Development of a positive group intervention for coexisting problems: A mixed methods study

Groupwork ◽  
2021 ◽  
Vol 29 (3) ◽  
Author(s):  
Katalin Ujhelyi Gomez ◽  
Jerome Carson ◽  
Gill Brown
Keyword(s):  
Mixed Methods ◽  
Positive Psychology ◽  
Group Intervention ◽  
Psychological Disorder ◽  
Service Users ◽  
Negative Consequences ◽  
Positive Approach ◽  
Positive Group ◽  
Wide Range ◽  
Addiction Service

Substance misuse commonly coexists with psychological disorder (dual diagnosis) making the problems more complex and the symptoms augmented with far-reaching negative consequences. Despite the wide range of support that treats both problems, clients often relapse. This study was the first empirical attempt to investigate how positive psychology can facilitate recovery by not focusing merely on the disorders but exploring and enhancing the positive aspects of clients’ lives moving them toward optimal human functioning. A mixed methods approach was applied to test a 12-week positive group intervention in two groups of service users (n=10) with coexisting disorders at an outpatient addiction service to explore the feasibility and acceptability of a positive approach in their recovery. Participants seemed to have benefitted from the programme, all positive concepts were found relevant, and the intervention was found feasible and acceptable by service users. It was concluded that a strengths-based positive approach has the potential to serve as a useful adjunct to the treatment of coexisting problems. Implications for treatment are discussed in terms of how positive psychology may be helpful in long-term recovery by providing alternative strategies to cope with mental illness and a substitute for the love, nurturing, and belonging that substances appear to offer to individuals.

Determining Emotional Tone and Verbal Behavior in Patients With Tinnitus and Hyperacusis: An Exploratory Mixed-Methods Study

2019 ◽  
Vol 28 (3) ◽  
pp. 660-672
Author(s):  
Suzanne H. Kimball ◽  
Toby Hamilton ◽  
Erin Benear ◽  
Jonathan Baldwin
Keyword(s):  
Mixed Methods ◽  
Verbal Behavior ◽  
Coping Strategies ◽  
Mixed Methods Study ◽  
Self Report ◽  
Anxiety And Depression ◽  
Negative Consequences ◽  
Emotional Tone ◽  
Explanatory Mixed Methods ◽  
Quantitative Results

Purpose The purpose of this study was to evaluate the emotional tone and verbal behavior of social media users who self-identified as having tinnitus and/or hyperacusis that caused self-described negative consequences on daily life or health. Research Design and Method An explanatory mixed-methods design was utilized. Two hundred “initial” and 200 “reply” Facebook posts were collected from members of a tinnitus group and a hyperacusis group. Data were analyzed via the LIWC 2015 software program and compared to typical bloggers. As this was an explanatory mixed-methods study, we used qualitative thematic analyses to explain, interpret, and illustrate the quantitative results. Results Overall, quantitative results indicated lower overall emotional tone for all categories (tinnitus and hyperacusis, initial and reply), which was mostly influenced by higher negative emotion. Higher levels of authenticity or truth were found in the hyperacusis sample but not in the tinnitus sample. Lower levels of clout (social standing) were indicated in all groups, and a lower level of analytical thinking style (concepts and complex categories rather than narratives) was found in the hyperacusis sample. Additional analysis of the language indicated higher levels of sadness and anxiety in all groups and lower levels of anger, particularly for initial replies. These data support prior findings indicating higher levels of anxiety and depression in this patient population based on the actual words in blog posts and not from self-report questionnaires. Qualitative results identified 3 major themes from both the tinnitus and hyperacusis texts: suffering, negative emotional tone, and coping strategies. Conclusions Results from this study suggest support for the predominant clinical view that patients with tinnitus and hyperacusis have higher levels of anxiety and depression than the general population. The extent of the suffering described and patterns of coping strategies suggest clinical practice patterns and the need for research in implementing improved practice plans.

