Sopeutumisvalmennuskursseille osallistuvien lasten vanhempien arvioita hyvinvoinnista, toimintakyvystä ja kurssiodotuksista

Sopeutumisvalmennus on psykososiaalista kuntoutusta, joka tarjoaa tietoa ja tukea sairaudesta tai vammasta, sen hoidosta ja selviytymiskeinoista. Lapset ja nuoret, joilla on pitkäaikaissairaus tai kehityksen häiriöitä, osallistuvat sopeutumisvalmennukseen useimmiten perheenjäsentensä kanssa. Tämän tutkimuksen tavoitteena oli 1) selvittää vanhempien käsityksiä lasten hyvinvoinnista ja toimintakyvystä, 2) arvioida vanhempien omaa hyvinvointia ja perheiden valtaistumista ja 3) selvittää kurssiodotuksia ja niihin yhteydessä olevia tekijöitä. Tutkimus kohdistui Kelan kuntoutuksena vuosina 2014–15 toteutettuihin diabeteskursseihin, oppimisen tai psyykkisen kehityksen häiriöiden kursseihin sekä moni- ja liikuntavammaisten lasten kursseihin. Lasten vanhemmat vastasivat kurssin alussa lomakekyselyyn (n = 357, vastausprosentti 59 %). Kaikissa kurssiryhmissä useimmat vanhemmat arvioivat lapsen terveydentilan hyväksi tai melko hyväksi. Vanhempien arviot niin omasta kuin lapsenkin hyvinvoinnista erosivat kurssiryhmittäin, mutta myös kurssiryhmien sisällä ilmeni vaihtelua. Vanhemmat, joiden lapsella oli diabetes, arvioivat hyvinvointia myönteisemmin kuin vanhemmat, joiden lapsella oli kehityksellinen häiriö. Vanhempien arviot omasta hyvinvoinnistaan korreloivat melko vahvasti lasta koskeviin hyvinvointiarvioihin. Sopeutumisvalmennukseen liittyvät odotukset ja tuen tarpeet koskivat erityisesti vertaistukea ja virkistäytymistä sekä tiedon saantia sairaudesta ja sen hoidosta ja kuntoutuksesta. Kurssiryhmä, lapsen toimintakyvyn rajoitteet, vanhempien hyvinvointi ja perheiden valtaistuminen olivat yhteydessä perheiden odotuksiin ja tuen tarpeisiin. Tutkimuksen keskeinen tulos koski perheen valtaistumisen ja kurssiodotusten välistä yhteyttä. Tarve ammatilliseen asiantuntijuuteen pohjautuvaan tietoon ja psykososiaaliseen tukeen oli vahvempaa niillä perheillä, joilla valtaistumisen tunne oli heikompaa. Sen sijaan ne perheet, joilla valtaistuminen oli voimakkaampaa, odottivat kursseilta vähemmän asiantuntijan tukea ja enemmän vertaistukea ja virkistäytymistä. Abstract Parents´ evaluations of their children´s wellbeing and functioning and identified expectations for psychosocial rehabilitation Finnish adaptation training represents psychosocial rehabilitation, which aims to offer information and guidance for living with an illness or disability as well as promoting coping skills. Children and adolescents with chronic illnesses or developmental disorders participate adaptation training mostly with their family members. The aim of this study was to 1) examine the parents´ perceptions of their child´s wellbeing and functioning, 2) depict their assessments on their own wellbeing and family empowerment, and 3) investigate their needs and expectations for the adaptation training as well as factors connected with different expectations. The study focused on three courses arranged for children either with diabetes, learning or psychological development disorders or multiple or mobility disabilities. The courses were organized in three rehabilitation centers. The parents answered the questionnaire at the beginning of the course (n=357, response rate 59 %). In all course groups most parents perceived their child’s health fairly good or good. The parents of children with diabetes evaluated their child’s wellbeing more positively than the parents of children with developmental disorders. The parents’ wellbeing correlated positively with the children´s wellbeing. Strongest rehabilitation needs and expectations were related to the domains of peer support and recreation, and information about illness or disability and its treatment. The course group, disability of the child, wellbeing of parents and children, and family empowerment were associated with the expectations and needs factors. The main finding of this study addressed the relationship ofthe family empowerment to the expectation domains. Families with weaker empowerment expressed more expectations and needs for professional information and support. More strongly empowered families expressed less needs for professional support and information but more expectations for peer support and recreation.

