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1 – 10 of 17Claire McDonald, Jessica Townsend and Caitlin Gillespie
Mental health staff often experience significant levels of stress working in the acute psychiatric inpatient setting. Team-building interventions can mitigate stress in…
Abstract
Purpose
Mental health staff often experience significant levels of stress working in the acute psychiatric inpatient setting. Team-building interventions can mitigate stress in health-care settings, via improvements in team-cohesion, staff interactions and communication skills. The “Tree of Life” (ToL) is a specific narrative therapy approach which uses the metaphor of a tree to facilitate the construction and sharing of strength-based stories. This study aims to describe the development of and evaluate the feasibility, acceptability and staff experiences of the “Team Tree”, an adapted Professional ToL (PToL) intervention.
Design/methodology/approach
A one-hour, Professional ToL intervention was designed for multidisciplinary acute inpatient staff teams working within a psychiatric hospital in London, UK. A mixed methods approach was used to evaluate the feasibility, acceptability and staff experiences of the session.
Findings
Participants were 46 multidisciplinary staff (33 women; 13 men) working across four acute psychiatric wards. The intervention was feasible to deliver and was acceptable to participants. Results showed significant improvements in self-reported mental well-being and team-cohesiveness scores post-session.
Practical implications
Psychologists face myriad barriers in working with staff teams in the acute inpatient setting. The “Team Tree” intervention was both well received by staff and practical to deliver within the challenging environment of the acute ward.
Originality/value
This adaptation of the original PToL emerged from the author’s work with distressed inpatient teams with limited time resources. To the best of the authors’ knowledge, this is the first description of this intervention using a single tree metaphor to facilitate a reflective and creative session with health-care teams.
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Natalie Peach, Ivana Kihas, Ashling Isik, Joanne Cassar, Emma Louise Barrett, Vanessa Cobham, Sudie E. Back, Sean Perrin, Sarah Bendall, Kathleen Brady, Joanne Ross, Maree Teesson, Louise Bezzina, Katherine A. Dobinson, Olivia Schollar-Root, Bronwyn Milne and Katherine L. Mills
Adolescence and emerging adulthood are key developmental stages with high risk for trauma exposure and the development of mental and substance-use disorders (SUDs). This study…
Abstract
Purpose
Adolescence and emerging adulthood are key developmental stages with high risk for trauma exposure and the development of mental and substance-use disorders (SUDs). This study aims to compare the clinical profiles of adolescents (aged 12–17 years) and emerging adults (aged 18–25 years) presenting for treatment of posttraumatic stress disorder (PTSD) and SUD.
Design/methodology/approach
Data was collected from the baseline assessment of individuals (n = 55) taking part in a randomized controlled trial examining the efficacy of an integrated psychological therapy for co-occurring PTSD and SUDs (PTSD+SUD) in young people.
Findings
Both age groups demonstrated complex and severe clinical profiles, including high-frequency trauma exposure, and very poor mental health reflected on measures of PTSD, SUD, suicidality and domains of social, emotional, behavioral and family functioning. There were few differences in clinical characteristics between the two groups.
Research limitations/implications
Similarity between the two groups suggests that the complex problems seen in emerging adults with PTSD + SUD are likely to have had their onset in adolescence or earlier and to have been present for several years by the time individuals present for treatment.
Originality/value
To the best of the authors’ knowledge, this is the first study to compare the demographic and clinical profiles of adolescents and emerging adults with PTSD + SUD. These findings yield important implications for practice and policy for this vulnerable group. Evidence-based prevention and early intervention approaches and access to care are critical. Alongside trauma-focused treatment, there is a critical need for integrated, trauma-informed approaches specifically tailored to young people with PTSD + SUD.
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Diagnostic overshadowing (DO) may be contributing to the worsening physical health outcomes for people diagnosed with mental health (MH) conditions. DO is a phenomenon researched…
Abstract
Purpose
Diagnostic overshadowing (DO) may be contributing to the worsening physical health outcomes for people diagnosed with mental health (MH) conditions. DO is a phenomenon researched worldwide, but there has been no systematic review of the evidence for its prevalence in UK health care. This paper aims to add to this body of knowledge, expanding the understanding of what factors are contributing to the poor physical well-being of people with diagnosed MH conditions.
Design/methodology/approach
A systematic search of three databases was conducted and after evaluation, three studies were selected for the review.
