of football following participation in the program. A quantitative pre-post study design was employed, with 27 participants completing a questionnaire consisting of outcome measures aimed to measure the above changes. Findings revealed statistically significant improvements in the Short Form 36 Health Survey Questionnaire (SF-36) "Energy/Fatigue" domain for the total sample and the Recovery Assessment Survey-Domains and Scales (RAS-DS) "Mastering My Illness" domain for first-time program participants. Statistically significant results were found for domains of "Social Functioning" and "Emotional Wellbeing" in groups incorporating additional social elements. The Engagement in Meaningful Activities Survey (EMAS) showed no change for the personal meaning participants attributed to football; however, high pre-test scores were noted. The "Kickstart to Recovery" program is attributed as a possible factor contributing to these results.
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Affiliation(s)
| | - Jenny Johnston
- Dublin South Central Mental Health Service, Crumlin, Ireland
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Matsuoka S. Development of a Culturally Sensitive Recovery-Oriented Nursing Care Model in Community Psychiatric Nursing. J Psychosoc Nurs Ment Health Serv 2023; 61:25-33. [PMID: 36479868 DOI: 10.3928/02793695-20221202-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
The current study aimed to develop a culturally sensitive recovery-oriented nursing care model in community psychiatric nursing. Through an exploration of recovery-oriented nursing care based on cultural sensitivity, which was done in a prior study and through a literature review, an initial model with six categories was developed. Semi-structured interviews were performed with eight community psychiatric nurses who used the model for 2 months in practice. Qualitative description was used to analyze the data. Participants completed a list of care items in each category of the model to compare ease of practice. The model was further refined to three levels of culturally sensitive nursing care. The model showed the importance of reflection based on recognition of cultural influences, relinquishing the power of the profession, and cooperation that accepts diverse values. [Journal of Psychosocial Nursing and Mental Health Services, 61(8), 25-33.].
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Swords C, Houston S. Exploring the Evidence for the Paradigms of Recovery and Social Work Converging in Mental Health Service Delivery Worldwide: Reflections from an Irish Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6460. [PMID: 37569000 PMCID: PMC10418325 DOI: 10.3390/ijerph20156460] [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: 06/01/2023] [Revised: 07/15/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023]
Abstract
Recovery within mental health service delivery is no longer a new consideration in the Western world. However, it is well-documented how challenging its implementation and translation to practice and reality have been in contemporary mental health systems. In conjunction with this, mental health social work is continuously being challenged and debated in relation to its role, responsibilities, and identity in service delivery. This is largely the consequence of the continued dominance of the biomedical model in relation to service delivery. Yet, if we critically reflect on the philosophy and ethos of recovery, it becomes very clear that social work should be the key profession to lead the development and improvement of recovery-orientated services across the globe. To illustrate this argument, the authors first draw on empirical research undertaken by the lead author within the Republic of Ireland on how recovery is socially constructed within mental health service delivery. The key stakeholders involved in the Irish study included professionals, service users, family members, and policy influencers, with participants taking part in semi-structured interviews. Secondly, the authors reflect on some of the findings from this Irish study, presenting an argument for not only a more significant role for social work in an Irish mental health context but also making comparisons from an international perspective. This includes exploring the role of critical social work traditions for supporting services to move beyond a philosophy of recovery that has, to date, overlooked the intersectional injustices and inequalities faced by hard-to-reach populations. Finally, the authors conclude by providing some possibilities for how the paradigms of social work and recovery can and should continue to converge towards each other, opening a space for social work to become a more dominant perspective within mental health systems worldwide.
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Affiliation(s)
- Calvin Swords
- Department of Applied Social Studies, National University of Ireland, W23F2H6 Maynooth, Ireland
| | - Stan Houston
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast BT71HL, UK;
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Nielsen JM, Buus N, Berring LL. Mental Health Recovery in Social Psychiatric Policies: A Reflexive Thematic Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6094. [PMID: 37372681 DOI: 10.3390/ijerph20126094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023]
Abstract
The realisation of recovery as an overarching goal of mental health care services has proven difficult to achieve in practice. At present, concepts of recovery are contested and unclear, which affects their implementation in psychiatric practices. We examined social psychiatric policies about recovery with the aim to explore their underlying assumptions about recovery. Relevant texts from the policies' knowledge bases were subjected to reflexive thematic analysis. We developed a central theme: "A clinical standardisation of the concept of recovery". The theme involved meaning clusters that encompassed conflicting and commonly shared assumptions about recovery across the text corpus. We discussed the findings from discourse analytical and governmentality perspectives. In conclusion, the policies' aim of providing clarity about recovery was circumvented by the very knowledge bases used to support their endeavours.
