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Ng F, Rennick-Egglestone S, Onwumere J, Newby C, Llewellyn-Beardsley J, Yeo C, Ali Y, Pollock K, Kotera Y, Pomberth S, Gavan SP, van der Krieke L, Robotham D, Gillard S, Thornicroft G, Slade M. Pragmatic, feasibility randomized controlled trial of a recorded mental health recovery narrative intervention: narrative experiences online intervention for informal carers (NEON-C). Front Psychiatry 2024; 14:1272396. [PMID: 38323025 PMCID: PMC10845336 DOI: 10.3389/fpsyt.2023.1272396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/14/2023] [Indexed: 02/08/2024] Open
Abstract
Introduction Informal carers of people with mental health problems often have unmet support needs. Mental health recovery narratives are increasingly accessible, but their relevance to and effect on informal carers have been minimally investigated. The Narrative Experiences Online (NEON) Intervention is a first-in-field intervention that provides informal carers with access to a diverse collection of recorded mental health recovery narratives. This trial aimed to examine the feasibility and acceptability of the NEON Intervention for informal carers. Methods This study involved a two-arm feasibility randomized controlled trial. Carers were randomly assigned to receiving versus not receiving the NEON Intervention. The feasibility aspects investigated included the acceptability of the intervention and of randomization, trial processes, engagement rates, recruitment procedures, attrition, sample size estimation, identification of candidate primary and secondary outcomes, and the feasibility of conducting a definitive trial. A qualitative process evaluation was conducted. Findings A total of 121 carers were eligible, of whom 54 were randomized (intervention: 27, control: 27). Twelve-month follow-up data were available for 36 carers. Carers accessed a mean of 25 narratives over a 12-month period, and the intervention group, compared with the control group, reported a small effect on hope and a moderate effect on the presence of meaning in life. Five modifications were recommended to improve the user experience, applicability, and trial processes. Discussion The NEON Intervention is feasible and acceptable. Significant refinement of the NEON Intervention and trial processes is required to personalize and ensure applicability to carers. Further feasibility testing is recommended prior to a definitive trial.
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Affiliation(s)
- Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Stefan Rennick-Egglestone
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Juliana Onwumere
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Kent, United Kingdom
| | - Christopher Newby
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Joy Llewellyn-Beardsley
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Caroline Yeo
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Yasmin Ali
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Kristian Pollock
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Yasuhiro Kotera
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Scott Pomberth
- NEON Lived Experience Advisory Panel, Nottingham, United Kingdom
| | - Sean P. Gavan
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research and Primary Care, The University of Manchester, Manchester, United Kingdom
| | - Lian van der Krieke
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, Netherlands
| | | | - Steve Gillard
- School of Health & Psychological Sciences, City, University of London, London, United Kingdom
| | - Graham Thornicroft
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- Health and Community Participation Division, Faculty of Nursing and Health Sciences, Nord University, Namsos, Norway
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Kroon SJC, Alma MA, Bak M, van der Krieke L, Bruggeman R. Values and practice of collaboration in a mental health care system in the Netherlands: a qualitative study. Int J Ment Health Syst 2023; 17:15. [PMID: 37291607 DOI: 10.1186/s13033-023-00584-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 05/23/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND To offer optimal care, the mental health system needs new routes for collaboration, involving both interprofessional and interorganizational aspects. The transition from intramural to extramural mental health care has given rise to new dynamics between public and mental health care, introducing a challenge for interprofessional and interorganizational collaboration. This study aims to determine values and expectations of collaboration and to understand how collaboration in mental health care organizations takes shape in daily practice. METHODS We conducted a qualitative study using semi-structured interviews and a focus group, in the setting of the Program for Mentally Vulnerable Persons (PMV). Data were analysed following thematic analysis. RESULTS We found three aspect that were considered important in collaboration: commonality, relationships, and psychological ownership. However, our findings indicate a discrepancy between what is considered essential in collaboration and how this materializes in day-to-day practice: collaboration appears to be less manageable than anticipated by interviewees. Our data suggest psychological ownership should be added as value to the interorganizational collaboration theory. CONCLUSION Our study offers a new definition of collaboration and adding "psychological ownership" to the existing literature on collaboration theory. Furthermore, we gained insight into how collaboration between different organizations works in practice. Our research points to a discrepancy between what all the partners find important in collaboration, and what they actually do in practice. Finally, we expressed ways to improve the collaboration, such as choosing between a chain or a network approach and acting on it and re-highlighting the goal of the Program Mentally Vulnerable persons.
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Affiliation(s)
- Suzanne J C Kroon
- Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Manna A Alma
- Department of Health Sciences, Applied Health Research , University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Meike Bak
- Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lian van der Krieke
- Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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3
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Van Eck RM, van Velden J, Vellinga A, van der Krieke L, Castelein S, de Haan L, Schirmbeck F, van Amelsvoort T, Bartels-Velthuis AA, Bruggeman R, Cahn W, Simons CJP, van Os J. Personal recovery suits us all: A study in patients with non-affective psychosis, unaffected siblings and healthy controls. Schizophr Res 2023; 255:24-32. [PMID: 36948073 DOI: 10.1016/j.schres.2023.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/25/2023] [Indexed: 03/24/2023]
Abstract
Personal recovery transcends illness and is a unifying human experience. Core elements in personal recovery are hope, meaning, and rebuilding oneself. Here we aim to investigate whether factors associated with personal recovery in patients with non-affective psychosis, unaffected siblings and healthy controls are similar. We investigated the association between personal recovery and resilience, social support, socio-demographic and illness-related variables in 580 patients, 630 siblings, and 351 healthy controls who participated in the Genetic Risk and Outcome of Psychosis (GROUP) study. Bi-variate associations between personal recovery and individual variables were assessed and multiple linear regression analyses were performed to estimate the proportion of variance in personal recovery that could be accounted for by the predictors and to investigate which predictors independently added to the model. Positive self was significantly and independently associated with personal recovery in all three groups. Pro-active action taking also seems to be important. Social functioning significantly contributed to explained variance in patients and siblings. Regarding illness-related factors, depressive symptoms had impact on personal recovery in both patients and siblings, whereas positive symptoms only did in siblings. The findings imply that not only personal recovery itself, but also some associated factors are universally human and suit us all. This means that patients and non-patients share supportive factors of personal recovery which may help to reach mutual understanding. Recovery-oriented practices and mental health services might be more effective when focusing also on improving self-image, functional coping styles and generating social interaction, next to the reduction of affective symptoms.