Findings
DO was found to have a high prevalence with structural, staffing and patient issues identified through a thematic analysis. Contemporary evidence shows themes identified are still impacting UK health care. Collaborative working across mental and physical health teams, thorough and lengthy assessments, and improved education for physical health care staff have been cited as mitigating factors to this practice.
Originality/value
To the best of the author’s knowledge, this paper is the first review of the evidence for diagnostic overshadowing taking place in UK health care.
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Rabia H. Haddad, Bushra Kh. Alhusamiah, Razan H. Haddad, Ayman M. Hamdan-Mansour, Younis H. Abuhashish and Jafar A. Alshraideh
This systematic review (SR) aims to evaluate and summarize the effectiveness of using eye movement desensitization and reprocessing (EMDR) intervention among individuals diagnosed…
Abstract
Purpose
This systematic review (SR) aims to evaluate and summarize the effectiveness of using eye movement desensitization and reprocessing (EMDR) intervention among individuals diagnosed with post-traumatic stress disorder (PTSD), as well as to highlight the standardized EMDR-based interventional protocol.
Design/methodology/approach
This SR is guided according to preferred reporting items for SRs and meta-analyses standards. Several online databases were used in searching for eligible studies in peer-reviewed journals relevant to the study keywords. The included studies were SRs and clinical trials that used EMDR interventions among patients experiencing PTSD symptoms, older than 18 years and were published in English language from 2015 to 2022. Three researchers independently contributed to study selections, data extraction and study evaluations from different aspects, including quality assessment, risk of bias and study synthesis.
Findings
A total of eight published studies met the inclusion criteria and were included in this SR; four articles were randomized controlled trials and four were SR and meta-analysis studies. In all included studies, the EMDR was used as a primary psychotherapy intervention for PTSD symptoms. The results of this extensive and comprehensive review showed that EMDR is an effective psychotherapeutic intervention to reduce and control the severity of symptoms among individuals with PTSD.
Research limitations/implications
It is important to acknowledge several limitations inherent in this study. First and foremost, it is noteworthy to mention that only studies conducted in the English language were included in this review, potentially restricting the overall scope and diversity of the findings. Furthermore, the number of studies incorporated into this review was limited, which may have implications for the comprehensiveness and generalizability of the results. Finally, it is worth noting that certain studies within this review had a relatively small sample size, which could potentially limit the statistical power and precision of the conclusions drawn.
Practical implications
This paper, a review of the literature, gives an overview of EMDR effectiveness, provides baseline information and plays a significant role in decreasing the gap in Jordanian literature regarding using EMDR as the strongest evident psychotherapy approach for PTSD treatment to help psychiatrists, psychologists and psychiatric nurses in the health-care sectors to design comprehensive strategies to enhance and improve the quality of health care and patients’ status.
Social implications
EMDR intervention offers significant alternative treatment opportunities for individuals suffering from PTSD, depression and anxiety. The implementation of EMDR for depression, anxiety and PTSD improves patient outcomes as compared to standard therapeutic modalities in PTSD.
Originality/value
This SR gives an overview and explains strong supportive evidence for the effectiveness of EMDR interventions among individuals with PTSD. Therefore, EMDR therapy could be assumed as one standard treatment option for PTSD, aiming at reducing treatment duration and cost of treatment and restoring the mental well-being and functionality of those suffering from PTSD.
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Yasmeen Abu Sumaqa, Manar Abu-Abbas, Omar Khraisat, Ahmad Rayan and Mohammad Othman Abudari
This study aims to identify the reasons for unmet health-care needs and related barriers among the Roma population with chronic diseases in Jordan.
Abstract
Purpose
This study aims to identify the reasons for unmet health-care needs and related barriers among the Roma population with chronic diseases in Jordan.
Design/methodology/approach
A descriptive survey with a cross-sectional design was conducted, involving a sample of 347 Jordanian Roma participants. Data collection was performed using a structured questionnaire based on the Canadian Community Health Survey.
Findings
The analysis revealed that within the three categories of reasons for unmet health-care needs (accessibility, availability and acceptability), “Transportation issues” under the accessibility category constitute the most reported reasons: (mean = 90.4%, SD = 22.6%), followed by “Cost” (mean = 89.0%, SD = 26.2%) and “Care not available in the area” (mean = 85.8%, SD = 23.6%). Predictors of unmet health-care needs were being married, having health insurance and self-perception of mental health (OR = 0.215, p = 0.044), (OR = 0.391, p = 0.008) and (OR = 0.302, p = 0.002) respectively.