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Affiliation(s)
- Jacob M Nielsen
- Psychiatric Research Unit, Centre for Relation & De-Escalation, Mental Health Services, 4200 Slagelse, Denmark
| | - Niels Buus
- Monash Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton 3800, Australia
- Department of Regional Health Research, University of Southern Denmark, 5230 Odense, Denmark
| | - Lene L Berring
- Psychiatric Research Unit, Centre for Relation & De-Escalation, Mental Health Services, 4200 Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5230 Odense, Denmark
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Healy LC, Benkwitz A, McVinnie Z, Sarkar M, Islin M, Brinded A, Dodge B, Opacic S, Swithenbank Z, Ranasinghe S, Oliver J, Karanika-Murray M, Nevill ME. Embedding Physical Activity into Community-Based Peer Support Groups for those Severely Affected by Mental Illness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2291. [PMID: 36767657 PMCID: PMC9916288 DOI: 10.3390/ijerph20032291] [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: 11/11/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
Despite a growing evidence base on the effectiveness of community-based physical activity interventions for mental health, there is a lack of studies that focus on those affected by severe mental illness (SMI), who often experience poorer physical health, and are less physically active than the wider population. The use of peer support groups in this context is also understudied, despite benefits being documented in other contexts. This study examined the impact and process of a nationwide project to embed physical activity into peer support groups for those affected by SMI. Following the embedding of physical activity within peer support groups, interviews and focus groups were conducted to explore the experiences of those involved with the project and analysed using reflexive thematic analysis. The key findings related to: 1) the social aspects of embedding physical activity in the groups; 2) the focus on peer support and informal physical activity (rather than organised sport) being beneficial; 3) doing things differently and lessons to learn; and 4) the impact of the COVID-19 pandemic. Overall, we found that peer support is an important feature to include in projects encouraging those severely affected by mental illness to become more physically active.
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Affiliation(s)
- Laura C. Healy
- Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
| | - Adam Benkwitz
- Sport, Physical Activity and Health Research Centre, Newman University, Birmingham B32 3NT, UK
| | - Zoe McVinnie
- Department of Psychology, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK
| | - Mustafa Sarkar
- Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
| | - Mel Islin
- Rethink Mental Illness, The Dumont, 28 Albert Embankment, London SE1 7GR, UK
| | - Andy Brinded
- Rethink Mental Illness, The Dumont, 28 Albert Embankment, London SE1 7GR, UK
| | - B. Dodge
- Rethink Mental Illness, The Dumont, 28 Albert Embankment, London SE1 7GR, UK
| | - Sofija Opacic
- Rethink Mental Illness, The Dumont, 28 Albert Embankment, London SE1 7GR, UK
| | - Zoe Swithenbank
- Rethink Mental Illness, The Dumont, 28 Albert Embankment, London SE1 7GR, UK
| | - Shanika Ranasinghe
- Rethink Mental Illness, The Dumont, 28 Albert Embankment, London SE1 7GR, UK
| | - Jennie Oliver
- Rethink Mental Illness, The Dumont, 28 Albert Embankment, London SE1 7GR, UK
| | - Maria Karanika-Murray
- School of Business, University of Leicester, Brookfield, 266 London Road, Leicester LE2 1RQ, UK
| | - Mary E. Nevill
- Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
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Chmielowska M, Mannocci N, Tansel A, Zisman-Ilani Y. Peer support and shared decision making in Open Dialogue: Opportunities and recommendations. Front Psychol 2022; 13:1059412. [PMID: 36571005 PMCID: PMC9773137 DOI: 10.3389/fpsyg.2022.1059412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 11/17/2022] [Indexed: 12/14/2022] Open
Abstract
Open dialogue (OD) is a person-centred social network model of crisis and continuing mental healthcare, which promotes agency and long-term recovery in mental illness. Peer support workers who have lived experience of mental illness play a key role in OD in the UK, as they enhance shared understanding of mental health crisis as part of the OD model and provide a sense of belonging and social inclusion. These elements are in alignment with the shared decision making (SDM) approach in mental health, which focuses on person-centred communication in treatment decision-making. The previously documented benefits of peer-led SDM include increased engagement with services, symptom reduction, increased employment opportunities, and reduced utilization of mental and general health services. While the contribution of peer support and SDM principles to OD has been acknowledged, there is only a small body of literature surrounding this development, and little guidance on how peer support can enhance treatment decision-making and other aspects of OD. This viewpoint, which was co-authored by people with lived experience of mental illness, clinicians, and researchers, discusses practical implications and recommendations for research and training for the provision of a co-produced OD model grounded in peer support and SDM.
