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1
Bibby, Paul. "Experiences of recovery in mental illness." Thesis, University of Edinburgh, 2009. http://hdl.handle.net/1842/4104.
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Introduction In recent years the concept of ‘recovery’ has become increasingly prevalent in both government and health service policy, and in the terminology used by mental health service users. The current study examines the experiences of recovery as described by service users living in a rural / semi-rural population. This is in contrast to the majority of similar studies, which have tended to focus on urban centres where population characteristics, and the services available to service users, differ in many ways. As such, the aim of the current study was to add to the growing theory regarding what constitutes recovery from the viewpoint of service users living in a relatively remote area of the UK. Methodology Eight adult participants, all of whom defined themselves as either recovering or having recovered from significant mental health problems, were interviewed about their experiences using a semi-structured interview. Interviews were audio-recorded, transcribed and analysed for emerging themes using a social constructionist version of Grounded Theory. Data Analysis & Discussion Analysis revealed a consistent set of themes emerging from the participant interviews. These are encapsulated in the concept of reflection and integration, and the dynamic nature of these phenomena over time. Participants made reference to the nature of their problems and the impact they had on relationships, the treatment they had sought and received, and the effects of their experiences on their notions of themselves as individuals. Conclusions The findings of the current study are discussed in the light of existing relevant literature and in relation to current policy initiatives. Comparisons to the emerging theory regarding recovery are drawn, and distinctions made between the existing theory and the findings which appear to be particularly pertinent to the sample population. Suggestions for clinical applications are made. Limitations of the study are also addressed, and areas for potential further research are outlined.
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Yates, Bernice Helen. "Illness demands and social support during recovery from a cardiac illness event /." Thesis, Connect to this title online; UW restricted, 1989. http://hdl.handle.net/1773/7268.
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Scott, A. I. F. "Recovery from depressive illness after electroconvulsive therapy." Thesis, University of Edinburgh, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.661691.
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Experiment One Plasma concentrations of oxytocin-associated neurophysin and prolactin were measured before and after the first treatment in a course of electro- convulsive therapy (ECT) given to 25 depressed patients. Plasma neurophysin concentration was measured by the radioimmunoassay (RIA) of Robinson (1975). The percentage peak increase in plasma neurophysin concentration was three times greater (p < 0.001) in the 16 depressed patients who had a good outcome two months after the last ECT compared with the nine who did not. The rise in plasma neurophysin concentration correlated (rho = 0.46, p < 0.05) with improvement in symptoms measured by the Hamilton Rating Scale for Depreseion (HRSD). There was no difference in the percentage peak increase in plasma prolactin concentration between patients who had a good outcome two months after the last ECT and those who did not. The rise in plasma prolactin concentration did not correlate with improvement in HRSD score. Experiment Two Serum concentrations of the vasopressin- (nHpI) and oxytocin-associated neurophysins (hNpII) were measured by the RIA of Legros et al. (1969) before and after the first ECT in a course of treatment given to 19 unipolar depressed patients. The percentage peak increase in nHpII was four times greater (p < 0.001) in the six patients who had a good outcome two months after the last ECT than in the patients who had a poor outcome. The rise in serum hNpII correlated with improvement in HRSD score (r = 0.50, p < 0.05) and improvement in score on the Montgomery and Asberg Depression Rating Scale (r = 0.47, p < 0.05). The rise in serum nHpI concentration did not correlate with improvement. There were no significant correlations between spikewave activity or total seizure activity measured by a six-channel electroencephalogram (EEG) and the rise in either of the neurophysins. Experiment Three Serum concentrations of the nHpI and nHpII were measured at the first and last treatments in a course of ECT given to 17 unipolar depressed patients (seven of whom also took part in Experiment Two). There were no significant differences in the average release of either neurophysin between the first and last treatments. There were no significant correlations between alterations in the release of the neurophysins between the first and last treatments and improvement in symptoms of depression. Conclusions Although there is a correlation between the release of hNpII after the first ECT and improvement in symptoms of depressive illness, the correlation is not sufficiently close to be of clinical utility in the prediction of ECT outcome. The reason for the correlation is not known. There was no support for the hypothesis that the release of nHpII was a correlate of cerebral seizure activity. The release of nHpII may be a sensitive measure of electrical stimulation in the midbrain or may occur at the same time as the release of a neurotransmitter with mood-regulating activity.
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Sapochnik, Manuela. "Illness perceptions and recovery style in schizophrenia." Thesis, University College London (University of London), 2005. http://discovery.ucl.ac.uk/1446771/.
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The literature review focuses on the perceptions and beliefs that individuals with schizophrenia hold about their illness, and how these may relate to outcome. The literature regarding Illness Perception in general, and Recovery Style in particular, illustrates how Health Psychology-based models may be useful in terms of understanding illness behaviour. The review concludes that this may well be a fruitful area for the development of theory-driven interventions to improve individuals' quality of life after a diagnosis of schizophrenia. The empirical paper reports a cross-sectional study investigating whether Illness Perceptions and Recovery Style are related to impairment or quality of life in a sample with relatively chronic schizophrenia. The main findings were that a more Integrating Recovery Style was associated with better outcome in all domains and that Illness Perceptions of greater coherence of the illness experience, and less emotional distress were associated with both better quality of life and a more Integrating Recovery Style. The critical review addresses the main topics of the clinical, practical and scientific implications of the findings of the empirical paper and attempts to link the findings to related areas of research such as models of trauma and attachment, in order understand the meaning of the findings in the context of this particular illness.
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Farrell, Kathleen M. "SELF-STIGMATIZATION AND RECOVERY FROM MENTAL ILLNESS." University of Cincinnati / OhioLINK, 2001. http://rave.ohiolink.edu/etdc/view?acc_num=ucin984583293.
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Andresen, Retta. "The experience of recovery from schizophrenia development of a definition, model and measure of recovery /." Access electronically, 2007. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20080703.161126/index.html.
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Landeen, Janet. "Recovery in schizophrenia, hope, self-efficacy, and illness intrusiveness." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0025/NQ49956.pdf.
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YANGARBER-HICKS, NATALIA ISAACOVNA. "RELIGIOUS COPING STYLES AND RECOVERY FROM SERIOUS MENTAL ILLNESS." University of Cincinnati / OhioLINK, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1021898649.
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Cherrington, Candace C. "Illness representation after Acute Myocardial Infarction : impact on recovery /." The Ohio State University, 2001. http://rave.ohiolink.edu/etdc/view?acc_num=osu1488204276530951.
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Gandhi, Trishna. "The role of illness representations in recovery from cardiovascular disease." Thesis, University of Sheffield, 2015. http://etheses.whiterose.ac.uk/9637/.
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This thesis aimed to explore the use of the Common Sense Model (Levanthal, 1980) in cardiovascular populations. The literature review critically evaluates the application of clinical interventions developed using the Common Sense Model (CSM), in a cardiovascular disease population. The research report used a cross-sectional design to investigate the relationship between illness representations using the CSM, coping, and psychological and functional outcomes in a post-stroke population.
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Stainsby, M. A. "Illness perceptions and recovery style in schizophrenia : a longitudinal study." Thesis, University College London (University of London), 2007. http://discovery.ucl.ac.uk/1446122/.
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Approaches to the study and treatment of schizophrenia can be classified according to their views of 'recovery', for example what it means and how likely it is to occur. A further source of difference relates to the level at which these approaches focus e.g. the mfrapersonal or mterpersonal. It is proposed that combining these provides a useful two-dimensional space in which to map out such approaches. This is illustrated in the first section using models of change in schizophrenia, which are summarized before being drawn out. In the second section, empirical data pertaining to the meaning of recovery and level of analysis in schizophrenia is reviewed and then related back to the various models of change. It is concluded that no one model of change or definition of recovery holds sway, but that instead each may have value according to the conditions that are most limiting for a particular individual e.g. symptoms, social disadvantages, or protective factors. Moreover, as these conditions change, so may the model of change or definition of recovery that it is most useful to use.
