Quality of life, recovery and decision-making: a mixed methods study of mental health recovery in social care

Purpose Mental health care is a complex system that includes social care organisations providing support for people with continuing needs. The relationship over time between decisional conflict, social support, quality of life and recovery outcomes across two time periods for people experiencing mental health problems in receipt of social care was investigated. Methods This is a mixed methods study comprised of a quantitative survey at two time points using measures of decisional conflict, social support, recovery and quality of life in a random sample (n = 122) using social care services in Wales, UK. In addition, 16 qualitative case studies were developed from data collected from individuals, a supportive other and a care worker (n = 41) to investigate trajectories of care. Survey responses were statistically analysed using SPSS and case study data were thematically analysed. Results Participants reported increasing decisional conflict and decreasing social support, recovery and quality of life over the two time points. Linear regression indicated that higher recovery scores predict better quality of life ratings and as ratings for social support decline this is associated with lower quality of life. Correlational analysis indicated that lower decisional conflict is associated with higher quality of life. Thematic analysis indicated that ‘connectedness and recovery’ is a product of ‘navigating the system of care’ and the experience of ‘choice and involvement’ achieved by individuals seeking help. Conclusions These results indicate that quality of life for people experiencing mental health difficulties is positively associated with social support and recovery and negatively associated with decisional delay

Study protocol: a mixed methods study to assess mental health recovery, shared decision-making and quality of life (Plan4Recovery)

BACKGROUND: Recovery in mental health care is complex, highly individual and can be facilitated by a range of professional and non-professional support. In this study we will examine how recovery from mental health problems is promoted in non-medical settings. We hypothesise a relationship between involvement in decisions about care, social support and recovery and quality of life outcomes. METHODS: We will use standardised validated instruments of involvement in decision-making, social contacts, recovery and quality of life with a random sample of people accessing non-statutory mental health social care services in Wales. We will add to this important information with detailed one to one case study interviews with people, their family members and their support workers. We will use a series of these interviews to examine how people build recovery over time to help us understand more about their involvement in decisions and the social links they build. DISCUSSION: We want to see how being involved in decisions about care and the social links people have are related to recovery and quality of life for people with experience of using mental health support services. We want to understand the different perspectives of the people involved in making recovery possible. We will use this information to guide further studies of particular types of social interventions and their use in helping recovery from mental health problems

Expressions 1987

https://openspace.dmacc.edu/expressions/1030/thumbnail.jp

Expressions 1978

Expressions contains selected work from some of the Creative Writing Contest winners and honorable mentions along with Commercial Art students at Des Moines Area Community College. Design, topography, and layout was accomplished by Journalism students.https://openspace.dmacc.edu/expressions/1000/thumbnail.jp

Agriculture-Industry Interlinkages: Some Theoretical and Methodological Issues in the Indian Context

The inter-relationship between agriculture and industry has been a long debated issue in most of the developing countries. In the Indian context, the issue has acquired interest since the industrial stagnation of the mid 1960s. Over the years the Indian economy has undergone a structural change in its sectoral composition: from a primary agro-based economy during 1970s, the economy has emerged as predominant in the service sector since the 1990s. This structural change and uneven pattern of growth of agriculture, industry and services sector in the post reforms period is likely to appear substantial changes in the production and demand linkages among various sectors, and in turn, could have significant implication for the growth and development process of the economy. This has triggered a renewed interest in studying the inter-relationship between agriculture and industry. The present paper tries to address some of the theoretical and methodological issues in analyzing the agriculture-industry interlinkages in the Indian context

Entrepreneurial intention among University students in Malaysia: integrating self-determination theory and the theory of planned behavior

The present study endeavors to develop a deeper understanding of the motivational processes involved in intentional entrepreneurial behavior. For this purpose, it integrates the social cognitive approach of the theory of planned behavior (TPB) and the organismic theory of motivation of self-determination theory (SDT). More specifically, it tests the role of basic psychological needs of autonomy, competence and relatedness as defined in SDT in shaping university students’ attitudes and intentions toward entrepreneurship. The sample of this study consisted of 438 (Males = 166, Females =272) 3rd and4th year university students from four Malaysian Public Universities. The results of the study show that the model strongly explains about 71% of the variance in entrepreneurial intention. Basic psychological needs of autonomy, competence and relatedness have a strong indirect impact on entrepreneurial intention via their attitudinal antecedents: attitude,subjective norm, and perceived behavioral control. This indicates a full-mediational model,where the attitudinal factors operated as transmitters of effects from the distal constructs ofSDT on entrepreneurial intention. These findings confirm that both SDT and the TPB provide complementary explanations of the motivational processes of entrepreneurial behavior. The study contributes to the existing knowledge by providing a theory-based understanding of the role of motivations in the formation of entrepreneurial intentions. It opens the way for future research to analyze how alternative motivations may affect new venture creation, survival and success

