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Article
Publication date: 7 November 2023

John McEwan McManus, Styliani Gkika and Elaine Swift

Hearing voices can be a debilitating and traumatic experience, and psychiatric hospitals can feel unsafe and overstimulating to voice hearers. Research suggests this may prolong a…

Abstract

Purpose

Hearing voices can be a debilitating and traumatic experience, and psychiatric hospitals can feel unsafe and overstimulating to voice hearers. Research suggests this may prolong a service user’s admission time and lead to an unhelpful experience. Therefore, a hearing voices group (HVG) was developed to create a safe space where voice hearers could share their story with others with lived experience and access support.

Design/methodology/approach

The group was developed by the first author under the supervision of the inpatient psychology lead. Both a practice-based and expert by experience-based approach were considered during the development of the group structure. The group also aligned with the Hearing Voices Network and the Trust’s values. A questionnaire was developed to evaluate the effectiveness of the group using six five-point Likert scale questions and three open questions to collect the data, which was then analysed.

Findings

The themes from the qualitative data showed that staff and ward-based promotion of the group were paramount to ensuring patient engagement. The results also showed that voice hearers found the group therapeutic, and some found the coping skills shared to be beneficial and effective.

Research limitations/implications

A large percentage of women (76%) reported that they had attended a HVG before. This was not the case for service users from the male unit and psychiatric intensive care unit. This result is considered to reflect the fact that women in that unit had the opportunity to attend more than once during their admission, rather than that they had accessed these groups in other settings or in the community. Therefore, in the future, it would be useful to change this question to “have you attended any other HVGs in the past, prior to this admission?”, which might be more appropriate for data collection.

Originality/value

To the best of the authors’ knowledge, this is the original work of the first author, who is an expert by experience and an assistant psychologist. The results suggest that HVGs can be beneficial for patients in acute and intensive mental health care and highlight some necessary adaptations and the importance of adopting an MDT approach in promoting therapeutic groups.

Details

Mental Health and Social Inclusion, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2042-8308

Keywords

Abstract

Purpose

This study aims to evaluate and summarize the effectiveness of cognitive behavioral therapy (CBT) and internet-based CBT (ICBT) interventions on relapse prevention and severity of symptoms among individuals with major depressive disorder (MDD). CBT is one of the most used and suggested interventions to manage MDD, whereas ICBT is a novel effective proposed approach.

Design/methodology/approach

The review was conducted following the preferred reporting items for systematic review and meta-analysis protocol. A comprehensive and extensive search was performed to identify and evaluate the relevant studies about the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD.

Findings

A total of eight research studies met the inclusion criteria and were included in this systematic review. RCT studies were conducted to assess and evaluate the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD. It has been found that CBT is a well-supported and evidently based effective psychotherapy for managing depressive symptoms and reducing the relapse and readmission rate among patients diagnosed with MDD. The ICBT demonstrated greater improvements in depressive symptoms during major depressive episodes among patients with MDDS. The ICBT program had good acceptability and satisfaction among participants in different countries.

Research limitations/implications

Despite the significant findings from this systematic review, certain limitations should be acknowledged. First, it is important to note that all the studies included in this review were exclusively conducted in the English language, potentially limiting the generalizability of the findings to non-English speaking populations. Second, the number of research studies incorporated in this systematic review was relatively limited, which may have resulted in a narrower scope of analysis. Finally, a few studies within the selected research had small sample sizes, which could potentially impact the precision and reliability of the overall conclusions drawn from this review. The authors recommend that nurses working in psychiatric units should use CBT interventions with patients with MDD.

Practical implications

This paper, a review of the literature gives an overview of CBT and ICBT interventions to reduce the severity of depressive symptoms and prevent patients’ relapse and rehospitalization and shows that CBT interventions are effective on relapse prevention among patients with MDD. In addition, there is still no standardized protocol to apply the CBT intervention in the scope of reducing the severity of depressive symptoms and preventing depression relapse among patients with major depressive disorder. Further research is needed to confirm the findings of this review. Future research is also needed to find out the most effective form and contents of CBT and ICBT interventions for MDD.

Social implications

CBT is a psychological intervention that has been recommended by the literature for the treatment of major depressive disorder (MDD). It is a widely recognized and accepted approach that combines cognitive and behavioral techniques to assist individuals overcome their depressive symptoms and improve their overall mental well-being. This would speculate that effectiveness associated with several aspects and combinations of different approaches in CBT interventions and the impact of different delivery models are essential for clinical practice and appropriate selection of the interventional combinations.

