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The purpose of the current review is to synthesize the evidence of patients' perspectives of recovery after hip fracture across the care continuum. A systematic search was conducted, focusing on qualitative data from hip fracture patients. Screening, quality appraisal, and a subset of articles for extraction were completed in duplicate. Themes were generated using a thematic synthesis of data from original studies. Fourteen high-quality qualitative studies were included. Four review themes were identified: recovery as participation, feelings of vulnerability, driving recovery, and reliance on support. Patients considered recovery as a return to pre-fracture activities or "normal" enabling independence. Feelings of vulnerability were observed irrespective of the time since hip fracture and only diminished when recovery of function and activities enabled participation in valued activities, e.g., outdoor mobility. Participants expressed a desire to engage in recovery with realistic expectations and the benefits of meaningful feedback reported. While reliance on healthcare professionals decreased towards a later stage of recovery, reliance on social support persisted until recovery was perceived to have been achieved. Patient perspectives highlighted hip fracture as a major life event requiring health professional and social support to overcome feelings of vulnerability and enable active engagement in recovery. Rehabilitation professionals should ensure expectations and goals are set early in the recovery process. Rehabilitation professionals should ensure goals set with patients are tailored to the individual's pre-fracture activities or "normal" promoting independence. Rehabilitation professionals should monitor goals ensuring they are providing support, motivation, and managing expectations across the care continuum. Rehabilitation professionals should address patients' feelings of vulnerability, particularly in the absence of social support, and ensure appropriate ongoing input to maximize recovery. [ABSTRACT FROM AUTHOR]

A life course approach recognizes the role of turning points in adding twists and turns in individuals' addiction recovery processes. The notion of certain key life events that trigger turning point experiences offers a valuable theoretical construct for understanding processes of change. The current study aimed to identify turning points and assess the role of contextual dynamics in generating long-term changes, based on lived experiences of persons in drug addiction recovery. A qualitative research design was applied using a Lifeline Interview Method (LIM), allowing a retrospective lens to elicit recovery narratives. Purposive sampling was utilized to compose a heterogeneous group of thirty persons in self-defined drug addiction recovery in Flanders (Belgium). An interpretative phenomenological approach was adopted during a thematic analysis, grounding the research claims in respondents' lived experiences. Key moments of change that were reported by participants are: (1) adverse drug-induced experiences; (2) becoming a parent; (3) 'hitting rock bottom'; (4) (dis)engagement of social networks and environments; and (5) addiction treatment. The findings illustrate the role of contextual dynamics that can facilitate (or hamper) experiencing these life events as turning points toward change. This study contradicts the notion of a single event or turning point causing abrupt changes in individuals' addiction trajectories. Contextual dynamics and meaning-making processes simultaneously influence whether specific life events can facilitate change. Treatment providers, researchers, and policymakers should take into account the process-based, situational, and relational nature of recovery. [ABSTRACT FROM AUTHOR]

To explore older adult's perceptions of early rehabilitation and recovery after hip fracture, as a complement to the UK standards for acute physiotherapy after hip fracture. In-depth semi-structured interviews with 15 adults aged 60 years or more in hospital after hip fracture surgery. A thematic analysis approach with interpretation informed by Bury's biographical disruption theoretical framework. Participants voiced the importance of self-determination, professional support, meaningful feedback, and social capital after hip fracture. Collaborative working with staff was required for meeting the UK standards. Participants voiced anxieties about their hip fracture when considered in conjunction with their age and co-existing conditions, anticipating a disruption to their previous physical and social activities. This new, more dependent, life situation was not acceptable to participants. This study suggests hip fracture alone, was not perceived as a biographical disruption by older adults although it is presented as a potential tipping point in the loss of independence, contributing to the wider disruption of advancing age and co-existing conditions. For successful implementation of the UK standards, goal setting should consider patients in the wider context of their advancing age and co-existing conditions to empower them to define a fresh narrative of self. Hip fracture was perceived as a potential tipping point in the loss of independence, contributing to the wider disruption of advancing age and co-existing conditions. Participants expressed uncertainty over their ability to recover their previous identity in the absence of professional support and/or social capital. Healthcare professionals need to educate and empower older adults to take charge of their own recovery. For successful implementation of the UK standards for acute physiotherapy, there is a need to contextualize goal setting to empower patients to define a fresh narrative of self. [ABSTRACT FROM AUTHOR]

