Accessible Summary What is known about the subject? Risk in psychiatry involves harm to self or others owing to mental health difficulties, for example iatrogenic effects of treatment, self‐harm, suicide and violence. Risk management is a framework to minimize risks, comprising of risk assessment, generation of risk management plans and evaluation of interventions. Literature has extensively explored risk management and presented a critique that its practices can lead to patient harm. However, there is a paucity of literature about what patients identify as helpful risk management practices, despite the potential for such patient views to ameliorate harm and improve mental health care. What this paper adds to existing knowledge Interpersonal relationships with clinicians, and communication that keeps patients involved and informed of management processes, were found to be central to beneficial risk management practices, while patients having agency and autonomy to influence their participation was also important. Beneficial interpersonal relationships and connectivity in the form of patients’ wider community of support were found to be influential in aiding risk management. Meaningful relationships, and particularly peer support, that maintained personal and collective identities were prevalent in the literature. What are the implications for practice? Rendering risk management more visible and accessible in practice might cultivate an openness that promotes patient participation. This includes drawing on a wider network of support, for example the patient’s friends and family, as well as having advocacy utilizing peer support. AbstractIntroductionMinimizing the harm that patients pose to themselves and others, due to mental health difficulties, is a central component of risk management in psychiatry. However, risk management itself can cause patient harm, but despite this and the potentially informative value of lived experience, little is known about what patients want or expect from risk management.AimTo review research and explore what patients consider beneficial in risk management practice.MethodA mixed studies systematic review utilizing PRISMA guidelines, alongside a convergent qualitative design to categorize findings.ResultsTwelve papers were identified, generating two categories of beneficial practices: interpersonal relationships and communication with clinicians; coupled with patient agency in their own risk management.DiscussionConnectivity appears important. Particularly patients feeling involved, and their voices being heard in both the identification of risks and then shaping risk management practice. Moreover, this included involvement of friends, family and peers to widen input and supportive networks beyond clinical relationships.Implications for PracticeRisk management needs to be an accessible part of care, which is more inclusive of patient views and needs. The latter might also be aided by drawing on the patient's wider community in order to provide more effective support and r...
This study investigated the relationship between professional intervention and the effect of that intervention on families with children with learning disabilities. A survey was conducted with 60 families in receipt of support services in the South West of England. This survey sought to establish whether families who were supported by Portage workers scored higher on the Enabling Practice Scale (EPS) than those who were supported by other family workers, such as community nurses for people with learning disabilities. Additionally, the survey sought to capture data on the relationship between parents' perceptions of their child's abilities and EPS scores. The results suggest that there is little difference between parent perceptions of these two types of family support, and no significant relationship between parents' perceptions of their child's abilities and how this impacts on the EPS scores. Findings are discussed within the context of the working practices of family workers, changes in health, social and education policy, and the increasing influence of consumers and service users.
This study explores perceptions of Quality of Life (QOL) of people with a learning disability and autism to facilitate a better understanding for clinical practice. Design/Methodology/Approach Mixed methods were used to gain perceptions of QOL from 20 individuals referred to their local diagnostic service. Individuals completed questionnaires which were compared with previous studies and participated in in-depth interviews which were thematically analysed. All data was contextualised in case examples. Findings Subjective wellbeing scores were lower than found in previous research. Social communication was raised extensively describing both positive and negative perceptions. Consistent themes around the need for tailored social support and the value autonomy over environment were raised. Research Limitations/Implications The study was small in scale and limited to subjects who has been referred for a diagnostic service. The study identified the need for further study and particularly in relation to the social communication domain of QoL and impact of stress and anxiety on QoL Originality/Value This study demonstrated that it is possible to access views from this group and that these views are nuanced. It suggests differences between reported QoL in people with learning disabilities who are and who are not autistic. Service design and individual approaches could be improved by a better understanding of different QoL perceptions of this group
Nutrition and exercise matter for everyone, including people with learning disabilities. Poor nutrition and lack of exercise can have adverse effects on emotional and physical health and wellbeing, which then affect the ability to cope with the demands of everyday life, including independent living and enjoyment of voluntary or paid work, college and leisure activities. Support staff need training and advice to understand this if they are to facilitate optimal quality of life.
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