Search

Accessible summary: What is known on the subject?: Medication does not always resolve a serious mood episode, and there is evidence that it needs to be combined with an evidence‐based psychotherapy to promote symptomatic and functional recovery.There is little known about what people with serious mood disorders want from mental health services to manage their mood. What the paper adds to existing knowledge?: Participants in this study wanted a framework other than the medical model for understanding and managing their mood.Their motivation to commence psychotherapy was based on a sense of having hit rock bottom and a need for understanding what was happening in order to better manage their mood. Introduction: There is little known about the motivations for people to participate in psychotherapy for depression. Aim: To explore why people, with a diagnosis of major depressive episode, chose to take part in a psychotherapy study and what they expected it to involve. Method: This was a qualitative study of participants' motivations and understandings of psychotherapy for depression. Data were collected using semi‐structured interviews and analysed using thematic analysis. Findings: Eight females and eight males with an age range from 21 years to 55 years were recruited. Three themes were identified that described why participants chose to participate in psychotherapy: medication was not enough, a turning point and making sense of experience. The participants chose to participate in psychotherapy after finding that medication was insufficient and this combined with a sense of crisis motivated them to engage in psychotherapy in order to learn to manage their mood differently. Discussion: The participants recognized that they wanted a framework other than a medical model with its reliance on medication, in order to make sense of their experiences and develop new self‐management strategies. Implications for Practice: Our study suggests that some people experiencing a serious mood disorder access psychotherapy after "hitting rock bottom" and finding insufficient help from medications. Mental health nurses need to be aware people do not always want a medical model approach to treatment of serious mood disorders and they need to provide the opportunity of engaging in a psychotherapeutic framework in order to better understand and manage their mood. [ABSTRACT FROM AUTHOR]

Critically reflecting on researcher–community partnerships is a key component in implementing chronic condition interventions in Indigenous communities. This paper draws on the results and learnings from a process evaluation that measures how well two research–community partnerships have followed the He Pikinga Waiora (HPW) Implementation Framework while co-designing chronic condition interventions in primary care. The HPW framework is centred on Indigenous self-determination and knowledge surrounded by community engagement, cultural centredness, systems thinking and integrated knowledge translation. The evaluation included in-depth interviews and online surveys with 10 team members. The findings demonstrate that the HPW framework was followed well, with strengths particularly in community engagement and relationship building. Areas for improvement included systems thinking and integrated knowledge translation to support sustainability of the interventions. The need for partnerships to use process evaluation results to support critical reflection is asserted, which helps build strong trust and synergy, power sharing and effective and sustainable implementation practices. It is concluded that the HPW framework is well suited to evaluating implementation of health interventions in primary care as it assists in the facilitation of better collaboration between researchers and Indigenous communities, and encourages the implementation team to reflect on power and privilege. [ABSTRACT FROM AUTHOR]

There is a growing interest in English-speaking jurisdictions, including Australia, North America, Canada, the United Kingdom and New Zealand, about the prevention of sexual abuse perpetrated by children against other children. The aim of this review was to identify opportunities for research, policy and practice which could enhance the prevention agenda relating to the perpetration of sexual abuse by children through conducting a Critical Interpretive Synthesis. Eleven electronic databases were searched in the period from 22 April to 23 May 2013 and included: SocINDEX, Social Services Abstracts, Applied Social Sciences Index and Abstracts, Family and Society Studies Worldwide, Project Muse, PsychINFO, Family and Society Plus, Jstor, Expanded Academic ASAP, Web of Science and Google Scholar. Key individual journals were also searched, including Child Abuse and Neglect and the Journal of Interpersonal Violence, as well as the grey literature. The search was guided by the research question: How could the prevention agenda relating to sexual abuse perpetrated by children be enhanced? The systematic literature search yielded 3323 titles, and 34 of these papers were included in the final synthesis. The authors identified five domains operating in the evidence base: characteristics, causes, communications, interventions and treatments. A synthesising construct emerged from the review: prevention-enhancing interactions. This construct referred to the potential for enhancing the prevention agenda which exists as the evidence domains interact with one another, and with the public health model of prevention. The authors consider this review to be a timely contribution to the current agenda pertaining to sexual abuse perpetrated by children. It provides researchers, policy makers and practitioners in the field with an evidence-informed conceptualisation of opportunities for enhancing prevention work. [ABSTRACT FROM AUTHOR]

Introduction. In 2009, the Royal New Zealand College of General Practitioners commissioned the development of a framework to facilitate quality-improvement activity in primary care settings. This paper outlines the development of the framework, which integrates concepts of quality with the reality of practice-based clinical care, and discusses its value for primary care quality improvement. Method. Framework development involved: (1) literature review of theoretical approaches to healthcare quality; (2) field work utilising a mixed methods approach to obtain empirical data; and (3) model design. Results. Primary care practitioners are juggling competing priorities. Models and tools that promote quality-related activity at practice level need to take into account, and incorporate by design, day-to-day clinical and practice functions. Conclusions. The quality framework identifies the components of primary care practice and locates this model within the concepts and activities necessary for quality improvement. It may be used by primary care organisations and practices to facilitate focussed quality-improvement activity and self-directed process review. The framework was developed for, and within a New Zealand primary care setting, and is applicable internationally and within other healthcare settings. [ABSTRACT FROM AUTHOR]