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Quenneville, Brenda. "Walking Recovery Talk : Mental Health Organizational Change." Thesis, Laurentian University of Sudbury, 2014. https://zone.biblio.laurentian.ca/dspace/handle/10219/2180.
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The full experience of mental illness cannot be described in isolation from the context in which one lives, yet the internal physical manifestation of symptoms has been the focus of treatment in western cultures. The “recovery” paradigm is emerging as best-practice philosophy for mental health practice and represents a significant departure from existing standards thereby challenging mental health organizations to re-negotiate their relationship with the dominant bio-medical model. Despite the growing acceptance of recovery philosophy, literature exploring large-scale recovery-oriented organizational change is sparse. The purpose of this research was twofold; 1) to outline the steps taken by change agents within an organization embarking on recovery organizational change, and 2) to understand the experience, including successes and challenges associated with change. The qualitative data obtained from interviewing seventeen participants revealed the impact of organizational contextual factors, leadership and communication on recovery organizational change. Further, the data exposed the complexity of challenging preconceptions and practice when trying to adopt recovery approaches. The findings may guide other community based mental health organizations in their recovery journey.
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Harvey, Megan E. "Mental Health Service Provider Knowledge, Attitudes and Competencies Regarding Recovery From Serious Mental Illness." University of Cincinnati / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1147840868.
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Adame, Alexandra Lynne. "Recovered voices, recovered lives a narrative analysis of psychiatric survivors' experiences of recovery /." Oxford, Ohio : Miami University, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1152813614.
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Benn, Lisa. "Psychological recovery following coronary angioplasty : illness cognitions, coping and well-being." Thesis, University of Leicester, 2006. http://hdl.handle.net/2381/7936.
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Aim: To investigate the nature of psychological adjustment following angioplasty and to assess the relative contributions of illness cognitions and coping in the context of the Self-Regulation Model (Leventhal, Meyer & Nerenz, 1980). Design: A longitudinal, prospective within-groups, multi-factorial study. Method: 120 participants were recruited from an opportunity sample of patients approached during admission to the Manchester Heart Centre for angioplasty. Questionnaires addressing illness beliefs, coping and psychological outcomes were presented at two time points; during admission and three months post-procedure. Results: Analysis revealed that angioplasty is followed by clinically and statistically significant psychological gains. Perceptions of the illness as serious, and having a cyclical time-course, together with a general difficulty in making sense of the illness, were associated with increased anxiety at the time of treatment, and in most cases also at three months. Higher levels of emotional representation were also strongly associated with anxiety and quality of life outcomes at both time points. Problem-focused and maladaptive coping also showed associations with psychological outcome at treatment and at three months. Illness beliefs were demonstrated to significantly predict psychological well-being, explaining a substantial proportion of variance, with emotional representation the strongest independent predictor. Coping was not found to mediate the relationship between illness beliefs, and psychological distress and quality of life. Conclusion: This research has demonstrated the utility of illness beliefs, and to an extent the Self Regulation Model in predicting psychological outcome in angioplasty. Cognitive factors may therefore serve as useful clinical indicators to help identity those patients at greatest risk of impaired recovery, which in the future may enable targeting with further support, and evidence permitting, psychological interventions. [Abstract taken from Section B: Research Report (Option 1)]
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Allen, Jodie Toni. "Reading the eating disorder memoir : negotiating identity in illness and recovery." Thesis, University of Cambridge, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.607978.
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Leith, Jaclyn E. "Recovery and Transformations from Loss in Adults with Serious Mental Illness." Bowling Green State University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1404701821.
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Bowen, Jennifer Anne. "Patients' perceptions of factors that affect recovery from illness in hospital." Thesis, Swansea University, 2009. https://cronfa.swan.ac.uk/Record/cronfa43075.
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Murphy, K. "Recovery-orientation in mental health services." Thesis, Canterbury Christ Church University, 2012. http://create.canterbury.ac.uk/11184/.
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Policy initiatives are calling for mental health services to change their ways of working to prioritising the promotion of service users’ personal recovery. This requires a major re-negotiation of working practices and the relationship between service users and staff/services and their respective social positions. Preliminary research has shown that change has been problematic. The present study aimed to explore the construction of recovery and the positioning of service users and staff during the adoption of recovery-oriented practices in a community support and recovery team. Transcripts of two rounds of focus groups with service users (n=9) and staff (n=5) held six months apart, service user care plans and Recovery Star notes were analysed using a Foucauldian Discourse Analysis. The study found that recovery was constructed as clinical/medical and personal recovery, at different times and in tension with each other. These constructions positioned service users as dependent, passive and hopeless or empowered and hopeful, and staff as helpless or facilitative. It was also apparent that a discourse of personal recovery was not available to service users. Staff oscillated between the constructions of recovery as medical and personal resulting in different subject positions and opportunities for action. The study concluded that adopting a recovery-orientation in services should lead to service users being positioned as more influential in decisions about their treatment and modes of support from the service, and services less likely to dictate their treatment. However, this can only happen if the recovery-orientation constitutes a widely shared discourse with all its assumptions and associated practices. The problematic aspects of the medical discourse and how it can position people socially and how those positions impact on the potential for personal recovery needs to be highlighted.
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Walby, Gary W. "Associations between individual, social, and service factors, recovery expectations and recovery strategies for individuals with mental illness." [Tampa, Fla.] : University of South Florida, 2006. http://purl.fcla.edu/usf/dc/et/SFE0002203.
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Tuffour, Isaac. "Black African service users experiences of recovery from mental illness in England." Thesis, City, University of London, 2017. http://openaccess.city.ac.uk/18096/.
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Background: Recovery is a complex and contested concept. Many studies have explored the meaning of the concept from the perspectives of service users suffering from mental illness. However, too little attention has been paid to the experiences of Black African service users (BASUs) living in England. At the time of writing this work there were no studies that have explored recovery from the perspectives of BASUs in England. Aims of the study: The aim of the present study is to explore experiences of recovery from mental illness of BASUs in England. Methodology and methods: Semi-structured interviews were conducted with twelve BASUs. The interviews were analysed using Interpretative Phenomenological Analysis (IPA). Findings: Five superordinate themes were derived from the analysis: (1) it is different in Africa; (2) it all started in England; (3) shattered; 4) ‘freaked out’; and (5) focus on recovery. An in-depth explanation of these superordinate themes and the related subordinate themes is presented. The findings highlight the multifaceted ways in which BASUs understand their experiences of mental illness and recovery. Discussion: The insight gained from these findings provided rich information about the complexities of the participants’ experiences of recovery from mental illness. Participants’ explanatory models of mental illness included the complexities of migration, African-centred worldviews and negative life experiences. Participants conceptualised recovery in the context of their social and cultural backgrounds, remission or eradication of symptoms, spirituality, resourcefulness, resilience and unique personal identities. An emerging conceptual model of recovery is formed (Figure 3). Findings are discussed considering existing theory and literature. Implications for clinical practice in relation to the provision of care and promoting recovery for BASUs in England are considered.
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Flannery, Halina. "Lay perceptions of illness and recovery for physical and mental health difficulties." Thesis, University of Surrey, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.658862.