Group-based positive psychotherapy for people living with acquired brain injury: a protocol for a feasibility study

Abstract Background Acquired brain injury (ABI) and other chronic conditions are placing unprecedented pressure on healthcare systems. In the UK, 1.3 million people live with the effects of brain injury, costing the UK economy approximately £15 billion per year. As a result, there is an urgent need to adapt existing healthcare delivery to meet increasing current and future demands. A focus on wellbeing may provide an innovative opportunity to reduce the pressure on healthcare services while also supporting patients to live more meaningful lives. The overarching aims of the study are as follows: (1) evaluate the feasibility of conducting a positive psychotherapy intervention for individuals with ABI and (2) ascertain under what conditions such an intervention would merit a fully powered randomised controlled trial (RCT) compared to a standard control group (TAU). Methods and analysis A randomised, two-arm feasibility trial involving allocation of patients to either a treatment group (positive psychotherapy) or control group (treatment as usual) group, according to a 1:1 ratio. A total of 60 participants at three sites will be recruited including 20 participants at each site. Assessments will be conducted at baseline, on completion of the 8-week intervention and 3 months following completion. These will include a range of questionnaire-based measures, psychophysiology and qualitative outcomes focusing on feasibility outcomes and participant experience. This study has been approved by the Wales Research Ethics Committee (IRAS project ID: 271,251, REC reference: 19/WA/0336). Discussion This study will be the first to examine the feasibility of an innovative, holistic positive psychotherapy intervention for people living with ABI, focused on individual, collective and planetary wellbeing, and will enable us to determine whether to proceed to a full randomised controlled trial. Trial registration ISRCTN12690685 , registered 11th November 2020

What innovations can address inequalities experienced by women and girls due to the COVID-19 pandemic across the different areas of life/domains: work, health, living standards, personal security, participation and education?

TOPLINE SUMMARYWhat is a Rapid Review?Our rapid reviews use a variation of the systematic review approach, abbreviating or omitting some components to generate the evidence to inform stakeholders promptly whilst maintaining attention to bias. They follow the methodological recommendations and minimum standards for conducting and reporting rapid reviews, including a structured protocol, systematic search, screening, data extraction, critical appraisal and evidence synthesis to answer a specific question and identify key research gaps. They take one to two months, depending on the breadth and complexity of the research topic/question(s), the extent of the evidence base and type of analysis required for synthesis.Background / Aim of Rapid ReviewThe COVID-19 pandemic has led to differential economic, health and social impacts illuminating prevailing gender inequalities (WEN Wales, 2020). This rapid review investigated evidence for effectiveness of interventions to address gender inequalities across the domains of work, health, living standards, personal security, participation, and education.Key FindingsExtent of the evidence base21 studies were identified: 7 reviews, 6 commentaries and 8 primary studiesLimited evidence for the effectiveness of identified innovations in minority groupsA lack of evaluation data for educational interventionsA lack of evidence for cost-effectiveness of the identified interventions14 additional articles were identified in the grey literature but not used to inform findings (apart from the Education domain, where there was a lack of peer-reviewed evidence).Recency of the evidence baseAll studies were published in 2020-2021Summary of findingsSome evidence supported interventions/innovations related to work: Permanent contracts, full-time hours, and national childcare programmes to increase income for women and thereby decrease the existing gender wage gap.More frequent use of online platforms in the presentation of professional work can reduce gender disparities due to time saved in travel away from home. Some evidence supported interventions/innovations related to health: Leadership in digital health companies could benefit from women developing gender-friendly technology that meets the health needs of women.Create authentic partnerships with black women and female-led organisations to reduce maternal morbidity and mortality (Bray &amp; McLemore, 2021). Some evidence supported interventions/innovations related to living standards including: Multi-dimensional care provided to women and their children experiencing homelessness. Limited evidence supported interventions/innovations related to personal security including: Specific training of social workers, psychologists and therapists to empower women to use coping strategies and utilise services to gain protection from abusive partners.Helplines, virtual safe spaces smart phone applications and online counselling to address issues of violence and abuse for women and girls. Very limited evidence supported interventions/innovations related to participation including: Use of online platforms to reduce gender disparities in the presentation of academic/professional work.Ensuring equal representation, including women and marginalised persons, in pandemic response and recovery planning and decision-making. Limited evidence from the grey literature described interventions/innovations related to education including: Teacher training curricula development to empower teachers to understand and challenge gender stereotypes in learning environments.Education for girls to enable participation in STEM.Policy ImplicationsThis evidence can be used to map against existing policies to identify which are supported by the evidence, which are not in current policy and could be implemented and where further research/evaluation is needed.Further research is needed to evaluate the effectiveness of educational innovations, the effectiveness of the innovations in minority groups and the social value gained from interventions to address gender inequalities.Strength of EvidenceOne systematic review on mobile interventions targeting common mental disorders among pregnant and postpartum women was rated as high quality (Saad et al., 2021). The overall confidence in the strength of evidence was rated as ‘low’ due to study designs. Searches did not include COVID specific resources or pre-prints. There may be additional interventions/innovations that have been implemented to reduce inequalities experienced by women and girls due to the COVID-19 pandemic but have not been evaluated or published in the literature and are therefore not included here.</jats:sec