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Affiliation(s)
- Marta Chmielowska
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- North East London NHS Foundation Trust Research and Development Department, London, United Kingdom
- Division of Psychology and Language Sciences, Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Nell Mannocci
- North East London NHS Foundation Trust Research and Development Department, London, United Kingdom
| | - Alexander Tansel
- North East London NHS Foundation Trust Research and Development Department, London, United Kingdom
| | - Yaara Zisman-Ilani
- Division of Psychology and Language Sciences, Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, United States
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Löfgren M, Rembeck G, Hange D, Björkelund C, Svenningsson I, Nordeman L. Promoting health literacy and sense of coherence in primary care patients with long-term impaired work ability-a pilot study. Scand J Prim Health Care 2022; 40:481-490. [PMID: 36622201 PMCID: PMC9848260 DOI: 10.1080/02813432.2022.2159191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Evaluate feasibility, partnerships, and study design of intervention to minimise sick leave. DESIGN AND SETTING The design was a pilot single arm intervention study in primary health care. Outcome measures at follow-ups for each participant were compared with baseline data for the same person. SUBJECTS Twenty primary health care patients with recurrent or long-term sick leave or health-related unemployment. INTERVENTION Patient education through interactive study groups that met half a day a week for eight subsequent weeks. Groups were led by experienced but not medically trained facilitators. The intervention was designed to improve participant health literacy, sense of coherence, health-related quality of life, and patient involvement in healthcare. MAIN OUTCOME MEASURES Primary outcome was the level of sick leave. Sick leave data were obtained from medical records when available, otherwise patient reported. Secondary outcomes regarding health literacy, sense of coherence, and health-related quality of life were measured with validated questionnaires at baseline and follow-ups. RESULTS Level of sick leave decreased significantly and participation in work preparatory activities increased during follow-up. Health literacy, sense of coherence (subscale sense of meaningfulness), and health-related quality of life (subscale social functioning) showed statistically significant improvement. Intervention, partnerships, and study design were feasible. CONCLUSION An educational programme, conducted in cooperation between primary health care and partners outside the healthcare system, was feasible and showed an impact on sick leave, health literacy, sense of coherence, and health-related quality of life.KEY FINDINGSA pilot study to evaluate an educational programme with study groups conducted in cooperation between primary health care and partners outside the healthcare system showed good feasibility.Sick leave decreased significantly six months after baseline.Health literacy, sense of coherence (subscale sense of meaningfulness), and health-related quality of life (subscale social function) improved significantly 6 months after baseline.
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Affiliation(s)
- Märit Löfgren
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development & Innovation Primary Health Care, Research, Education, Development & Innovation Center Södra Älvsborg, Borås, Sweden
- CONTACT Märit Löfgren Primary Health Care, School of Public Health and Community Medicine, Box 453, Gothenburg, 40530, Sweden
| | - Gun Rembeck
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development & Innovation Primary Health Care, Research, Education, Development & Innovation Center Södra Älvsborg, Borås, Sweden
- Region Västra Götaland, Regional Health, Borås Youth Guidance Center, Borås, Sweden
| | - Dominique Hange
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development & Innovation Primary Health Care, Research, Education, Development & Innovation Center Skaraborg, Skövde, Sweden
| | - Cecilia Björkelund
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Irene Svenningsson
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development & Innovation Primary Health Care, Research, Education, Development & Innovation Center Fyrbodal, Vänersborg, Sweden
| | - Lena Nordeman
- Region Västra Götaland, Research, Education, Development & Innovation Primary Health Care, Research, Education, Development & Innovation Center Södra Älvsborg, Borås, Sweden
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Green B, García-Mieres H. Construing journeys to recovery from psychosis: A qualitative analysis of first-person accounts. Psychol Psychother 2022; 95:888-904. [PMID: 35670416 DOI: 10.1111/papt.12408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 05/12/2022] [Accepted: 05/18/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To perform a qualitative analysis of the factors that were construed as salient in facilitating the process of recovery in the narratives of people with psychosis who had their first-person accounts (FPAs) published in an academic journal. METHODS Computerized textual analysis was undertaken of 156 FPAs written by persons who had experienced psychosis and published in the Schizophrenia Bulletin between 1979 and 2020. Constructs were extracted from the FPAs and coded in terms of Mental health treatment and therapy, Self-management and Multiple factors; recovery processes (Connectedness, Hope, Identity, Meaning and Empowerment), Struggles and Turning points. RESULTS Psychosis impacted on individuals in profound and diverse ways. This was reflected in the different pathways to recovery included in the FPAs. Underlying the different pathways was the salience of re-engagement in the shared reality of others; development of a cohesive and positive self; empowerment through the use of self-management strategies, and making sense of experience through reconstruing what was meaningful. Personal constructs identified in the FPAs provided insight into both challenges faced and alternative avenues of movement that were perceived as available. CONCLUSIONS Processes that support individuals re-engaging with the shared reality of others are central to recovery. Supportive relationships and fostering open dialogue were consistent themes across the different pathways that recovery journeys took. Establishing a meaningful lifestyle and recovering a positive sense of identity were a key challenge following psychosis onset. Appreciation of experiences contained in FPAs has the potential to enhance the effectiveness and humanity of mental health care.