Habitation, Urban Context and Psychosocial Rehabilitation

This paper articulates architecture, urbanism and mental health through the study of specific habitation, called Therapeutic Residences, for people with severe mental illness who undergo psychosocial rehabilitation. The study analyzes the insertion of these habitations in the urban scheme, in relation to the possibilities of social coexistence, access to commerce, services and other public equipment through the presentation of two case studies located in the west zone of the city of Rio de Janeiro. Besides the considerations linked to the urban space in its physical sense, it also touches on the subjective questions inherent to the exchanges and experiences possible in this context. The methodological strategies correspond to the survey and data analysis along with a qualitative approach. Information made available by City Hall and Mental Health Office, satellite images, semi-structured interviews directed to professionals involved in assisting at the Therapeutic Residences and, in the case of the habitants, open interviews were used. The results indicate the offer of services, the location and the relation of the houses with the street as fundamental factors to the stimulus of social coexistence. It is concluded that the closed condominium model exclusive to TR, in addition to the fragility and difficulties in the urban area in which it is inserted, it hinders the process of psychosocial rehabilitation and it still refers to the idea of an asylum institution. The model of a one-story house integrated to the consolidated urban fabric suggests more possibilities of creating community ties and appropriating the urban space.

Sairauskäsitykset, elämänhallinta ja sopeutumisvalmennusta koskevat odotukset

Sopeutumisvalmennus on kuntoutusmuoto, jonka avulla pyritään tukemaan kuntoutujaa vamman tai pitkäaikaisen sairauden hallinnassa. Tutkimuksen tavoitteena oli selvittää sopeutumisvalmennukseen saapuvien aikuisten kuntoutujien elämäntilannetta, sairauskäsityksiä, hallinnan tunnetta, terveyteen liittyvää valtaistumista ja sopeutumisvalmennukseen kohdistuvia odotuksia. Kurssimuotoja oli kolme: syöpää, fibromyalgiaa ja diabetesta sairastavien kurssit. Neljän kuntoutuslaitoksen toteuttamille kursseille osallistui vuosina 2014–15 toteutetun tiedonkeruun aikana 581 kuntoutujaa, joista 377 (65 %) antoi kirjallisen suostumuksen osallistua tutkimukseen ja vastasi alkukyselylomakkeeseen. Kurssiryhmät erosivat sairauskäsitystensä suhteen toisistaan. Kuntoutujien elämäntilanne, sosiaalinen ja institutionaalinen luottamus sekä sairauden rajoitukset olivat yhteydessä hallinnan tunteeseen. Sopeutumisvalmennukseen kohdistuvat odotukset muodostivat neljä ulottuvuutta: palvelutietoja, sairautta ja sen hoitoa koskevia tietoja, psykososiaalista asiantuntijatukea sekä vertaistukea koskevat odotukset. Odotukset vaihtelivat kurssiryhmittäin. Sairauskäsityksiin liittyvät sairauden oireet, huolestuneisuus, tunnereaktiot ja käsitys hoidon vaikutuksista ja omista vaikutusmahdollisuuksista selittivät odotusten vaihtelua. Tietoihin ja psykososiaaliseen asiantuntija-apuun kohdistuvien odotusten todennäköisyyttä lisäsi terveyteen liittyvän valtaistumisen osalta tiedollisen hallinnan vähäisyys, kun taas vertaistukeen liittyvien odotusten todennäköisyyttä lisäsi vahva tiedollinen ja psykososiaalinen hallinta. Abstract Illness perceptions, empowerment and rehabilitation expectations of persons attending psychosocial rehabilitation Adaptation training is a form of psychosocial rehabilitation that aims to empower the client in coping with his or her illness or disability. The aim of the study was to examine the life situation, sense of mastery, illness perceptions, health-related empowerment and rehabilitation needs and expectations of clients attending adaptation training courses for adults with cancer, fibromyalgia or diabetes. In 2014–15, 581 clients attended these courses in four rehabilitation centers; 377 of them gave their informed consent to participate the study and answered the questionnaire at the beginning of the course. The three groups differed according to their illness perceptions and rehabilitation expectations, but there was also much variance between group members. Life situation, perceived disability, and social and institutional trust were associated with sense of mastery. Rehabilitation expectations were grouped into four main dimensions, i.e., information about services and support, information about the illness and treatment and rehabilitation options, psychosocial professional support, and peer support. Illness perceptions, i.e. perceived symptoms, worry, emotional reactions, experienced outcomes of treatment, and perceptions of one’s own possibilities to influence the illness were associated with different dimensions. Health-related empowerment was also connected with expectations. Expectations for information and professional help were stronger in those with weak informational mastery, whereas expectations for peer support were stronger with those whose informational and psychosocial mastery was better than average.