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Affiliation(s)
- Robin Michael Van Eck
- Mentrum, part of Arkin, the Netherlands; Arkin, Institute for Mental Health, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands.
| | - Judith van Velden
- Arkin, Institute for Mental Health, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - Astrid Vellinga
- Mentrum, part of Arkin, the Netherlands; Arkin, Institute for Mental Health, Amsterdam, the Netherlands
| | - Lian van der Krieke
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research center, Groningen, the Netherlands
| | - Stynke Castelein
- Lentis Research, Lentis Psychiatric Institute, Groningen, the Netherlands; Faculty of Behavioural and Social Sciences, Department of Clinical Psychology, Groningen, the Netherlands
| | - Lieuwe de Haan
- Arkin, Institute for Mental Health, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - Frederike Schirmbeck
- Arkin, Institute for Mental Health, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - Therese van Amelsvoort
- Maastricht University, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht, the Netherlands
| | - Agna A Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research center, Groningen, the Netherlands
| | - Richard Bruggeman
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research center, Groningen, the Netherlands; University of Groningen, Department of Clinical and Developmental Neuropsychology, Groningen, the Netherlands
| | - Wiepke Cahn
- University Medical Center Utrecht, Department of Psychiatry, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, the Netherlands; Altrecht, General Mental Health Care, Utrecht, the Netherlands
| | - Claudia J P Simons
- Maastricht University, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht, the Netherlands; GGzE Institute for Mental Health Care, Eindhoven, the Netherlands
| | - Jim van Os
- University Medical Center Utrecht, Department of Psychiatry, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, the Netherlands; King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, United Kingdom
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van de Beek MH, Landman E, Veling W, Schoevers RA, van der Krieke L. Discussing the unspoken: A qualitative analysis of online forum discussions on mental health problems in young Moroccan-Dutch migrants. Transcult Psychiatry 2022; 60:86-98. [PMID: 35939051 DOI: 10.1177/13634615221105118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Migrants and their offspring are at increased risk of developing mental disorders. Previous research has shown associations between adverse social factors (e.g., discrimination, lack of social support) and mental health problems in migrants, but it is unknown how these associations are understood by migrants themselves. In this study, we aimed to gain explorative insight into the way young Moroccan-Dutch people experience their social environment, and how they relate this social environment to the development of mental health problems. At www.marokko.nl, the largest online discussion platform for young Moroccan-Dutch people, contributors discuss a broad variety of subjects, including societal, cultural, religious, and mental health issues. Combining deductive and inductive approaches to qualitative data analysis, we analysed 22 forum discussions at marokko.nl about mental health problems, after which data saturation was reached. Contributors described feeling isolated and experiencing discrimination in their social environment. Contributor comments identified social challenges arising from Dutch society, Dutch culture (e.g., being too individualistic), Moroccan culture (e.g., strict parenting style), and living between these two cultures. These social challenges are perceived to be associated with mental health problems. Furthermore, we created a model describing the different types of explanations contributors used for mental health problems, being: religious (e.g., possession); medical (i.e., a bio-psycho-social cause); or a combination of both. This model can help clinicians in delivering culturally sensitive mental health care. Lastly, this study shows the taboo on mental health problems in the Moroccan-Dutch population and the opportunity to open up in the online environment.
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Affiliation(s)
- Madelien H van de Beek
- Dimence Institute for Mental Health, Dimence Group, Deventer, the Netherlands.,University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Erwin Landman
- Dimence Institute for Mental Health, Dimence Group, Deventer, the Netherlands.,Department of Development Psychology, University of Tilburg, Tilburg, Netherlands
| | - Wim Veling
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Robert A Schoevers
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lian van der Krieke
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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5
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Bos FM, Schreuder MJ, George SV, Doornbos B, Bruggeman R, van der Krieke L, Haarman BCM, Wichers M, Snippe E. Anticipating manic and depressive transitions in patients with bipolar disorder using early warning signals. Int J Bipolar Disord 2022; 10:12. [PMID: 35397076 PMCID: PMC8994809 DOI: 10.1186/s40345-022-00258-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 03/01/2022] [Indexed: 11/30/2022] Open
Abstract
Background In bipolar disorder treatment, accurate episode prediction is paramount but remains difficult. A novel idiographic approach to prediction is to monitor generic early warning signals (EWS), which may manifest in symptom dynamics. EWS could thus form personalized alerts in clinical care. The present study investigated whether EWS can anticipate manic and depressive transitions in individual patients with bipolar disorder. Methods Twenty bipolar type I/II patients (with ≥ 2 episodes in the previous year) participated in ecological momentary assessment (EMA), completing five questionnaires a day for four months (Mean = 491 observations per person). Transitions were determined by weekly completed questionnaires on depressive (Quick Inventory for Depressive Symptomatology Self-Report) and manic (Altman Self-Rating Mania Scale) symptoms. EWS (rises in autocorrelation at lag-1 and standard deviation) were calculated in moving windows over 17 affective and symptomatic EMA states. Positive and negative predictive values were calculated to determine clinical utility. Results Eleven patients reported 1–2 transitions. The presence of EWS increased the probability of impending depressive and manic transitions from 32-36% to 46–48% (autocorrelation) and 29–41% (standard deviation). However, the absence of EWS could not be taken as a sign that no transition would occur in the near future. The momentary states that indicated nearby transitions most accurately (predictive values: 65–100%) were full of ideas, worry, and agitation. Large individual differences in the utility of EWS were found. Conclusions EWS show theoretical promise in anticipating manic and depressive transitions in bipolar disorder, but the level of false positives and negatives, as well as the heterogeneity within and between individuals and preprocessing methods currently limit clinical utility. Supplementary Information The online version contains supplementary material available at 10.1186/s40345-022-00258-4.
