1
|
Klingaman EA, Lucksted A, Crosby ES, Kacmarek CN, Peeples A, Hack S, Blank Y, Schwartz E. A phenomenological inquiry into the costs and consequences of insomnia for veterans with serious mental illness. J Sleep Res 2024:e14227. [PMID: 38923629 DOI: 10.1111/jsr.14227] [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: 10/14/2023] [Revised: 02/20/2024] [Accepted: 04/16/2024] [Indexed: 06/28/2024]
Abstract
Many individuals with serious mental illness (i.e. schizophrenia spectrum, bipolar or major depressive disorders, with serious functional impairments) have insomnia symptoms. Insomnia is a common reason for mental health referrals in the Veterans Health Administration. The primary aim of this study was to explore the costs (what participants lose or what trade-offs they make due to insomnia) and consequences (how insomnia impacts functioning) of insomnia for veterans with serious mental illness. Semi-structured interviews of 20 veterans with insomnia and serious mental illness were collected as data using an inductive phenomenological approach. Two main themes were identified: Sleep Affects Mental Health and Functioning; and Compromising to Cope. Results illuminate pathways by which sleep effort destabilizes functional recovery, and illustrate how sleep has multiplicative positive impacts on functioning and mood. Researchers and clinicians alike must explore supporting people with serious mental illness in replacing sleep effort with the recovery of meaningful identity-driven, values-based experiences formerly conceded due to serious mental illness, insomnia or both.
Collapse
Affiliation(s)
- Elizabeth A Klingaman
- VA Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA
| | - Alicia Lucksted
- VA Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA
| | - Eric S Crosby
- VA Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA
| | - Corinne N Kacmarek
- VA Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA
| | - Amanda Peeples
- VA Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA
| | - Samantha Hack
- VA Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA
| | - Yelena Blank
- VA Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA
| | - Elana Schwartz
- VA Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA
| |
Collapse
|
2
|
Gunnarsson AB, Jansson JÅ, Eklund M. Is there any job for me? Qualitative exploration of support needs among young Swedish adults with psychosis envisioning productive activities. Work 2024; 78:783-795. [PMID: 38160389 PMCID: PMC11307013 DOI: 10.3233/wor-230311] [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: 06/05/2023] [Accepted: 11/10/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Unemployment is high not only among people with mental illness, but also among young adults in general. The combination of having a severe mental illness and being young entails a particularly problematic situation for young people with psychosis. This study aimed to understand how this group envision their future possibilities for entering the labour market or engaging in other productive activities. OBJECTIVE To explore how young adults with psychosis perceive their possibilities, wishes and support needs for gaining employment or engaging in other productive activities. METHODS A descriptive design with qualitative individual in-depth interviews was used. Eighteen young adults with psychosis, aged 18-30 years, were interviewed. Data was analysed with qualitative content analysis. RESULTS Four categories based on the experiences of the participants as being vital for having work or other productive activities were generated: "Wishing for a role in the community", "Being my own coach", "Needing personal support" and "Having a supportive workplace". Each of them included sub-categories. CONCLUSION The young adults with psychosis were a long way from having paid work, but they desired to have a worker role in the community. They are a heterogeneous group, which entails that it is important that professionals and employers have a person-centered and holistic approach, listening to the individuals themselves.
