Correlates of motivation for treatment among alcohol service users in Uganda

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
David Kalema ◽  
Lore Van Damme ◽  
Sofie Vindevogel ◽  
Ilse Derluyn ◽  
Peter Baguma ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Psychological Needs ◽  
Longitudinal Impact ◽  
Service Users ◽  
Treatment Motivation ◽  
Treatment Needs ◽  
Content Type ◽  
Addiction Severity ◽  
Motivation For Treatment ◽  
External Motivation

Purpose Given the scarce literature on alcohol use disorders (AUD) and their treatment in developing countries, this paper aims to explore motivation levels and their correlates among alcohol service users in two residential treatment centres in Kampala, Uganda. This study how motivation levels of Ugandan alcohol service users compare with those from American studies; and the specific factors affecting internal and external motivation in the Ugandan context. Design/methodology/approach The motivation for treatment was measured among 100 individuals entering AUD treatment using the Texas Christian University (TCU) Treatment needs and Motivation scale. The WHOQoL–BREF, Addiction Severity Index–6 and Hopkins Symptoms Check List–37 were used to measure addiction severity, quality of life (QoL) and psychopathology, respectively. Correlates of motivation were identified using linear regression analyses. Findings Ugandan service users demonstrated low treatment motivation in the treatment needs a domain. While addiction severity (recent heavy alcohol use) and participating in private treatment were associated with higher internal and external motivation, deterioration in physical and environmental QoL, depressive symptoms and lower education were linked with higher internal motivation. Research limitations/implications Different elements affect domains of treatment motivation, requiring attention for clients’ unique needs as influenced by their background, addiction severity, QoL, psychological needs and contextual factors (e.g. treatment setting). Further studies are needed to explore additional correlates of motivation for treatment among alcohol service users in Uganda and to assess the longitudinal impact of motivation on treatment outcomes. Originality/value Although motivation has been extensively studied, clinicians are challenged in understanding and explaining motivational dynamics given the multiplicity of factors influencing change-related decisions and behaviours and the diversity in substance-using populations. This need is even bigger in non-Western societies as cultural differences may require differential therapeutic management. This is one of the first studies measuring motivation for AUD treatment in a low-income country and offers insight for understanding motivation dynamics in similar settings.

Preliminary evaluation of a forensic dual diagnosis intervention

2015 ◽  
Vol 8 (1) ◽  
pp. 42-56 ◽  
Author(s):  
Marc Samuel Tibber ◽  
Nicola Piek ◽  
Sara Boulter
Keyword(s):  
Treatment Outcome ◽  
Motivational Interviewing ◽  
Coping Strategies ◽  
Dual Diagnosis ◽  
Readiness For Change ◽  
Self Report ◽  
Service Users ◽  
Content Type ◽  
Stage 1 ◽  
Motivation For Treatment

Purpose – This study is a post hoc service level investigation into the efficacy of a forensic dual diagnosis intervention. The treatment programme incorporated the principles of cognitive behavioural therapy and Motivational Interviewing, and was comprised of three stages: psycho-education into the links between mental/physical health, substance use and offending, the cultivation of coping strategies and relapse prevention planning. The paper aims to discuss these issues. Design/methodology/approach – Treatment outcome was tracked using pre- and post- stage 1 and 2 measures, and included self-report questionnaires that probed service users’ readiness for change, motivations for treatment and perceived effectiveness of coping strategies (n=80 and 37 patients for stages 1 and 2, respectively). In addition, service users undertook a knowledge “quiz”, which probed information retention. Findings – The results show that whilst psycho-education (stage 1) increased service users’ knowledge of key issues, this had no parallel effects on other measures. In contrast, completion of stage 2 led to an increase in external motivation for treatment, although this did not translate into a shift in service users’ readiness for change. Research limitations/implications – These findings are consistent with the Motivational Interviewing literature and highlight the need for a shift in internalised motivation for treatment if change is to be elicited. Further, they point towards the viability of using self-report measures to monitor treatment outcome in a secure forensic setting. Originality/value – These findings have a number of implications for the design and on-going evaluation of forensic dual diagnosis services, an area of research that is currently under-represented in the literature.