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Objective: This study aimed to explore illness representations and attitudes about personal recovery in physical and mental health conditions in a lay sample. Design: 263 participants took part in an experimental study using vignettes describing the symptoms of four conditions: depression, schizophrenia, psoriasis and Type 1 diabetes. The within group factor was condition type (physical and mental health). The between groups factor was duration of symptoms (two weeks/ 'acute' or one year/ 'chronic'). Measures: Participants completed the lllness Perception Questionnaire - Revised for Healthy Individuals (Figueiras & Alves, 2007) and questions regarding their attitudes about the importance of personal attributes, such as optimism and resilience, in recovery (,personal recovery'). Results: The inter-relationship of illness representations followed some of the general patterns found in previous research. Participants attributed mental health vignettes to more psychosocial causes and placed more importance on personal recovery than they did for physical health vignettes, although there were some interaction effects of chronicity. Personal recovery attitudes positively correlated with psychosocial causes in all conditions and perceived personal control in all conditions except diabetes. Conclusion: Preliminary evidence was found that lay attitudes about personal attributes being important for recovery was more endorsed in mental health than physical health conditions and was related to perceptions of personal control and psychosocial causes of illness.
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Anthony, Kathleen Hope. "Exploring Helper and Consumer Partnerships That Facilitate Recovery From Severe Mental Illness." Bowling Green State University / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1131125531.
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Shanahan, Patricia. "Pathways to employment for people in the recovery phase of mental illness." Thesis, Middlesex University, 2015. http://eprints.mdx.ac.uk/18499/.
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The study sought to identify through the action research process what local employers concerns were in relation to the employment of individuals in a phase of recovery from mental illness. The barriers to employment experienced by service users living in a North London Borough were also explored. The study aimed to gain an in-depth understanding of the reluctance by employers to employ individuals with a known mental illness who are in a phase of recovery. It also sought to hear about the lived experiences and perspectives on the barriers experienced to accessing or being in employment from a service user’s perspective. There is limited literature examining this area within this North London Borough. This qualitative study was informed by my professional background where I hold a dual role of managing mental health services in the community and as a lecturer in Cognitive Behavioural Therapy at Middlesex University. Both roles are concerned with promoting the mental health well-being of individuals who experience mental illness. The study adopted an action research design, where six focus groups were held, three with service users and three with employers or employer representatives within a North London Borough.16 employer representatives and 28 service users participated across the six focus groups. The data gathered from each focus group was digitally recorded and transcribed verbatim. Thematic analysis was used to identify the main themes and subsequent sub –themes from the data gathered. The findings from the research indicate that there are many stakeholders that are involved in supporting individuals back into employment. They also show that mental health and mental ill health are poorly understood in workplace environments. Evidence from this study indicated that while work and employment were thought by both participant types to be important determinants of mental health those individuals with diagnosed mental illnesses remain at a significant disadvantage in the employment market. This points to a need for developments that educate employers, employees and various other stake-holders involved in the employment process on mental health and mental illness in the work- place environment. The main contribution of this research is that of a support and educational package for employers and employees, which has core content but will change in its focus depending on the audience it is being delivered to.
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Netto, Julie Ann. "Vocational recovery in mental illness - the gap between policy and person-centredness." Thesis, Curtin University, 2013. http://hdl.handle.net/20.500.11937/901.
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Vocation has been described as a calling and a means of fulfilment; and personal recovery as the process of living life as well as possible. Vocational recovery can be envisaged as a person with mental illness regaining or establishing valued roles associated with vocation as it is broadly defined. This thesis explores how people with mental illness establish and achieve their vocational recovery goals within the context of complex and ever-changing policy and service settings.
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Stuart, Simon Robertson. "Exploring recovery from severe and enduring mental illness using qualitative methods : a portfolio thesis." Thesis, University of Edinburgh, 2015. http://hdl.handle.net/1842/28695.
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This thesis offers a critical consideration of the recovery approach to severe and enduring mental-health problems (Roberts & Boardman, 2013; Anthony, 1993), with the primary-research element focused on recovery after forensic secure care. A systematic review of qualitative research into recovery processes was conducted, using best-fit framework synthesis as a method of analysis (chapter 2). An expansion of the CHIME recovery model (Leamy et al., 2011) is proposed, in which the difficulties experienced by service users are more prominently considered. Chapters 3 and 4 report an investigation of the barriers to recovery perceived by people discharged from forensic secure care, using interpretative phenomenological analysis as a method (Smith et al., 2009). Eight participants were interviewed, and five superordinate themes are proposed: living in the shadow of the past, power imbalances, security and care, reconfigured relationships, and ‘recovery’ as a barrier to recovery. The final chapter of the portfolio is a shorter reflective paper considering the wider context of the work.
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Merriweather, Judith Lorna. "Exploration of the factors that influence nutritional recovery following critical illness : a mixed methods study." Thesis, University of Edinburgh, 2014. http://hdl.handle.net/1842/9571.
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Survivors of critical illness suffer from a range of problems affecting physical, psychological and social well-being (Needham et al 2011). Weakness, fatigue and malnutrition are highly prevalent during the months following a critical illness. Few studies have systematically and comprehensively explored the factors that influence nutritional recovery or ways to overcome them. The aim of this study was to provide a comprehensive understanding of the factors influencing nutritional recovery, and the relationship between them, in post intensive care (ICU) patients. A model of care was then developed to improve current management of nutrition for patients recovering from critical illness. Grounded theory methodology was used with a mixed method research design. Nutritional status and intake were assessed on discharge from ICU and at three months post ICU discharge. The process of nutritional recovery during the first three months post ICU discharge was explored from a patient perspective and at the level of ward organisation of care, through observation of practice and interviewing patients and staff. Seventeen patients, who had required greater than 48 hours ventilation, were recruited on discharge from the ICU. On transfer to the ward 9 of the 17 patients were assessed as well-nourished and 8 were malnourished using Subjective Global Assessment. At three months post ICU discharge 14 patients were followed up (1 lost to follow up, 1 incapacitated following illness and 1 went overseas). Seven of these were classified as well-nourished and the other 7 were malnourished. Patients universally failed to meet their nutritional targets during their ward stay and although intakes had improved by three months post ICU discharge, the majority of patients were still not achieving their nutritional requirements. Qualitative data revealed that patients' nutritional intake was influenced by interrelated system breakdowns during the recovery process; this emerged as the overarching core theme. Three sub-themes were ‘experiencing a dysfunctional body’, ‘experiencing socio-cultural changes in relation to eating and ‘encountering organisational nutritional care delivery failures’. This study identified connections and interrelations between these concepts and provided new insights into the factors that influence the nutritional care of post ICU patients. In order to optimise nutritional rehabilitation in this patient group a model of care has been developed which addresses the identified organisational and patient related factors that were shown to influence the nutritional recovery of patients after critical illness. This nutritional strategy will need to be evaluated in clinical trials or quality improvement programmes.
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Henderson, Anthony Roy. "Consumer perspectives of recovery from the effects of a severe mental illness : a grounded theory study." University of Western Australia. School of Psychiatry and Clinical Neurosciences, 2007. http://theses.library.uwa.edu.au/adt-WU2007.0220.
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Interest in the ability of people to recover from a severe mental illness has a long history. During the 1980s, however, there was a paradigm shift away research driven by clinicians immersed in the quantitative, objective microcosm of anatomy and physiology towards understanding recovery from a consumer perspective. Even so the experiences of consumers has remained relatively unexplored, with the lion's share of research emanating from the United States of America. At the time of writing the proposal for this study in 2000, there was not even one Australian study of a mental health consumer perspective of recovery from severe mental illness reported in the literature. The principal aim of conducting this research was to address this need. The author, therefore, undertook this grounded theory study to: (a) explore what recovery from the effects of a severe mental illness meant to the consumers in Western Australia; (b) identify what consumers of mental health services in Western Australia wanted in their lives; and thus (c) develop a substantive theory of recovery. Fifteen participants diagnosed with either an affective disorder or schizophrenia were each interviewed and the resultant data were analysed using the constant comparative method. Comparative analysis is a long-held method of analysing data in sociology. Analysis is achieved by asking questions such as what, when, where, how, of the data and comparing similarities and differences with the various concepts within and across sets of data. The findings revealed that the basic social psychological problem (BSPP) for participants was LOSS. In order to address this problem, participants engaged in the basic social process (BSP) of OVERCOMING LOSS. The BSP is a title given to the central theme that emerges from the data and illustrates that a social process occurs overtime. The BSP emerged as a process comprising three phases: First Recuperation, second Moving Forward and third Getting Back. The analysis further revealed that the participants viewed recovery as either
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Barbic, Skye. "The effectiveness of the recovery workbook as a psychoeducation intervention for facilitating recovery in persons with serious mental illness." Thesis, Kingston, Ont. : [s.n.], 2007. http://hdl.handle.net/1974/491.