Collapse
Affiliation(s)
- A. Birgitta Gunnarsson
- Department of Research and Development, Region Kronoberg, Växjö, Sweden
- Department of Clinical Neuroscience and Rehabilitation, University of Gothenburg, Gothenburg, Sweden
| | | | - Mona Eklund
- Department of Health Sciences, Lund University, Lund, Sweden
| |
Collapse
|
3
|
“Moving on to an Open World”: A Study of Participants’ Experience in Meaningful Activities and Recovery (MA&R). Occup Ther Int 2022; 2022:7418667. [DOI: 10.1155/2022/7418667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 10/12/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022] Open
Abstract
Background. Meaningful activities and Recovery (MA&R) is a peer coled occupational therapy intervention, to support occupational engagement among persons with psychiatric disabilities. Aim. To investigate participants’ perspectives on how MA&R influenced occupational engagement and recovery processes. Material and Methods. A qualitative study with a phenomenological-hermeneutic design. Individual semistructured interviews were conducted with three women and ten men who had participated in MA&R. Participants were recruited from community mental health centres and municipality mental health services in two Danish municipalities. Analysis strategy was based on Malterud’s Systematic Text Condensation. Results. MA&R was perceived as a practical approach to recovery, by providing an opportunity for reorientation, meaning, making in mundane activities, and a new outlook on everyday life. Participating in MA&R challenged a black and white approach to activities, put emphasis on “the little things”, and enhanced curiosity, presence, and joy in occupational engagement. Conclusion. MA&R supported participants in developing a new “lens” on meaningful activities. The lens enhanced occupational engagement and made it possible to live according to personal preference. Results can inform further development and delivery of recovery-oriented occupational therapy interventions and add to the understandings of how occupational engagement and recovery are intertwined and manifested through everyday experiences. Thus, occupational engagement is an important target for recovery-oriented interventions. Occupational therapists and peer-workers coleading such interventions is feasible and makes good sense to the participants.
Collapse
|
4
|
Renwick L, McWilliams C, Schaff O, Russell L, Ramsdale S, Morris RL. Stakeholder identified research priorities for early intervention in psychosis. Health Expect 2022; 25:2960-2970. [PMID: 36129063 DOI: 10.1111/hex.13604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 08/29/2022] [Accepted: 09/02/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Public resources to answer pertinent research questions about the impact of illness and treatment on people with mental health problems are limited. To target funds effectively and efficiently and maximize the health benefits to populations, prioritizing research areas is needed. Research agendas are generally driven by researcher and funder priorities, however, there is growing recognition of the need to include user-defined research priorities to make research more relevant, needs-based and efficient. OBJECTIVE To gain consensus on top priorities for research into early intervention in psychosis through a robust, democratic process for prioritization enlisting the views of key stakeholders including users, carers and healthcare professionals. We also sought to determine which user-prioritized questions were supported by scientific evidence. DESIGN AND METHODS We used a modified nominal group technique to gain consensus on unanswered questions that were obtained by survey and ranked at successive stages by a steering group comprising users, carer representatives and clinicians from relevant disciplines and stakeholder bodies. We checked each question posed in the survey was unanswered in research by reviewing evidence in five databases (Medline, Cinahl, PsychInfo, EMBASE and Cochrane Database). RESULTS Two hundred and eighty-three questions were submitted by 207 people. After checking for relevance, reframing and examining for duplicates, 258 questions remained. We gained consensus on 10 priority questions; these largely represented themes around access and engagement, information needs before and after treatment acceptance, and the influence of service-user (SU) priorities and beliefs on treatment choices and effectiveness. A recovery SUtheme identified specific self-management questions and more globally, a need to fully identify factors that impact recovery. DISCUSSION AND CONCLUSIONS Published research findings indicated that the priorities of service users, carers and healthcare professionals were aligned with researchers' and funders' priorities in some areas and misaligned in others providing vital opportunities to develop research agendas that more closely reflect users' needs. PATIENT AND PUBLIC CONTRIBUTION Initial results were presented at stakeholder workshops which included service-users, carers, health professionals and researchers during a consensus workshop to prioritize research questions and allow the opportunity for feedback. Patient and public representatives formed part of the steering group and were consulted regularly during the research process.