Originality/value

This systematic review focuses on the various studies that explore the effectiveness of face-to-face CBT and ICBT in reducing depressive symptoms among patients with major depressive disorder. These studies were conducted in different countries such as Iran, Australia, Pennsylvania and the USA.

Details

Mental Health and Social Inclusion, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2042-8308

Keywords

Article
Publication date: 12 April 2024

Robert J. Kane, Jordan M. Hyatt and Matthew J. Teti

The paper examines the historical shifts in policing strategies towards individuals with SMI and vulnerable populations, highlighting the development of co-response models…

Abstract

Purpose

The paper examines the historical shifts in policing strategies towards individuals with SMI and vulnerable populations, highlighting the development of co-response models, introducing the concept of “untethered” co-response.

Design/methodology/approach

This paper conducts a review of literature to trace the evolution of police responses to individuals with serious mental illness (SMI) and vulnerable populations. It categorizes four generations of police approaches—zero-policing, over-policing, crisis intervention and co-response—and introduces a fifth generation, the “untethered” co-response model exemplified by Project SCOPE in Philadelphia.

Findings

The review identifies historical patterns of police response to SMI individuals, emphasizing the challenges and consequences associated with over-policing. It outlines the evolution from crisis intervention teams to co-response models and introduces Project SCOPE as an innovative “untethered” co-response approach.

Research limitations/implications

The research acknowledges the challenges in evaluating the effectiveness of crisis intervention teams and co-response models due to variations in implementation and limited standardized models. It emphasizes the need for more rigorous research, including randomized controlled trials, to substantiate claims about the effectiveness of these models.

Practical implications

The paper suggests that the “untethered” co-response model, exemplified by Project SCOPE, has the potential to positively impact criminal justice and social service outcomes for vulnerable populations. It encourages ongoing policy and evaluative research to inform evidence-based practice and mitigate collateral harms associated with policing responses.

Social implications

Given the rising interactions between police and individuals with mental health issues, exacerbated by the COVID-19 pandemic, the paper highlights the urgency for innovative, non-policing-driven responses to vulnerable persons.

Originality/value

The paper contributes to the literature by proposing a fifth generation of police response to vulnerable persons, the “untethered” co-response model and presenting Project SCOPE as a practical example.

Details

Policing: An International Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1363-951X

Keywords

Article
Publication date: 26 September 2023

Çağrı Hamurcu, Hayriye Dilek Yalvac Hamurcu and Merve Karakuş

This study aimed to examine the financial risk-taking behaviors of adult individuals diagnosed with attention deficit hyperactivity disorder (ADHD).

Abstract

Purpose

This study aimed to examine the financial risk-taking behaviors of adult individuals diagnosed with attention deficit hyperactivity disorder (ADHD).

Design/methodology/approach

The study was conducted with adults (n = 80) diagnosed with ADHD and healthy controls (n = 80). In order to measure risk-taking in the financial domain, the items in the investment and gambling sub-dimensions of the Domain-Specific Risk-Taking Scale (DOSPERT) were applied.

Findings

Adults with ADHD had higher investment and gambling risk-taking and expected benefits scores than the control group, and there was no difference between the two groups in terms of risk perceptions. In the regression analysis, there was a positive linear relationship between the investment and gambling risk-taking scores and the expected benefits scores in both groups. There was a negative linear relationship between investment risk-taking and risk perceptions scores only in the control group.

Originality/value

In terms of investment and gambling, both risk-taking and expected benefits are greater in individuals with ADHD. It has been observed that while healthy individuals take investment risks, they evaluate according to the expected benefits and risk perceptions, while individuals with ADHD make evaluations only according to the expected benefits, risk perceptions do not predict financial risk-taking in individuals with ADHD. When it comes to risk-taking related to gambling, both groups take risks only according to their expectations of benefits, not their perceptions of risk. The study provides outputs that can contribute to the literature in terms of the effects of ADHD diagnosis on financial decision-making processes in the context of risk-taking.

Details

Review of Behavioral Finance, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1940-5979

Keywords

Article
Publication date: 31 January 2024

Margit Malmmose and Mai Skjøtt Linneberg

The objective of this study is to examine developments in the discursive practice of non-financial reporting in the public healthcare sector. In doing so, the authors investigate…

Abstract

Purpose

The objective of this study is to examine developments in the discursive practice of non-financial reporting in the public healthcare sector. In doing so, the authors investigate how the main reform foci of productivity and quality are represented, with a specific focus on the patient.

