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Purpose: There is a lack of research informing service requirements for older (aged≥55 years) forensic mental health patients. The aim of this research was to increase knowledge about older forensic mental health patients' quality of life, wellbeing, recovery, and progress, in order to make recommendations of how to facilitate and enhance these factors. Methods: In-depth interviews with patients (N = 37) and staff (N = 48) were undertaken; data were analysed using thematic analysis. Results: Environmental (e.g., physical, structural and facilities), relational (staff, family and friends) and individual (characteristics, feelings, behaviours) factors were identified as enablers and/or obstacles to wellbeing, recovery, progress and quality of life. Conclusions: The physical and psychological environment of services needs to be adapted to meet the needs of patients. Therapeutic relationships with staff should be encouraged and a person-centred and individual recovery approach adopted. Prosocial relationships with peers, friends and family need to be fostered to enable positive recovery outcomes. Older patients should be empowered to develop a sense of autonomy to enable quality of life, wellbeing, and recovery, and progress. [ABSTRACT FROM AUTHOR]

Purpose: There is a pressing need for substance use services to know more about how to promote recovery from substance use problems, particularly in later life. Psychological sense of community (PSOC) is an important recovery dimension. This study aims to clarify in what ways PSOC and communities influence later life recovery processes. Method: A collaborative and deductive reflexive thematic approach was used to analyse 23 interviews with older adults in recovery from different substance use problems. Results: The findings suggest that PSOC and recovery in later life include multiple communities (relational, geographical, substance use-related, ideal and service-related) and affective states (PSOC and NPSOC). Older adults' recovery, moreover, can be described as personal and heterogenic (with respect to community relationships, individual needs, type of substance use problem, age of onset and meaningful activities). Conclusions: The findings confirm age of onset, type of substance use problem and community memberships as essential to later life recovery. They also supplement prior evidence on community resources and challenges to later life recovery. Importantly, the new findings extend and nuance current understandings of later life recovery. Taken together, the article illustrates MPSOC as a useful concept, with central practical and theoretical implications for later life recovery. [ABSTRACT FROM AUTHOR]

Purpose: This study explored the experiences of people with stress-related illness participating in a nature-based intervention programme in a northern natural setting. Methods: A longitudinal case study was conducted with two women participating in a nature-based intervention programme on a farm. Data were collected by semi-structured interviews, diaries, rating scales, and self-assessment. Qualitative data were analysed by qualitative content analysis and quantitative data are presented descriptively. Results: The theme of finding a source for recovery and well-being permeates all categories. The participants perceived the farm and nature to be a calming refuge; they learned to be in the present and could manage the tasks. In togetherness with each other and the facilitator on the farm they felt understood and confident, experienced joy, and found opportunities for change. They gained knowledge and positive memories and found new approaches in life. Self-assessment questionnaires indicated improvements of functioning in everyday life and reduced stress-related exhaustion at the end of the NBI programme. Conclusions: Nature-based interventions lasting for a relatively short period seem to promote health and may be a complement to other treatments of stress-related illness. Further research is needed with a larger number of participants and in various natural settings. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to illuminate the lived experiences and the path of recovery for adults sustaining a hip fracture before the age of 60. Methods: Participants were purposively sampled from a prospective multicenter cohort study in Sweden and Denmark, and narrative interviews were conducted with 19 individuals 0.7-3.5 years after the fracture. We used a phenomenological hermeneutic method to describe the participants' expressed essential meaning. Results: The experience of sustaining a hip fracture was expressed as a painful and protracted process of regaining self-confidence, function, and independence. It also implied a sense of growing old from one day to the next. Participants were afraid of new falls and fractures, resulting in an increased wariness. When expressing fears and persisting symptoms, participants described being neglected and marginalized by the healthcare system, which was perceived as non-receptive and routinely driven by a notion that hip fractures affect only the elderly. Rehabilitation targeted towards needs different from those of elderly individuals was requested. Conclusion: The lived experience of sustaining a hip fracture in individuals under 60 includes substantial challenges in everyday life, even up to 3.5 years after the injury. Rehabilitation pathways tailored to the needs of younger patients are requested. [ABSTRACT FROM AUTHOR]

Self-efficacy plays a role in the process of making lifestyle changes. After bariatric surgery, patients must adapt to several lifelong lifestyle changes. The aim of this study was to explore patients' experiences of recovery after bariatric surgery in those reporting low preoperative self-efficacy. This qualitative inductive interview study included 18 participants. Individual interviews were conducted approximately one year after the surgery. Data were analysed using thematic analysis. The analysis identified one theme, and five subthemes describing recovery after bariatric surgery. Participants described being at a crossroads before surgery and having to make a change. After surgery, they had to learn to handle their new situation, which included getting to know their new body, handling thoughts about themselves, and managing social relations. To enhance their situation, support and information were essential. Social relations, support, successes, and challenges influenced their self-efficacy, and thoughts about adopting lifestyle changes, maintaining motivation, and handling setbacks. Recovery one year after bariatric surgery is an ongoing process that involves challenges encountered in lifestyle changes and physical and psychological transformations. Self-efficacy is not static and is influenced during the recovery process. Support and information are essential to enhance patient recovery after bariatric surgery. [ABSTRACT FROM AUTHOR]

