A mixed methods study examining perceptions by service-users of their involuntary admission in relation to levels of insight

2021 ◽  
pp. 002076402110619
Author(s):  
Siobhan Smyth ◽  
John McFarland ◽  
David McGuiness ◽  
Sarah Summerville ◽  
Emma Bainbridge ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Care Process ◽  
Service Improvement ◽  
Service Users ◽  
Involuntary Admission ◽  
Negative Attitudes ◽  
Need For Treatment ◽  
Negative Perceptions ◽  
Time Of Admission ◽  
Coercive Care

Background: Poor insight is associated with negative attitudes to involuntary admission and care in qualitative studies. Aims: The current paper aims to examine and compare retrospective qualitative perceptions of service-users in relation to their involuntary admission with their levels of clinical insight, using a mixed methods approach. Methods: Forty two participants were assessed 3 months after the revocation of their involuntary admission. Each provided qualitative data relating to their perceptions of the coercive care process, which was analysed using content analysis, along with a quantitative measurement of insight, the Schedule for the Assessment of Insight-Expanded (SAI-E). Employing a mixed methods design and incorporating NVivo matrix coding queries, the datasets were merged to enable qualitative themes to be identified against the quantitative data. Results: Differences were observed between those with high and low insight in terms of their understanding of the need for treatment, their levels of arousal at the time of admission and how they perceived the compassion of health professionals. Certain negative perceptions of care appeared more universal and were common across those with high and low insight. Conclusion: Some negative perceptions of coercive practices appear linked to inherent elements of psychotic illness such as unawareness of illness. Individuals with higher levels of insight tended to perceive their involuntary admission and receiving a diagnosis as beneficial. Negative views that persist amongst service users with high insight levels can highlight areas for successful service improvement, including increased emphasis on non-pharmacotherapy based supports during the coercive care process.

scholarly journals Predictors of involuntary patients’ satisfaction with care: prospective study

BJPsych Open ◽  
2018 ◽  
Vol 4 (6) ◽  
pp. 492-500 ◽  
Author(s):  
Emma Bainbridge ◽  
Brian Hallahan ◽  
David McGuinness ◽  
Patricia Gunning ◽  
John Newell ◽  
...  
Keyword(s):  
Older Age ◽  
Satisfaction With Care ◽  
Involuntary Admission ◽  
Negative Attitudes ◽  
Regression Modelling ◽  
Patients Satisfaction ◽  
Admission Data ◽  
Representative Cohort ◽  
Coercive Care

BackgroundInvoluntary admission can be traumatic and is associated with negative attitudes that persist after the episode of illness has abated.AimsWe aimed to prospectively assess satisfaction with care at the points of involuntary admission and symptomatic recovery, and identify their sociodemographic, clinical and service experience predictors.MethodLevels of satisfaction with care, and clinical and sociodemographic variables were obtained from a representative cohort of 263 patients at the point of involuntary admission and from 155 of these patients 3 months after termination of the involuntary admission. Data were analysed with multiple linear regression modelling.ResultsHigher baseline awareness of illness (B = 0.19, P < 0.001) and older age (B = 0.05, P = 0.001) were associated with more satisfaction with care at baseline and follow-up. Transition to greater satisfaction with care was associated with improvements in awareness of illness (B = 0.13, P < 0.001) and in symptoms (B = 0.05, P = 0.02), as well as older age (B = 0.04, P = 0.01). Objective coercive experiences were not associated with variation in satisfaction with care.ConclusionsThere is wide variation in satisfaction with coercive care. Greater satisfaction with care is positively associated with clinical variables such as increased awareness of illness.Declaration of interestNone.

scholarly journals Students’ and Instructors’ Understandings, Attitudes and Beliefs about Educational Theories: Results of a Mixed-Methods Study

2021 ◽  
Vol 11 (5) ◽  
pp. 197
Author(s):  
Stefan T. Siegel ◽  
Martin Daumiller
Keyword(s):  
Mixed Methods ◽  
Mixed Methods Study ◽  
Attitudes And Beliefs ◽  
Abstract Concepts ◽  
Negative Attitudes ◽  
Self Reflection ◽  
Educational Theories ◽  
Practical Implications ◽  
Constitutive Element ◽  
Educational Studies

(1) Background: Educational theories are a constitutive element of educational studies. Despite their theoretical relevance, little is still known about students’ and instructors’ understandings of educational theories and their theory-related attitudes and beliefs. (2) Methods: To elucidate these constructs and to test their relevance, we conducted a mixed-methods study with 32 students and 12 instructors of educational studies at a German university. (3) Results: We found that both groups perceived educational theories as rather abstract concepts. Students reported rather negative attitudes and naive beliefs. For both groups, we found that attitudes and beliefs were strongly tied to motivational and affective aspects when dealing with educational theories, which stresses their relevance for educational studies. (4) Conclusions: We suggest a systematic theoretical clarification of the term educational theories. Furthermore, consideration of students’ and instructors’ theory-related attitudes and beliefs can give rise to meaningful practical implications (e.g., through self-reflection).

scholarly journals A narrative review of literature on the use of health and social care by older trans adults: what can United Kingdom services learn?

