Conceptualising and measuring the well-being of people with psychosis: Systematic review and narrative synthesis

Schrank, Beate; Bird, Victoria; Tylee, André; Coggins, Tony; Rashid, Tayyab; Slade, Mike

doi:10.1016/j.socscimed.2013.05.011

Cited by 61 publications

(63 citation statements)

References 55 publications

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“…Well-being has been less clearly defined. 54 A recent review of well-being 55 proposed 'a new definition of wellbeing as the balance point between an individual's resource pool and the challenges faced' (p. 230). Resources and challenges referred to the psychological, social and physical.…”

Section: Health and Well-beingmentioning

confidence: 99%

Improving community health networks for people with severe mental illness: a case study investigation

Pinfold

Sweet

Porter³

et al. 2015

Health Services and Delivery Research

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IntroductionPolicy drivers in mental health to address personal recovery, stigma and poor physical health indicate that new service solutions are required. This study aimed to understand how connections to people, places and activities were utilised by individuals with severe mental illness (SMI) to benefit health and wellbeing.MethodsA five-module mixed-methods design was undertaken in two study sites. Data were collected from 150 network-mapping interviews and 41 in-depth follow-up interviews with people with SMI; in-depth interviews with 30 organisation stakeholders and 12 organisation leaders; and 44 telephone interviews with practitioners. We undertook a three-stage synthesis process including independent lived experience feedback, and a patient and public involvement team participated in tool design, data collection, analysis and write-up.ResultsThree personal network types were found in our study using the community health network approach: diverse and active; family and stable; formal and sparse. Controlled for other factors we found only four variables significantly associated with which network type a participant had: living alone or not; housing status; formal education; long-term sickness or disability. Diagnosis was not a factor. These variables are challenging to address but they do point to potential for network change. The qualitative interviews with people with SMI provided further understanding of connection-building and resource utilisation. We explored individual agency across each network type, and identified recognition of the importance and value of social support and active connection management alongside the risks of isolation, even for those most affected by mental illness. We identified tensions in personal networks, be that relationships with practitioners or families, dealing with the impact of stigma, or frustrations of not being in employment, which all impact on network resources and well-being. The value of connectedness within personal networks of people, place and activity for supporting recovery was evident in shaping identity, providing meaning to life and sense of belonging, gaining access to new resources, structuring routines and helping individuals ‘move on’ in their recovery journey.Health-care practitioners recognised that social factors were important in recovery but reported system-level barriers (workload, administrative bureaucracy, limited contact time with clients) in addressing these issues fully. Even practitioners working in third-sector services whose remit involved increasing clients’ social connection faced restrictions due to being evaluated by outcome criteria that limited holistic recovery-focused practices. Service providers were keen to promote recovery-focused approaches. We found contrasts between recovery ideology within mental health policy and recovery practice on the ground. In particular, the social aspects of supporting people with SMI are often underprioritised in the health-care system. In a demanding and changing context, strategic multiagency working was seen as crucial but we found few examples of embedded multisector organisation partnerships.ConclusionWhile our exploratory study has limitations, findings suggest potential for people with SMI to be supported to become more active managers of their personal networks to support well-being regardless of current network type. The health and social care system does not currently deliver multiagency integrated solutions to support SMI and social recovery.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Health and Well-beingmentioning

confidence: 99%

Improving community health networks for people with severe mental illness: a case study investigation

Pinfold

Sweet

Porter³

et al. 2015

Health Services and Delivery Research

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“…Th e shift from objectivity to subjectivity has led well-being, adherence, and QoL to become key concepts in the treatment of psychotic disorders (Schrank et al 2013).…”

Section: Lai Antipsychotic Treatment From the Insidementioning

confidence: 99%

The effects of switching from oral to LAI antipsychotic treatment on subjective experience of schizophrenic and schizoaffective patients: Preliminary results

Pietrini

Spadafora

Talamba

et al. 2015

International Journal of Psychiatry in Clinical Practice

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“…The costs and benefits for both patients and clinicians following such a re-orientation would need investigation. More generally, the issue of how decisions are made is a proxy indicator for broader debates about the core purpose of mental health systems (43), and the implications of an orientation towards recovery (44) and well-being (45).…”

Section: Clinical and Research Implicationsmentioning

confidence: 99%

Empowerment and satisfaction in a multinational study of routine clinical practice

Clarke

Puschner

Jordan

et al. 2014

Acta Psychiatr Scand

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Mike (2015) Empowerment and satisfaction in a multinational study of routine clinical practice. Acta Psychiatrica Scandinavica, 131 (5). pp. 369-378. ISSN 1600-0447Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/34260/1/AFD%20APS%20CEDAR%20Empowerment %20and%20satisfaction.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the University of Nottingham End User licence and may be reused according to the conditions of the licence. For more details see: http://eprints.nottingham.ac.uk/end_user_agreement.pdf A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. We tested whether mental health patients are more satisfied with a decision made (a) using their preferred decision-making style and (b) with a clinician with the same decision-making style preference. MethodAs part of the CEDAR Study (ISRCTN75841675), a convenience sample of 445 patients with severe mental illness from six European countries were assessed for desired clinical decision-making style (rated by patients and paired clinicians), decision-specific experienced style and satisfaction. ResultsPatients who experienced more involvement in decision-making than they desired rated higher satisfaction (OR=2.47, p=0.005, 95%CI 1.32 to 4.63). Decisions made with clinicians whose decision-making style preference was for more active involvement than the patient preference were rated with higher satisfaction (OR=3.17, p=0.003, 95%CI 1.48 to 6.82). ConclusionMore active involvement in decision-making than the patient stated as desired was associated with higher satisfaction. A clinical orientation towards empowering, rather than shared, decision-making may maximise satisfaction. KeywordsDecision Making, Mental Health 3. The extent to which the decision topic impacted on preference and agreement is unknown.4

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Conceptualising and measuring the well-being of people with psychosis: Systematic review and narrative synthesis

Cited by 61 publications

References 55 publications

Improving community health networks for people with severe mental illness: a case study investigation

Improving community health networks for people with severe mental illness: a case study investigation

The effects of switching from oral to LAI antipsychotic treatment on subjective experience of schizophrenic and schizoaffective patients: Preliminary results

Empowerment and satisfaction in a multinational study of routine clinical practice

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