The feasibility and acceptability study of a positive psychology group intervention for people with severe psychiatric conditions

2021 ◽  
pp. 1-14
Author(s):  
Carmen Valiente ◽  
Regina Espinosa ◽  
Alba Contreras ◽  
Almudena Trucharte ◽  
Rocío Caballero ◽  
...  
Keyword(s):  
Positive Psychology ◽  
Group Intervention ◽  
Psychiatric Conditions

scholarly journals Design and psychometric evaluation of epilepsy-related apathy scale (E-RAS) in adults with epilepsy: a sequential exploratory mixed methods design

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abbas Shamsalinia ◽  
Mozhgan Moradi ◽  
Reza Ebrahimi Rad ◽  
Reza Ghadimi ◽  
Mansoureh Ashghali Farahani ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Mixed Methods ◽  
Care Providers ◽  
Divergent Validity ◽  
Validity And Reliability ◽  
Mixed Methods Design ◽  
Scale Evaluation ◽  
Wide Range ◽  
Epileptic Patients ◽  
Convergent And Divergent Validity

Abstract Background Apathy in patients with epilepsy is associated with a wide range of consequences that reduce the patient’s ability to perform social functions and participate in self-care and rehabilitation programs. Therefore, apathy is one of the important diagnoses of the healthcare team in the process of caring for epileptic patients and its dimensions need to be examined and recognized. Therefore, appropriate instruments with the sociocultural milieu of each community should be provided to health care providers. The aim of the present study was to design and measure epilepsy–related apathy scale (E-RAS) in adults with epilepsy. Methods This study of sequential exploratory mixed methods design was conducted in Iran from April 2019 to December 2019. In the Item generation stage, two inductive (face-to-face and semi-structured interviews with 17 adult epileptic patients) and deductive (literature review) were used. In item reduction, integration of qualitative and literature reviews and scale evaluation were accomplished. For Scale Evaluation, face, content, construct [exploratory factor analysis (EFA) (n = 360) and confirmatory factor analysis (CFA) (n = 200)], convergent and divergent Validity and reliability (internal consistency and stability) were investigated. Results The results of EFA showed that E-RAS has four factors, namely, motivation; self-regulatory; cognition and emotional-effective. These four latent factors accounted for a total of 48.351% of the total variance in the E-RAS construct. The results of CFA showed that the 4-factor model of E-RAS has the highest fit with the data. The results of convergent and divergent validity showed that the values of composite reliability (CR) and average variance extracted (AVE) for the four factors were greater than 0.7 and 0.5, respectively, and the value of AVE for each factor was greater than CR. The Cronbach’s alpha coefficient for the whole scale was obtained 0.815. The results of the test-retest showed that there was a significant agreement between the test and retest scores (P < 0.001). Conclusion E-RAS is a multidimensional construct consisting of 24 items, and has acceptable validity and reliability for the study of epilepsy-related apathy in adult epileptic patients.

scholarly journals Healthcare Providers’ Perceptions of Challenges with Frequent Users of Emergency Department Care in Switzerland: A Qualitative Study

2021 ◽  
Vol 58 ◽  
pp. 004695802110281
Author(s):  
Patrick Bodenmann ◽  
Miriam Kasztura ◽  
Madison Graells ◽  
Elodie Schmutz ◽  
Oriane Chastonay ◽  
...  
Keyword(s):  
Online Survey ◽  
Emergency Services ◽  
Healthcare Providers ◽  
Negative Consequences ◽  
Emergency Department Care ◽  
Frequent Users ◽  
Complex Needs ◽  
Wide Range ◽  
Ed Overcrowding ◽  
Ed Visits

Frequent users of emergency departments (FUED; ≥ 5 ED visits/year) commonly cumulate medical, social, and substance use problems requiring complex and sustained care coordination often unavailable in ED. This study aimed to explore ED healthcare providers’ challenges related to FUED care to gain insight into the support and resources required to address FUED complex needs. An online survey was sent to all general adult emergency services within Switzerland (N = 106). Participants were asked to indicate the extent to which they perceived that FUED represented a problem and to describe the main challenges encountered. In total, 208 physicians and nurses from 75 EDs (70.7%) completed the survey. Among the 208 participants, 134 (64%) reported that FUED represented a challenge and 133 described 1 to 5 challenges encountered. A conventional content analysis yielded 4 main categories of perceived challenges. Negative consequences in the ED secondary to FUED’s presence (eg, ED overcrowding, staff helplessness, and fatigue) was the most frequently reported challenge, followed by challenges related to FUEDs’ characteristics (eg, mental health and social problems) leading to healthcare complexity. The third most frequently encountered challenge was related to the ED inappropriateness and inefficiency to address FUEDs’ needs. Finally, challenges related to the lack of FUED healthcare network were the least often mentioned. ED healthcare providers experience a wide range of challenges related to FUED care. These findings suggest that currently EDs nor their staff are equipped to address FUEDs’ complex needs.

scholarly journals Service user and clinician perspectives on the use of outcome measures in psychological therapy