2021 ◽  
pp. 1-22
Author(s):  
Susan Mary Benbow ◽  
Charlotte Eost-Telling ◽  
Paul Kingston
Keyword(s):  
Health Care ◽  
Social Care ◽  
The United States ◽  
Narrative Review ◽  
Cultural Humility ◽  
Service Improvement ◽  
Service Users ◽  
Strong Argument ◽  
Health And Social Care ◽  
Economic Inequalities

Abstract We carried out a narrative review and thematic analysis of literature on the physical health care, mental health care and social care of trans older adults to ascertain what is known about older trans adults’ contacts with and use of health and social care. Thirty papers were found: a majority originated in the United States of America. Five themes were identified: experience of discrimination/prejudice and disrespect; health inequalities; socio-economic inequalities; positive practice; and staff training and education. The first three themes present challenges for providers and service users. Experiences of discrimination/prejudice and disrespect over the course of their lives powerfully influence how older trans adults engage with care services and practitioners. Health and socio-economic inequalities suggest that older trans adults are likely to have greater need of services and care. The remaining two themes offer opportunities for service improvement. We conclude that more research is needed, that there is a strong argument for taking a lifecourse perspective in a spirit of cultural humility, and that contextual societal factors influence service users and providers. We identify positive trans-inclusive practices which we commend to services. More needs to be done now to make older adult services appropriate and welcoming for trans service users.

scholarly journals Adapting Coordinated Specialty Care in the Post-COVID-19 Era: Study Protocol for an Integrative Mixed-methods Study

2021 ◽  
Author(s):  
Sapana Patel ◽  
Iruma Bello ◽  
Leopoldo J. Cabassa ◽  
Ilana R. Nossel ◽  
Melanie M. Wall ◽  
...  
Keyword(s):  
New York ◽  
Mixed Methods ◽  
Service Utilization ◽  
New York State ◽  
Specialty Care ◽  
The State ◽  
Care Process ◽  
Model Adaptation ◽  
York State ◽  
State And Local

Abstract Background: Coordinated Specialty Care (CSC) programs provide evidence-based services for young people with a recent onset of a psychotic disorder. OnTrackNY is a nationally recognized model of CSC treatment in New York state. In 2019, OnTrackNY was awarded a hub within the Early Psychosis Intervention Network (EPINET) to advance its learning health care system (LHS). The OnTrackNY network is comprised of 23 CSC teams across New York state. OnTrack Central, an intermediary organization, provides training and implementation support to OnTrackNY teams. OnTrack Central coordinates a centralized data collection protocol for quality improvement and evaluation of program fidelity and a mechanism to support practice based-research. OnTrackNY sites’ breadth coupled with OnTrack Central oversight provides an opportunity to examine the impacts of the COVID-19 crisis in New York State. Methods: This project will examine the implications of modifications to service delivery within the OnTrackNY LHS during and after the COVID-19 crisis. We will use the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) to classify systematically, code, and analyze modifications to CSC services and ascertain their impact. We will utilize integrative mixed methods. Qualitative interviews with multi-level stakeholders (program participants, families, providers, team leaders, agency leaders, trainers (OnTrack Central), and decision-makers at the state and local levels) will be used to understand the process making decisions, information about modifications to CSC services, and their impact. Analysis of OnTrackNY program data will facilitate examining trends in team staffing and functioning, and participant service utilization and outcomes. Study findings will be summarized in a CSC Model Adaptation Guide, which will identify modifications as fidelity consistent or not, and their impact on service utilization and care outcomes. Discussion: A CSC Model Adaptation Guide will inform CSC programs, and the state and local mental health authorities to which they are accountable, regarding modifications to CSC services and the impact of these changes on care process, and participant service utilization and outcomes. The guide will also inform the development of tailored technical assistance that CSC programs may need within OnTrackNY, the EPINET network, and CSC programs nationally. Trial Registration: NCT04021719, July 16th, 2019.