Now they’re listening: involvement in clinical psychology training

2019 ◽  
Vol 23 (1) ◽  
pp. 23-29
Author(s):  
Laura Lea ◽  
Sue Holttum ◽  
Victoria Butters ◽  
Diana Byrne ◽  
Helen Cable ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Clinical Psychology ◽  
Health Professionals ◽  
Service User ◽  
Health Workers ◽  
Psychology Training ◽  
Service Users ◽  
Clinical Psychology Training ◽  
Content Type

PurposeThe 2014/2015 UK requirement for involvement of service users and carers in training mental health professionals has prompted the authors to review the work of involvement in clinical psychology training in the university programme. Have the voices of service users and carers been heard? The paper aims to discuss this issue.Design/methodology/approachThe authors update the paper of 2011 in which the authors described the challenges of inclusion and the specific approaches the authors take to involvement. The authors do this in the context of the recent change to UK standards for service user and carer involvement, and recent developments in relation to partnership working and co-production in mental healthcare. The authors describe the work carried out by the authors – members of a service user involvement group at a UK university – to ensure the voices of people affected by mental health difficulties are included in all aspects of training.FindingsCareful work and the need for dedicated time is required to enable inclusive, effective and comprehensive participation in a mental health training programme. It is apparent that there is a group of service users whose voice is less heard: those who are training to be mental health workers.Social implicationsFor some people, involvement has increased. Trainee mental health professionals’ own experience of distress may need more recognition and valuing.Originality/valueThe authors are in a unique position to review a service-user-led project, which has run for 12 years, whose aim has been to embed involvement in training. The authors can identify both achievements and challenges.

An outcomes study of eTherapy for dual diagnosis using Breaking Free Online

2014 ◽  
Vol 7 (2) ◽  
pp. 52-62 ◽  
Author(s):  
Sarah Elison ◽  
Jonathan Ward ◽  
Glyn Davies ◽  
Nicky Lidbetter ◽  
Daniel Hulme ◽  
...  
Keyword(s):  
Mental Health ◽  
Dual Diagnosis ◽  
Substance Dependence ◽  
Clinical Effectiveness ◽  
Outcome Data ◽  
Post Treatment ◽  
Service Users ◽  
Original Cohort ◽  
Content Type ◽  
Self Help

Purpose – In recent years there has been a proliferation of computer-based psychotherapeutic interventions for common mental health difficulties. Building on this, a small number of such interventions have now been developed to address substance dependence, one of which is Breaking Free Online (BFO). A new “eTherapy” self-help service, which was set up by the UK mental health charity Self-Help Services, has provided access to BFO to service users presenting with comorbid mental health and substance misuse difficulties. The purpose of this paper is to evaluate a range of clinical outcomes in the first cohort of service users accessing this dual diagnosis service. Design/methodology/approach – A number of standardised psychometric assessments were conducted with service users at baseline and post-treatment at discharge from the service. Outcome data were available for 47 service users out of an original cohort of 74. Findings – Statistically significant improvements were found in terms of measures of social functioning, depression, anxiety, alcohol and drug use and social anxiety. Clinically relevant gains were also identified, with fewer service users reaching threshold scores for depression and anxiety at post-treatment compared to baseline. Effect sizes also indicated that the identified improvements across the psychometric measures were robust and significant. Research limitations/implications – These findings provide further support for the clinical effectiveness of BFO, and also provide evidence that an eTherapy self-help service may be appropriate for some individuals presenting with dual diagnosis. Further research is underway with larger and alternative clinical populations to examine the effectiveness of BFO and also this novel eTherapy self-help approach. Originality/value – This paper has provided initial data to support effectiveness of a novel eTherapy service for dual diagnosis.

scholarly journals Mental health nurses’ perceptions of attachment style as a construct in a medium secure hospital: a thematic analysis

2015 ◽  
Vol 10 (4) ◽  
pp. 218-233 ◽  
Author(s):  
Nikki Boniwell ◽  
Leanne Etheridge ◽  
Ruth Bagshaw ◽  
Joanne Sullivan ◽  
Andrew Watt
Keyword(s):  
Attachment Theory ◽  
Attachment Style ◽  
Thematic Analysis ◽  
Service User ◽  
Attachment Styles ◽  
Personality Development ◽  
Educational Interventions ◽  
Service Users ◽  
Structured Interviews ◽  
Content Type