Originality/value
Unmet health-care needs are highly prevalent among Jordanian Roma, rendering them a vulnerable group susceptible to other diseases. To address this pressing issue, concerted and comprehensive efforts should be made to improve the utilization and accessibility of health-care services within this community. Furthermore, efforts should be made to elevate their social standing and status. facilitate their integration into the broader community.
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The primary objective of this study is to understand the motivational process of the nurses who were engaged in COVID care and performed organizational citizenship behavior (OCB…
Abstract
Purpose
The primary objective of this study is to understand the motivational process of the nurses who were engaged in COVID care and performed organizational citizenship behavior (OCB) without caring about their own lives. This study also aims to investigate the consequences of such OCB on life satisfaction when the situation continues for a longer period.
Design/methodology/approach
For the study’s first objective, an online cross-sectional survey was conducted on 236 critical care nurses from 18 states of India extending over the period from March 2021 to November 2021, when the country passed through the second wave of COVID-19 infection. For the second objective, a longitudinal study compared the life satisfaction level during and post-COVID by giving a one-year gap (November 2022).
Findings
The findings of this study reveal that during this COVID period, nurses were strongly performing OCB through their organizational and professional commitment, but one year later, they were identified with a low level of life satisfaction.
Originality/value
Research on nurses has already categorized the profession under high emotional labor. Research also reveals that an individual’s emotional labor strategy (deep acting or surface acting) determines job satisfaction. However, under the COVID situation, nurses have displayed an extraordinary level of OCB by placing their own life at risk. Analysis of this study indicates that the OCB within the nurses during the COVID period originated from their commitment, not from the emotional labor strategy, which they used to select as a coping mechanism. However, one year later, it has affected their mental health and lowered their life satisfaction.
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Zainab Al-Attar and Rachel Worthington
Clinically, it is often observed that autistic people may have a heightened need for rules and may find rule violations very distressing. It is clinically plausible that autistic…
Abstract
Purpose
Clinically, it is often observed that autistic people may have a heightened need for rules and may find rule violations very distressing. It is clinically plausible that autistic individuals may be prone to hyper-morality and greater reactivity and adverse experiences arising from moral threats and violations. Such adverse experiences may, in some instances, lead to moral distress (MD) or in more extreme cases moral injury. Thus, this study aims to examine how MD can operate in the context of autism.
Design/methodology/approach
The authors explore clinical hypotheses on how MD can intersect with different features of autism by drawing on clinical and research knowledge of autism spectrum disorder and how it contextualises experiences of morality.
Findings
Based on a review of the literature and theory, the authors hypothesise that autistic individuals may be more prone to MD where they have a lower threshold for MD. As a result of this lower threshold, they may have more frequent exposure to MD, experience more immediate and intense subjective reactions to moral transgressions, for more protracted periods. Also, they may find it more difficult to over-ride and neutralise moral outrage. As a result, they may be more susceptible to mental health sequelae and impaired social and occupational functioning. Practical recommendations are made for clinicians supporting people with autism with a propensity for MD or moral injury, to improve their quality of life.
Practical implications
Practical recommendations are made for clinicians supporting people with autism with a propensity for MD or moral injury, to improve their quality of life.
Originality/value
Understanding MD in an autistic context is important for detecting and treating the adverse impacts of MD on autistic individuals. Importantly, erroneous preconceptions about moral reasoning in autism need to be mitigated to fully understand the moral experiences and harness the many strengths of people with autism.
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Mahvia Gul, Aniqa Kanwal and Husnain Ali Chaudhry
Caregivers for older adults play a crucial role in protecting those diagnosed with dementia. These caregivers often experience heightened anxiety, depression and burdens…
Abstract
Purpose
Caregivers for older adults play a crucial role in protecting those diagnosed with dementia. These caregivers often experience heightened anxiety, depression and burdens associated with their responsibilities. Sufficient support and efficient coping mechanisms alleviate distress and caregiving burdens, thereby enhancing and protecting adults. Acceptance and commitment therapy (ACT) fosters acceptance of internal experiences and promotes behaviors aligned with personal values. This single-arm pilot study aims to evaluate the feasibility, acceptability and preliminary effects of an online ACT intervention (Online Acceptance and Commitment Therapy Intervention for Caregivers [OACTIC]) on well-being aspects among dementia caregivers, emphasizing the importance of tailored interventions to protect older adults and their caregivers.