Design/methodology/approach

Drawing on critical discourse analysis (CDA), the authors conduct a longitudinal study (2007–2018) of healthcare reporting foci across the five administrative regions responsible for public hospitals in Denmark. The study analyses sixty annual reports and draws on contemporary reform documents over this period. CDA enables a micro-textual analysis, combined with macro-insights and discussions on social practice.

Findings

The findings show complex webs of presentation strategies, but in particular two changes occur during the period. First, the patient is centred throughout but the framing changes from productivity and waiting lists to quality and dialogue. Second, in the first years, the regions present themselves as actively highlighting financial and quality concerns, which changes to a passive and indirect form of presentation steered by indicators and patient legislation enforced by central government. This enhances passivity and distance in healthcare regional non-financial reporting where the regions seek to conform to such demands. Simultaneously, however, the authors find a tendency to highlight very different local initiatives, which shows an attempt to go beyond a pure automatic mode of reporting found in earlier studies.

Originality/value

Responding to the literature on both healthcare and financial reporting, this study identifies novel links between micro-level texts and macro-level social practices, enabling insights into the potentially intertwined impacts of public-sector reporting. The authors offer insights into the complexity of the construction of non-financial reporting in the public sector, which has a wider impact and different intentions than private-sector reporting.

Details

Accounting, Auditing & Accountability Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0951-3574

Keywords

Article
Publication date: 16 April 2024

Sadia Zahid, Bushra Rauf, Rachel Lee, Hafsa Sheikh, Ashok Roy and Rani Pathania

A quantitative observational study was conducted. The purpose of this study is to examine the continuing adherence to the stopping over-medication of people with intellectual…

Abstract

Purpose

A quantitative observational study was conducted. The purpose of this study is to examine the continuing adherence to the stopping over-medication of people with intellectual disability and/or autism guidelines for a cohort of outpatients seen in the outpatients’ clinics in the two teams who participated in this study to review the trend of psychotropic prescribing with a prescription indication along with the utilisation of non-pharmacological interventions.

Design/methodology/approach

Data was retrospectively collected over a period of one year for patients sampled conveniently in the outpatient’s clinic. The data was collected from two sites from psychiatric letters to the general practitioners (GPs), with the focus being psychotropic prescription indication and their adherence to British National Formulary limits, inclusion of a wider multi-disciplinary team or MDT (including nurses, psychologists and health support workers), use of Clinical Global Impression (CGI) scale for assessing medication side effects and response to treatment.

Findings

Most of the patients had at least one review in the previous six months. Antipsychotics were the highest prescribed medications without an indication for their use (13.3%) followed by anxiolytics and other medications. CGI recording was suboptimal, with 26% of the patient population did not have medication side effects and effectiveness monitored through this method. In total, 41% of patients were open to community nurses followed by other disciplines.

Originality/value

To the best of the authors’ knowledge, this is an original article following the pilot study completed by the authors.

Details

Advances in Mental Health and Intellectual Disabilities, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 1 April 2024

Lorna Montgomery and Adi Cooper

Institutional abuse is a worldwide phenomenon with the UK also subject to several high-profile abuse scandals perpetuated on people with learning disabilities and/or mental health…

Abstract

Purpose

Institutional abuse is a worldwide phenomenon with the UK also subject to several high-profile abuse scandals perpetuated on people with learning disabilities and/or mental health conditions living within institutional settings. This study aims to provide a broad perspective of safeguarding practices within institutional care to inform practice and service development in this area.

Design/methodology/approach

A narrative overview was undertaken of a range of empirical evidence, discussion papers, enquiry reports, reports from regulatory bodies and professional guidance to explore safeguarding practices within institutional care for individuals with learning disabilities and/or mental health conditions.

Findings

A range of literature was identified that exposed and explored abuse in this context. Three key themes were identified: failings within institutional care; safeguarding issues and concerns; and good practice within institutional care. Whilst guidance is available, standards are explicit and protocols facilitate improvement potential in this area, a consistent message was that statutory recommendations for reform have not been effective.

Originality/value

This paper provides an important resource for practitioners and service providers involved in institutional care. An accessible overview of both the empirical evidence and grey literature on adult safeguarding within institutional settings is provided, along with a range of standards and resources that specify practice in these settings.

Details

The Journal of Adult Protection, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 24 October 2023

Barrie Green and Jake Stanworth

This paper aims to critically compare the impact and preparedness for practice of two types of mental health nurse training in the UK. One being a hospital-based apprenticeship…

Abstract

Purpose

This paper aims to critically compare the impact and preparedness for practice of two types of mental health nurse training in the UK. One being a hospital-based apprenticeship model from the 1980s; the other a university-based and more academically focussed approach from this millennium.