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Affiliation(s)
- Fionneke M Bos
- Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands. .,Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Marieke J Schreuder
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sandip V George
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Computer Science , University College London , London, United Kingdom
| | - Bennard Doornbos
- Lentis Research, Lentis Psychiatric Institute, Groningen, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Lian van der Krieke
- Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.,Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bartholomeus C M Haarman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marieke Wichers
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Evelien Snippe
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Slade M, Rennick-Egglestone S, Llewellyn-Beardsley J, Yeo C, Roe J, Bailey S, Smith RA, Booth S, Harrison J, Bhogal A, Penas Morán P, Hui A, Quadri D, Robinson C, Smuk M, Farkas M, Davidson L, van der Krieke L, Slade E, Bond C, Nicholson J, Grundy A, Charles A, Hare-Duke L, Pollock K, Ng F. Recorded Mental Health Recovery Narratives as a Resource for People Affected by Mental Health Problems: Development of the Narrative Experiences Online (NEON) Intervention. JMIR Form Res 2021; 5:e24417. [PMID: 34042595 PMCID: PMC8193481 DOI: 10.2196/24417] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/06/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The internet enables sharing of narratives about health concerns on a substantial scale, and some digital health narratives have been integrated into digital health interventions. Narratives describing recovery from health problems are a focus of research, including those presented in recorded (eg, invariant) form. No clinical trial has been conducted on a web-based intervention providing access to a collection of Recorded Recovery Narratives (RRNs). OBJECTIVE This study presents knowledge produced through the development of the Narrative Experiences Online (NEON) Intervention, a web-based intervention incorporating the algorithmic recommendation of RRNs. METHODS Knowledge was gathered through knowledge integration (KI) activities. KI1 synthesized previous studies to produce the NEON Impact Model describing how accessing RRNs produces health-related outcomes. KI2 developed curation principles for the NEON Collection of RRNs through consultation with the NEON Lived Experience Advisory Panel and the curation of a preliminary collection. KI3 identified harm minimization strategies for the NEON Intervention through consultation with the NEON International Advisory Board and Lived Experience Advisory Panel. The NEON Intervention was finalized through 2 research studies (RS). In RS1, mental health service users (N=40) rated the immediate impact of randomly presented narratives to validate narrative feedback questions used to inform the recommendation algorithm. In RS2, mental health service users (n=25) were interviewed about their immediate response to a prototype of the NEON Intervention and trial procedures and then were interviewed again after 1 month of use. The usability and acceptability of the prototype and trial procedures were evaluated and refinements were made. RESULTS KI1 produced the NEON Impact Model, which identifies moderators (recipient and context), mechanisms of connection (reflection, comparison, learning, and empathy), processes (identification of change from narrative structure or content and internalization of observed change), and outcomes (helpful and unhelpful). KI2 identified 22 curation principles, including a mission to build a large, heterogeneous collection to maximize opportunities for connection. KI3 identified seven harm minimization strategies, including content warnings, proactive and reactive blocking of narratives, and providing resources for the self-management of emotional distress. RS1 found variation in the impact of narratives on different participants, indicating that participant-level feedback on individual narratives is needed to inform a recommender system. The order of presentation did not predict narrative feedback. RS2 identified amendments to web-based trial procedures and the NEON Intervention. Participants accessed some narratives multiple times, use reduced over the 4-week period, and narrative feedback was provided for 31.8% (105/330) of narrative accesses. CONCLUSIONS RRNs can be integrated into web-based interventions. Evaluating the NEON Intervention in a clinical trial is feasible. The mixed methods design for developing the NEON Intervention can guide its extension to other clinical populations, the design of other web-based mental health interventions, and the development of narrative-based interventions in mental health.
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Affiliation(s)
- Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Stefan Rennick-Egglestone
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Joy Llewellyn-Beardsley
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Caroline Yeo
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - James Roe
- National Institute for Health Research, ARC East Midlands, University of Nottingham, Nottingham, United Kingdom
| | - Sylvia Bailey
- NEON Lived Experience Advisory Panel, Nottingham, United Kingdom
| | | | - Susie Booth
- NEON Lived Experience Advisory Panel, Nottingham, United Kingdom
| | - Julian Harrison
- NEON Lived Experience Advisory Panel, Nottingham, United Kingdom
| | - Adaresh Bhogal
- NEON Lived Experience Advisory Panel, Nottingham, United Kingdom
| | - Patricia Penas Morán
- Department of Personality, Assessment and Psychological Treatment, University of Deusto, Bilbao, Spain
| | - Ada Hui
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Dania Quadri
- GKT School of Medical Education, King's College London, London, United Kingdom
| | - Clare Robinson
- Centre for Primary Care & Public Health, Pragmatic Clinical Trials Unit, Queen Mary University of London, London, United Kingdom
| | - Melanie Smuk
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Marianne Farkas
- College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Larry Davidson
- Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Lian van der Krieke
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, Netherlands
| | - Emily Slade
- Department of Computer Science, University of Oxford, Oxford, United Kingdom
| | - Carmel Bond
- Nottingham University Business School, University of Nottingham, Nottingham, United Kingdom
| | - Joe Nicholson
- School of Humanities, University of Nottingham, Nottingham, United Kingdom
| | - Andrew Grundy
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Ashleigh Charles
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Laurie Hare-Duke
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Kristian Pollock
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
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7
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Bos FM, Snippe E, Bruggeman R, Doornbos B, Wichers M, van der Krieke L. Recommendations for the use of long-term experience sampling in bipolar disorder care: a qualitative study of patient and clinician experiences. Int J Bipolar Disord 2020; 8:38. [PMID: 33258015 PMCID: PMC7704990 DOI: 10.1186/s40345-020-00201-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/08/2020] [Indexed: 11/10/2022] Open
Abstract
Background Self-monitoring has been shown to improve the self-management and treatment of patients with bipolar disorder. However, current self-monitoring methods are limited to once-daily retrospectively assessed mood, which may not suit the rapid mood fluctuations in bipolar disorder. The experience sampling method (ESM), which assesses mood in real-time several times a day, may overcome these limitations. This study set out to assess the experiences of patients and clinicians with the addition of ESM monitoring, real-time alerts, and personalized feedback to clinical care. Participants were twenty patients with bipolar disorder type I/II and their clinicians. For four months, patients completed five ESM assessments per day on mood, symptoms, and activities. Weekly symptom questionnaires alerted patients and clinicians to potential episodes. After the monitoring, a personalized feedback report based on the patient’s data was discussed between patient and clinician. Three months later, patient and clinician were both interviewed. Results Thematic analysis of the transcripts resulted in four themes: perceived effects of the monitoring, alerts, and feedback, and recommendations for implementation of ESM. ESM was perceived as helping patients to cope better with their disorder by increasing awareness, offering new insights, and encouraging life style adjustments. ESM was further believed to facilitate communication between patient and clinician and to lead to new treatment directions. However, high assessment burden and pre-occupation with negative mood and having a disorder were also described. Patients and clinicians advocated for increased personalization and embedding of ESM in care. Conclusions This study demonstrates that long-term ESM monitoring, alerts, and personalized feedback are perceived as beneficial to the treatment and self-management of patients with bipolar disorder. Future research should further test the clinical utility of ESM. Clinically relevant feedback and technology need to be developed to enable personalized integration of ESM in clinical care.