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Griffith, David Morgan. "Persisting inflammation after critical illness : prevalence, risk factors and association with physical recovery." Thesis, University of Edinburgh, 2014. http://hdl.handle.net/1842/23955.
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Introduction: Survivors of critical illness suffer physical, psychological, and social problems. The factors hindering recovery and the best rehabilitation interventions remain illusive. Critical illness is associated with inflammation that persists in some individuals and this might affect recovery. The hypotheses for the thesis are 1. Persistent inflammation is common after critical illness. 2. Persistent inflammation is associated with functional recovery. 3. Persistent inflammation is associated with critical illness-induced viral reactivation. 4. Biomarkers may help predict functional disability. The main part of the project was based on 197 of the 240 patients enrolled in the RECOVER trial who also consented to take part in an inflammation sub study. Systematic Review. Aims: Prevalence of systemic inflammation in ICU survivors; association of inflammation with physical recovery. 7433 references identified. 208 full text articles were reviewed. 57 were eligible. 22 studies included the relevant data. CRP at ICU discharge was elevated ( > 10mg/L) in most cases (70% of mixed medical/surgical patients and 100% of severe sepsis survivors). Lower CRP observed in trauma patients (23mg/L), VAP (46mg/L), > 6 days in ICU (45mg/L), and medical ICU patients (36mg/L). CRP was higher in sepsis (107mg/L) and surgical ICU patients (99mg/L). IL-6, TNF-a, and PCT were elevated in most patients at ICU discharge. Ninety percent of acute COPD exacerbations admitted to ICU had elevated CRP at hospital discharge and 43% general adult ICU patients fulfilled SIRS criteria 3 days after ICU discharge. Anaemic ICU survivors had elevated CRP and IL-6 at 6 months. There were no studies that measured both inflammation and physical function after ICU discharge. Association of inflammation with functional outcome after critical illness. Aims: Prevalence of inflammation in heterogeneous ICU cohort, association of CRP with Rivermead Mobility Index (RMI) and other outcome measures at 3 months. At ICU discharge, 173 patients (94%) had elevated serum CRP with a median concentration of 27 (11-60) mg/L. At hospital discharge 169 patients (90%) had elevated CRP with a median concentration of 21 (8-42) mg/L, At 3 months 72 patients (59%) had elevated CRP with a median concentration of 4 (1-12) mg/L. CRP was associated with RMI (p < 0.01), and percentage of predicted handgrip strength (HGS) (p=0.03) at 3 months. CMV infection, systemic inflammation and the post ICU syndrome. Aims: Prevalence of active and latent CMV at ICU discharge; association between CMV, inflammation, and recovery. 115 patients (62.8%) had latent CMV. 13 (11.4%) had active CMV (11.4% of those with prior CMV and 7.2% of ICU survivors). Active CMV associated with longer hospital length of stay (57 days v 28 days p=0.016), poorer baseline physical function (HGS 12 v 16 p=0.032; RMI 1 v 2 p=0.018). At 3 months, patients with latent CMV infection had higher CRP (5.4 v 2.8mg/L p=0.06), higher HNE (118 v 91.3 pg/mL p < 0.00), lower TGF β (9.2 v 11.4 ng/mL p=0.01), and were slower on 2 min timed up and go test (p=0.03). Active CMV infection at ICU discharge was not associated with inflammation or physical function at 3 months. Prediction of physical disability after ICU discharge. Aims: To identify risk factors for poor physical function; to derive a prognostic index to identify for poor functional outcome. Age, Functional Comorbidity Index, Scottish Index of Multiple Deprivation quintile, CMV IgG status, ventilator days, baseline RMI, physical component of SGA, CRP, and SLPI met statistical criteria for consideration in the multivariable models. 2 linear multivariable models with reasonable fit (R2=0.175; 0.193) were constructed. AUCs were 0.759 for the clinical model and 0.725 for the model incorporating biochemical markers. The models did not perform any better than a baseline assessment of mobility (RMI).
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Spencer, Matt. "An ecological exploration of personal recovery in the context of severe mental illness." Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12477/.
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This study had two objectives: to develop an ecological understanding of personal recovery in the context of severe mental illness (SMI) with a UK-based sample, and to develop a model of the discovery of hope and meaning in recovery, and relevant helping and hindering factors. A grounded theory methodology was employed as a framework for collecting and analysing qualitative data. The study provides an emergent ecological model of growth in the context of personal recovery incorporating seven theoretical categories including; prevailing contexts, the importance of relationships, purposeful goals, values-commitment, emerging self-efficacy, wellness experience, and tangible and intangible hope. The emergent model provides a novel understanding of the individual, ecological and interactional factors facilitating the discovery of hope and meaning in life. It is anticipated that such findings will benefit the provision of statutory and peer-run mental health services, and support further research into growth in the context of SMI.
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Dave, Milli. "A cultural understanding of British Indian people's views of recovery in mental illness." Thesis, Staffordshire University, 2015. http://eprints.staffs.ac.uk/2238/.
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This thesis aimed to explore the views held by British Indians towards recovery in mental illness. Indian people in particular are under- represented in mental health statistics which can make it difficult to understand their views of mental illness. Understanding cultural perspectives can provide insight into the way in which Indian people conceptualise mental illness. Research related to Indian people’s attitudes towards mental illness was reviewed. The research demonstrated that Indian people were able to identify signs of mental illness however, lacked knowledge of certain aspects of mental illness and its causes. Differences in attitudes were influenced by gender, age, profession, education and generation. The review demonstrated an absence of research conducted outside of India, examining Indian people’s views of different aspects of mental illness such as recovery. Due to this gap in research, Q methodology was used to obtain the views of British Indian people (from the Gujarati and Punjabi subgroups) regarding necessary factors for recovery in mental illness. A sample of 20 participants were asked to Q sort 52 statements pertaining to recovery based on their personal beliefs. Factor analysis revealed four factors representing a range of viewpoints related to recovery. A number of key aspects necessary for recovery were highlighted. Recovery was seen as a journey of self- discovery requiring insight and positivity and additionally, the importance of acceptance was identified. British Indians also preferred to keep mental health difficulties hidden due to a fear of stigmatisation from the wider community. The role of family members and spirituality was highlighted. Differences in viewpoints of British Indians born in the United Kingdom and those born in India and Africa are significant in understanding the impact of acculturation in help- seeking behaviours. The reflective commentary provides analysis of the research process and a reflexive account is presented.
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Olson, Paul O. "Experiences of mental illness, treatment and recovery in schizophrenia : an existential-phenomenological exploration." Thesis, Middlesex University, 2016. http://eprints.mdx.ac.uk/21226/.