Have infection control and prevention measures resulted in any adverse outcomes for care home and domiciliary care residents and staff?

TOPLINE SUMMARYWhat is a Rapid Review?Our rapid reviews use a variation of the systematic review approach, abbreviating or omitting some components to generate the evidence to inform stakeholders promptly whilst maintaining attention to bias. They follow the methodological recommendations and minimum standards for conducting and reporting rapid reviews, including a structured protocol, systematic search, screening, data extraction, critical appraisal and evidence synthesis to answer a specific question and identify key research gaps. They take 1-2 months, depending on the breadth and complexity of the research topic/question(s), the extent of the evidence base and type of analysis required for synthesis.Background / Aim of Rapid ReviewCare for older and vulnerable people must sustain core infection prevention and control (IPC) practices and remain vigilant for COVID-19 transmission to prevent virus spread and protect residents and healthcare professionals from severe infections, hospitalisations and death.However, these measures could potentially lead to adverse outcomes such as decreased mental wellbeing in patients and staff. A recent publication by Public Health England examines the effectiveness of IPC practices for reducing COVID-19 transmission in care homes (Duval et al., 2021). We explore evidence relating to adverse outcomes from IPC practices to help inform policy recommendations and identify gaps within the literature where further research can be prioritised.Key FindingsExtent of the evidence base15 studies were identified: 14 primary studies and one rapid reviewRecency of the evidence baseOf the primary studies, six were published in 2020 and eight were published in 2021The rapid review was published in 2021.Summary of findingsThis rapid review focuses on adverse outcomes resulting from increased IPC measures put in place during the COVID-19 pandemic. Whilst there is some evidence to show that there may be a link between IPC measures and adverse outcomes, causation cannot be assumed.During the COVID-19 restrictions, the cognition, mental wellbeing and behaviour of residents in care homes were negatively affectedIncreased IPC procedures during the COVID-19 pandemic increased stress and burden among care staff because of increased workload and dilemmas between adhering well to IPC procedures and providing the best care for the care recipientsCOVID-19 IPC procedures were not well developed at the beginning of the COVID-19 pandemic, but evidence from 2021 suggests that good adherence to IPC measures can enable visitations by family members and medical professionals into care homesOnly one study investigating domiciliary care was found. Therefore, it is difficult to make conclusions related specifically to this care settingNo published studies have reported on the costs or cost-effectiveness of IPC measures or have explored the cost implications of adverse outcomes associated with IPC measuresBest quality evidenceOnly one study was deemed as high quality based on the quality appraisal checklist ranking. This was a mixed methods study design (Tulloch et al., 2021).Policy ImplicationsSince March 2020, there have been many changes to government guidelines relating to procedures to keep the population safe from COVID-19 harm. Policies vary according to country, even within the UK. Important issues such as care home visitation policies have changed in such a way that care home staff have felt it difficult to keep up with the changes, which in itself increased the burden on those staff. The following implications were identified from this work:IPC policies should be clear, concise and tailored to care homes and domiciliary care settingsIncreased attention to workforce planning is needed to ensure adequate staffing and to reduce individual burdenRestrictions (e.g. visitation) for care home residents needs to be balanced by additional psychological supportFurther research with robust methods in this area is urgently needed especially in the domiciliary care settingStrength of EvidenceOne limitation is the lack of high-quality evidence from the included studies. Confidence in the strength of evidence about adverse outcomes of COVID-19 IPC procedures was rated as ‘low’ overall. Whilst the majority of studies achieved a ‘moderate’ score based on the quality appraisal tools used, due to the nature of the methods used, the overall quality of evidence is low.</jats:sec