The Rehabilitation Effectiveness for Activities for Life (REAL) study: a national programme of research into NHS inpatient mental health rehabilitation services across England

Killaspy, Helen; King, Michael; Holloway, Frank; Craig, Thomas J.; Cook, Sarah; Mundy, Timothy; Leavey, Gerard; McCrone, Paul; Koeser, Leonardo; Omar, Rumana; Marston, Louise; Arbuthnott, Maurice; Green, Nick; Harrison, Isobel; Lean, Melanie; Gee, Melanie; Bhanbhro, Sadiq

doi:10.3310/pgfar05070

Cited by 6 publications

(4 citation statements)

References 117 publications

(268 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Inpatient psychiatric rehabilitation services provide step‐down transitions for patients who do not adequately recover in secure mental health inpatient units (Killaspy et al, ). Approximately 10%–20% of affected individuals undergoing these services suffer from psychosis (e.g., schizophrenia) with long‐term mental health problems and require ongoing support to achieve and sustain their recovery (Killaspy et al, ).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with family functioning among people with a diagnosis of schizophrenia and primary family caregivers

Hsiao

Tsai

2020

Psychiatric Ment Health Nurs

View full text Add to dashboard Cite

Accessible summary What is known on the subject? Families act not only as the primary support for people with a diagnosis of schizophrenia but also as partners in the healthcare system. Families who have members with mental disorders, particularly schizophrenia, experience challenges in family functioning. Research on families in relation to schizophrenia primarily focuses on the determinants that affect family functioning from primary family caregivers' perspectives. What does the paper add to existing knowledge? This report provides evidence that there is a concordance between family functioning and inpatient psychiatric rehabilitation facilities for the patient–caregiver dyad; both care‐receivers and primary family caregivers considered family functioning as poor. Care‐receivers with lower education levels, increased number of previous hospitalizations and poor quality of family‐centred care experienced unhealthy family functioning. Primary family caregivers and care‐receivers with higher education levels, lower suicidality and greater quality of family‐centred care experienced healthier family functioning. What are the implications for practice? Understanding the degree of family functioning, particularly its concordance and correlates as perceived by patients and primary family caregivers, may serve as a platform for inculcating assessment of family functioning to achieve holistic patient care. Open dialogue in family‐focused care planning is essential to facilitate collaborative partnerships and improve family functioning among people with a diagnosis of schizophrenia and their primary family caregivers. Further research on culturally relevant, evidence‐based family interventions to enhance the functioning of affected families is warranted, especially for families with members in inpatient psychiatric rehabilitation facilities. Abstract IntroductionFamilies provide frontline caregiving support for people with a diagnosis of schizophrenia. However, research primarily addresses correlates of family functioning from primary family caregivers' perspectives. AimTo examine perceived family functioning, particularly its concordance within patient–caregiver dyads and associated factors in families of people living with schizophrenia. MethodsA cross‐sectional, descriptive correlational design was used. A total of 133 dyads of patients and primary family caregivers from inpatient psychiatric rehabilitation services participated. Descriptive statistics, independent‐sample t test, one‐way ANOVA, Pearson's correlation coefficients, intraclass correlation coefficient and stepwise multiple linear regression analyses were applied. ResultsFamily functioning was perceived as impaired by patient–caregiver dyads, and there existed a concordance in this regard. Patients' and family caregivers' education levels, patients' suicidality, number of previous hospitalizations and quality of family‐centred care correlated with patients' and primary family caregivers' family functioning. DiscussionFindings highlight the impo...

show abstract

Section: Introductionmentioning

confidence: 99%

Factors associated with family functioning among people with a diagnosis of schizophrenia and primary family caregivers

Hsiao

Tsai

2020

Psychiatric Ment Health Nurs

View full text Add to dashboard Cite

show abstract

“…This can be done by explaining in detail what is to be done, to adapt the environment during the activity, and to confirm that the individual has done something well afterwards. This type of approach is well described in the remotivation theory [ 38 ], and the use of this theory in interventions has shown positive results in earlier studies with both depressed and cognitively low functioning individuals, not greatly dissimilar to the target group in the present study [ 39 – 41 ]. An implication for SH services can be to stimulate the development of a recovery nurturing environment as described by Nordaunet & Sælør [ 11 ].…”