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Affiliation(s)
- Fionneke M Bos
- Rob Giel Research Center, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands. .,Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Evelien Snippe
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Richard Bruggeman
- Rob Giel Research Center, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Bennard Doornbos
- Department of Specialized Training, Psychiatric Hospital Mental Health Services Drenthe, Outpatient Clinics, Assen, The Netherlands
| | - Marieke Wichers
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lian van der Krieke
- Rob Giel Research Center, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.,Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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8
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Rennick-Egglestone S, Elliott R, Smuk M, Robinson C, Bailey S, Smith R, Keppens J, Hussain H, Pollock K, Cuijpers P, Llewellyn-Beardsley J, Ng F, Yeo C, Roe J, Hui A, van der Krieke L, Walcott R, Slade M. Impact of receiving recorded mental health recovery narratives on quality of life in people experiencing psychosis, people experiencing other mental health problems and for informal carers: Narrative Experiences Online (NEON) study protocol for three randomised controlled trials. Trials 2020; 21:661. [PMID: 32690105 PMCID: PMC7370499 DOI: 10.1186/s13063-020-04428-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/17/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Mental health recovery narratives have been defined as first-person lived experience accounts of recovery from mental health problems which refer to events or actions over a period of time and which include elements of adversity or struggle, and also self-defined strengths, successes or survival. They are readily available in invariant recorded form, including text, audio or video. Previous studies have provided evidence that receiving recorded recovery narratives can provide benefits to recipients. This protocol describes three pragmatic trials that will be conducted by the Narrative Experiences Online (NEON) study using the NEON Intervention, a web application that delivers recorded recovery narratives to its users. The aim of the NEON Trial is to understand whether receiving online recorded recovery narratives through the NEON Intervention benefits people with experience of psychosis. The aim of the NEON-O and NEON-C trials is to evaluate the feasibility of conducting a definitive trial on the use of the NEON Intervention with people experiencing non-psychosis mental health problems and those who care for others experiencing mental health problems respectively. METHODS The NEON Trial will recruit 683 participants with experience of psychosis. The NEON-O Trial will recruit at least 100 participants with experience of non-psychosis mental health problems. The NEON-C Trial will recruit at least 100 participants with experience of caring for others who have experienced mental health problems. In all three trials, participants will be randomly allocated into one of two arms. Intervention arm participants will receive treatment as usual plus immediate access to the NEON Intervention for 1 year. Control arm participants will receive treatment as usual plus access to the NEON Intervention after 1 year. All participants will complete demographics and outcome measures at baseline, 1 week, 12 weeks and 52 weeks. For the NEON Trial, the primary outcome measure is the Manchester Short Assessment of Quality of Life at 52 weeks, and secondary outcome measures are the CORE-10, Herth Hope Index, Mental Health Confidence Scale and Meaning in Life Questionnaire. A cost-effectiveness analysis will be conducted using data collected through the EQ-5D-5 L and the Client Service Receipt Inventory. DISCUSSION NEON Trial analyses will establish both effectiveness and cost-effectiveness of the NEON Intervention for people with experience of psychosis, and hence inform future clinical recommendations for this population. TRIAL REGISTRATION All trials were prospectively registered with ISRCTN. NEON Trial: ISRCTN11152837 . Registered on 13 August 2018. NEON-C Trial: ISRCTN76355273 . Registered on 9 January 2020. NEON-O Trial: ISRCTN63197153 . Registered on 9 January 2020.
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Affiliation(s)
- Stefan Rennick-Egglestone
- School of Health Sciences, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.
| | - Rachel Elliott
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Melanie Smuk
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UK
| | - Clare Robinson
- Centre for Primary Care & Public Health, Pragmatic Clinical Trials Unit, Queen Mary University of London, 58 Turner St, London, E1 2AB, UK
| | - Sylvia Bailey
- NEON Lived Experience Advisory Panel, Nottingham, UK
| | - Roger Smith
- NEON Lived Experience Advisory Panel, Nottingham, UK
| | - Jeroen Keppens
- Department of Informatics, King's College London, Bush House, 30 Aldwych, London, WC2B 4BG, UK
| | - Hannah Hussain
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Kristian Pollock
- School of Health Sciences, Queens Medical Centre, Nottingham, NG7 2UH, UK
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Joy Llewellyn-Beardsley
- School of Health Sciences, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
| | - Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
| | - Caroline Yeo
- School of Health Sciences, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
| | - James Roe
- National Institute for Health Research, ARC East Midlands, University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK
| | - Ada Hui
- School of Health Sciences, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
| | - Lian van der Krieke
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - Rianna Walcott
- Department of Digital Humanities, King's College London, Strand, London, WC2R 2LS, UK
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
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van der Krieke L, Bartels-Velthuis AA, Sytema S. Personal Recovery Among Service Users Compared With Siblings and a Control Group: A Critical Note on Recovery Assessment. Psychiatr Serv 2019; 70:1123-1129. [PMID: 31451064 DOI: 10.1176/appi.ps.201900049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE One way to boost the implementation of a recovery-oriented practice in psychiatric care may be by including outcome measures assessing recovery. However, the five core processes of personal recovery-connectedness, hope and optimism about the future, identity, meaning in life, and empowerment (collectively known as CHIME)-are not service user-specific and can be relevant to nonservice users as well. It is unknown whether recovery processes are measurably different among users and nonusers of mental health services. This study aimed to compare scores on the 24-item Recovery Assessment Scale (RAS) among service users with psychosis (in remission and not in remission), their siblings, and a control group, after the validation of the RAS Dutch version. METHODS Psychometric evaluation and comparative analyses (analysis of variance and tests of clinical significance) were performed on data from service users (N=581), their siblings (N=632), and control group members (N=372) in the longitudinal Genetic Risk and Outcome in Psychosis study in the Netherlands. RESULTS Results showed that the psychometric validity of the RAS Dutch version was adequate. A significant, moderate effect was found for the RAS total score (F=31.73, df=3 and 1,559, p<0.001; Cohen's f=0.25). However, clinical significance analysis showed that a substantial number of service users had recovered, including those in remission and those not in remission, and that substantial numbers of siblings and control group members had not recovered. CONCLUSIONS The findings call into question the usefulness of the RAS in outcome assessment, given that the differences detected in recovery between service users, siblings, and control group members had limited clinical relevance.