Collapse
Affiliation(s)
- Laoise Renwick
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK
| | - Caitlin McWilliams
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK
| | - Olivia Schaff
- The Education Campus - Oxford Road, Central Manchester Foundation NHS Trust Library Services, Manchester, UK
| | - Laura Russell
- The Education and Research Centre - Wythenshawe Hospital, Central Manchester Foundation NHS Trust, Manchester, UK
| | - Susan Ramsdale
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK
| | - Rebecca Lauren Morris
- NIHR Greater Manchester Patient Safety Translation Research Centre,Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Manchester, UK
| |
Collapse
|
5
|
Fusar-Poli P, Estradé A, Stanghellini G, Venables J, Onwumere J, Messas G, Gilardi L, Nelson B, Patel V, Bonoldi I, Aragona M, Cabrera A, Rico J, Hoque A, Otaiku J, Hunter N, Tamelini MG, Maschião LF, Puchivailo MC, Piedade VL, Kéri P, Kpodo L, Sunkel C, Bao J, Shiers D, Kuipers E, Arango C, Maj M. The lived experience of psychosis: a bottom-up review co-written by experts by experience and academics. World Psychiatry 2022; 21:168-188. [PMID: 35524616 PMCID: PMC9077608 DOI: 10.1002/wps.20959] [Citation(s) in RCA: 71] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Psychosis is the most ineffable experience of mental disorder. We provide here the first co-written bottom-up review of the lived experience of psychosis, whereby experts by experience primarily selected the subjective themes, that were subsequently enriched by phenomenologically-informed perspectives. First-person accounts within and outside the medical field were screened and discussed in collaborative workshops involving numerous individuals with lived experience of psychosis as well as family members and carers, representing a global network of organizations. The material was complemented by semantic analyses and shared across all collaborators in a cloud-based system. The early phases of psychosis (i.e., premorbid and prodromal stages) were found to be characterized by core existential themes including loss of common sense, perplexity and lack of immersion in the world with compromised vital contact with reality, heightened salience and a feeling that something important is about to happen, perturbation of the sense of self, and need to hide the tumultuous inner experiences. The first episode stage was found to be denoted by some transitory relief associated with the onset of delusions, intense self-referentiality and permeated self-world boundaries, tumultuous internal noise, and dissolution of the sense of self with social withdrawal. Core lived experiences of the later stages (i.e., relapsing and chronic) involved grieving personal losses, feeling split, and struggling to accept the constant inner chaos, the new self, the diagnosis and an uncertain future. The experience of receiving psychiatric treatments, such as inpatient and outpatient care, social interventions, psychological treatments and medications, included both positive and negative aspects, and was determined by the hope of achieving recovery, understood as an enduring journey of reconstructing the sense of personhood and re-establishing the lost bonds with others towards meaningful goals. These findings can inform clinical practice, research and education. Psychosis is one of the most painful and upsetting existential experiences, so dizzyingly alien to our usual patterns of life and so unspeakably enigmatic and human.
Collapse
Affiliation(s)
- Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- OASIS service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley, London, UK
| | - Andrés Estradé
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Giovanni Stanghellini
- Department of Psychological, Territorial and Health Sciences, "G. d'Annunzio" University, Chieti, Italy
- Center for Studies on Phenomenology and Psychiatry, Medical Faculty, "D. Portales" University, Santiago, Chile
| | - Jemma Venables
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Juliana Onwumere
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Beckenham, UK
| | - Guilherme Messas
- Mental Health Department, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | | | - Barnaby Nelson
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ilaria Bonoldi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Ana Cabrera
- Asociación Española de Apoyo en Psicosis, Madrid, Spain
| | - Joseba Rico
- Asociación Española de Apoyo en Psicosis, Madrid, Spain