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Affiliation(s)
- Bob Green
- Independent Scholar, Formerly Statewide Forensic Mental Health Team, Queensland Forensic Mental Health Service, Brisbane, Qld, Australia
| | - Helena García-Mieres
- Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions M'ediques, Barcelona, Spain.,Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain.,Centro Investigación Biomédica en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Zhang Y. Application Research of Humanistic Care and Situational Integration in Nursing of Schizophrenia in Recovery Period. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:4705107. [PMID: 36262979 PMCID: PMC9553477 DOI: 10.1155/2022/4705107] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/17/2022] [Accepted: 08/30/2022] [Indexed: 01/26/2023]
Abstract
Objective To formulate corresponding nursing humanistic care measures according to the needs of patients, evaluate the intervention effect of patients, and provide reference for nursing staff to better provide nursing humanistic care for patients with schizophrenia in convalescence. Methods Using the random number table method, 110 inpatients with convalescent schizophrenia were randomly divided into the control group (n = 55) and the experimental group (n = 55). The sample t-test was used to compare the changes of patient insight, treatment attitude, rehabilitation efficacy, and negative emotion score before and after nursing humanistic nursing intervention, and analyze the effect of nursing humanistic care intervention. Results Nursing satisfaction: the nursing satisfaction of the experimental group increased from 84.6% to 96.2%, after intervention, satisfaction of the experimental group was 96.2% higher than that of 86.5% of the control group. Conclusion Nursing intervention measures based on needs of nursing humanistic care can improve nursing satisfaction, insight and treatment attitude of patients, enhance recovery effect of patients, reduce negative emotions of patients, and benefit recovery of patients' conditions.
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Affiliation(s)
- Yanhua Zhang
- Rehabilitation Department, Hangzhou Fuyang Third People's Hospital, Hangzhou 311400, Zhejiang, China
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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.
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Beate Larsen I, Georg Friesinger J, Strømland M, Topor A. You realise you are better when you want to live, want to go out, want to see people: Recovery as assemblage. Int J Soc Psychiatry 2022; 68:1108-1115. [PMID: 34015980 PMCID: PMC9310138 DOI: 10.1177/00207640211019452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND The lack of social and material perspectives in descriptions of recovery processes is almost common in recovery research. AIM Consequently, we investigated recovery stories and how people with mental health and/or addiction challenges included social and material aspects in these stories. METHOD We conducted focus group and individual interviews. We investigated how the participants narrated their stories and how they assembled places and people in their recovery stories. RESULTS We found that narratives of recovery became assemblages where humans and their environments co-exist and are interdependent. CONCLUSION As such, narratives about recovery are about everyday assemblages of well-being into which stories of insecurity are interwoven, without a start or stop point.
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Affiliation(s)
- Inger Beate Larsen
- Department of Psychosocial Health, University of Agder, Grimstad, Norway
| | - Jan Georg Friesinger
- Department of Psychosocial Health, University of Agder, Grimstad, Norway
- Jan Georg Friesinger, Department of Psychosocial Health, University of Agder, Jon Lilletunsvei 9, Grimstad 4879, Norway.
| | - Monica Strømland
- Department of Psychosocial Health, University of Agder, Grimstad, Norway
| | - Alain Topor
- Department of Psychosocial Health, University of Agder, Grimstad, Norway
- Department of Social Work, Stockholm University, Stockholm, Sweden
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Wormdahl I, Hatling T, Husum TL, Kjus SHH, Rugkåsa J, Brodersen D, Christensen SD, Nyborg PS, Skolseng TB, Ødegård EI, Andersen AM, Gundersen E, Rise MB. The ReCoN intervention: a co-created comprehensive intervention for primary mental health care aiming to prevent involuntary admissions. BMC Health Serv Res 2022; 22:931. [PMID: 35854270 PMCID: PMC9296016 DOI: 10.1186/s12913-022-08302-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 07/05/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Reducing involuntary psychiatric admissions is a global concern. In Norway, the rate of involuntary admissions was 199 per 100,000 people 16 years and older in 2020. Individuals' paths towards involuntary psychiatric admissions usually unfold when they live in the community and referrals to such admissions are often initiated by primary health care professionals. Interventions at the primary health care level can therefore have the potential to prevent such admissions. Interventions developed specifically for this care level are, however, lacking. To enhance the quality and development of services in a way that meets stakeholders' needs and facilitates implementation to practice, involving both persons with lived experience and service providers in developing such interventions is requested. AIM To develop a comprehensive intervention for primary mental health care aiming to prevent involuntary admissions of adults. METHODS This study had an action research approach with a participatory research design. Dialogue conferences with multiple stakeholders in five Norwegian municipalities, inductive thematic analysis of data material from the conferences, and a series of feedback meetings were conducted. RESULTS The co-creation process resulted in the development of the ReCoN (Reducing Coercion in Norway) intervention. This is a comprehensive intervention that includes six strategy areas: [1] Management, [2] Involving Persons with Lived Experience and Family Carers, [3] Competence Development, [4] Collaboration across Primary and Specialist Care Levels, [5] Collaboration within the Primary Care Level, and [6] Tailoring Individual Services. Each strategy area has two to four action areas with specified measures that constitute the practical actions or tasks that are believed to collectively impact the need for involuntary admissions. CONCLUSIONS The ReCoN intervention has the potential for application to both national and international mental health services. The co-creation process with the full range of stakeholders ensures face validity, acceptability, and relevance. The effectiveness of the ReCoN intervention is currently being tested in a cluster randomised controlled trial. Given positive effects, the ReCoN intervention may impact individuals with a severe mental illness at risk of involuntary admissions, as more people may experience empowerment and autonomy instead of coercion in their recovery process.