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This study explores in depth the narratives and experience of recovery from a convenience sample of seven participants with a schizophrenia diagnosis, but now remitted (Andreasen et al, 2005). Three lifeworlds (phases) emerged using hermeneutic phenomenology: (A) Losing existential grounding; (B) Being-within-the-system (i.e. hospitalised); and (C) Outside schizophrenia. Outside has a double meaning as it both emerges from the narratives and also is an important base for existential exploration: what else needs to happen except psychiatry? Each lifeworld had a different meaning and different behaviours connected to it. Two necessary transitions were identified: First, accepting help; and second, an existential construction or re- construction depending on where in your life course you become affected. Psychotherapy was useful, but not necessary for remission and recovery.
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Trustam, Emma. "Exploring recovery in people with learning disabilities." Thesis, Canterbury Christ Church University, 2014. http://create.canterbury.ac.uk/12767/.
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A literature review examines how mental health difficulties may differ for people with learning disabilities (PwLD) and the general population; with respect to their vulnerability to mental ill-health and the definition, presentation and treatment of mental health problems. Factors which have been found to positively impact on the mental health of PwLD are then explored. The review considers methodological limitations and gaps in our understanding, highlighting a need for further research focusing on mental health recovery for individuals with learning disabilities. Section B presents a study exploring what recovery means for people with learning disabilities and mental health difficulties. Interviews were conducted with nine individuals and Interpretative Phenomenological Analysis used. A model was developed which described participants’ entry to the therapeutic service and their progression towards recovery. The model firstly describes how participants felt entering the service, their Mental Health/Therapy Experience, and explains how these experiences were validated and the recovery process enabled through the therapeutic alliance. Once enabled, the second dimension of the model is detailed, that of the Client Recovery Experience which extends across three phases of recovery. The first phase, Feeling Better describes elements perceived as integral to improved mental health. The second phase, Recovery Ongoing identifies that more input is required. Thirdly, Attainability?: Reality, Ideals and Fantasy, reveals PwLD’s perceptions of recovery and the techniques used in striving to achieve this. Salient features of recovery specific to PwLD are recognised as important to clinical practice, and results suggest there is a need to openly discuss LD identity, and address idealisations surrounding a non-LD one. This would involve setting realistic goals and managing expectations accordingly and focussing on social integration as a way of enabling ongoing recovery.
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von, Schoultz Benedict. "Återhämtning från psykossjukdom." Thesis, Ersta Sköndal högskola, Institutionen för socialvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-3999.
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The objective of this study is to understand how people with psychiatric diseases who are enrolled at a psychiatric clinic experience the recovery process and which internal motivations and external factors influence the process. The study is based on interviews with five people who have been enrolled at a psychiatric clinic. Another aim of the study is to understand how the importance of the outpatient care for the personal recovery and the improvement opportunities of the support from the rehabilitation unit that the interviewees see. The study is qualitative and abductive approach was chosen. This means that the study is based on empirical data supported by established theories. The interviews have been semi-structured and the results have been analyzed based on previous research about recovery from psychiatric diseases. The results show that there are several similarities between the individual recovery stories in the study and there are also clear links to the findings of the international research that has been taken into account in this study. The study shows a painful but at the same time hopeful recovery process where all respondents developed strategies to handle the psychiatric disease and the symptoms of it. The medication, some kind of faith and memories of life before the psychiatric disease occurred all proved to be of importance in the recovery process. It is also clear that the recovery process is closely related to a social process where friends, colleagues, family members and professional caretakers contribute with support, continuity and by creating a sense of belonging. Furthermore, the study shows that the closest family not only has an externally supporting function. It also works as an inner motivation to keep on fighting to get back. The meeting premises of the psychiatric clinic and the accessibility of the caretakers also proved to be of importance in the recovery process. Three clear improvement opportunities where discovered in the study: More organized group activities for a specific type of patients, increased knowledge sharing and transfer about psychiatric diseases and that people involved in the process pass on a stronger feeling of hope.Denna studie handlar om hur personer inskrivna på en öppenpsykiatrisk rehabiliteringsenhet för människor med psykossjukdom upplever återhämtningsprocessen och vilka inre motiv och yttre faktorer det är som stödjer denna process. Studien baseras på fem intervjuer av personer inskrivna på rehabiliteringsenheten. Ett mål har också varit att undersöka vilken betydelse öppenvården har för den personliga återhämtningen och vilka önskningar de intervjuade personerna har i syfte att förbättra stödet från rehabiliteringsenheten. Studien har en kvalitativ ansats och en abduktiv forskningsstrategi valdes. Detta innebär att studien utgår från empiriska data men att teoretiska moment samtidigt har beaktats. Semistrukturerade intervjuer har genomförts och resultatet analyserades utifrån tidigare forskning om återhämtning från psykisk sjukdom. Resultatet visar att det finns flera likheter mellan de individuella återhämtningsberättelserna som personerna i studien delar med sig av och likheter i relation till den nationella och internationella forskningen. Studien ger en bild av en smärtsam men samtidigt hoppfull återhämtningsprocess där samtliga intervjupersoner utvecklat strategier i förhållande till psykossjukdomen och dess symtom. Medicinerna, någon form av tro eller andlighet och minnet av livet innan insjuknandet i psykossjukdom visar sig vara betydelsefullt i återhämtningsprocessen. Samtidigt framgår det också hur återhämtningen så starkt är förbunden med en social process där vänner, arbetskollegor, professionella och familjemedlemmar bidrar med stöd, samhörighet och kontinuitet. Vidare visar studien att den närmaste familjen har en yttre stödjande funktion men att de också utgör ett inre motiv till att fortsätta kämpa, återhämta sig eller tillfriskna. Enhetens träfflokal och personalens lättillgänglighet visar sig vara betydelsefullt för de intervjuade. Tre önskningar om enhetsförändringar förmedlas genom studien: En mer organiserad gruppverksamhet riktad mot en specifik grupp brukare, en ökad kunskapsförmedling om psykiska sjukdomar och en ökad förmedling av hopp.
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Lee, Alisha. "An Evaluation of Changes in Cognitive Appraisal and Emotion Regulation in the Treatment of PTSD in Individuals with Severe Mental Illness." University of Toledo / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1436786618.
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Leonard, Lucy. "Metacognition and recovery style in psychosis." Thesis, Canterbury Christ Church University, 2011. http://create.canterbury.ac.uk/10324/.
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Section A reviews the literature which has investigated variables found to relate to recovery style in individuals with psychosis. Studies exploring the attachment, self-esteem, depression and executive functioning are evaluated and conclusions drawn. Section B reports the findings of an empirical study investigating the relationship between metacognition, recovery style, anxiety and depression in a community sample of individuals with psychosis. Objective; Research has shown that individuals with psychosis will either integrate their experience of psychosis or seal the experience over. Little is known about what leads to these different styles of recovery but poor attachment, depression, low self-esteem and poor executive functioning have been linked to a sealing-over style. This study hypothesised that sealing is linked to unhealthy metacognitive beliefs and also to higher levels of anxiety and depression. Method; Forty-three participants with a diagnosis of psychosis were recruited. They completed the Metacognitions Questionnaire-30, Recovery Style Questionnaire and the Hospital Anxiety and Depression Scale. Results; Correlational analysis revealed that only one facet of metacognition linked to sealing over; this being positive beliefs about worry and this was maintained when the effects of anxiety and depression were accounted for. Contrary to the hypothesis, recovery style did not correlate with anxiety or depression but unhealthy metacognition was linked to both anxiety and depression. Conclusions; The findings of this study suggest that a sealing-over recovery style may be linked to one specific area of metacognitive dysfunction. They also cast doubt on previous theories which link low mood to a sealing-over style. Limitations of this study include its cross-sectional design. Future research which expands on these findings is encouraged and longitudinal research is particularly called for. Section C provides a critical evaluation of the project, answering four questions regarding what the author has learnt from the study, what might have been done differently, how the study might affect the author‟s clinical work in future and possible future research directions.