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Affiliation(s)
- Lian van der Krieke
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, the Netherlands
| | - Agna A Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, the Netherlands
| | - Sjoerd Sytema
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, the Netherlands
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- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, the Netherlands
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10
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Bos FM, Snippe E, Bruggeman R, Wichers M, van der Krieke L. Insights of Patients and Clinicians on the Promise of the Experience Sampling Method for Psychiatric Care. Psychiatr Serv 2019; 70:983-991. [PMID: 31434558 DOI: 10.1176/appi.ps.201900050] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This qualitative study aimed to map the relevance of the experience sampling method (ESM) for psychiatric practice and identify barriers and facilitators for implementation, as perceived by patients and clinicians. METHODS Participants were 22 patients with various diagnoses and 21 clinicians (e.g., psychiatrists, psychologists) who participated in interviews or focus groups. Using Atlas.TI, the authors conducted qualitative thematic analysis to analyze the transcripts, resulting in four themes: applications, advantages, undesirable effects, and requirements for implementation of ESM in care. RESULTS Clinicians and patients believed ESM could be relevant in every phase of care to increase patients' awareness, insight, and self-management; personalize interventions; and alert patients to rising symptoms. Further, ESM was expected to improve the patient-clinician relationship; lead to objective, personalized, reliable and visual data; and increase efficiency of care. However, participants warned against high assessment burden and potential symptom worsening. CONCLUSIONS This study provides first evidence that the potential of ESM is recognized by both patients and clinicians. Key recommendations for optimal implementation of ESM in psychiatric care include flexible application of ESM, collaboration between patient and clinician, regular evaluation, awareness of negative reactivity, availability to patients with different psychiatric syndromes, and implementation by an interdisciplinary team of patients, clinicians, researchers, and information technology specialists.
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Affiliation(s)
- Fionneke M Bos
- Rob Giel Research Center (Bos, Bruggeman, van der Krieke) and Interdisciplinary Center Psychopathology and Emotion Regulation (Bos, Snippe, Wichers, van der Krieke), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Evelien Snippe
- Rob Giel Research Center (Bos, Bruggeman, van der Krieke) and Interdisciplinary Center Psychopathology and Emotion Regulation (Bos, Snippe, Wichers, van der Krieke), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Richard Bruggeman
- Rob Giel Research Center (Bos, Bruggeman, van der Krieke) and Interdisciplinary Center Psychopathology and Emotion Regulation (Bos, Snippe, Wichers, van der Krieke), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marieke Wichers
- Rob Giel Research Center (Bos, Bruggeman, van der Krieke) and Interdisciplinary Center Psychopathology and Emotion Regulation (Bos, Snippe, Wichers, van der Krieke), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lian van der Krieke
- Rob Giel Research Center (Bos, Bruggeman, van der Krieke) and Interdisciplinary Center Psychopathology and Emotion Regulation (Bos, Snippe, Wichers, van der Krieke), Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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11
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Drost LM, van der Krieke L, Iedema-den Boer Z, Sytema S, Schippers GM. Social support in chat sessions for adolescents and young adults living with a family member with mental illness. Int J Ment Health Nurs 2018; 27:683-692. [PMID: 28573828 DOI: 10.1111/inm.12354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/02/2017] [Indexed: 11/29/2022]
Abstract
Children from families with a mental illness are at risk of developing negative health outcomes. Online interventions are a new way to offer support to these children. The present study utilized a website that had been developed to support Dutch youth who had a family member with a mental illness. The objective was to analyse monitored and unmonitored chatroom conversations among these young people, and specifically to compare supportive messages and self-disclosures of experiences. We electronically imported session transcripts of 34 chatroom conversations into the qualitative analysis software Atlas.ti. A content analysis was performed on 4252 messages from 22 female participants. A correlational analysis was then conducted to identify significant associations between sent and received supportive statements and disclosing statements. We found supporting comments in approximately 34% of the conversations and disclosures of problems in the home in approximately 15-18% of the messages. Participants made approximately twice as many disclosing statements and approximately half as many supportive statements in the monitored sessions compared to the unmonitored sessions. The number of disclosures that were sent was positively correlated with the amount of social support that was received. The number of disclosures sent was negatively correlated with the amount of social support that was sent, but only in the unmonitored sessions. Considering the greater reach of Internet interventions, online chatroom sessions might be provided as complementary to, or as an alternative to, face-to-face groups for supporting youth with a family member who has a mental illness.
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Affiliation(s)
- Louisa M Drost
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lian van der Krieke
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Zamira Iedema-den Boer
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sjoerd Sytema
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerard M Schippers
- Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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12
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van de Beek MH, van der Krieke L, Schoevers RA, Veling W. Social exclusion and psychopathology in an online cohort of Moroccan-Dutch migrants: Results of the MEDINA-study. PLoS One 2017; 12:e0179827. [PMID: 28692653 PMCID: PMC5503196 DOI: 10.1371/journal.pone.0179827] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 06/05/2017] [Indexed: 12/02/2022] Open
Abstract
Introduction Migration is seen as a risk factor for developing psychiatric symptoms and experiencing social exclusion. In the Netherlands, the Moroccan-Dutch population is the second largest migrant group. 70% of all young Moroccan-Dutch people meet each other in the online community www.marokko.nl. Within this community, we investigated the association between experiences of social exclusion and self-reported depressive symptoms and psychotic experiences. Materials and methods Participants were recruited via the website www.marokko.nl. They completed an online survey, with screening instruments for depressive symptoms (K10) and psychotic experiences (PQ-16), measures of social exclusion (perceived discrimination, social defeat and social support), and questions about demographical information. With regression analysis the association between social exclusion and psychiatric symptoms was investigated. Results We included 267 participants; 87% were female. 27% of the sample has received mental healthcare in the past. Over 50% of these people screened positive for depressive symptoms and psychotic experiences. Perceived discrimination and social defeat were significantly associated with psychotic experiences and social defeat was associated with depressive symptoms. Social support and higher education were associated with less depressive symptoms and psychotic experiences. Discussion Our findings suggest that the online environment allows for epidemiological research and early symptom detection. Levels of psychopathology were high in our sample. This suggests that a part of this young ethnic minority population might not get adequate mental healthcare. Since this population can be reached through Internet, the online environment may therefore also offer an appropriate setting for intervention, to increase resilience towards social exclusion.