Design/methodology/approach

This autoethnographic reflective commentary describes and reviews the effectiveness of two training curricula for Registered Mental Nurse (RMN) training. The first being the certificate-level 1983 syllabus of the UK Central Council for Nursing, Midwifery and Health Visiting, which was replaced in the late 1990s by diploma and degree-level Project 2000 training of the General Nursing Council. Using a reflective narrative approach to describe the lived experience of two qualified nurses, it compares, reviews and critiques both initiatives.

Findings

The author/researchers found both benefits and negatives inherent in each model. These were grouped into five key headings, which are a sense of belonging/identity; exposure to clinical practice; differences in training modality; development of clinical management skills and clinical preparedness; and academic merit. The older curriculum lacked an academic or research base, whereas the more recent approach encouraged and enhanced this element. However, with regard to preparing the clinician/registered nurse to feel confident in addressing a range of clinical and managerial challenges, the older style training seems to deliver better outcomes. They conclude that a move towards a “middle ground” between the two models may be of benefit to future RMN preparation.

Research limitations/implications

This study reports on the experience of two registered nurses. Therefore, the sample size is small. However, autoethnography is acknowledged as an effective means of delivering qualitative research; in addition, the authors access and use material from the wider literature to triangulate and critique their approach. This paper adds to the literature but also allows for duplication by others to further test the findings.

Practical implications

This type of study provides an opportunity for others to review, compare and contrast nursing or other multi-discipline changes in training/curriculum. The research method is one that is transferable and can be used within areas of practice, which have resource limitations. It provides an opportunity to replicate it in other services or jurisdictions.

Social implications

Nursing in the UK has experienced significant change over the past four decades. For RMNs, the move from hospitals into the community has been transformational. In addition, the influence of higher academic standards and the influence of the recent pandemic have challenged the profession and individuals within it. This study demonstrates positive and negative elements of the dilemma faced by nurses and offers a further contribution to this area.

Originality/value

There are a number of academic papers, media stories, statutory reports and guidance that explore the impact of changes within nurse training. This paper uses a first person autoethnographic study of the impact and effectiveness of these changes at a human level, the nurse on the ground. It uses the ward medicine keys as the vehicle to represent the huge responsibility that newly qualified nurses must face; this is not widely represented elsewhere in the literature!

Details

Mental Health and Social Inclusion, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2042-8308

Keywords

Article
Publication date: 21 March 2024

Archana Shrivastava and Ashish Shrivastava

This study aims to investigate the consumer behavior toward telemedicine services in India during the COVID-19 pandemic onset. With lockdown restrictions and safety concerns in…

Abstract

Purpose

This study aims to investigate the consumer behavior toward telemedicine services in India during the COVID-19 pandemic onset. With lockdown restrictions and safety concerns in visiting brick-and-mortar clinics or hospitals during the pandemic, Telemedicine had emerged as a potent alternative for seeking redressal to health issues. Based on theory and focus interviews with the telemedicine users, the researchers proposed a model to understand the intent and actual usage of telemedicine in India.

Design/methodology/approach

The cross-sectional study undertaken used a questionnaire designed on a seven-point Likert scale and administered to respondents with the objective of identifying the determinants of intent and actual usage of telemedicine services. Simple random sampling was used to collect primary data. The data was cleaned and finally a sample of 405 responses complete in all respects was considered for analysis. The questionnaire comprised of 34 items and following the recommendation of Hair et al. (2016), which says the minimum sample size in structural equation modeling should be ten times the number of indicator variables, a sample size of 405 was deemed adequate.

Findings

The research paper finds that performance expectancy, attitude, credibility and self-efficacy positively impact the intention of consumers to use telemedicine services. As the effort expectancy or risk perception toward telemedicine increases the intent and actual usage of telemedicine decreases. The intention to use telemedicine emerged as a strong predictor of the actual usage of telemedicine. Intent to use telemedicine was explained 81.4% by its predictors of performance expectancy, effort expectancy, attitude, risk, credibility and self-efficacy, and actual usage was explained 79.9% by its predictors. This study also reports that telemedicine was found to be popular among chronic as well as episodic patients though the preference was skewed in favor of the episodic patients. One of the advantages of telemedicine is its availability round the clock, and the study found that 8 a. m. to 12 noon time slot as the most preferred slot for seeking telemedicine services.