2015 ◽  
Vol 8 ◽  
Author(s):  
Graham R. Thew ◽  
Louise Fountain ◽  
Paul M. Salkovskis
Keyword(s):  
Clinical Practice ◽  
Service User ◽  
Outcome Measurement ◽  
Psychological Therapy ◽  
Service Development ◽  
Service Users ◽  
Routine Outcome Measurement ◽  
Episode Of Care ◽  
Wide Range ◽  
Clinician Perspectives

AbstractWhile the benefits of routine outcome measurement have been extolled and to some degree researched, it is surprising that service user opinions on this common therapy practice have largely not been investigated. This study aimed to assess service users’ experiences of completing measures during psychological therapy, with a view to exploring how therapists can maximize how helpful measures are in therapy. Fifteen participants completed surveys about the use of measures in their current episode of care. Ten clinicians also completed a survey about their use of, and views about, measures. Results showed that despite mixed experiences in how measures were explained and used, service users showed generally favourable attitudes towards their use in therapy, with them being perceived as most helpful when well integrated into sessions by their therapists. Clinicians reported using a wide range of measures, and generally endorsed positive beliefs about measures more strongly than negative ones. Implications for clinical practice, service development, and further research are discussed.

Prevention of Alcohol Misuse: A Review of Health Promotion Efforts among American Indians

1995 ◽  
Vol 9 (4) ◽  
pp. 288-299 ◽  
Author(s):  
Philip A. May ◽  
James R. Moran
Keyword(s):  
Health Promotion ◽  
Native American ◽  
American Indian ◽  
American Indians ◽  
Local Community ◽  
Alcohol Misuse ◽  
Heavy Drinking ◽  
Community Empowerment ◽  
Negative Consequences ◽  
Wide Range

Purpose. The purpose of this review is to provide an overview of a wide range of potentially useful strategies to address the prevention of alcohol misuse among American Indians. This broad approach to the review is useful because the extreme heterogeneity of the American Indian population requires that health promotion professionals explore many options and tailor their activities to specific communities. Search Method. A literature search was initiated through MEDLINE using the following key words: prevention, alcohol, substance abuse, American Indian, and Native American. The search yielded 29 articles from the years 1982 through 1994. These articles, along with 45 previously identified in three overview articles, form the basis of the review and discussion in this paper. Summary of findings. As a group, American Indians experience many health problems that are related to alcohol misuse. Comparison of Indians to non-Indians shows that the age of first involvement with alcohol is younger, the frequency and amount of drinking is greater, and negative consequences are more common. Health promotion programs that address these issues must take into account American Indian heterogeneity and should use a comprehensive approach that addresses both heavy drinking and the sequelae of problems related to alcohol misuse. Major Conclusions. Important concepts for providing health promotion services to this population are: cultural relevance must be carefully planned and monitored; individuals in the local community must be involved; the drunken Indian stereotype must be addressed; and community empowerment should be an important goal.

scholarly journals Understanding Implementation of a Digital Self-Monitoring Intervention for Relapse Prevention in Psychosis: Protocol for a Mixed Method Process Evaluation

10.2196/15634 ◽  
2019 ◽  
Vol 8 (12) ◽  
pp. e15634 ◽  
Author(s):  
Stephanie Allan ◽  
Hamish Mcleod ◽  
Simon Bradstreet ◽  
Sara Beedie ◽  
Bethany Moir ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Process Evaluation ◽  
Relapse Prevention ◽  
Evaluation Studies ◽  
Well Being ◽  
Mobile App ◽  
Warning Signs ◽  
Evaluation Framework ◽  
Health Staff ◽  
Negative Consequences

Background Relapse is common in people who experience psychosis and is associated with many negative consequences, both societal and personal. People who relapse often exhibit changes (early warning signs [EWS]) in the period before relapse. Successful identification of EWS offers an opportunity for relapse prevention. However, several known barriers impede the use of EWS monitoring approaches. Early signs Monitoring to Prevent relapse in psychosis and prOmote Well-being, Engagement, and Recovery (EMPOWER) is a complex digital intervention that uses a mobile app to enhance the detection and management of self-reported changes in well-being. This is currently being tested in a pilot cluster randomized controlled trial. As digital interventions have not been widely used in relapse prevention, little is known about their implementation. Process evaluation studies run in parallel to clinical trials can provide valuable data on intervention feasibility. Objective This study aims to transparently describe the protocol for the process evaluation element of the EMPOWER trial. We will focus on the development of a process evaluation framework sensitive to the worldview of service users, mental health staff, and carers; the aims of the process evaluation itself; the proposed studies to address these aims; and a plan for integration of results from separate process evaluation studies into one overall report. Methods The overall process evaluation will utilize mixed methods across 6 substudies. Among them, 4 will use qualitative methodologies, 1 will use a mixed methods approach, and 1 will use quantitative methodologies. Results The results of all studies will be triangulated into an overall analysis and interpretation of key implementation lessons. EMPOWER was funded in 2016, recruitment finished in January 2018. Data analysis is currently under way and the first results are expected to be submitted for publication in December 2019. Conclusions The findings from this study will help identify implementation facilitators and barriers to EMPOWER. These insights will inform both upscaling decisions and optimization of a definitive trial. Trial Registration ISRCTN Registry ISRCTN99559262; http://www.isrctn.com/ISRCTN99559262 International Registered Report Identifier (IRRID) DERR1-10.2196/15634