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Affiliation(s)
- Madelien H. van de Beek
- Dimence Institute for Mental Health, Dimence Group, Zwolle, the Netherlands
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- * E-mail:
| | - Lian van der Krieke
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Robert A. Schoevers
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Wim Veling
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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13
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Bos FM, Snippe E, de Vos S, Hartmann JA, Simons CJ, van der Krieke L, de Jonge P, Wichers M. Can We Jump from Cross-Sectional to Dynamic Interpretations of Networks? Implications for the Network Perspective in Psychiatry. Psychother Psychosom 2017; 86:175-177. [PMID: 28490028 PMCID: PMC5516409 DOI: 10.1159/000453583] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 11/17/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Fionneke M. Bos
- University of Groningen, University Medical Center Groningen, Rob Giel Research Center, Groningen, The Netherlands,University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands,*Fionneke M. Bos, MSc, University of Groningen, University Medical Center Groningen, Rob Giel Research Center, PO Box 30.001, NL-9700 RB Groningen (The Netherlands), E-Mail
| | - Evelien Snippe
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| | - Stijn de Vos
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| | - Jessica A. Hartmann
- Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, The Netherlands,Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Claudia J.P. Simons
- Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, The Netherlands,GGzE, Institute of Mental Health Care Eindhoven and De Kempen, Eindhoven, The Netherlands
| | - Lian van der Krieke
- University of Groningen, University Medical Center Groningen, Rob Giel Research Center, Groningen, The Netherlands,University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| | - Peter de Jonge
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands,Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - Marieke Wichers
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
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Drost LM, van der Krieke L, Sytema S, Schippers GM. Self-expressed strengths and resources of children of parents with a mental illness: A systematic review. Int J Ment Health Nurs 2016; 25:102-15. [PMID: 26692281 DOI: 10.1111/inm.12176] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2015] [Indexed: 11/26/2022]
Abstract
The aim of the present study was to explore the strengths children reported to have acquired while coping with their parents illness, and the external factors these children indicated had facilitated their coping process. A systematic literature search was conducted of peer-reviewed papers that focused on self-reported experiences of children with parents who had mental illness, and revealed their strengths and resources. The search included the following databases: MEDLINE, PsycINFO, and CINAHL. Results were filtered according to whether search terms appeared in the title or abstract. Fifty-seven full-text papers were reviewed; 26 of them met the inclusion criteria and were included in the review. The statements were analysed using content analysis. The search identified 160 relevant statements, 38 (24%) of which could be described as self-reported strengths, and 122 (76%) as self-reported resources. According to these statements, the children described themselves as more mature, independent, and empathic than their peers who did not have a parent with a mental illness, and as having acquired several abilities. The statements about resources indicated that the children regarded social support, information, and particularly the support of mental health-care professionals as helpful when living with a parent with a mental illness. Recommendations for nursing actions to support children's ability to cope with their parents' illness are outlined.
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Affiliation(s)
- Louisa M Drost
- Rob Giel Research Centre, University Medical Centre Groningen, University of Groningen
| | - Lian van der Krieke
- Rob Giel Research Centre, University Medical Centre Groningen, University of Groningen
| | - Sjoerd Sytema
- Rob Giel Research Centre, University Medical Centre Groningen, University of Groningen
| | - Gerard M Schippers
- Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
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15
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Emerencia AC, van der Krieke L, Bos EH, de Jonge P, Petkov N, Aiello M. Automating Vector Autoregression on Electronic Patient Diary Data. IEEE J Biomed Health Inform 2016; 20:631-43. [DOI: 10.1109/jbhi.2015.2402280] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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16
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van der Krieke L, Emerencia AC, Bos EH, Rosmalen JG, Riese H, Aiello M, Sytema S, de Jonge P. Ecological Momentary Assessments and Automated Time Series Analysis to Promote Tailored Health Care: A Proof-of-Principle Study. JMIR Res Protoc 2015; 4:e100. [PMID: 26254160 PMCID: PMC4705023 DOI: 10.2196/resprot.4000] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 06/16/2015] [Accepted: 06/24/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Health promotion can be tailored by combining ecological momentary assessments (EMA) with time series analysis. This combined method allows for studying the temporal order of dynamic relationships among variables, which may provide concrete indications for intervention. However, application of this method in health care practice is hampered because analyses are conducted manually and advanced statistical expertise is required. OBJECTIVE This study aims to show how this limitation can be overcome by introducing automated vector autoregressive modeling (VAR) of EMA data and to evaluate its feasibility through comparisons with results of previously published manual analyses. METHODS We developed a Web-based open source application, called AutoVAR, which automates time series analyses of EMA data and provides output that is intended to be interpretable by nonexperts. The statistical technique we used was VAR. AutoVAR tests and evaluates all possible VAR models within a given combinatorial search space and summarizes their results, thereby replacing the researcher's tasks of conducting the analysis, making an informed selection of models, and choosing the best model. We compared the output of AutoVAR to the output of a previously published manual analysis (n=4). RESULTS An illustrative example consisting of 4 analyses was provided. Compared to the manual output, the AutoVAR output presents similar model characteristics and statistical results in terms of the Akaike information criterion, the Bayesian information criterion, and the test statistic of the Granger causality test. CONCLUSIONS Results suggest that automated analysis and interpretation of times series is feasible. Compared to a manual procedure, the automated procedure is more robust and can save days of time. These findings may pave the way for using time series analysis for health promotion on a larger scale. AutoVAR was evaluated using the results of a previously conducted manual analysis. Analysis of additional datasets is needed in order to validate and refine the application for general use.
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Affiliation(s)
- Lian van der Krieke
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, Netherlands.
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van der Krieke L, Bird V, Leamy M, Bacon F, Dunn R, Pesola F, Janosik M, Le Boutillier C, Williams J, Slade M. The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study. Implement Sci 2015; 10:73. [PMID: 26002350 PMCID: PMC4453226 DOI: 10.1186/s13012-015-0262-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 05/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical guidelines for the treatment of people experiencing psychosis have existed for over a decade, but implementation of recommended interventions is limited. Identifying influences on implementation may help to reduce this translational gap. The Structured Assessment of Feasibility (SAFE) measure is a standardised assessment of implementation blocks and enablers. The aim of this study was to characterise and compare the implementation blocks and enablers for recommended psychosis interventions. METHODS SAFE was used to evaluate and compare three groups of interventions recommended in the 2014 NICE psychosis guideline: pharmacological (43 trials testing 5 interventions), psychosocial (65 trials testing 5 interventions), and recovery (19 trials testing 5 interventions). The 127 trial reports rated with SAFE were supplemented by published intervention manuals, research protocols, trial registrations and design papers. Differences in the number of blocks and enablers across the three interventions were tested statistically, and feasibility profiles were generated. RESULTS There was no difference between psychosocial and recovery interventions in the number of blocks or enablers to implementation. Pharmacological interventions (a) had fewer blocks than both psychosocial interventions (χ (2)(3) = 133.77, p < 0.001) and recovery interventions (χ (2)(3) = 104.67, p < 0.001) and (b) did not differ in number of enablers from recovery interventions (χ (2)(3) = 0.74, p = 0.863) but had fewer enablers than psychosocial interventions (χ (2)(3) = 28.92, p < 0.001). Potential adverse events associated with the intervention tend to be a block for pharmacological interventions, whereas complexity of the intervention was the most consistent block for recovery and psychosocial interventions. CONCLUSIONS Feasibility profiles show that pharmacological interventions are relatively easy to implement but can sometimes involve risks. Psychosocial and recovery interventions are relatively complex but tend to be more flexible and more often manualised. SAFE ratings can contribute to tackling the current implementation challenges in mental health services, by providing a reporting guideline structure for researchers to maximise the potential for implementation and by informing prioritisation decisions by clinical guideline developers and service managers.