| | - Arif Hoque
- Young Person's Mental Health Advisory Group (YPMHAG), King's College London, London, UK
| | - Jummy Otaiku
- Young Person's Mental Health Advisory Group (YPMHAG), King's College London, London, UK
| | - Nicholas Hunter
- NHS South London and Maudsley (SLaM) Recovery College, London, UK
| | - Melissa G Tamelini
- Institute of Psychiatry, Hospital das Clínicas de São Paulo, São Paulo, Brazil
| | - Luca F Maschião
- Mental Health Department, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | - Mariana Cardoso Puchivailo
- Mental Health Department, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
- Department of Psychology, FAE University Center, Curitiba, Brazil
| | - Valter L Piedade
- Mental Health Department, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | - Péter Kéri
- Global Alliance of Mental Illness Advocacy Networks-Europe (GAMIAN-Europe), Brussels, Belgium
| | - Lily Kpodo
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Jianan Bao
- OASIS service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Forensic and Neurodevelopment Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - David Shiers
- Psychosis Research Unit, Greater Manchester Mental Health Trust, Manchester, UK
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- School of Medicine, Keele University, Staffordshire, UK
| | - Elizabeth Kuipers
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Beckenham, UK
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, IiSGM, CIBERSAM, Complutense University of Madrid, Madrid, Spain
| | - Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| |
Collapse
|
6
|
Alyahya NM, Munro I, Moss C. The experience of psychosis and recovery from consumers' perspectives: An integrative literature review. J Psychiatr Ment Health Nurs 2022; 29:99-115. [PMID: 33031615 DOI: 10.1111/jpm.12696] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 11/30/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Since the first decade of this century, few qualitative studies and literature reviews have reported consumers' experiences of psychosis and recovery. The findings from these studies need further exploration. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: New insights into consumers' experiences of psychosis were generated. Additionally, understanding of consumers' conceptions and experiences of recovery were reported. Consumers' insights into the enablers and barriers to recovery that they encountered were also identified. Gaps in the literature remain, particularly those related to the effects of gender and culture on consumers' experiences of and recovery from psychosis. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses' understanding of consumers' perspectives and experiences of psychosis is vital to enhancing the quality of mental health nursing when caring for people living with psychosis. To support user-based recovery, mental health nurses need to incorporate person-centred approaches and reduce their preferencing of medical understandings of recovery. ABSTRACT INTRODUCTION: Psychosis is a distressing disorder. Consumers' perspectives about their experiences of psychosis and recovery are essential aspects of mental health nursing. AIMS To review contemporary evidence related to consumers' experiences of and recovery from psychosis. METHOD An integrative review was the method used; six databases were systematically searched. Of the 157 articles screened, 14 met the inclusion criteria and were assessed for quality using Joanna Briggs Institute Appraisal tools. Data were compared, classified and integrated. RESULTS Findings revealed that consumers' experiences of psychosis included issues with self-expression and language, psychosocial problems and stigma. Also, consumers' experiences associated with their recovery were reported, and this included their perspectives on the enablers and barriers that they encountered. DISCUSSION Consumer's experiences of and recovery from psychosis provide an essential basis for managing and working with people experiencing psychosis. Further research identifying the potential effects of gender and culture into consumers' lived experiences is required. IMPLICATIONS FOR PRACTICE Exploring the experience of someone with psychosis will help nurses to understand the impacts of this condition. This understanding can guide nurses to apply recovery-oriented practices. Specific aspects of psychosis experience, including gender and culture, should inform nurses' practices towards recovery.