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Murphy, Michael. "Residential placement and well-being among persons recovering from serious mental illness." Thesis, Boston College, 2008. http://hdl.handle.net/2345/31.
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Thesis advisor: Thomas O'HareTwo primary community-based programs currently in use for people who suffer from severe, persistent mental illnesses are staffed group-homes, or intensive outreach residential programs, where the consumer lives independently and services are provided in vivo. This study utilized a cross-sectional relational design and employed a consumer survey to examine how the well-being of people with severe and persistent mental illness and who receive one of these residential services. Well-being refers to the general quality of a person’s life and living situation, including their own perceptions of the quality of their life. For the purposes of this study, well-being was operationalized as the product of three domains: 1). demographic/diagnostic characteristics, including age, gender, race, length of service, educational level, marital status, diagnosis, and intensity of residential support; 2). objective life satisfaction indicators, such as immediate social network, extended social network, independent living/self care, working/productivity, global functioning, freedom from crisis/hospitalization; and 3). subjective life satisfaction indicators, including satisfaction with living arrangements, money, leisure time, family, social life, and health. An analysis of demographic and diagnostic variables indicated that with the exception of education level, respondents living in group homes are very similar to their counterparts receiving supported housing. Independent functioning ability was significantly higher for respondents receiving supported housing services in eight areas, including cooking, shopping, housekeeping, personal finances, use of medications, active use of services, pursuit of recovery goals, and ability to find and use health care. Group home residents were significantly more likely to have substance abuse problems than respondents receiving supported housing, and were more likely to have problems that could put them or others at risk. Respondents living independently with supported housing services reported higher satisfaction with their living situation and with their relationship to their family. Group home residents were more satisfied about the availability of money for leisure activities. Exploratory analysis of the data using logistic regression suggested that such an analysis might be useful in identifying which qualities of applicants for residential services would provide a better “fit” to a particular model of treatment. Implications for policy, practice, and future research are addressed
Thesis (PhD) — Boston College, 2008
Submitted to: Boston College. Graduate School of Social Work
Discipline: Social Work
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Potokar, Danielle Nicole. "Living with Serious Mental Illness: The Role of Personal Loss in Recovery and Quality of Life." Bowling Green, Ohio : Bowling Green State University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=bgsu1224012694.
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Drungaite, Akvile. "Anorexia Nervosa : What Makes Patients Feel Better During the Illness and the Process of Recovery?" Thesis, University of Skövde, School of Life Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-3021.
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Objective: When caring for a patient with Anorexia Nervosa (AN) it is difficult for the registered nurses to develop a good nurse-patient relationship due to a lack of understanding for the illness. It is important for the nurse to understand the suffering that the AN patients experience, and what makes them feel better, to be able to improve the patient-nurse relationship. This study aims to explore what makes patients with AN feel better during the illness and the process of recovery.
Method: A qualitative scientific approach was used. Eight autobiographies were selected as data for this study. Both English and Swedish books were used. The data was analyzed using a qualitative method of data analysis.
Results: The ways patients with AN could feel better are presented in seven themes: being seen as a whole individual behind the illness, being able to trust and find security, taking responsibility for recovery, finding motivation to keep fighting towards recovery, when one's suffering is noticed, filling a void, and the strengthening of the relationship between care giver and patient. This study may help registered nurses understand the needs of the patient recovering from AN and help them meet these needs in a better way.
Avsikt: För sjuksköterskor är det svårt att utveckla en bra sjuksköterske-patient relation när de vårdar patienter med anorexia nervosa (AN), eftersom det finns brister i deras förståelse för sjukdomen. För att kunna stärka relationen mellan sjuksköterskor och patienter är det viktigt för sjuksköterskan att förstå det lidandet som patienter med AN upplever och vad som kan lindra det. Syftet med denna studie är att utforska vad som får patienter med AN att må bättre under sjukdomens lopp och tillfrisknandet.
Metod: En kvalitativ metod valdes för att utföra studien. Sex självbiografier valdes som data till studien. Böcker skrivna på svenska och engelska användes. En kvalitativ dataanalys, enligt Dahlberg, användes för att tolka data.
Resultat: Resultatet presenteras i sju teman: att bli sedd som en individ bakom sjukdomen, att kunna känna tillit och hitta trygghet, att ta eget ansvar för tillfrisknandet, att hitta motivation för att fortsätta kämpa mot tillfrisknandet, att ens lidande uppmärksammas, att fylla ett tomrum efter sjukdomen och att stärka relationen mellan vårdare och patient. Denna studie kan hjälpa allmänna sjuksköterskor att förstå de behov patienter med AN har och hjälpa dem att bemöta deras behov på ett bra sätt.
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Cooper, Althea Frances. "Cardiac rehabilitation and recovery from myocardial infarction : the role of patients' illness and treatment beliefs." Thesis, University of Brighton, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.411914.
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Bateman, Anthony Philip. "Anaemia and its impact on recovery and quality of life in survivors of critical illness." Thesis, University of Edinburgh, 2011. http://hdl.handle.net/1842/24964.
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Survivors of critical illness experience a significant burden of persisting physical, psychological and cognitive dysfunction during recovery as a result of the interaction between factors relating to the ICU environment, the invasive treatments required and the pre-morbid health of the patient. Little is known about the long term complications of critical illness and the impact they have on recovery. Physical morbidity is common due to generalised muscle atrophy and weakness due to the catabolic state and immobility associated with critical illness. There is a high prevalence of anaemia in critically ill patients due to iatrogenic blood loss and the inflammatory state impairing erythrogenesis but little is known about its persistence and effects on physical recovery. The studies presented in this thesis aimed to evaluate the prevalence of anaemia and physical morbidity in survivors of critical illness and to explore the potential contribution of anaemia to impaired physical function and poor quality of life during recovery. The TRAC study was a single centre, prospective, observational cohort study aimed to determine the prevalence and pathophysiology of anaemia following critical illness. Indices of erythropoiesis, inflammation and health related quality of life were measured over 6 months and showed that anaemia persists up to 6 months and was associated with evidence of an ongoing inflammatory state and impairment of erythropoiesis. Health related quality of life was also noted to be impaired raising the possibility that anaemia may affect quality of life following critical illness. The Ps and Qs study was a two centre, prospective observational study aimed to investigate actual and perceived physical function during recovery from critical illness and the associated impact upon health related quality of life. Simple measures of psychological state and organ function were also recorded. The study showed that survivors of critical illness had a normal pre-morbid perceived physical function but a reduced quality of life. Both were significantly worsened by the critical illness and remained impaired up to 6 months. Actual physical function in our heterogeneous population was reduced to levels associated with very severe chronic disease. There was evidence of a significant level of post traumatic stress disorder, persisting anaemia and malnutrition but no other organ dysfunction during recovery. Further analysis of the Ps and Qs data was performed to investigate potential links between anaemia, physical function and quality of life. Perceived physical function, actual physical function and quality of life were all impaired in the presence of anaemia. Additionally, anaemia was associated with a longer ICU stay and increased age but not with severity of illness or the degree of organ failure developed during ICU stay. The persistence of anaemia was also associated with malnutrition and inflammation. In conclusion these studies show that physical function and health related quality of life are dramatically affected by critical illness. There is a high prevalence of anaemia in survivors of critical illness, which is associated with ongoing inflammation and impaired erythropoiesis. Importantly, the data also show that quality of life and physical recovery are further impaired in the presence of anaemia. Further studies are required to evaluate the effects of anaemia on physical recovery from critical illness and investigate the potential benefits of treatments for anaemia on physical rehabilitation.
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Pearce, Dianna R. "Relationship Between Educational Leisure Motivation and Recovery From Mental Illness Among Members of Clubhouse International." Thesis, Walden University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10241118.