Purpose – Attachment Theory can be regarded as central to the concept of relational security. There is a paucity of research examining the coherence of this construct for ward-based staff. The paper aims to discuss these issues. Design/methodology/approach – Five female nurses from the acute admission and assessment ward of a UK medium secure unit acted as participants. Semi-structured interviews were conducted, and inductive thematic analysis was applied. Findings – Six themes; “staff-service user relationships”, “staff diversities”, “service user backgrounds”, “variability in service users’ presentations”, “service users with personality disorder are problematic” and “nurses do not use attachment” emerged from the data. The nurses used heuristic models of attachment-related behaviour and they lacked knowledge of constructs associated with Attachment Theory. Research limitations/implications – Acute admissions may not be representative of all treatment contexts. Traditional models of attachment style may have only limited relevance in forensic services. Practical implications – Limited knowledge and confidence in the nurses regarding how Attachment Theory might apply to service users is interesting because it may limit the extent to which care, treatment and risk management might be informed by an understanding of service user representations of therapeutic relationships. Training and educational interventions for nurses that enhance understanding of personality development and attachment styles are warranted. Originality/value – The importance of nurses for achieving relational security is emphasised and the adequacy of their training is questioned.

Satisfaction of tuberculosis patients with health services in Ghana

2017 ◽  
Vol 30 (6) ◽  
pp. 545-553 ◽  
Author(s):  
Frank Bonsu ◽  
Felix Afutu ◽  
Nii Nortey Hanson-Nortey ◽  
Mary-Anne Ahiabu ◽  
Joshua Amo-Adjei
Keyword(s):  
Client Satisfaction ◽  
Service Providers ◽  
Healthcare Providers ◽  
Large Body ◽  
Service Users ◽  
Content Type ◽  
Sputum Production ◽  
Interview Guide

Purpose Within human services, client satisfaction is highly prioritised and considered a mark of responsiveness in service delivery. A large body of research has examined the concept of satisfaction from the perspective of service users. However, not much is known about how service providers construct client satisfaction. The purpose of this paper is to throw light on healthcare professionals’ perspectives on patient satisfaction, using tuberculosis (TB) clinics as a case study. Design/methodology/approach In-depth interviews were conducted with 35 TB clinic supervisors purposively sampled from six out of the ten regions of Ghana. An unstructured interview guide was employed. The recorded IDIs were transcribed, edited and entered into QSR NVivo 10.0 and analysed inductively. Findings Respondents defined service satisfaction as involving education/counselling (on drugs, nature of condition, sputum production, caregivers and contacts of patients), patient follow-up, assignment of reliable treatment supporters as well as being attentive and receptive to patients, service availability (e.g. punctuality at work, availability of commodities), positive assurances about disease prognosis and respect for patients. Practical implications Complementing opinions of health service users with those of providers can offer key performance improvement areas for health managers. Originality/value To the best of the authors’ knowledge, this is a first study that has examined healthcare providers’ views on what makes their clients satisfied with the services they provide.

Six sigma in health-care service: a case study on COVID 19 patients’ satisfaction

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kaja Bantha Navas Raja Mohamed ◽  
Palaninatha Raja M. ◽  
SharmilaParveen S. ◽  
John Rajan A. ◽  
Ranjitham Anderson
Keyword(s):  
Health Care ◽  
Waiting Time ◽  
Six Sigma ◽  
Quality Function Deployment ◽  
Health Care Service ◽  
Psychological Needs ◽  
Process Standardization ◽  
Content Type ◽  
Patients Satisfaction