scholarly journals STUDENTS’ ATTITUDES TOWARD STATISTICS ACROSS THE DISCIPLINES: A MIXED-METHODS APPROACH

2012 ◽  
Vol 11 (2) ◽  
pp. 45-56
Author(s):  
JAMES D. GRIFFITH ◽  
LEA T. ADAMS ◽  
LUCY L. GU ◽  
CHRISTIAN L. HART ◽  
PENNEY NICHOLS-WHITEHEAD
Keyword(s):  
Mixed Methods ◽  
Undergraduate Students ◽  
Qualitative Methodology ◽  
Statistics Education ◽  
Business Majors ◽  
Negative Attitudes ◽  
Mixed Methods Approach ◽  
Research Journal ◽  
Attitudes Toward Statistics ◽  
Students Attitudes

Students’ attitudes toward statistics were investigated using a mixed-methods approach including a discovery-oriented qualitative methodology among 684 undergraduate students across business, criminal justice, and psychology majors where at least one course in statistics was required. Students were asked about their attitudes toward statistics and the reasons for their attitudes. Five categories resulted for those with positive and negative attitudes and were separated on the basis of discipline. Approximately 63% of students indicated a positive attitude toward statistics. Business majors were most positive and were more likely to believe statistics would be used in their future career. Multiple methodological approaches have now provided data on the various domains of attitudes toward statistics and those implications are discussed. First published November 2012 at Statistics Education Research Journal: Archives

scholarly journals The person behind the label: co-production as a tool in teaching about borderline personality disorder

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S122-S122
Author(s):  
Nyakomi Adwok ◽  
Sharon Nightingale
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Mental Health Professionals ◽  
Service User ◽  
Borderline Personality ◽  
Junior Doctors ◽  
Service Users ◽  
Teaching Session ◽  
Negative Attitudes

AimsThe overarching aim of the session was to address and reduce stigma around Borderline Personality Disorder among doctors. The three main objectives were:To increase empathy and understanding around Borderline Personality Disorder by exposing junior doctors to service user perspectives outside a clinical setting;To address knowledge gaps identified by junior doctors in a self-reported questionnaire disseminated prior to the teaching session;To offer junior doctors a basic psychological framework to base their assessment and formulation of service users with personality disorders.Background‘Borderline Personality Disorder: The Person Behind the Label’ was the title of the first co-produced teaching session in the Leeds and York Partnership Foundation Trust (LYPFT). Prior to the teaching session, an online questionnaire was sent out to trainees. The results highlighted three key issues:Negative attitudes towards service users with personality disorders;Poor subjective knowledge of the psychological models of personality disorders;Perception among trainees that they do not receive adequate training to deal with the challenges service users with personality disorders present.MethodA teaching session was co-produced by a team of two service users, a principal clinical psychologist within the Leeds Personality Disorder Network (PDN) and a core Psychiatry trainee. It was delivered in a 75 minute session to 40 attendees consisting of both trainee doctors and consultants.ResultFeedback was collected immediately after the session through the use of anonymous feedback forms. The response to the training was overwhelmingly positive with all 28 respondents rating the session as 4/5 or 5/5 on a satisfaction scale ranging from 1 (poor) to excellent (5). Key themes from the feedback included appreciation for the service user perspective and teaching on psychological theory. The fourth question in the questionnaire: “How will this teaching impact your work?” produced the highest number of responses (25/28) and provided evidence that the above listed objectives of the session were met.ConclusionCo-produced teaching has great potential to address negative attitudes around highly stigmatised conditions by bridging the gap that often exists between service users and mental health professionals.

scholarly journals Preventing and Managing Urinary Tract Infections: Enhancing the Role of Community Pharmacists—A Mixed Methods Study

Antibiotics ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 583 ◽  
Author(s):  
Nathan Peiffer-Smadja ◽  
Rosalie Allison ◽  
Leah F. Jones ◽  
Alison Holmes ◽  
Parvesh Patel ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Urinary Tract ◽  
Community Pharmacists ◽  
Mixed Methods Study ◽  
Urinary Symptoms ◽  
Service Users ◽  
Specific Patient ◽  
Tract Infections