The concept of recovery is commonly described as multifaceted and contested in the field of mental health and substance abuse. The aim of this study is to explore how understandings of recovery and recovery orientation of services are developed through daily practices and collaboration between service users and professionals. Eight pairs of participants were interviewed together, in accordance with the dyadic interview method. The dyads/pairs consisted of service users and professional helpers. A collaborative hermeneutic-phenomenological analysis was used to analyse data. Data were analysed into three overarching and entangled themes, exploring how recovery-oriented collaboration and knowledge encompasses (a) recovery as relational processes. These processes are entangled with (b) recovery as situated in time and place. Furthermore, relational processes and dimensions of time and place are situated in and supported or hindered by (c) recovery orientation as part of the municipal policies, understood as the regulations, frameworks and decisions guiding mental health and substance abuse services in the municipality. The further development of recovery-oriented services should focus on facilitating open-ended and flexible ways of developing practices and relationships. This involves recognizing how relationships contribute to the development of knowledge and practices. [ABSTRACT FROM AUTHOR]

Purpose: Community Health Centres (CHCs) are an essential component of primary health care (PHC) in Canada. This article examines health providers' understandings and experiences regarding stigma towards mental health and substance use (MHSU) issues, as well as their ideas for an effective intervention to address stigma and discrimination, in three CHCs in Toronto, Ontario. Methods: Using a phenomenological approach, we conducted twenty-three interviews with senior staff members and peer workers, and three focus groups with front-line health providers. Ahybrid approach to thematic analysis was employed, entailing a combination of emergent and a priori coding. Results: The findings indicate that PHC settings are sites where multiple forms of stigma create health service barriers. Stigma and discrimination associated with MHSU also cohere around intersecting experiences of gender, race, class, age and other issues including the degree and visibility of distress. Clients may find social norms to be alienating, including behavioural expectations in Canadian PHC settings. Conclusions: Given the turmoil in clients' lives, systematic efforts to mitigate stigma were inhibited by myriad proximate factors that demanded urgent response. Health providers were enthusiastic about implementing anti-stigma/recovery-based approaches that could be integrated into current CHC services. Their recommendations for interventions centred around communication and education, such as training, CHC-wide meetings, and anti-stigma campaigns in surrounding communities. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to examine what was beneficial and what was challenging in a group intervention for young adults based on RENEW principles in a municipal employment centre. RENEW (Rehabilitation for Empowerment, Natural support, Education, and Work) is an education-oriented support model for young people. Method: The eight young adults who participated in the group and three mentors who led the group were interviewed about their experiences with the group, and a workshop was held for staff to validate the themes found in the study. Results: Three themes emerged, one denoted the importance of helpful personal relationships, both between the mentors and the young adults and among the young adults; another denoted how an authentic attitude from the mentors made group exercises inconspicuous as the group members experienced activities in the group as originating from spontaneous, genuine interest rather than the manual-based exercises they were. The last theme conveyed how the group process was challenged by the institutionally regulated compulsory attendance and the mentors' lack of teamwork resources. Conclusions: The study suggests that meeting young adults authentically and flexibly combining a certain element of self-disclosure with a manual-based group intervention such as RENEW can strengthen relatedness and convey hope, thereby supporting educational rehabilitation. [ABSTRACT FROM AUTHOR]

Background:There is a growing understanding that mental health problems and prolonged contact with mental healthcare systems can affect people’s identities. Working with identity is an important element in mental health recovery. Purpose:In this article, we explore the significance of participation in a music and theatre workshop in terms of people`s experiences of identity. Design and methods:This is a qualitative study based on a hermeneutical phenomenological epistemology. Data were collected from in-depth interviews with 11 participants at a music and theater workshop, analysed through a narrative analysis and presented in an ideographical “long” narrative form. The music and theater workshop is not overtly therapeutic although the activity takes place in a Norwegian mental health hospital for adults living with long-term mental health problems. Results:We identified three crosscutting themes: (1)becoming a whole person,(2)being allowed to hold multiple identitiesand (3)exploring diverse perspectives. Conclusion:Findings show that participation in the music and theatre workshop transformed the participants’ experiences of identity on two levels: individually and collectively. The participants developed a broader picture of themselves through their creative work with others. When they developed new identities, the narratives of themselves expanded. [ABSTRACT FROM PUBLISHER]