Purpose The purpose of this paper is to determine the major influencing factors for the COVID 19 patients’ satisfaction with a six sigma framework model and to explore the successful deployment of six sigma in the health-care sector a case study on COVID 19 patients’ satisfaction. Design/methodology/approach The study is based on a descriptive research design conducted in Chennai, India between May to July 2020 wherein 1,000 COVID 19 patients were studied. The convenience sampling method is used by the researcher for data collection. In this research paper, define-measure-analysis-improve-control methodology has been applied and factors such as assurance, process standardization, infrastructure, waiting time, cost were analyzed using quality function deployment (QFD), regression analysis and Monte Carlo simulation. Findings The applied six sigma model indicated that process standardization contributed the most toward the variation in COVID 19 patients’ satisfaction. Assurance by doctors is the second important factor. The interpersonal quality is important, which indicates a higher level of psychological needs in COVID 19 patients. Waiting time is another important factor influencing COVID 19 patients’ satisfaction. One of the unexpected findings is that cost is insignificant in influencing COVID 19 patients’ satisfaction. Originality/value Six Sigma focuses on process variation improvement that encourages data analysis and problem-solving statistical techniques and evaluates the ability of a process to perform defect-free. Six sigma focused toward COVID 19 patients’ satisfaction has not been carried out, which this paper has done.

Human rights of people with mental illness diagnosis: perceptions among service users, family members and health professionals in Tunisia

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mayssa Rekhis ◽  
Sami Ouanes ◽  
Abir Ben Hamouda ◽  
Rym Rafrafi
Keyword(s):  
Mental Illness ◽  
Human Rights ◽  
Family Members ◽  
Mental Illnesses ◽  
Service Users ◽  
Content Type ◽  
People With Mental Illness ◽  
The Family ◽  
The Right ◽  
Main Factor

Purpose This study aims to assess the awareness about the rights of people with mental illness in the main psychiatric hospital in Tunisia among the service users, the family members and the staff. Design/methodology/approach The Convention of Rights of People with Disabilities mandates that State Parties initiate and maintain campaigns and human rights training to promote understanding of the rights of people with mental illnesses, considered as a main factor for their fulfillment. Service users, family members and staff evaluated, through a survey, the importance of ten rights for persons with mental illness, stated in the convention. Findings Disparities were found in the perception of the different rights by and between the three groups. The highest levels of awareness were associated with the freedom from torture or degrading treatment and the right to live with dignity and respect, whereas the lower importance were assigned to the right to participation in recovery plans, to give consent and to exercise legal capacity. Originality/value The lack of awareness and the poor perception of rights of people with mental illness is one of the barriers to their achievement. More training and awareness raising is necessary.

Is co-production working well in recovery colleges? Emergent themes from a systematic narrative review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Karen Louise Bester ◽  
Anne McGlade ◽  
Eithne Darragh
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Social Care ◽  
The Body ◽  
Bibliographic Databases ◽  
Service Users ◽  
Content Type ◽  
Practitioner Attitudes ◽  
Health And Social Care ◽  
The Impact

Purpose “Co-production” is a process in health and social care wherein service users and practitioners work in partnership. Recovery colleges (RCs) are educational establishments offering mental health education; a cornerstone feature is that courses are designed and delivered in parity by both mental health practitioners and “peers” – people with lived experience of mental illness. This paper aims to consider, through the identification of key themes, whether co-production within RCs is operating successfully. Design/methodology/approach The paper is a systematic review of qualitative literature. Relevant concept groups were systematically searched using three bibliographic databases: Medline, Social Care Online and Scopus. Articles were quality appraised and then synthesised through inductive thematic analysis and emergent trends identified. Findings Synthesis identified three key themes relating to the impact of co-production in RCs: practitioner attitudes, power dynamics between practitioners and service users, and RCs’ relationships with their host organisations. As a result of RC engagement, traditional practitioner/patient hierarchies were found to be eroding. Practitioners felt they were more person-centred. RCs can model good co-productive practices to their host organisations. The review concluded, with some caveats, that RC co-production was of high fidelity. Originality/value RC research is growing, but the body of evidence remains relatively small. Most of what exists examine the impact of RCs on individuals’ overall recovery and mental health; there is a limited empirical investigation into whether their flagship feature of parity between peers and practitioners is genuine.