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Affiliation(s)
- Irene Wormdahl
- grid.458589.d Norwegian Resource Centre for Community Mental Health, NTNU Social Research, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Trond Hatling
- grid.458589.d Norwegian Resource Centre for Community Mental Health, NTNU Social Research, Trondheim, Norway
| | - Tonje Lossius Husum
- grid.5510.10000 0004 1936 8921Centre for Medical Ethics, Institute for Health & Society, University of Oslo, Oslo, Norway ,grid.412414.60000 0000 9151 4445Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Solveig Helene Høymork Kjus
- grid.458589.d Norwegian Resource Centre for Community Mental Health, NTNU Social Research, Trondheim, Norway
| | - Jorun Rugkåsa
- grid.411279.80000 0000 9637 455XHealth Service Research Unit, Akershus University Hospital, Lørenskog, Norway ,grid.463530.70000 0004 7417 509XCentre for Care Research, University of South-Eastern Norway, Porsgrunn, Norway
| | - Dorte Brodersen
- Department of Health Care, Ullensaker Municipality, Ullensaker, Norway
| | | | - Petter Sundt Nyborg
- Department of Mental Health and Addiction, Elverum Municipality, Elverum, Norway
| | | | - Eva Irene Ødegård
- Department of Mental Health and Addiction, Grimstad Municipality, Grimstad, Norway
| | | | | | - Marit B. Rise
- grid.5947.f0000 0001 1516 2393Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Topor A, Boe TD, Larsen IB. The Lost Social Context of Recovery Psychiatrization of a Social Process. FRONTIERS IN SOCIOLOGY 2022; 7:832201. [PMID: 35463189 PMCID: PMC9022098 DOI: 10.3389/fsoc.2022.832201] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/11/2022] [Indexed: 06/14/2023]
Abstract
From being a concept questioning the core of psychiatric knowledge and practice, recovery has been adopted as a guiding vison for mental health policy and practice by different local, national, and international organizations. The aim of this article is to contextualize the different understandings of recovery and its psychiatrization through the emergence of an individualizing and de-contextualized definition which have gained a dominant position. It ends with an attempt to formulate a new definition of recovery which integrates people in their social context. Research results from various follow-up studies showing the possibility of recovery from severe mental distress have stressed the importance of societal, social and relational factors as well of the person's own agency when facing their distress and reactions from their environment. These researches were published in the 1970s and 80s; a period of struggle for liberation from colonialism, of struggle by women and black people for their civil rights, and a time of de-institutionalization of services directed toward the poor, elderly, handicapped, prisoners, and people with mental health problems. Recovery research pointed at the central role of individuals in their recovery journey and it was understood as a personal process in a social context. However, with neo-liberal political agenda, the personal role of individuals and their own responsibility for their well-being was stressed, and contextual understandings and the role of social, material and cultural changes to promote recovery faded away. Thus, during recent decades recovery has been mostly defined as an individualistic journey of changing the persons and their perception of their situation, but not of changing this situation. Contextual aspects are almost absent. The most quoted definition accepts the limits posed by an illness-based model. This kind of definition might be a reason for the wide acceptance of a phenomenon that was initially experienced as a break with the bio-medical paradigm. Recently, this dominant individualized understanding of recovery has been criticized by service users, clinicians and researchers, making possible a redefinition of recovery as a social process in material and cultural contexts.