Collapse
Affiliation(s)
- Norah M Alyahya
- School of Nursing and Midwifery, Monash University, Frankston, VIC., Australia.,College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Ian Munro
- School of Nursing and Midwifery, Monash University, Frankston, VIC., Australia
| | - Cheryle Moss
- School of Nursing and Midwifery, Monash University, Frankston, VIC., Australia
| |
Collapse
|
7
|
O’Keeffe D, Sheridan A, Kelly A, Doyle R, Madigan K, Lawlor E, Clarke M. A qualitative study exploring personal recovery meaning and the potential influence of clinical recovery status on this meaning 20 years after a first-episode psychosis. Soc Psychiatry Psychiatr Epidemiol 2022; 57:473-483. [PMID: 34143247 PMCID: PMC8934321 DOI: 10.1007/s00127-021-02121-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 06/02/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Long-term data on recovery conceptualisation in psychotic illness are needed to support mental health services to organise themselves according to recovery-oriented frameworks. To our knowledge, no previous research has investigated how first-episode psychosis (FEP) service users (sampled across psychotic illness type) perceive recovery beyond 5 years after diagnosis. We aimed to explore personal recovery meaning with individuals 20 years after their FEP and examine the potential influence of clinical recovery status on how they defined recovery (i.e. personal recovery). METHODS Twenty participants were purposefully sampled from an epidemiologically representative FEP incidence cohort. At 20-year follow-up, semi-structured interviews were conducted with 10 cohort members who met full 'functional recovery criteria' (Clinically Recovered Group) and 10 who did not (Not Clinically Recovered Group). A thematic analysis was performed to develop shared themes and group-specific sub-themes to capture agreement and divergence between groups. RESULTS Five shared themes were produced: pursuing balance in conflict, generating meaning in life, experiencing a dynamic personal relationship with time, redressing inequality while managing added challenges/vulnerability, and directing life from resilience to flourishing. The five group-specific sub-themes developed illuminate differences in the meaning ascribed to personal recovery by each group. CONCLUSION Findings emphasise the role of time in how personal recovery is conceptualised by service users and identify ways clinical recovery may influence personal recovery meaning in FEP at mid-later life. Mental health services failing to consider temporal changes in meaning-making and discounting clinical recovery risk ignoring key factors affecting personal recovery.
Collapse
Affiliation(s)
- Donal O’Keeffe
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland ,School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Ann Sheridan
- School of Nursing, Midwifery, and Health Systems, University College Dublin, Dublin, Ireland
| | - Aine Kelly
- Saint John of God Hospitaller Services, Dublin, Ireland
| | - Roisin Doyle
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland
| | - Kevin Madigan
- Saint John of God Community Services, Dublin, Ireland ,School of Postgraduate Studies, Faculty of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Mary Clarke
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland ,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| |
Collapse
|
8
|
Kalfa S, Branicki L, Brammer S. Organizational accommodation of employee mental health conditions and unintended stigma. INTERNATIONAL JOURNAL OF HUMAN RESOURCE MANAGEMENT 2021. [DOI: 10.1080/09585192.2021.1910536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Senia Kalfa
- Macquarie Business School, Macquarie University, Macquarie Park, NSW, Australia
| | - Layla Branicki
- The Open University Business School, The Open University, Milton Keynes, United Kingdom
| | - Stephen Brammer
- Bath School of Management, University of Bath, Bath, United Kingdom
| |
Collapse
|
9
|
Ang MS, Rekhi G, Lee J. Vocational Profile and Correlates of Employment in People With Schizophrenia: The Role of Avolition. Front Psychiatry 2020; 11:856. [PMID: 33192630 PMCID: PMC7481460 DOI: 10.3389/fpsyt.2020.00856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/06/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Employment was associated with recovery in individuals with schizophrenia. Our study aimed to delineate the vocational profile and investigate factors associated with likelihood of employment in individuals with schizophrenia. MATERIALS AND METHODS 276 community dwelling outpatients with schizophrenia were recruited; 274 completed the Positive and Negative Syndrome Scale (PANSS) and Brief Negative Symptom Scale (BNSS). Information on employment status, work outcomes and demographics were collected. Occupation was coded in accordance with the Singapore standard occupational classification. Either BNSS Motivation and Pleasure (MAP) and Emotional Expressivity (EE) or BNSS five-factor (Anhedonia, Asociality, Avolition, Blunted Affect, Alogia) were examined with PANSS factors and demographics in logistic regression with employment status and working full-time as outcome variables. RESULTS One-hundred and twenty-seven (46.01%) participants were employed; 65 (51.18%) worked full-time. In the model with BNSS MAP-EE, MAP (OR=0.897, CI=0.854-0.941) and presence of physical comorbidity (OR=0.533, CI=0.304-0.937) were associated with reduced likelihood of employment; female sex (OR=0.286, CI=0.128 - 0.637) was associated with working part-time. In the model with BNSS five-factor, Avolition (OR=0.541, CI=0.440-0.666), and PANSS Positive (OR=0.924, CI=0.855-0.997) were associated with reduced likelihood of employment; female sex (OR=0.289, CI=0.126 - 0.662) and Avolition (OR=0.644, CI=0.475 - 0.872) were associated with working part-time. DISCUSSION Our study described the vocational profile and correlates of employment in a developed urban Asian country. Negative symptoms, particularly MAP and Avolition, positive symptoms, and physical comorbidity reduced an individual's likelihood of employment, while female sex and Avolition were associated with working part-time. Efforts to identify and address these factors are necessary to encourage employment in individuals with schizophrenia.
