Families in Assertive Community Treatment (ACT) Teams in Norway: A Cross-Sectional Study on Relatives’ Experiences of Involvement and Alienation

Abstract

International research shows that relatives of people with mental illness are rarely involved by mental health services. Assertive Community Treatment (ACT) has been recently implemented in Norway. The experience of relatives of ACT users is largely unknown. The aim of this study was to explore relatives' experience with ACT-teams in Norway. Data were collected using the family involvement and alienation questionnaire, consisting of experiences of approach, and alienation from the provision of professional care. 38 Relatives participated in this study. A majority experienced a positive approach (openness, confirmation, and cooperation) from the ACT teams, which also was considered better compared to previous services. They considered openness and cooperation as essential aspects from the professionals. Almost half did not feel alienated (powerlessness and social isolation). Higher level of being approached positively was significantly associated with lower level of feeling alienated. The knowledge of what constituted relatives' positive experiences with the ACT teams should be transferred into practice regarding how to form a positive alliance with relatives.

Adaptation and evaluation of the Family Involvement and Alienation Questionnaire for use in the care of older people, psychiatric care, palliative care and diabetes care

“…Previous studies where the FIAQ was used indicate that a higher level of the experience of being approached positively is associated with a lower level of feelings of alienation and vice versa (Ewertzon et al., ; Weimand, Israel, & Ewertzon, ). This result is in accordance with the theoretical frameworks described above.…”

Family Members’ Experiences with the Healthcare Professionals in Nursing Homes – A Survey Study

“…The assessments in the FIAQ-R are subjective and the data consists of ordered categories. As in previous studies using the FIAQ or the FIAQ-R [10][11][12][17][18][19] data were analyzed using rank-based, non-parametric statistical methods. 20 The median level (Md) and quartiles (Q 1 ;Q 3 ) were used to describe the response profiles.…”

“…This concept has been studied among family members in the context of psychiatric care. [10][11][12] These studies showed that being approached positively by the health care professionals was associated with a lower level of feeling of alienation. To our knowledge, there has been no research concerning alienation among family members in the context of the care of older people.…”

“…This is contrary to studies performed in the context of psychiatric care, which show higher levels of alienation. [10][11][12] This could be due to the compulsory nature of the care, 10 and also the patient not always wanting the family to be involved. 25 Such a situation can lead to dilemmas in the healthcare professionals' meetings with the family members.…”

Navigating in a Misty Landscape – Perceptions of Supporting a Relative Residing in Supported Housing for People with a Psychiatric Disability

“…Family members' views on the opportunities for meaningful activity in the SH context could therefore be important for identifying possible limitations in this aspect of housing support and generating ideas as to how to improve the support. The perceptions of family members can be used to form a positive alliance between the family members and the staff, which may in turn benefit the residents (Weimand et al, 2018).…”