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Affiliation(s)
- Alain Topor
- Department of Social Work, Stockholm University, Stockholm, Sweden
- Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
| | - Tore Dag Boe
- Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
| | - Inger Beate Larsen
- Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
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Kinane C, Osborne J, Ishaq Y, Colman M, MacInnes D. Peer supported Open Dialogue in the National Health Service: implementing and evaluating a new approach to Mental Health Care. BMC Psychiatry 2022; 22:138. [PMID: 35193551 PMCID: PMC8862567 DOI: 10.1186/s12888-022-03731-7] [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] [Received: 02/26/2021] [Accepted: 01/19/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Open Dialogue is an internationally developing approach to mental health care based on collaboration between an individual and their family and social network. Our quest for better approaches to Mental Health Care with improved carer and service user experience led us to develop and test a model of Peer Supported Open Dialogue (POD). There is no research currently looking at the implementation and effectiveness of a standalone POD team in the NHS so we evaluate its implementation, clinical outcomes and value to service users and their families. METHOD A before-after design was used. 50 service users treated by the POD Team were recruited and participants from their family and wider social network. Service user self report questionnaires covering wellbeing, functioning, satisfaction were collected and one carer self report measure; at baseline, three and six months. A clinician reported measure was collected at baseline and six months. Clinicians perceptions of practice were collected following network meetings. RESULTS 50 service users treated were recruited with a mean age of 35 years with slightly more males than females. Service users reported signficant improvements in wellbeing and functioning. There was a marked increase in perceived support by carers. Over half the meetings were attended by carers. The Community Mental Health Survey showed high satisfaction rates for service users including carer involvement. CONCLUSIONS The study indicated it was possible to transform to deliver a clinically effective POD service in the NHS. This innovative approach provided continuity of care within the social network, with improved carer support and significant improvements in clinical outcomes and their experiences. TRIAL REGISTRATION ( isrctn.com/ISRCTN36004039 . Retrospectively registered 04/01/2019.
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Affiliation(s)
- Catherine Kinane
- Combat Stress, Tyrwhitt House, Oaklawn Road, Leatherhead, KT22 0BX UK
| | - James Osborne
- grid.498478.eFarm Villa, Kent and Medway NHS and Social Care Partnership Trust, Hermitage Lane, Kent, ME16 9PH UK
| | - Yasmin Ishaq
- grid.498478.eFarm Villa, Kent and Medway NHS and Social Care Partnership Trust, Hermitage Lane, Kent, ME16 9PH UK
| | - Marcus Colman
- grid.498478.eFarm Villa, Kent and Medway NHS and Social Care Partnership Trust, Hermitage Lane, Kent, ME16 9PH UK
| | - Douglas MacInnes
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, CT1 1QU, UK.
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Klevan T, Sommer M, Borg M, Karlsson B, Sundet R, Kim HS. Part III: Recovery-Oriented Practices in Community Mental Health and Substance Abuse Services: A Meta-Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413180. [PMID: 34948790 PMCID: PMC8701262 DOI: 10.3390/ijerph182413180] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 12/05/2022]
Abstract
In recent decades, recovery-oriented practice has become the major approach in mental health and substance abuse care, especially in community mental health and substance abuse services. Various models of recovery-oriented practice have come to form the basis of the integration of this approach in service settings. The study aims to elucidate the characteristics of recovery-oriented practice as experienced by participants in the practice. The method used was a qualitative meta-synthesis that integrated the findings from thirty-four empirical papers published by one research group. Four meta-themes were developed: (a) helping and supporting, (b) collaborating and relating, (c) identity integration in practice, and (d) generating hope through nurturing and helping. These themes emphasize the value of relationships and connectedness, contextuality, and resources that can be mobilized in practice. The results emphasize the need to incorporate the elements in the four major themes as “working capital” for practitioners to realize recovery-oriented practice. The concepts of personal, social, and economic capital as working capital are elaborated, drawing from the meta-themes as the basis for recovery-oriented practice in mental health and substance abuse services.
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"It's More Than Just Exercise": Tailored Exercise at a Community-Based Activity Center as a Liminal Space along the Road to Mental Health Recovery and Citizenship. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910516. [PMID: 34639815 PMCID: PMC8507912 DOI: 10.3390/ijerph181910516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/26/2021] [Accepted: 10/02/2021] [Indexed: 11/29/2022]
Abstract
Mental health care policies call for health-promoting and recovery-oriented interventions, as well as community-based programs supporting healthier habits. The purpose of this study was to explore how individuals facing mental health challenges experienced participating in tailored exercise at a community-based activity center, and what role tailored exercise could play in supporting an individual’s process of recovery. Data were collected through in-depth interviews with nine adults experiencing poor mental health who engaged in exercise at the activity center. Interviews were audio-recorded, transcribed verbatim and analyzed using systematic text condensation. Participants spoke about the community-based program being a safe space where they could “come as they are” (Theme 1). Taking part in the program was “more than just exercise” and allowed them to connect with others (Theme 2). The experiences they gained from exercise also helped with other areas in life and provided them with a safe space to build their confidence towards the “transition back to the outside” (Theme 3). We summarized the findings into one overall theme: “inside vs. outside”. In conclusion, a community-based activity center acted as a liminal space that aided mental health recovery by allowing participants to feel safe, accepted and supported, as well as experience citizenship. The findings highlight the need to treat mental health challenges as a contextual phenomenon and creating arenas for community and citizenship in society.