Background: Community pharmacists are involved in antimicrobial stewardship through self-care advice and delivering medications for uncomplicated infections. Objectives: This mixed methods study aimed to identify opportunities to enhance the role of community pharmacists in the management of service users with suspected or confirmed urinary tract infection (UTI). Methods: Data collection was through a service user survey (n = 51) and pharmacist surveys and semi-structured interviews before (16 interviews, 22 questionnaires) and after (15 interviews, 16 questionnaires) trialing UTI leaflets designed to be shared with service users. Data were analysed inductively using thematic analysis and descriptive tabulation of quantitative data. Results: Twenty-five percent (n = 13/51) of service users with urinary symptoms sought help from a pharmacist first and 65% (n = 33/51) were comfortable discussing their urinary symptoms with a pharmacist in a private space. Community pharmacists were confident as the first professional contact for service users with uncomplicated UTI (n = 13/16, 81%), but indicated the lack of a specific patient referral pathway (n = 16/16, 100%), the need for additional funding and staff (n = 10/16, 62%), and the importance of developing prescription options for pharmacists (5/16, 31%). All community pharmacists reported playing a daily role in controlling antimicrobial resistance by educating service users about viral and bacterial infections and promoting a healthy lifestyle. Enhancing their role will need greater integrated working with general practices and more prescribers based in community pharmacy. Conclusion: This study suggests that community pharmacists could play a greater role in the management of uncomplicated UTI. The current reconfiguration of primary care in England with primary care networks and integrated care systems could provide a real opportunity for this collaborative working with potential learning for international initiatives.

Self-harm presentations in emergency departments: staff attitudes and triage

2019 ◽  
Vol 28 (22) ◽  
pp. 1468-1476 ◽  
Author(s):  
Sithandazile Masuku
Keyword(s):  
Emergency Departments ◽  
Formal Education ◽  
Evidence Base ◽  
Public Health Issue ◽  
Service Improvement ◽  
Staff Attitudes ◽  
Services Research ◽  
Negative Attitudes ◽  
History Of ◽  
Self Harm

Addressing the rising incidence of self-harm and the demand this places on emergency departments (EDs) are UK Government healthcare priorities. A history of self-harm is linked with suicide risk, so self-harm is a public health issue. The ED is the first point of contact for many people who self-harm so it plays a pivotal role in access to services. Research has highlighted difficulties around triage and assessment in EDs of patients who self-harm, especially frequent attenders. The evidence base on patient experience related to addressing negative staff attitudes is lacking, despite their potent nature and impact on care. Limited knowledge of self-harm aetiology and clinical inexperience have been found to be fundamental to nurses' negative attitudes when dealing with patients who self-harm. This has been linked to negative patient outcomes, including a reluctance to engage with services. This article acknowledges positive changes that have been made and highlights the importance of the triage stage, which is a potential service improvement area, where it would be possible to start and drive positive change in the care of people who self-harm. To address knowledge gaps in education and management, clinical understanding of the aetiology of self-harm should be improved with the aid of education on self-harm cycles. Nurses should also be made aware of common myths surrounding self-harm, as these are barriers to care. Recommendations for practice include partnership working and the urgent need for formal education on this topic for all health professionals working in EDs.

Inequality and Democratic Support in Indonesia

2020 ◽  
Vol 93 (1) ◽  
pp. 31-58 ◽  
Author(s):  
Burhanuddin Muhtadi ◽  
Eve Warburton
Keyword(s):  
Public Support ◽  
Partisan Politics ◽  
Negative Attitudes ◽  
Income Gap ◽  
Political Preferences ◽  
Support For Democracy ◽  
Negative Perceptions ◽  
Perceptions Of Inequality ◽  
Democratic Support ◽  
The Relationship

Indonesia is a country of significant inequalities, but we know little about how Indonesians feel about the gap between rich and poor. Comparative research suggests that negative perceptions of inequality can erode public support for democratic institutions. Using survey data, we explore the relationship between inequality and support for democracy in Indonesia. We find Indonesians are divided in their beliefs about income distribution. But this variation is not determined by actual levels of inequality around the country, nor by people's own economic situation; instead, political preferences and partisan biases are what matter most. Beliefs about inequality in Indonesia have become increasingly partisan over the course of the Jokowi presidency: supporters of the political opposition are far more likely to view the income gap as unfair, while supporters of the incumbent president tend to disagree—but they disagree much more when prompted by partisan cues. We also find that Indonesians who believe socio-economic inequality is unjust are more likely to hold negative attitudes toward democracy. We trace both trends back to populist campaigns and the increasingly polarized ideological competition that marked the country's recent elections. The shift toward more partisan politics in contemporary Indonesia has, we argue, consequences for how voters perceive inequality and how they feel about the democratic status quo.

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