Practical implications

Chang (2004) opined that telemedicine can fulfill the needs of all stakeholders: citizens, health-care consumers, medical doctors and health-care professionals, policymakers, and so on. Considering the promise telemedicine holds, this realm must be studied and leveraged to the full potential. The study found that patients were using telemedicine even for their day-to-day aliments. This indicates a growing popularity of telemedicine and as such an opportunity for telemedicine companies to leverage it. In India, pharmaceutical companies cannot give commercial advertisements for medicines, and the same can only be sold through a registered medical practitioner’s prescription. As such there is total dependency on the medical practitioner for the sale of medicines. Telemedicine companies offer services of home delivering medicines clubbed with medical consultation thus giving them forward integration in their business models. Using telemedicine the patients had control over the timings of the services offered, and as such the waiting time to get a consultation and subsequent treatment was reduced considerably. Best medical advice from across the globe is available to the patient at less cost. Medical practitioners also stand to benefit as they can treat a variety of cases, collaborate among the medical fraternity and give consultation safely in case of fatal contagious diseases.

Originality/value

This study points to a definite growing popularity of telemedicine services not only in episodic patients but also chronic patients. Telemedicine with its unique advantages holds the promise to grow exponentially in the future and is a compelling health-care segment to focus on for delivering health-care solution to the geographically distant consumers.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1750-6123

Keywords

Article
Publication date: 25 March 2024

Angela Crocker, Jill Titterington and Michelle Tennyson

This study aims to evaluate the quality of a speech and language therapy (SLT) swallow service provided to adults with intellectual disability (ID) by exploring the process and…

Abstract

Purpose

This study aims to evaluate the quality of a speech and language therapy (SLT) swallow service provided to adults with intellectual disability (ID) by exploring the process and outcome factors; to explore the process of what is done to and for the patient including identifying dysphagia, choking and pneumonia risk, typical interventions and management; examine clinical outcomes; and explore the relationship of outcomes with risk factors, satisfaction with the service and the impact of the service on the number of choking incidents and admissions to acute hospital with swallow concerns.

Design/methodology/approach

There were three specific work packages: (1) collecting and scrutinising patient data from the clinical record for adults with ID referred to the SLT swallow service over a six-month period. The researcher created aims, defined the limits to achieve the aims, designed a standardised data collection form, set out where data was in the clinical record, piloted, set limits for collection and trained reviewers; (2) gathering experience and satisfaction surveys from patients, caregivers and referrers over the six-month study period; and (3) monitoring choking adverse incident reports and hospital admission with swallow concerns for the whole ID population.

Findings

Choking and hospital admission were the main reasons for referral, and pneumonia risk significantly predicted dysphagia impairment. The research highlighted common dysphagia risk factors, interventions and recommendations for this population. The SLT swallow service is a quality service that is highly valued by patients, their caregivers and referrers. The service achieves significant clinical improvements, helps identify dysphagia and provides management to reduce associated risks.

Research limitations/implications

This study found common dysphagia risk factors, interventions and recommendations; it also found that the therapy outcome measures/Royal College of Speech and Language Therapy online outcome tool was a meaningful outcome measure, and that pneumonia risk significantly predicted dysphagia impairment, all of which could inform the identified dysphagia research priorities for this population.

Practical implications

Naming usual care in treatment and recommendations could help ensure a fair service and could help form quality indicators. People with ID, their caregivers and staff generated valuable ideas for improvement, and further involvement work could create a logic model for the service. Other future work could explore the use of screening tools, increase multidisciplinary team working, improve access to instrumental assessments, raise awareness of swallowing and promote important oral health and medication reviews. By using this information to shape quality improvement work and policies, one can work toward addressing high health-related inequalities and preventable deaths associated with dysphagia in this vulnerable population.

Social implications

It may be useful to raise awareness that adults with ID age earlier and that one should not exclude them from older people’s services because of an age threshold, often set higher than their life expectancy. This study highlighted a possible inequality of access issue for adults with ID who do not have direct care or day care staff. There is a need to increase access to awareness training so caregivers and general practitioners can recognise swallow difficulties and know how to make a referral for a swallow assessment.

Originality/value

Overall, the evaluation of the swallow service to adults with ID suggests that SLT have a quality service for adults with ID that is highly valued and provides significant clinical improvements. By building on these strengths, SLT could extend the reach, influence and impact of their services to help those adults with ID who have emerging swallow difficulties or who do not access the service.

Details

Tizard Learning Disability Review, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1359-5474

Keywords

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