Meaningful Ways of Understanding and Measuring Change for People with Borderline Personality Disorder: A Thematic Analysis

2018 ◽  
Vol 46 (5) ◽  
pp. 528-540 ◽  
Author(s):  
Louise McCusker ◽  
Marie-Louise Turner ◽  
Georgina Pike ◽  
Helen Startup
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Borderline Personality ◽  
Complex Nature ◽  
Service Users ◽  
Starting Point ◽  
Wide Range ◽  
Measuring Change

Background:The effective treatment of Borderline Personality Disorder (BPD) presents healthcare providers with a significant challenge. The evidence base remains limited partially due to a lack of professional consensus and service user involvement regarding ways of measuring change. As a result, the limited evidence that is available draws on such a wide range of outcome measures, that comparison across treatment types is hindered, maintaining a lack of clarity regarding the clinical needs of this group.Aims:This investigation aimed to follow the National Institute of Clinical Excellence (NICE, 2009) research recommendations by asking service users about meaningful change within their recovery. This forms a starting point for the future development of a tailored outcome measure.Method:Fifteen service users with a diagnosis of BPD participated in three focus groups across two specialist Personality Disorder services. The focus groups were analysed using Thematic Analysis.Results:Two superordinate themes were synthesized from the data: (1) recovery to what?: ‘How do you rewrite who you are?’; and (2) conditions for change. Each superordinate theme further consisted of three subordinate themes which elucidated the over-arching themes.Conclusion:This investigation highlights the complex nature of measuring change in people who have received a BPD diagnosis. Further research is needed to develop meaningful ways of measuring change according to the needs and priorities of people with BPD.

A Review of Gunshot Noise as Factor in Hearing Disorders

2019 ◽  
Vol 105 (6) ◽  
pp. 904-911 ◽  
Author(s):  
Ewa Skrodzka ◽  
Andrzej Wicher ◽  
Roman Gołe¸biewski
Keyword(s):  
Hearing Loss ◽  
Hair Cells ◽  
Impulse Noise ◽  
Noise Exposure ◽  
Single Shot ◽  
Negative Consequences ◽  
Mean Values ◽  
Sport Training ◽  
Wide Range ◽  
Auditory Systems

The impulse noise produced by personal weapons (guns, rifles, shotguns) during military activity, and while people engage in sport, training and hunting, is a threat to the auditory systems of soldiers, civilians, policemen, hunters, forest officers, sportspeople and bystanders not actively engaged in professional or recreational firing. An overview of noise levels generated by different types of weapon is provided, and potential short-term and long-term consequences for the human auditory system are described. The mean values of LC, peak sound pressure level during the shot, at the shooter's ears, for various types of weapons are approximately 160 dB SPL. These are levels that can cause permanent, irreversible negative effects on hearing (hearing loss, tinnitus, etc.) even as a result of a single shot being fired. One of the largest groups of weapon users in Poland (about 120 thousand) are hunters and field masters. They are not obligated by any regulations to protect their auditory systems from impulse noise. This means that this group of firearm users is at particularly high risk of hearing damage. On the basis of the literature review, it is shown that hearing exposure to high-level impulse noise such as a gunshot can result in such consequences as damage to the middle ear and destruction of the outer/inner hair cells in the cochlea. Especially difficult to diagnose is 'hidden hearing loss', i.e. damage to the synaptic connections between the hair cells of the inner ear and the auditory nerve fibres, which is not reflected in the results of basic audiometric testing and can cause hearing problems many years after impulse noise exposure. The wide range of negative consequences of gunfire noise clearly indicates the need for the hearing of the shooters to be protected.

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.

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