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Affiliation(s)
- Lian van der Krieke
- University Medical Center Groningen, University Center for Psychiatry, University of Groningen, Groningen, The Netherlands. .,Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Victoria Bird
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Mary Leamy
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Faye Bacon
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Rebecca Dunn
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Francesca Pesola
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Monika Janosik
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Clair Le Boutillier
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Julie Williams
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Mike Slade
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
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Affiliation(s)
- Lian van der Krieke
- Dr. Van der Krieke is with the University Center for Psychiatry, University Medical Center, Groningen, the Netherlands (e-mail: ). Dr. Boonstra is with GGZ Friesland and the NHL University of Applied Sciences. Ms. Malda is with GGZ Friesland
| | - Nynke Boonstra
- Dr. Van der Krieke is with the University Center for Psychiatry, University Medical Center, Groningen, the Netherlands (e-mail: ). Dr. Boonstra is with GGZ Friesland and the NHL University of Applied Sciences. Ms. Malda is with GGZ Friesland
| | - Aaltsje Malda
- Dr. Van der Krieke is with the University Center for Psychiatry, University Medical Center, Groningen, the Netherlands (e-mail: ). Dr. Boonstra is with GGZ Friesland and the NHL University of Applied Sciences. Ms. Malda is with GGZ Friesland
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van de Beek MH, van der Krieke L, Schoevers RA. Migrants Examined for Determinants of psychopathology through INternet Assessment (MEDINA) study: a cross-sectional study among visitors of an Internet community. BMJ Open 2014; 4:e003980. [PMID: 24384899 PMCID: PMC3902347 DOI: 10.1136/bmjopen-2013-003980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Migration is a risk factor for the onset of psychopathology. A range of social factors may play a role in the aetiology of psychiatric disorders in migrants. A better understanding of these associations is needed to develop preventive interventions to reduce the disease burden in the migrant population. Research among minority groups is generally time consuming and it is difficult to recruit participants. Internet can offer interesting new possibilities to conduct research among ethnic minorities. This article describes the design of an epidemiological study in the Moroccan-Dutch population, which will be entirely performed online. We investigate the association between social factors and psychopathology. METHODS AND ANALYSIS The website Marokko.nl is visited by 70% of the young Moroccan-Dutch population in the Netherlands. This website therefore provides a unique possibility for research within this population. We will conduct a survey with online questionnaires via this website. The online survey consists of several validated short self-report questionnaires, measuring depressive and anxiety symptoms (The Kessler Psychological Distress Scale (K10)), psychotic symptoms (The Prodromal Questionnaire-16 (PQ-16)) and instruments measuring discrimination, social support and social defeat. Furthermore, demographic characteristics are collected. We will use univariate and multivariate methods for analysing the data. ETHICS AND DISSEMINATION The local medical ethical committee has assessed the study protocol and judged that the study could be conducted without their approval. Knowledge dissemination will take place through peer-reviewed publication in scientific journals as well as publication for participants on the project website. DISCUSSION In this study we further explore the association between psychopathology and social factors within an online Moroccan-Dutch sample. The recruitment of participants via the website Marokko.nl creates a big advantage in collecting a large sample of a specific migrant population. Strengths and limitations of the methodology are discussed. Furthermore, we review the advantages and challenges of online epidemiological research methods.
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Affiliation(s)
- Madelien Hermina van de Beek
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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van der Krieke L, Wunderink L, Emerencia AC, de Jonge P, Sytema S. E-mental health self-management for psychotic disorders: state of the art and future perspectives. Psychiatr Serv 2014; 65:33-49. [PMID: 24129842 DOI: 10.1176/appi.ps.201300050] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The aim of this review was to investigate to what extent information technology may support self-management among service users with psychotic disorders. The investigation aimed to answer the following questions: What types of e-mental health self-management interventions have been developed and evaluated? What is the current evidence on clinical outcome and cost-effectiveness of the identified interventions? To what extent are e-mental health self-management interventions oriented toward the service user? METHODS A systematic review of references through July 2012 derived from MEDLINE, PsycINFO, AMED, CINAHL, and the Library, Information Science and Technology database was performed. Studies of e-mental health self-management interventions for persons with psychotic disorders were selected independently by three reviewers. RESULTS Twenty-eight studies met the inclusion criteria. E-mental health self-management interventions included psychoeducation, medication management, communication and shared decision making, management of daily functioning, lifestyle management, peer support, and real-time self-monitoring by daily measurements (experience sampling monitoring). Summary effect sizes were large for medication management (.92) and small for psychoeducation (.37) and communication and shared decision making (.21). For all other studies, individual effect sizes were calculated. The only economic analysis conducted reported more short-term costs for the e-mental health intervention. CONCLUSIONS People with psychotic disorders were able and willing to use e-mental health services. Results suggest that e-mental health services are at least as effective as usual care or nontechnological approaches. Larger effects were found for medication management e-mental health services. No studies reported a negative effect. Results must be interpreted cautiously, because they are based on a small number of studies.