Section: Discussionmentioning

confidence: 56%

A day in the life of people with severe mental illness living in supported housing

et al. 2020

View full text Add to dashboard Cite

Background People with severe mental illness (SMI) living in supported housing (SH) struggle in everyday life and we currently lack a comprehensive body of knowledge concerning how the residents experience their day. This paper aimed to gain knowledge about how people with SMI describe a day in SH in Sweden, in particular the activities they most frequently engage in and how they experience what they do in or outside their home. Furthermore, it is important to gain knowledge of which activities motivate residents to leave the housing facility and to participate in the community. This new knowledge can help staff to encourage a recovery process among the residents. Methods One hundred thirty-three people living in SH completed a time-use diary and a mixed-methods approach was applied, including calculations of what activity that was most frequently performed and a manifest content analysis addressing experiences of activity. Results The residents had a low activity level and were often alone. Approximately one-half of the reported activities were performed in their own apartments, and generally unaccompanied. A quarter of the activities were performed in the common areas and a further quarter outside the SH. The most frequently performed activities were quiet and tranquil ones, e.g. listening to music and resting. Doing errands and group activities with staff and residents were the main activities that motivated leaving the facility. The participant experience of a day is presented in three categories: “Experiences of chosen and enforced togetherness and overcoming loneliness”, “Environmental change and emotional balance can generate activity”, and “Met and unmet needs for support, friendship and security”. Conclusions The residents were generally satisfied with their quiet and tranquil lifestyle and appeared to demand little of life, which may relate to previous experiences of institutional life and can constitute a challenge for staff. The findings highlight experiences that can help to improve SH. Services need to support individually adjusted contextual stimuli and individualize the support to help residents find a good balance and motivate them to be active in and outside SH, which can support a recovery process.

show abstract

“…The Care Quality Commission found good evidence of participation in normal day-to-day activities being made available at inpatient units, including accessing communitybased walking programmes [40], but there is little evidence of provision to help people continue activities once discharged from hospital. A recent study found that inpatient rehabilitation improved activity levels but these gains were not sustained following discharge and recommended work with local community services to enable discharged patients to maintain activities [41].…”

Section: Resultsmentioning

confidence: 99%

Co-production of “nature walks for wellbeing” public health intervention for people with severe mental illness: use of theory and practical know-how

et al. 2020

View full text Add to dashboard Cite

Background: Interventions need to be developed in a timely and relatively low-cost manner in order to respond to, and quickly address, major public health concerns. We aimed to quickly develop an intervention to support people with severe mental ill-health, that is systematic, well founded both in theory and evidence, without the support of significant funding or resource. In this article we aim to open and elucidate the contents of the 'black box' of intervention development. Methods: A multidisciplinary team of seven academics and health practitioners, together with service user input, developed an intervention in 2018 by scoping the literature, face-to-face meetings, email and telephone. Researcher fieldnotes were analysed to describe how the intervention was developed in four iterative steps. Results: In step 1 and 2, scoping the literature showed that, a) people with severe mental illness have high mortality risk in part due to high levels of sedentary behaviour and low levels of exercise; b) barriers to being active include mood, stress, body weight, money, lack of programmes and facilities and stigma c) 'nature walks' has potential as an intervention to address the problem. In Step 3, the team agreed what needed to be included in the intervention so it addressed the "five ways to mental wellbeing" i.e., help people to connect, be active, take notice, keep learning and give. The intervention was mapped to key behavioural change concepts such as, personal relevance, relapse prevention, self-efficacy. In Step 4, the team worked out how best to implement the intervention. The intervention would be delivered over 12 weeks by members of the hospital team and community walk volunteers. Participants would receive a nature walks booklet and text messages. Conclusions: We developed a theoretically-informed, evidence-based nature walks programme in a timely and relatively low-cost manner relevant in an era of growing mental illness and funding austerity. Further research is required to test if the intervention is effective and if this approach to intervention development works.

show abstract

The Rehabilitation Effectiveness for Activities for Life (REAL) study: a national programme of research into NHS inpatient mental health rehabilitation services across England

Cited by 6 publications

References 117 publications

Factors associated with family functioning among people with a diagnosis of schizophrenia and primary family caregivers

Factors associated with family functioning among people with a diagnosis of schizophrenia and primary family caregivers

A day in the life of people with severe mental illness living in supported housing

Co-production of “nature walks for wellbeing” public health intervention for people with severe mental illness: use of theory and practical know-how

Contact Info

Product

Resources

About