To understand how the social networks of a new recovery community can help sustain recovery, focusing on processes of social identity change, in the context of the wider UK recovery movement. A cross-sectional, mixed-methods social network analysis (SNA) of ego-network sociograms to map network transitions, using retrospective measures. Ten men were recruited from a peer-worker programme, in the South Ayrshire Alcohol and Drug Partnership (ADP), West of Scotland. Network measures were compared between two timepoints, just prior to current recovery and the present time. Measures included size and density, closeness of members, and their positive or negative influence, proportion of alcohol and other drug (AOD) using and recovery peers, and extent of separate subgroups. These were complemented with qualitative interview data. There was a significant transition in network composition, with the replacing of AOD-using peers with recovery peers and a broader transformation from relationships being framed as negative to positive. However, there was no significant transition in network structure, with AOD-using and recovery networks both consisting of strong ties and a similar density of connections between people in the networks. The transition in network composition between pre-recovery and the present indicates a different set of social influences, while the similarities in network structure indicate that the recovery network replaced the role of the using network in providing close bonds. This helped reduce social isolation experienced in early-recovery and provided a pathway into more structured opportunities for volunteering and employment. [ABSTRACT FROM AUTHOR]

Objectives: The concept of recovery has exerted considerable traction in mental health services for adults of working age, but less so in older people's mental health services. The aim of this study was to evaluate the feasibility of a staff-level recovery intervention in older people's mental health services. Method: The study used a mixed-method pre-post design. The study took place in NHS older people's mental health services, UK. Staff participants were multi-disciplinary mental health team members from the same service. The intervention was a manualised staff-level recovery intervention called the Older Adults Recovery Intervention (OARI). Measurement included the Recovery Knowledge Inventory and the Recovery Attitudes Questionnaire (RAQ-7) as well as fidelity data and in-depth qualitative interviews. Results: OARI was delivered to 204 staff in 15 clinical teams. There was a statistically significant change towards improvement in four of the six recovery attitude and knowledge sub-scales. There were positive findings in change in practice at individual level, but not at team level. A number of context barriers were identified leading to the intervention not being delivered as intended. Conclusions: Further development of OARI will involve a clearer distinction about the practice implications for service users with dementia versus functional illnesses, a stronger focus on implementation support, more use of evidence in training materials and a tailoring of context to meet professional group training needs. Overall, this study contributes novel data to the evidence base for recovery within older people's mental health services. [ABSTRACT FROM AUTHOR]

There is increasing recognition that cultivating compassion for oneself and others can act as an antidote to feelings of threat, shame, humiliation and paranoia. This study aimed to explore the further development of a narrative-based measure of compassion. We hypothesised that greater compassion would be associated with lower levels of positive symptoms, negative symptoms, cognitive disorganisation, excitement and emotional distress. Participants were 29 individuals with psychosis. Greater narrative compassion was associated with less negative symptoms, less cognitive disorganisation and less excitement. We found no correlations between narrative compassion and the Self-Compassion Scale. Notwithstanding the methodological problems of our study, our findings have important implications for developing an attachment-based understanding of compassion and the use of compassion to support recovery from complex mental health problems such as psychosis. [ABSTRACT FROM AUTHOR]

Recovery group participation is relevant to both clinical and research activity. Its measurement with the Recovery Group Participation Scale (RGPS) is an attempt to have a measurement of participation across a range of recovery groups. The factor structure, among other psychometric properties of the scale, is however, undefined. The present study examined the factor structure of the RGPS in alcohol and drug recovery populations in Birmingham and Glasgow, United Kingdom. Participants from the Birmingham (n = 219) and Glasgow (n = 205) recovery studies who had a completed form of the RGPS formed the basis for the factor structure examination. Principal component analysis extracted one factor, which accounted for 39.3% and 67.4% in the Birmingham and the Glasgow samples, respectively. Overall scores on the RGPS were associated with higher quality-of-life scores and with greater self-esteem and social networks of nonusers in recovery. The key question that remains to be addressed is the evolving role of recovery group participation in prospective studies of growth of recovery capital and sustained recovery. [ABSTRACT FROM AUTHOR]