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Individuals with serious mental illness (SMI) exhibit low motivation to participate in educational leisure activities at Clubhouses accredited by Clubhouse International (CI). This correlational study examined the relationship between each of 4 motives, intellectual, social, competence-mastery, and stimulus-avoidance, to engage in leisure activities, and the perception of recovery from SMI. Knowles’s theory of andragogy supported the concept of informal self-directed learning, which occurs with leisure activities. Literature indicates that participating in leisure activities such as those offered at Clubhouses aids in the recovery from SMI. Quantitative data were collected from a convenience sample of 75 individuals at 4 CI clubhouses using 2 Likert-scale instruments, the Leisure Motivational Scale (LMS) and the Recovery Assessment Scale – Domains and Stages (RAS-DS). Pearson correlation coefficients indicated significant moderate positive correlations between each of 4 motives, intellectual, social, competence-mastery, and stimulus-avoidance, to engage in leisure activities, and the perception of recovery from SMI. These findings were used to design a professional development program on motivation to teach the staff at a Clubhouse about how to engage members in leisure activities. The study has the potential to inspire positive social change by motivating members to improve their quality of life, learn social and work skills, develop friendships and a support system, reengage with society, and to become employed.
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Pearce, Dianna Rene. "Relationship Between Educational Leisure Motivation and Recovery From Mental Illness Among Members of Clubhouse International." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/2997.
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Individuals with serious mental illness (SMI) exhibit low motivation to participate in educational leisure activities at Clubhouses accredited by Clubhouse International (CI). This correlational study examined the relationship between each of 4 motives, intellectual, social, competence-mastery, and stimulus-avoidance, to engage in leisure activities, and the perception of recovery from SMI. Knowles's theory of andragogy supported the concept of informal self-directed learning, which occurs with leisure activities. Literature indicates that participating in leisure activities such as those offered at Clubhouses aids in the recovery from SMI. Quantitative data were collected from a convenience sample of 75 individuals at 4 CI clubhouses using 2 Likert-scale instruments, the Leisure Motivational Scale (LMS) and the Recovery Assessment Scale - Domains and Stages (RAS-DS). Pearson correlation coefficients indicated significant moderate positive correlations between each of 4 motives, intellectual, social, competence-mastery, and stimulus-avoidance, to engage in leisure activities, and the perception of recovery from SMI. These findings were used to design a professional development program on motivation to teach the staff at a Clubhouse about how to engage members in leisure activities. The study has the potential to inspire positive social change by motivating members to improve their quality of life, learn social and work skills, develop friendships and a support system, reengage with society, and to become employed.
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Boström, Michaela. "The significance of social support in the recovery process from severe mental illness - A Case study from Uganda." Thesis, Södertörns högskola, Institutionen för naturvetenskap, miljö och teknik, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-21746.
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This study aims to examine howdifferent forms of social support are perceived to affect the recovery process of people with severe mental health difficulties, and what factors people within this group perceive as being most beneficial for their recovery. This study was conducted in Uganda for eight weeks during November 2013 and December 2013 and is based on semi-structured interviews with people in recovery from severe mental illness such as bi-polar affective disorder and schizophrenia. This study is using Interpretative phenomenological analysis (IPA), which is a qualitative research approach, and the strength of IPA is its commitment to examine lived experience and personal meaning in detail. This study has shown that social support received from service user organisations was perceived to highly affect the recovery process in a most fundamental way. The service user organisations/associations were seen as platforms providing acceptance, understanding and recognition of what one has been or are going through. In terms of social support from family members, this was neither described as particularly helpful or hindering for the recovery process by most of the participants; this finding was somewhat unexpected but could be explained due to the complexity that proved to exist within the relationships between the participants and their family members. Medication was perceived as very important in terms of recovery, however it was strongly pointed out that medication alone was not enough. Despite this a majority of the participants had negative perceptions regarding both the dosage and the prescribed medicine itself particularly the prescription of Chlorpromazine, here feelings of being overmedicated and dealing with severe side effects were expressed, leading to some of the participants changing the prescribed dose on their own, so called manipulative medication.
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Goldsmith, Rachel Edrea Stern. "Making meaning outside of the system a narrative exploration of recovery within a peer-run setting /." Oxford, Ohio : Miami University, 2010. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1272243278.
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Färdig, Rickard. "Illness Management and Recovery : Implementation and evaluation of a psychosocial program for schizophrenia and schizoaffective disorder." Doctoral thesis, Uppsala universitet, Psykiatri, Ulleråker, Akademiska sjukhuset, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-175241.
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The aim of the present thesis was to examine the effectiveness of the Illness Management and Recovery (IMR) program for teaching clients with schizophrenia or schizoaffective disorder to better manage their illness and to promote recovery. This was accomplished through an examination of the program’s effects on psychosocial functioning and psychopathology, the evaluation of general and specific impact of neurocognition on learning the fundamentals of illness self-management, and the impact of symptom severity on outcome of the IMR program. The utility of the illness management and recovery scale to evaluate illness self-management of clients with schizophrenia and schizoaffective disorder was also investigated. The effects of the IMR program were evaluated in a randomized controlled trial that compared participants in the program to participants receiving treatment as usual. 41 participants were recruited at six psychiatric outpatient rehabilitation centers in Uppsala, Sweden, and were randomly assigned to IMR groups for approximately 40 sessions or to a treatment as usual control condition. The IMR program participants demonstrated greater improvement compared to participants in treatment as usual in illness self-management, reduced psychiatric symptoms, improved coping skills, and decreases in suicidal ideation. The findings suggest that the IMR program is effective in improving the ability of individuals with schizophrenia and schizoaffective disorder to better manage their illness. Possible association between neurocognitive functioning and the acquisition of illness self-management skills was investigated in a total of 53 participants who completed the IMR program. Speed of processing was related to client reported illness self-management skills acquisition, before and after controlling for psychiatric symptoms and medication, but neurocognitive functioning did not predict improvement in clinician ratings of client illness self-management skills. The findings suggest that compromised neurocognitive functioning does not reduce response to training in illness self-management. The impact of symptom severity on outcome of the IMR program was explored in 52 participants who completed the program. The results suggest that significantly more participants met the severity criterion of remission at post-treatment, and it appears that participants not reaching the severity criterion at post-treatment, also benefited from the IMR program, as indicated by the similar effect sizes of the two subgroups (meeting versus not meeting the severity criterion at post-treatment). The psychometric properties of the Illness Management and Recovery Scale (IMRS) were evaluated in 107 participants with a diagnosis of schizophrenia or schizoaffective disorder. And an item-by-item investigation was conducted in order to establish their utility in monitoring the clients' progress in the IMR program. Both the client and clinician version of the IMRS demonstrated satisfactory internal consistency, large test-retest reliability, and convergent validity with conceptually related measures of psychiatric symptoms, quality of life, and perception of recovery. The findings support the utility of the IMRS as a measure of illness self-management and recovery in clients with schizophrenia and schizoaffective disorder. The general findings of this thesis support the IMR program to be effective in improving the ability of the participants to manage their disorder. The impact of neurocognitive dysfunction on the participants’ ability to learn the fundamentals