Multidisciplinary team members’ perceptions regarding advanced psychiatric nurses’ attitudes on mental healthcare

Background: The attitudes of advanced psychiatric nurses significantly contribute to the management, treatment plan and care of the mental healthcare users, and resultantly affects the quality and standards of mental healthcare. Considering these effects, it is imperative to understand how the attitudes of advanced psychiatric nurses are perceived by other multidisciplinary team members.Aim: To describe the perceptions of the multidisciplinary team members regarding advanced psychiatric nurses’ attitudes in clinical practice.Setting: Three mental health institutions were utilised to obtain the perceptions related to the attitudes displayed by advanced psychiatric nurses in the clinical environment.Method: A qualitative research descriptive approach was adopted to obtain in-depth descriptions of the attitudes portrayed by advanced psychiatric nurses. Eight purposefully sampled multidisciplinary team members were interviewed to obtain information. Data were analysed using Colaizzi’s method.Results: Themes and sub-themes emerged. Mental healthcare providers exhibited both negative and positive attitudes towards mental health patients. By perception, unfavorable attitudes hindered effective communication and psychosocial rehabilitation programs for mental health patients. Positivity enhanced feedback during ward rounds and during clinical meetings.Conclusion: Despite the positive impact advanced psychiatric nurses have on mental health care, views regarding mental health patients remain negative. It is recommended that advanced psychiatric nursing education curriculum address negative attitudes, views, and stereotypes. Mental healthcare users need to be provided with psychosocial rehabilitation programs and activities that address advance psychiatric nurses’ lack of initiatives.Contribution: A clear set of principles and protocols underpins the collaborative effort among multidisciplinary teams in mental health care.

Virtual Reality Rehabilitation’s Impact on Negative Symptoms and Psychosocial Rehabilitation in Schizophrenia Spectrum Disorder: A Systematic Review

Background: Schizophrenia is a chronic psychiatric disorder with symptoms that can severely affect patients’ quality of life. While drug administration inhibits most of the positive symptoms, it fails to effectively treat the negative symptoms and in turn relies on rehabilitation therapies. With technological progress, virtual reality (VR) has been the target of recent studies in terms of mental health rehabilitation and has been shown to be a tool with ecological validity in order to introduce the individual to situations similar to their daily life. Methods: From July to August 2021, we conducted a systematic review with the purpose of understanding the impact of virtual reality rehabilitation on negative symptoms and psychosocial rehabilitation in the schizophrenia spectrum. The searches were performed in the databases Web of Science, Scopus, and PubMed. Results: In our search, we identified 201 results, where 108 duplicates were excluded, resulting in a final balance of 93. After reading and assessing the titles and abstracts, 66 studies were excluded. Of the remaining 27 reports, 23 were excluded for not meeting the previously defined eligibility criteria, resulting in the inclusion of four studies in this systematic review. Conclusions: The available data on the specific topic was limited and could have been more complete. However, in our review, we were able to identify statistically relevant results demonstrating the effectiveness of intervention. We could find medium to large effects, allowing VR to be an ally for rehabilitation of symptoms related to schizophrenia.

Sopeutumisvalmennuskurssin koetut hyödyt ja vaikutukset

Sopeutumisvalmennuksen tavoitteena on tukea kuntoutujaa vamman tai pitkäaikaisen sairauden hallinnassa ja tarjota mahdollisuus vertaistukeen. Tutkimuksen tavoitteena oli selvittää sopeutumisvalmennuksen koettuja hyötyjä sekä terveydentilassa, toimintakyvyssä, hallinnan tunteessa ja valtaistumisessa tapahtuneita muutoksia ja niihin yhteydessä olevia kontekstitekijöitä. Tutkimukseen osallistui syöpää, fibromyalgiaa ja tyypin 1 diabetesta sairastavia kuntoutujia, jotka vastasivat ennen kurssin alkua lomakekyselyyn (n = 377) ja puoli vuotta kurssin päättymisen jälkeen seurantakyselyyn (n = 303). Kuntoutujista 58 % ilmoitti saaneensa valmennuksesta erittäin tai melko paljon hyötyä arjessa selviytymiseen: diabetesta sairastavat useammin kuin muut. Hyötykokemukset olivat epävakaassa elämäntilanteessa olevilla muita kuntoutujia harvinaisempia. Terveyteen liittyvä valtaistuminen oli vahvistunut kaikissa kuntoutujaryhmissä, erityisesti tiedollisen hallinnan osalta. Tutkimuksessa ei ollut vertailuryhmää, mikä on otettava huomioon tuloksia arvioitaessa. Abstract Subjective benefits, empowerment and psychological well-being after psychosocial rehabilitation Adaptation training is psychosocial rehabilitation that aims to empower clients to cope with their illness or disability. The aim of the study was to examine subjective benefits as well as changes in subjective health, functional capacity, sense of mastery and health-related empowerment and contextual factors connected with these changes. The study group consisted of persons with cancer, fibromyalgia and Type 1 diabetes answering a pre-treatment questionnaire (n = 377) and six months after the intervention a mailed follow-up questionnaire (n = 303). Of the respondents, 58 % reported positive gains for their daily life from the intervention, those with diabetes more often than other groups. Those in disadvantaged life situations reported gains more seldom than the other groups. Health-related empowerment had strengthened in all study groups. There was no comparison group in the study which must be taken into account when assessing the results. Keywords: psychosocial rehabilitation, subjective benefits, empowerment