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22
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Bendel-Rozow T. Recovery-oriented dance movement therapy group with adults coping with severe mental health conditions: A controlled trial. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2021.101830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Part I: Dynamics of Recovery: A Meta-Synthesis Exploring the Nature of Mental Health and Substance Abuse Recovery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157761. [PMID: 34360054 PMCID: PMC8345607 DOI: 10.3390/ijerph18157761] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/24/2021] [Accepted: 07/06/2021] [Indexed: 11/17/2022]
Abstract
Recovery-oriented care has become a leading vision across countries. To develop services and communities in more recovery-oriented directions, enhanced understandings of recovery in terms of personal and social contexts are important prerequisites. The aim of this study is to explore the nature and characteristics of the experiences of recovery. The method used is a form of qualitative meta-synthesis that integrates the findings from multiple qualitative studies published by one research group. Twenty-eight empirical papers with a focus on recovery as personal and contextual experiences were included in this meta-synthesis. Five meta-themes were developed: (a) being normal, (b) respecting and accepting oneself, (c) being in control, (d) recovery as intentional, and (e) recovery as material and social. The themes describe how recovery encompasses dynamics between personal experiences and contextual dimensions. This meta-synthesis consolidated an understanding of recovery as dynamics of the self and others, and as dynamics of the self and material resources. This understanding of recovery suggests the need to work not only with the person, but also with families, networks, social systems, and local communities, thus developing mental health and substance abuse services in more collaborative, open-ended, and context-sensitive directions.
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Sampaio ML, Bispo Júnior JP. Towards comprehensive mental health care: experiences and challenges of psychosocial care in Brazil. BMC Public Health 2021; 21:1352. [PMID: 34238266 PMCID: PMC8268580 DOI: 10.1186/s12889-021-11397-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 06/28/2021] [Indexed: 12/02/2022] Open
Abstract
Background Recommendations are in place for mental health (MH) care to be developed into a comprehensive, people-centred perspective and organised primarily through community services. In recent decades, Brazil has promoted psychiatric reform aimed at transforming the hospital-centred model into a psychosocial model of MH. However, current political and economic changes threaten this reform. This article analyses the comprehensive MH care offered by a Psychosocial Care Network (Rede de Atenção Psicossocial – RAPS) in Brazil. Methods The study involved semi-structured in-depth interviews with 33 stakeholders (policymakers, health professionals, and MH service users) and direct observation of MH services members of the RAPS. Data were analysed using framework analysis with the following dimensions: mental health services access, long-term mental health care, comprehensive mental health care, and crisis patient care. Results Results indicated progression towards comprehensive MH care provision. We identified MH care provided primarily by community services, featuring an ‘open door’ policy, development of localised actions and a search for autonomy. Deinstitutionalisation principles and the psychosocial model support a comprehensive view of MH by policy makers, MH professionals, and users. However, difficulties in providing comprehensive care remain, with the main challenges being insufficient services offered and difficulties in user access at all levels of care, fragile integration between services, lack of clear definitions of the responsibilities of each service, discontinuity of care, limitations in family support, and fragility in crisis patient care. Conclusion We highlight the need to increase funding and services of RAPS, qualification of staff professional, family support, and development of strategies for integrating services. Support and expansion of MH care depend on strengthening the Brazilian health system, which is in danger of being dismantled. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11397-1.
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Affiliation(s)
- Mariá Lanzotti Sampaio
- Multidisciplinary Institute of Health, Federal University of Bahia (UFBA), Vitória da Conquista, Brazil
| | - José Patrício Bispo Júnior
- Multidisciplinary Institute of Health, Federal University of Bahia (UFBA), Vitória da Conquista, Brazil.
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Sommer M, Biong S, Borg M, Karlsson B, Klevan T, Ness O, Nesse L, Oute J, Sundet R, Kim HS. Part II: Living Life: A Meta-Synthesis Exploring Recovery as Processual Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116115. [PMID: 34204024 PMCID: PMC8201104 DOI: 10.3390/ijerph18116115] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 11/16/2022]
Abstract
Recovery, a prominent concern in mental health care worldwide, has been variously defined, requiring further clarification of the term as processual. Few studies have comprehensively addressed the nature of recovery processes. This study aims to explore the nature and characteristics of experiences of recovery as processual. The method used is a form of qualitative meta-synthesis that integrates the findings from 28 qualitative studies published during the past 15 years by one research group. Three meta-themes were developed: (a) recovery processes as step-wise, cyclical, and continuous, (b) recovery as everyday experiences, and (c) recovery as relational. These themes describe how recovery is intertwined with the way life in general unfolds in terms of human relationships, learning, coping, and ordinary everyday living. This meta-synthesis consolidates an understanding of recovery as fundamental processes of living in terms of being, doing, and accessing. These processes are contextualized in relation to mental health and/or substance abuse problems and highlight the need for support to facilitate the person's access to necessary personal, social, and material resources to live an ordinary life in recovery.