of illness self-management seems to be limited, and symptom severity did not limit the benefits of the IMR program. Support for the utility of the IMRS to monitor the participants’ progress in the program was also found, providing a brief and economical method for assessing outcome of the IMR program.Syftet med föreliggande avhandlingsarbete var att undersöka Illness Management and Recovery (IMR) programmets effekter av att lära klienter att bättre hantera negativa konsekvenser av schizofreni eller schizoaffektiv sjukdom och att främja återhämtning. Detta åstadkoms genom en utvärdering av IMR programmets inverkan på psykosocial funktion och psykopatologi, en undersökning av specifik och generell påverkan av neurokognition avseende deltagarnas möjligheter att lära in grundläggande sjukdomshanteringsfärdigheter (illness self-management), samt en undersökning av huruvida schizofrenisymtomens svårighetsgrad inverkar på programutfallet. Vidare undersöktes Illness Management and Recovery Skalans (IMRS) användbarhet för att utvärdera sjukdomshantering och återhämtning (illness self-management and recovery) hos personer med schizofreni eller schizoaffektiv sjukdom. IMR programmets effekter utvärderades genom en randomiserad kontrollerad studie i vilken 41 programdeltagare jämfördes med deltagare i kontrollgrupp vilka fick enbart sedvanlig psykiatrisk behandling. Deltagarna rekryterades vid sex subspecialiserade psykiatriska öppenvårdsmottagningar och slumpades till att antingen delta i IMR programmet eller kontrollgrupp. IMR programmets deltagare uppvisade i jämförelse med kontrollgruppen förbättring i sjukdomshantering, minskade psykiatriska symtom, förbättrade coping-färdigheter samt minskade självmordsbeteenden. Resultaten stöder antagandet att IMR programmet är effektivt vad gäller att förbättra deltagarnas förmåga att hantera negativa effekter av schizofreni och schizoaffektiv sjukdom. Möjliga associationer mellan neurokognitiv funktion och förmågan att tillägna sig färdigheter för sjukdomshantering undersöktes hos 53 deltagare som genomförde IMR programmet. Resultaten pekar på att neurokognitiva svårigheter inte inverkar på deltagarnas möjligheter att lära sig sjukdomshantering enligt IMR modellen. Processhastighet var relaterad till klientrapporterad sjukdomshantering men inte till klinikerrapporterad sjukdomshantering. Processhastighet tycks vara relevant för klientens upplevelse av hur väl han eller hon tillägnat sig programmets strategier och färdigheter, snarare än sjukdomshantering per se. Huruvida schizofrenisymtomens svårighetsgrad inverkar på utfallet av IMR programmet undersöktes hos 52 deltagare som genomförde IMR programmet. Resultaten pekar på att signifikant fler deltagare uppfyllde svårighetsgradskriteriet för remission av schizofrenisymtom efter genomfört IMR program. Även deltagare som inte uppfyllde svårighetsgradskriteriet har nytta av IMR programmet något som indikeras av de båda gruppernas (uppfyllde jämfört med uppfyllde inte svårighetsgradskriteriet) likartade effektstorlekar. Illness Management and Recovery Skalans (IMRS) psykometriska egenskaper undersöktes för 107 deltagare med en schizofreni eller schizoaffektiv diagnos. Skalans enskilda frågor analyserades för att undersöka skalans användbarhet för att utvärdera deltagares progress och utfall i IMR programmet. Både klient och kliniker versionen av skalan uppvisade tillfredsställande intern konsistens, stor test-retest reliabilitet och konvergent validitet med konceptuellt relaterade instrument för psykiatriska symtom, livskvalité och återhämtning. Resultaten stöder antagandet att IMRS är ett användbart instrument för att utvärdera sjukdomskontroll och återhämtning för personer med schizofreni eller schizoaffektiv sjukdom. Avhandlingsarbetets resultat stöder antagandet att IMR programmet är effektivt vad gäller att förbättra deltagarnas förmåga att hantera de negativa konsekvenserna av schizofreni och schizoaffektiv sjukdom. Neurokognitiva svårigheter inverkar i begränsad utsträckning på deltagarnas möjligheter att lära sig sjukdomshantering och schizofrenisymtom tycks ha begränsad inverkan på programutfallet. Resultaten stöder även antagandet att IMRS är ett användbart instrument för att utvärdera sjukdomskontroll och återhämtning för personer med schizofreni eller schizoaffektiv sjukdom, vilket erbjuder en kortfattad och ekonomisk metod att utvärdera effekterna av IMR.
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Bartova, Zdenka. "Learning from the experts: Qualitative study of the lived experience of mental illness." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2014. https://ro.ecu.edu.au/theses/1412.
Full textAbstract:
Severe mental illness has a profound effect on the affected individuals yet it does not necessarily prevent them from leading a meaningful and fulfilling life, and therefore recovering. Recovery has received a great interest in clinical and consumer research yet little is known about how those individuals who do not primarily identify with recovery respond to the concept and come to accept it as something that is personally meaningful. Using a qualitative approach following the principles of Gadamer’s (1975) hermeneutics, the present study explored people’s subjective experience of mental illness with the aim of identifying factors related to their views of mental illness, their adaptation, coping and recovery, and the subjective meanings they gave to the phenomenon.
In Phase I, 25 adults diagnosed with mental illness participated in unstructured, confidential interviews at the end of which they completed the Recovery Assessment Scale-Revised (RAS-R) (Corrigan et al., 1999). The study identified six main themes related to person-centred and social/relational factors that played a role in the persons’ life with mental illness: (a) mental illness as a journey, (b) personal conceptualisations of mental illness, (c) illness management and coping, (d) losses and gains, (e) professional help, and (f) the role of others.
Phase II was completed by 18 participants from the original sample who were provided with feedback on their respective RAS-R (Corrigan et al., 1999) results and who in turn provided their feedback on the scale and their experience of completing it; this was followed by a discussion of recovery. The participant narratives suggested that recovery was conceptualised in two broad ways: as a return to baseline following crisis and as living as best as one can given personal circumstances. The findings further indicated that recovery as a concept had the potential to remain abstract and lack in meaning unless the person’s biases and perceptions were explored in an opened, non-directive conversation.
Both the initial interview and the follow-up session were audiotaped, transcribed and consequently subjected to thematic content analysis. Following the analysis, the participants were invited for a third interview during which they were asked to provide feedback on the analysis and add further information. This represented Phase III, which was completed by 10 participants from the original sample; this phase also served as a reflection on the experience of research participation. Findings indicated that research participation was generally seen as a positive experience that could have potentially therapeutic benefits. The process involved active engagement for both the participants and the researcher, which may have helped foster closeness but that also raised a number of ethical dilemmas, primarily in terms of dual roles and researcher self-disclosure.
Overall, the studies highlighted the complex interplay of both clinical and non-clinical factors that the individuals took into account as they were making sense of their experience. The studies have a number of clinical implications, specifically addressing the role of hospitals in treatment, the relationship between mental illness and trauma, participatory assessment of recovery, and the role of clinical psychology in the treatment of severe mental illness. Furthermore, the studies point out the potential benefits of supplementing clinical work, whether in research or in treatment, with the methods and processes of Gadamerian hermeneutics.
The core principles of the Gadamerian approach (the fusion of the horizons of meaning, the hermeneutic circle and the dialogue) promote viewing of a phenomenon as a contextually embedded experience that is interpreted through the person’s pre-existing views and his/her present range of vision. The approach conceptualises interactions between two parties as opened conversations that aim at shared understanding, rather than objective truth. Such conversations are characterised by a back-and-forth movement between the whole and its parts, which eventually leads to improved understanding. Therefore greater appreciation of contextual information and meaning-making processes; treating both sources of expertise (consumer and professional) as equally important; viewing psychopathology as only one part of mental illness and mental illness as one part of the person’s life; and finally approaching clinical and research interactions as relational endeavours that test the underlying assumptions of both parties could help influence the way mental health professionals work with individuals with severe mental illness.
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Hupp, Danelle R. "A Qualitative Analysis of Participant Feedback from the Wellness Management and Recovery (WMR) Program." University of Toledo / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1309874873.
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Bench, Suzanne Deborah. "Self-regulation and coping during early critical illness recovery : the contribution of critical care discharge information." Thesis, King's College London (University of London), 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.674846.
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