Collapse
Affiliation(s)
- Mei San Ang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Gurpreet Rekhi
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore, Singapore.,North Region & Department of Psychosis, Institute of Mental Health, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| |
Collapse
|
10
|
Gunnarsson AB, Eklund M. Young people with psychiatric disabilities and their views of day centres. Scand J Occup Ther 2016; 24:167-177. [PMID: 27141968 DOI: 10.1080/11038128.2016.1178327] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Young people with psychiatric disabilities may require support in structuring their everyday life. To learn more about the relevance of day centres in this respect, this study aimed to examine the experiences of young people with psychiatric disabilities. A particular focus was on the perceptions of meaningful occupation when visiting day centres, their reasons for not choosing this option when given it and what they desired instead. A qualitative design based on individual interviews was used. Twelve women and eight men between 18 and 35 years, with a need for organized daily occupations, participated as informants. Qualitative content analysis revealed three categories: 'Being in a context', 'Balancing between developing and stagnating', and 'Longing for something more'. The findings indicated that the occupations were inherently age neutral, as were the possibilities for socializing. There was a desire for more activities in the community and more support for engaging in occupations that other young people did. A major issue in the accomplishment of this was the need to earn money, and the lack of opportunities for doing that in the day centre context was a considerable drawback. The findings highlight the importance of identifying young people's views when designing day centres.
Collapse
Affiliation(s)
- A Birgitta Gunnarsson
- a Department of Research and Development , Region Kronoberg , Växjö , Sweden.,b Department of Clinical Neuroscience and Rehabilitation , The Sahlgrenska Academy at University of Gothenburg , Gothenburg , Sweden
| | - Mona Eklund
- c Department of Health Sciences , Lund University , Lund , Sweden
| |
Collapse
|
11
|
Doroud N, Fossey E, Fortune T. Recovery as an occupational journey: A scoping review exploring the links between occupational engagement and recovery for people with enduring mental health issues. Aust Occup Ther J 2015; 62:378-92. [DOI: 10.1111/1440-1630.12238] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Nastaran Doroud
- Department of Community and Clinical Allied Health; School of Allied Health; La Trobe University; Bundoora Victoria Australia
| | - Ellie Fossey
- Living with Disability Research Centre; School of Allied Health; La Trobe University; Bundoora Victoria Australia
| | - Tracy Fortune
- Department of Community and Clinical Allied Health; School of Allied Health; La Trobe University; Bundoora Victoria Australia
| |
Collapse
|
12
|
Bjørkedal S, Torsting A, Møller T. Rewarding yet demanding: client perspectives on enabling occupations during early stages of recovery from schizophrenia. Scand J Occup Ther 2015; 23:97-106. [DOI: 10.3109/11038128.2015.1082624] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
13
|
Hitch D, Lhuede K. Research priorities in mental health occupational therapy: A study of clinician perspectives. Aust Occup Ther J 2015; 62:326-32. [PMID: 26395384 DOI: 10.1111/1440-1630.12223] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIM The evidence to support mental health occupational therapy has proliferated in the early years of this century, but this growth has tended to be organic rather than targeted. Previous efforts to identify research priorities in this area of practice are either out dated, or encompass discrete areas of practice. The aim of this study was to identify priority areas for research in mental health occupational therapy from clinician's perspectives. METHODS A Policy Delphi method was used to enable occupational therapists to define and differentiate their perspectives