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Affiliation(s)
- Mona Sommer
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
- Correspondence:
| | - Stian Biong
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
| | - Marit Borg
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
| | - Bengt Karlsson
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
| | - Trude Klevan
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
| | - Ottar Ness
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology, 7042 Trondheim, Norway;
| | - Linda Nesse
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences (NMBU), 1430 Ås, Norway;
| | - Jeppe Oute
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
| | - Rolf Sundet
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
| | - Hesook Suzie Kim
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), 3040 Drammen, Norway; (S.B.); (M.B.); (B.K.); (T.K.); (J.O.); (R.S.); (H.S.K.)
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Blackhall KK, Downie IP, Ramchandani P, Kusanale A, Walsh S, Srinivasan B, Shields H, Brennan PA, Singh RP. Provision of Emergency Maxillofacial Service During the COVID-19 Pandemic : A Collaborative Five Centre UK Study. Br J Oral Maxillofac Surg 2020; 58:698-703. [PMID: 32482348 PMCID: PMC7247479 DOI: 10.1016/j.bjoms.2020.05.020] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 05/15/2020] [Indexed: 12/13/2022]
Abstract
The global pandemic of Coronavirus disease (COVID-19) represents one of the greatest challenges to healthcare systems, and has forced medical specialties to rapidly adapt their approaches to patient care. Oral and Maxillofacial Surgery is considered particularly at risk of disease transmission due to aerosol generation during surgical interventions, patient proximity and operating environment. On day 2 (26th March, 2020) of when severe restrictions in population movement were instigated in the United Kingdom, we began a study to prospectively monitor the presentation and management of maxillofacial emergencies at five hospital trusts. Data was collected onto an online live database fed through a smartphone application. Of the total 529 patients over six weeks, 395 attended for face-to-face consultations and 134 patients received remote consultations via telephone or video link. There were 255 trauma related cases, 221 infection and 48 cases of postoperative complications. Most trauma cases were minor soft tissue injury related to slip, trip or fall at home. There were 44 cases of facial fractures with a tendency for conservative treatment. 19 cases were related to domestic violence or self-harm. Of the 216 dental related emergencies, 68% could have been managed in the primary care setting. A quarter of all emergency patients were satisfactorily managed by remote consultations. There was a significant change in the provision of emergency maxillofacial service during the pandemic lockdown. We discuss the study findings as well as the potential implications in relation to planning for possible further COVID- 19 spikes and future pandemics.
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Affiliation(s)
- K K Blackhall
- Dept. Oral and Maxillofacial Surgery, Salisbury District Hospital, Salisbury, Wiltshire, SP2 8BJ
| | - I P Downie
- Dept. Oral and Maxillofacial Surgery, Salisbury District Hospital, Salisbury, Wiltshire, SP2 8BJ
| | - P Ramchandani
- Dept. Oral and Maxillofacial Surgery, Poole Hospital, Longfleet Rd, Poole, BH15 2JB
| | - A Kusanale
- Dept. Oral and Maxillofacial Surgery, Poole Hospital, Longfleet Rd, Poole, BH15 2JB
| | - S Walsh
- Dept. Oral and Maxillofacial Surgery, St Richard's Hospital, Spitalfield Ln, Chichester, PO19 6SE
| | - B Srinivasan
- Dept. Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Cosham, Portsmouth, PO6 3LY
| | - H Shields
- Dept. Oral and Maxillofacial Surgery, Southampton University Hospital, Tremona Rd, Southampton, SO16 6YD
| | - P A Brennan
- Dept. Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Cosham, Portsmouth, PO6 3LY
| | - R P Singh
- Dept. Oral and Maxillofacial Surgery, Southampton University Hospital, Tremona Rd, Southampton, SO16 6YD.
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Abstract
BACKGROUND Electroconvulsive therapy (ECT) is a controversial treatment. Research has predominantly focused on clinician assessment of short-term efficacy and, occasionally, on participant experiences of the treatment itself. While service user accounts of the long-term impacts of ECT are reported, they are dispersed throughout the literature and typically tangential to studie's main foci. AIM The aim of this study was to synthesise service-user accounts, within peer-reviewed literature, of long-term impacts of ECT in their daily lives. METHODS A qualitative meta-synthesis was conducted. A systematic literature search identified qualitative articles meeting the inclusion criteria. Results sections of eligible papers were analysed thematically. RESULTS From 16 eligible papers, the review identified 11 long-term impacts, four social influences and five strategies that people employed to navigate these long-term impacts. CONCLUSION Limited research has examined long-term experiences of ECT from service-user perspectives. These lived experience perspectives are required to facilitate peer-to-peer learning and assist future service delivery to align with needs of people living with long-term ECT impacts.
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Affiliation(s)
- K Wells
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - N Hancock
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - A Honey
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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