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van der Krieke L, Emerencia AC, Boonstra N, Wunderink L, de Jonge P, Sytema S. A web-based tool to support shared decision making for people with a psychotic disorder: randomized controlled trial and process evaluation. J Med Internet Res 2013; 15:e216. [PMID: 24100091 PMCID: PMC3806550 DOI: 10.2196/jmir.2851] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 08/29/2013] [Accepted: 09/15/2013] [Indexed: 11/21/2022] Open
Abstract
Background Mental health policy makers encourage the development of electronic decision aids to increase patient participation in medical decision making. Evidence is needed to determine whether these decision aids are helpful in clinical practice and whether they lead to increased patient involvement and better outcomes. Objective This study reports the outcome of a randomized controlled trial and process evaluation of a Web-based intervention to facilitate shared decision making for people with psychotic disorders. Methods The study was carried out in a Dutch mental health institution. Patients were recruited from 2 outpatient teams for patients with psychosis (N=250). Patients in the intervention condition (n=124) were provided an account to access a Web-based information and decision tool aimed to support patients in acquiring an overview of their needs and appropriate treatment options provided by their mental health care organization. Patients were given the opportunity to use the Web-based tool either on their own (at their home computer or at a computer of the service) or with the support of an assistant. Patients in the control group received care as usual (n=126). Half of the patients in the sample were patients experiencing a first episode of psychosis; the other half were patients with a chronic psychosis. Primary outcome was patient-perceived involvement in medical decision making, measured with the Combined Outcome Measure for Risk Communication and Treatment Decision-making Effectiveness (COMRADE). Process evaluation consisted of questionnaire-based surveys, open interviews, and researcher observation. Results In all, 73 patients completed the follow-up measurement and were included in the final analysis (response rate 29.2%). More than one-third (48/124, 38.7%) of the patients who were provided access to the Web-based decision aid used it, and most used its full functionality. No differences were found between the intervention and control conditions on perceived involvement in medical decision making (COMRADE satisfaction with communication: F1,68=0.422, P=.52; COMRADE confidence in decision: F1,67=0.086, P=.77). In addition, results of the process evaluation suggest that the intervention did not optimally fit in with routine practice of the participating teams. Conclusions The development of electronic decision aids to facilitate shared medical decision making is encouraged and many people with a psychotic disorder can work with them. This holds for both first-episode patients and long-term care patients, although the latter group might need more assistance. However, results of this paper could not support the assumption that the use of electronic decision aids increases patient involvement in medical decision making. This may be because of weak implementation of the study protocol and a low response rate. Trial Registration Dutch Trial Register (NTR) trial number: 10340; http://www.trialregister.nl/trialreg/admin/rctsearch.asp?Term=10340 (Archived by WebCite at http://www.webcitation.org/6Jj5umAeS).
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Affiliation(s)
- Lian van der Krieke
- University of Groningen, University Medical Center, University Center for Psychiatry, Groningen, Netherlands.
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Emerencia A, van der Krieke L, Sytema S, Petkov N, Aiello M. Generating personalized advice for schizophrenia patients. Artif Intell Med 2013; 58:23-36. [PMID: 23419698 DOI: 10.1016/j.artmed.2013.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 12/11/2012] [Accepted: 01/08/2013] [Indexed: 11/17/2022]
Abstract
UNLABELLED The results of routine patient assessments in psychiatric healthcare in the Northern Netherlands are primarily used to support clinicians. We developed Wegweis, a web-based advice platform, to make this data accessible and understandable for patients. OBJECTIVE We show that a fully automated explanation and interpretation of assessment results for schizophrenia patients, which prioritizes the information in the same way that a clinician would, is possible and is considered helpful and relevant by patients. The goal is not to replace the clinician but rather to function as a second perspective and to enable patient empowerment through knowledge. METHODS We have developed and implemented an ontology-based approach for selecting and ranking information for schizophrenia patients based on their routine assessment results. Our approach ranks information by severity of associated schizophrenia-related problems and uses an ontology to decouple problems from advice, which adds robustness to the system, because advice can be inferred for problems that have no exact match. RESULTS We created a problem ontology, validated by a group of experts, to combine and interpret the results of multiple schizophrenia-specific questionnaires. We designed and implemented a novel ontology-based algorithm for ranking and selecting advice, based on questionnaire answers. We designed, implemented, and illustrated Wegweis, a proof of concept for our algorithm, and, to the best of our knowledge, the first fully automated interpretation of assessment results for patients suffering from schizophrenia. We evaluated the system vis-à-vis the opinions of clinicians and patients in two experiments. For the task of identifying important problems based on MANSA questionnaires (the MANSA is a satisfaction questionnaire commonly used in schizophrenia assessments), our system corresponds to the opinion of clinicians 94% of the time for the first three problems and 72% of the time, overall. Patients find two out of the first three advice topics selected by the system to be relevant and roughly half of the advice topics overall. CONCLUSIONS Our findings suggest that an approach that uses problem severities to identify important problems for a patient corresponds closely to the way a clinician thinks. Furthermore, after applying a severity threshold, the majority of advice units selected by the system are considered relevant by the patients. Our findings pave the way for the development of systems that facilitate patient-centered care for chronic illnesses by automating the sharing of assessment results between patient and clinician.
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Affiliation(s)
- Ando Emerencia
- University of Groningen, Nijenborgh 9, 9747 AG Groningen, The Netherlands.
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van der Krieke L, Emerencia AC, Aiello M, Sytema S. Usability evaluation of a web-based support system for people with a schizophrenia diagnosis. J Med Internet Res 2012; 14:e24. [PMID: 22311883 PMCID: PMC3374538 DOI: 10.2196/jmir.1921] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 12/16/2011] [Accepted: 12/19/2011] [Indexed: 11/21/2022] Open
Abstract
Background Routine Outcome Monitoring (ROM) is a systematic way of assessing service users’ health conditions for the purpose of better aiding their care. ROM consists of various measures used to assess a service user’s physical, psychological, and social condition. While ROM is becoming increasingly important in the mental health care sector, one of its weaknesses is that ROM is not always sufficiently service user-oriented. First, clinicians tend to concentrate on those ROM results that provide information about clinical symptoms and functioning, whereas it has been suggested that a service user-oriented approach needs to focus on personal recovery. Second, service users have limited access to ROM results and they are often not equipped to interpret them. These problems need to be addressed, as access to resources and the opportunity to share decision making has been indicated as a prerequisite for service users to become a more equal partner in communication with their clinicians. Furthermore, shared decision making has been shown to improve the therapeutic alliance and to lead to better care. Objective Our aim is to build a web-based support system which makes ROM results more accessible to service users and to provide them with more concrete and personalized information about their functioning (ie, symptoms, housing, social contacts) that they can use to discuss treatment options with their clinician. In this study, we will report on the usability of the web-based support system for service users with schizophrenia. Methods First, we developed a prototype of a web-based support system in a multidisciplinary project team, including end-users. We then conducted a usability study of the support system consisting of (1) a heuristic evaluation, (2) a qualitative evaluation and (3) a quantitative evaluation. Results Fifteen service users with a schizophrenia diagnosis and four information and communication technology (ICT) experts participated in the study. The results show that people with a schizophrenia diagnosis were able to use the support system easily. Furthermore, the content of the advice generated by the support system was considered meaningful and supportive. Conclusions This study shows that the support system prototype has valuable potential to improve the ROM practice and it is worthwhile to further develop it into a more mature system. Furthermore, the results add to prior research into web applications for people with psychotic disorders, in that it shows that this group of end users can work with web-based and computer-based systems, despite the cognitive problems they experience.
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Affiliation(s)
- Lian van der Krieke
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
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Affiliation(s)
- Lian van der Krieke
- University Medical Center Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands.
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