Recovery-oriented nursing service for people with schizophrenia in the community: An integrative review

Thongsalab, Jutharat; Yunibhand, Jintana; Uthis, Penpaktr

doi:10.33546/bnj.2632

Cited by 3 publications

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“…The complex relationship between hospitalisation and personal recovery underscores the need for a nuanced understanding, considering factors like remission and relapse. 28 Interestingly, while cognitive insight and social support showed a moderately positive correlation with personal recovery, neither of them emerged as significantly associated factors in the multinomial logistic model. This suggests that their influence may be less critical in differentiating specific recovery stages, especially within the Thai community setting.…”

Section: Main Findingsmentioning

confidence: 87%

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Navigating personal recovery: multinomial logistic regression analysis of schizophrenia outcomes in community-dwelling individuals

Thongsalab,

Yunibhand,

Uthis

2024

Gen Psych

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BackgroundSchizophrenia is a chronic mental disorder affecting individuals globally, emphasising the significance of personal recovery in mental healthcare. Understanding the recovery stages and the associated factors can provide essential insights for targeted interventions.AimsThis study aimed to discern the stages of personal recovery in Thai patients with schizophrenia and elucidate the associated factors with each stage.MethodsA multistage sampling technique was employed, selecting 231 patients with schizophrenia from mental health outpatient departments of general and psychiatric hospitals. Data collected from March to May 2023 included screening for psychotic symptoms using the Brief Psychiatric Rating Scale and six self-report questionnaires—Stage of Recovery Scale, Beck Cognitive Insight Scale, Brief Resilience Scale, Family Support, Therapeutic Relationship-Patients Version and Social Support Questionnaire—along with personal data sheets. Pearson correlation and multinomial logistic regression were performed.ResultsThe predominant personal recovery stage among participants was stage 3, ‘living with disabilities’, comprising 42.4% of the participants. Key factors contributing to personal recovery, explaining approximately 38.4% of the variance, included resilience, family support, therapeutic alliance, hospitalisations since onset and recovery-oriented nursing service utilisation. Logit equations for stages 3 and 4 are as follows: stage 3 (living with disability): logit=−4.44+0.74×resilience+0.07×therapeutic alliance+0.02×recovery-oriented nursing service utilisation; stage 4 (living beyond disability): logit=−11.57–0.05×hospitalisation since onset+1.96×resilience+0.11×family support+0.06×therapeutic alliance.ConclusionThe findings emphasise the significance of mental health nursing interventions. In conjunction with recovery-oriented nursing services, strengthening resilience, therapeutic alliances and family support may accelerate personal recovery and reduce hospitalisations among individuals with schizophrenia.

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Section: Main Findingsmentioning

confidence: 87%

“…The complex relationship between hospitalisation and personal recovery underscores the need for a nuanced understanding, considering factors like remission and relapse. 28 …”

Section: Discussionmentioning

confidence: 99%

Navigating personal recovery: multinomial logistic regression analysis of schizophrenia outcomes in community-dwelling individuals

Thongsalab,

Yunibhand,

Uthis

2024

Gen Psych

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Effective provider communication for personal agency in mental health recovery: A cross‐sectional study on Japanese users' perspectives

Okumura,

Katsuki

2024

Psychiatric Ment Health Nurs

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Accessible summaryWhat is known on the subject? Recovery‐oriented practices in community‐based mental health services are of increasing importance. The recovery journey of individuals with mental illness starts with a sense of agency, and a therapeutic relationship with the providers who support them is a prerequisite. In Japan, the construction of community‐based integrated care systems for individuals with mental illness is positioned as a priority health issue, with communication with familiar individuals being particularly important for recovery in Japanese and Asian cultures. What the paper adds to existing knowledge? This study is the first to examine effective communication factors for personal agency in the recovery of individuals with mental illness, focusing on addressing uncertainty about treatment choices and dissatisfaction with decision‐making, and considering the user's personal recovery journey. In recovery‐oriented practice, it is important to prioritize addressing the emotional aspects of decision‐making alongside the mental illness condition, supporting users' self‐determination in their unique recovery journeys. What are the implications for practice? The findings emphasized the need to actively engage with users' perspectives and emotions, emphasize shared life planning, and foster a therapeutic relationship based on partnership. Providers should approach dialogue as carefully as medication prescriptions, prioritizing the establishment of an effective therapeutic relationship with the user. These characteristics are essential for developing a strong therapeutic relationship and effectively facilitating users' recovery. The findings are applicable not only to nurses but to all mental health service providers, contributing to the advancement of recovery‐oriented practice. AbstractIntroductionRecovery‐oriented practice in community‐based mental health services is crucial for individuals with mental illness, with communication with familiar individuals being important for recovery in Japanese and Asian cultures.AimThis study aimed to examine effective communication factors for personal agency in recovery by investigating the association between perceived support provided through communication and personal agency of individuals with mental illness.MethodA cross‐sectional study was conducted among community‐dwelling Japanese mental health service users, assessing subjective agency, decisional conflict, staff support for personal recovery, activation for mental health self‐management, demographic variables and living difficulties. Multiple linear regression analysis identified factors predicting subjective agency, revealing characteristics of effective provider communication for recovery.ResultsData from 222 users were analysed, revealing negative correlations between uncertainty about treatment choices and ineffective decision‐making with higher subjective agency, while staff support for personal recovery positively correlated with higher subjective agency.DiscussionIn recovery‐oriented practice, prioritizing users' emotional experiences during decision‐making and supporting their self‐determination in their unique recovery journeys is crucial.Implications for PracticeProviders should approach dialogue as carefully as medication prescriptions, prioritizing therapeutic partnerships with users. The findings extend beyond nursing to all mental health service providers, advancing the theory of recovery‐oriented practice.