Trauma-informed servant leadership in health and social care settings

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Daryl Mahon
Keyword(s):  
Servant Leadership ◽  
Conceptual Model ◽  
Social Care ◽  
Large Body ◽  
Well Being ◽  
Service Users ◽  
Content Type ◽  
Starting Point ◽  
Health And Social Care ◽  
Trauma Informed

Purpose Practitioners, organisations and policy makers in health and social care settings are increasingly recognising the need for trauma-informed approaches in organisational settings, with morbidity and financial burdens a growing concern over the past few years. Servant leadership has a unique focus on emotional healing, service to others as the first priority, in addition to the growth, well-being and personal and professional development of key stakeholders. This paper aims to discuss Trauma Informed Servant Leadership (TISL). Design/methodology/approach A targeted review of the servant leadership and trauma-informed care literature was conducted. Relevant studies, including systematic review and meta-analysis, were sourced, with the resulting interpretation informing the conceptual model. Findings Although there are general guidelines regarding how to go about instituting trauma-informed approaches, with calls for organisational leadership to adapt the often cited six trauma-informed principles, to date there has not been a leadership approach elucidated which takes as its starting point and core feature to be trauma informed. At the same time, there is a paucity of research elucidating trauma outcomes for service users or employees in the literature when a trauma-informed approach is used. However, there is a large body of evidence indicating that servant leadership has many of the outcomes at the employee level that trauma-informed approaches are attempting to attain. Thus, the author builds on a previous conceptual paper in which a model of servant leadership and servant leadership supervision are proposed to mitigate against compassion fatigue and secondary trauma in the health and social care sector. The author extends that research to this paper by recasting servant leadership as a trauma-informed model of leadership that naturally operationalises trauma-informed principles. Research limitations/implications A lack of primary data limits the extent to which conclusions can be drawn on the effectiveness of this conceptual model. However, the model is based on robust research across the differential components used; therefore, it can act as a framework for future empirical research designs to be studies at the organisational level. Both the servant leadership and trauma-informed literatures have been extended with the addition of this model. Practical implications TISL can complement the trauma-informed approach and may also be viable as an alternative to trauma-informed approaches. This paper offers guidelines to practitioners and organisations in health and social care on how to operationalise important trauma-informed principles through leadership. Social implications This conceptual model may help reduce the burden of trauma and re-traumatisation encountered by practitioners and service users in health and social care settings, impacting on morbidity. Originality/value To the best of the author’s knowledge, this is a novel approach, the first of its kind.

Adaptive clothing features to support daily exercising needs of muscular dystrophy victimized women in Sri Lanka

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Niromi Seram ◽  
Rivini Mataraarachchi ◽  
Thanuri Jayaneththi
Keyword(s):  
Muscular Dystrophy ◽  
Sri Lanka ◽  
Research Effort ◽  
Health And Safety ◽  
Psychological Needs ◽  
Daily Basis ◽  
Structured Interviews ◽  
Content Type ◽  
Daily Exercise ◽  
Custom Made

Purpose Exercising is a key approach adopted by muscular dystrophy patients to halt the weakening of muscles as it can eventually lead to serious immobility issues. Though it is essential to exercise on a daily basis for healthy living, there is no mention of any research effort in the current literature regarding the development of an apparel product for these mobility-affected patients that might assist them both in meeting their exercising needs and providing them some comfort in their daily living. Thus, this paper aims to focus on identifying the specific needs of muscular dystrophy victims and proposing special adaptive clothing solutions to support their daily exercise and mobility needs. Design/methodology/approach To achieve the objectives of this study, attention was focused on the muscular dystrophy afflicted women in Sri Lanka. Semi-structured interviews were conducted with the female victims of muscular dystrophy and their lifestyles were observed carefully; additional data were gathered by holding semi-structured interviews with their physiotherapists. Further, interviews were conducted with both garment technologists and fabric technologists too. Data gathered through these methods were analyzed qualitatively using the principles of thematic analysis and then aggregate conclusions were drawn. Findings It was observed that the patients were engaged in special activities such as exercising three times a day besides following their normal day-to-day activities to maintain and develop muscle strength. It soon became evident that these women found it difficult to perform their daily exercise routines with their regular clothing and were looking for custom made clothing they could wear all day long in comfort and avoid the problems that arose while exercising. The study specifies the requirements that must be met to satisfy both generic and specific needs. Considering all these aspects some adaptive clothing solutions were proposed to support daily exercising activity with respect to comfort, convenience, health and safety, as well as socio-cultural and psychological needs. Originality/value The area of fusing generic and specific features to support the daily exercising needs of muscular dystrophy victims is an untouched field of experimentation and being a need of the disabled, the present study marks a milestone on the way to a novel area of apparel design, besides exploring a new field of research.

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