Design/methodology/approach
The caregiver must be ≥21 years of age (i.e. a parent, spouse, partner, sibling or adult child), or they must be the primary caregiver of older adults with dementia for ≥12 months and have scores that indicate moderate or higher on the scale of anxiety, depression and poor quality of life. Participants received an online-based ACT over six weekly 1-h sessions. The following outcome measures were administered at baseline (T1), immediately post-intervention (T2) and three-month follow-up (T3): Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Zarit Burden Interview, The Experience of Suffering Measure and Acceptance and Action Questionnaire-II.
Findings
All 45 participants completed the study, with 93.3% rating their OACTIC experience as “completely satisfied.”
Originality/value
OACTIC (Trial Registration# AEARCTR-0012366) is a novel study conducted in Pakistan, offering a cost-effective and time-efficient treatment approach that enhances the psychological well-being and protects older adults and their caregivers.
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Michael Fehsenfeld, Sofie Buch Mejsner, Helle Terkildsen Maindal and Viola Burau
Interprofessional collaboration and coordination are critical to developing solutions to complex problems, and many workplaces engage in coordination and collaboration across…
Abstract
Purpose
Interprofessional collaboration and coordination are critical to developing solutions to complex problems, and many workplaces engage in coordination and collaboration across organizational boundaries. This development changes work conditions and workplaces for many people. The ethnographic study of workplaces needs to re-configure the toolbox to adjust to such changes. The purpose of this study was to explore how the ethnographic study of dispersed workplaces can benefit from the analytical concept of boundary work.
Design/methodology/approach
A multi-sited ethnographic study was conducted in two health promotion programs, introducing new collaborative relations across sectors and professions. The concept of boundary work was applied as the conceptual frame and introduced the diagnosis of gestational diabetes mellitus (GDM) as a boundary object.
Findings
Professional boundaries are key to understanding interorganizational and interprofessional collaborations. The ethnographic study of complex, multi-sited settings using boundary work as a conceptual framework can enrich workplace ethnographies by demonstrating how professions position themselves through framing. Such framing strategies are used to construct, defend or contest boundaries. Boundary objects may potentially bridge devices connecting people across boundaries.
Originality/value
The traditional ethnographic notion of “following” an object or a subject is difficult in a workplace environment dispersed across multiple sites and involving many different actors. This suggests that workplace ethnographies studying interorganizational workplaces would benefit from a shift in focus from place-based or group-based ethnography to a field-level ethnography of relations using boundary work as an analytical frame.
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Alessandra Girardi, Lorraine Higham, Sarrah Fatima, Elanor Webb, Pieter Snyman, Paul Wallang and Kieran C. Breen
Social avoidance disorders can be disruptive to the individual as they begin to over-manage their lives, at times avoiding social and work commitments. A potential therapeutic…
Abstract
Purpose
Social avoidance disorders can be disruptive to the individual as they begin to over-manage their lives, at times avoiding social and work commitments. A potential therapeutic approach is exposure therapy and a virtual reality (VR) treatment approach, gameChange VR, has been developed. This provides an opportunity to test their fears in virtual environments. This study aims to investigate the feasibility of using this VR approach to treat people with social avoidance problems within a secure mental health setting.
Design/methodology/approach
Nine participants completed the gameChange VR sessions. Participants received 30-minute VR sessions for up to six weeks using selected scenarios at five levels of difficulty. Patients’ comments and behaviours were noted and clinical staff also provided feedback on their observations of patients’ use and experience with VR.
Findings
Overall, patients felt that the gameChange VR helped them to build their confidence and reduce their overall anxiety as they became more comfortable with the equipment. Both patients and staff generally found the intervention easy to use and the staff reported an overall high level of engagement among the participants. The key issues raised largely related to technical and safety issues.
Originality/value
While a previous study was carried out using gameChange VR with an outpatient cohort, this was the first using an inpatient group in a secure mental health setting. It has demonstrated that the intervention is viable in this setting, although further studies are required to identify the specific patient population that would benefit optimally from the therapy.
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