on research priorities. Forty-two occupational therapists took part in the first two rounds of this method, with 69% (n = 29) going on to complete the third and final round of data collection. A Likert scale was used to rate the importance of each priority, and descriptive quantitative analysis undertaken to identify those most consistently identified as being highly important. RESULTS Four research priorities were identified as being highly important in this study: (i) working in an occupationally focussed way; (ii) consumer experience of therapy groups; (iii) identifying factors which increase consumer engagement in occupation; and (iv) engaging patients on the inpatient unit in meaningful and positive occupation. CONCLUSIONS Two of the priority areas are already the subject of substantial evidence bases, but there has been far less research into consumer experiences of groups and occupational engagement in acute settings. Collaboration between research teams and greater consumer inclusion are recommended for the future. SIGNIFICANCE OF THE STUDY This study provides an updated indication of research priorities for mental health occupational therapy in Australia.
Collapse
Affiliation(s)
- Danielle Hitch
- NorthWestern Mental Health, Psychosocial Research Centre, Coburg, Victoria, Australia
| | - Kate Lhuede
- NorthWestern Mental Health, Psychosocial Research Centre, Coburg, Victoria, Australia
| |
Collapse
|
14
|
Arblaster K, Mackenzie L, Willis K. Mental health consumer participation in education: a structured literature review. Aust Occup Ther J 2015; 62:341-62. [DOI: 10.1111/1440-1630.12205] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Karen Arblaster
- University of Western Sydney; Sydney New South Wales Australia
- University of Sydney; Sydney, New South Wales Australia
| | | | - Karen Willis
- Australian Catholic University; Melbourne, Victoria Australia
| |
Collapse
|
15
|
Hancock N, Honey A, Bundy AC. Sources of meaning derived from occupational engagement for people recovering from mental illness. Br J Occup Ther 2015. [DOI: 10.1177/0308022614562789] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Engagement in meaningful occupations is of central importance in mental health recovery. The purpose of this study was to gain a richer understanding of the relationships between occupations, sources of meaning and recovery for people living with mental illness. Method People living with mental illness ( n = 78) attending an Australian Clubhouse completed the recovery assessment scale and socially valued role classification scale. Qualitative and quantitative data were analysed using mixed methods. Findings The most meaningful occupations were those most likely to provide opportunities for social connection and being valued by others. The frequency with which these socially derived sources of meaning were identified far outweighed other sources: positive sense of self; skills/personal development; time use/routine; financial gain and fun/pleasure. Neither the occupations identified as most meaningful nor the source of meaning differed depending on level of recovery. Conclusion Irrespective of stage of recovery, socially derived aspects of meaning are most frequently prioritized by people living with mental illness. In facilitating engagement in personally meaningful occupations, occupational therapists need to understand that, for many, meaningfulness centres around inter-dependence: being with others, belonging, giving or contributing and being valued by others.
Collapse
Affiliation(s)
| | - Anne Honey
- Senior lecturer, The University of Sydney, Australia
| | - Anita C Bundy
- Professor and Chair, The University of Sydney, Australia
| |
Collapse
|
16
|
Okon S, Webb D, Zehnder E, Kobylski M, Morrow C, Reid V, Schultz-Keil E. Health and Wellness Outcomes for Members in a Psychosocial Rehabilitation Clubhouse Participating in a Healthy Lifestyle Design Program. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/0164212x.2014.1001012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
17
|
|