Sail training refers to sea voyages designed to foster personal and social change. Such training has mainly involved young people but may have the potential to benefit adults who are recovering from drug and alcohol addiction. During the voyage described here clients in drug rehabilitation centres across the UK were given the opportunity to participate in a 5-day sail training voyage. Pre- and post-voyage interviews were conducted with 11 clients to explore their experiences of being selected and participating in this voyage. Clients enjoyed the experience and found it to be beneficial, promoting self-insight, new life plans and social skills development. Living in an unfamiliar, potentially dangerous and inescapable environment necessitating close proximity to others and teamwork under the supervision of expert authority figures generated bonding with and caring for others; as well as the development of new competencies and greater self-confidence. The findings suggest that sail training can be beneficial to clients in recovery from addiction and highlight key features that may optimise effectiveness. [ABSTRACT FROM AUTHOR]

Background: Project Access UK was designed to provide real-world observations on the status of medication-assisted treatment (MAT) of opioid dependence. Methods: 544 respondents from three groups (physicians, patients in MAT and out-of-treatment users) were interviewed or completed questionnaires. Results: Patient reasons for seeking treatment included ending their dependence and improving their health and well-being. Patients and users reported a mean of 4.0 versus 2.7 prior MAT episodes, but patient awareness of the main treatment options varied from 94% for methadone to 46% for buprenorphine–naloxone. Among patients, 49% requested a specific medication (mostly methadone) and 78% of requests were granted. Forty percent of patients were not currently receiving psychosocial or key- working support. Daily supervised dosing was most commonly cited as a condition of staying in treatment with the biggest impact on daily life (36%). Among patients, 56% continued to use illicit drugs on top of their MAT and few (7%) were in employment. The majority of patients (56%) and users (51%) had been in prison (an average of 6.8 times). Conclusion: Patients are motivated to recover. However, the full range of evidence-based interventions are not fully utilised and many patients cycle repeatedly through periods of treatment, relapse and imprisonment. [ABSTRACT FROM PUBLISHER]

Background: Having access to information and communication technologies (ICTs) is a prerequisite to meaningful participation in society. Objectives: This paper seeks to: i. explore the engagement of homeless drug users (HDUs) with ICTs and ii. discuss the findings with reference to recovery from drug dependence. Methods: The study design was qualitative and longitudinal, involving data collected in 2012-13 via 52 semi-structured interviews with 30 homeless drug users (25 men; five women). Participants were recruited from 17 hostels in two English cities. Interview data were analyzed using Framework. Results: HDUs had access to ICTs, used ICTs, and wanted to engage with them more. Experiences of digital exclusion were a function of participants' inability to afford ICTs, the relatively cheap and poor quality technology available to them, limited knowledge about ICTs, and lack of support in using them. That HDUs were often unable to take full advantage of technology because they had nobody to explain what their devices could do or to show them how they worked was ironic given that using ICTs to (re)establish and maintain relationships were functions of technology that HDUs particularly liked. Conclusions: The physical, human, cultural, and social capital of HDUs influenced their access to, and use of, ICTs. Equally, ICTs were themselves an important recovery resource. Services and others should endeavor to provide HDUs with easy access to good quality technology, as well as offers of support and education so that all individuals have the knowledge and confidence to make optimum use of the technology that is available to them. [ABSTRACT FROM AUTHOR]

Based on documentary analyses and interviews with twenty key informants in 2012, this paper analyses the shift in British drugs policy towards 'recovery' from the perspectives of major stakeholders. The processes involved in reopening the debate surrounding the role of substitution treatment and its re-emergence on to the policy agenda are examined. Drawing on Kingdon's work on agenda-setting, the ways in which methadone maintenance was challenged and defended by key stakeholders in the initial phase of policy development and the negotiation of a 'recovery' focus as the organizing concept for British drugs policy are explored. Study limitations are noted. [ABSTRACT FROM AUTHOR]

The study was based on a peer snowballing method involving members of a service users group in Birmingham, United Kingdom, who were asked to identify and interview members of their peer networks who had achieved 'sustained recovery' of one year. Two hundred and nineteen individuals were recruited who defined themselves as being in recovery, consisting of 132 individuals in medication maintained recovery and 87 in abstinent recovery. Those in maintained recovery were more anxious about using heroin and had lower self-efficacy, worse physical health, poorer quality of life, and more peer group members still using. Being older was associated with greater quality of life (rather than time since last use) supporting a 'maturing out' hypothesis. [ABSTRACT FROM AUTHOR]