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Application of International Classification of Functioning, Vital Disabilities and Health to assess the effectiveness of rehabilitation in a psychiatric hospital

Petrova,

Vishnyakova,

Kalinina

2024

Medical and Social Expert Evaluation and Rehabilitation

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BACKGROUND: The International Classification of Functioning, Disability and Health ICF is an important tool for planning, implementing and evaluating the effectiveness of the rehabilitation process. In addition, the use of the ICF makes it possible to objectify the level of quality of medical care. However, this classification is not quite enough used in practice still, including psychiatric practice, where (due to the specifics of these patients) a certain adaptation is required (in terms of choosing the set of the most informative domains). AIM: To evaluate the effectiveness of the rehabilitation of patients with mental disorders based on the use of the ICF. MATERIALS AND METHODS: Using data from case histories and special questionnaires, 500 patients of the psychiatric hospital were studied — a number of domains included in the ICF were identified and analyzed (domains characterizing “body functions”, “activity and participation”, “environmental factors”): upon admission, on 10th day of treatment, upon discharge. The study was conducted for 6 months by an all-over method. The exclusion criteria were: age under 18 and over 80; the presence of acute psychotic symptoms at the time of examination; the presence of severe cognitive dysfunctions that prevent the assessment of functional limitations, vital activity and health; duration of hospitalization less than 10 days. Statistical analysis of the collected material was carried out using application programs in Microsoft Office Excel.10. RESULTS: Among the examined patients, women accounted for 52.6% (263 people). In the age structure, 30.8% (154 people) were patients under 30 years of age; 24.2% (121 people) — 30–39 years old; 13.2% (96 people) — 40–49 years old; 12.8% (64 people) are 50–59 years old and 13.0% (65 people) are 60 years old and older. Average age — 39.5±0.6 years. In the nosological structure, 16.8% (84 people) were patients with organic mental disorders; 12.8% (64 people) — with mental and behavioral disorders associated with the use of psychoactive substances; 19.8% (99 people) — with schizophrenia, schizotypal and delusional disorders; 16.2% (81 people) — with mood disorders; 17.0% (85 people) — with stress-related neurotic disorders and somatoform disorders; 17.4% (87 people) with personality and behavior disorders in adulthood. Upon admission, the following disorders were the most pronounced: mental stability (which occurred in 80.6% of patients — 403 people); regulation of emotions — 390 people (78.0%); control of impulsive impulses — 382 people (76.4%); stability of attention — 388 people (77.6%); switching of attention — 376 people (75.2%); separation of attention — 374 people (74.8%); concentration of attention — 371 people (74.2%); psychomotor control — 354 people (70.8%). During the treatment, the prevalence of all identified disorders significantly decreased (differences in the proportion of patients with various disorders upon admission — on 10th day of treatment — upon discharge are statistically significant with a reliability of more than 95.5%). CONCLUSION: This dynamic proves the effectiveness of rehabilitation in general and the importance of nursing intervention in particular.

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Recovery-oriented nursing service for people with schizophrenia in the community: An integrative review

Cited by 3 publications

References 69 publications

Navigating personal recovery: multinomial logistic regression analysis of schizophrenia outcomes in community-dwelling individuals

Navigating personal recovery: multinomial logistic regression analysis of schizophrenia outcomes in community-dwelling individuals

Effective provider communication for personal agency in mental health recovery: A cross‐sectional study on Japanese users' perspectives

Application of International Classification of Functioning, Vital Disabilities and Health to assess the effectiveness of rehabilitation in a psychiatric hospital

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