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Purpose: Cognitive fatigue is commonly reported and described as disabling by patients recovering from neurological conditions including stroke. However, cognitive fatigue is usually underdiagnosed among stroke survivors which leads to a lack of specific treatments for this condition. Therefore, the aim of this study was to explore post-stroke cognitive fatigue as it is experienced by stroke survivors. Methods: This qualitative research followed the principles of descriptive phenomenology within a constructivist paradigm. Individual semi-structured interviews were conducted with stroke survivors experiencing post-stroke cognitive fatigue recruited through the Heart and Stroke Foundation, the Canadian Partnership for Stroke Recovery, and social media posts. Data were analyzed through inductive content analysis. Results: Eleven stroke survivors participated. The analysis revealed five themes illustrating the experience and descriptions of post-stroke cognitive fatigue: (1) characteristics, (2) aggravating factors, (3) management, (4) effect of cognitive fatigue on daily life, and (5) social awareness and support. Conclusion: This study highlights the complexity of post-stroke cognitive fatigue. Cognitive fatigue becomes more evident after discharge; therefore, clinicians should consistently screen for it and provide proper education to the patients and their carers. IMPLICATIONS FOR REHABILITATION: Cognitive fatigue is a complex phenomenon that can negatively affect the daily life of stroke survivors. Sensory-overloaded environments, emotional distress, poor sleep, and engaging in complex cognitive tasks can trigger post-stroke cognitive fatigue. More education on the concept of cognitive fatigue should be provided to healthcare providers to be able to identify and manage this symptom properly. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about how parents' transactions with health and educational professionals shape their experience of these systems, and impact on capacities to support their child with acquired brain injury (ABI). We explored experiences of specific transactions and perceptions of impact. Methods: A focus group and individual interviews were conducted with seven parents of children in the chronic phase of recovery following ABI. Thematic analysis was used to interpret the data. Results: Four superordinate themes were identified: "These Encounters Matter," "A Person not a Number—Interpersonal Skills that Count," "The Blind Leading the Blind," and "Becoming the Backbone." Findings highlighted that these transactions mattered to parents, promoting either distress or empowerment. Positive outcomes were characterized by transactions related to communication, empathy, trust, collaboration, and connection. However, there was a perception of the "blind leading the blind" and that ultimately parents needed to enter such transactions armed with knowledge and their own therapeutic goals. Conclusions: Our findings unpack contextual and transactional elements of parents' experiences with health and education professionals which empower or distress. Understanding and improving these processes is important, given the central role families play in child outcomes following ABI. Implications for clinical practice are discussed. IMPLICATIONS FOR REHABILITATION: Findings suggest encounters with health and education professionals impact parent functioning and enable, or undermine, them in supporting their child with acquired brain injury. Transactional processes between parents and professionals that led to empowering and positive, or disempowering and negative, outcomes were elucidated and professionals are invited to consider these. Training for health and education professionals related to knowledge of childhood acquired brain injury, but also attunement and interpersonal processes for consultations with parents, are highlighted as important. Findings suggest that helping parents develop effective advocacy skills for their child may also be indicated. [ABSTRACT FROM AUTHOR]

Purpose: Physical interventions during subacute rehabilitation have potential to improve functional recovery. This study explored the perspectives of children and adolescents with acquired brain injury (ABI) and their parents with respect to physical rehabilitation during the subacute phase. Methods: Thirteen children and adolescents with ABI and their parents were included and interviewed using semi-structured interviews. Interview transcripts were analysed using inductive thematic analysis approach. Results: Six themes were identified: 1) beliefs of physical rehabilitation, 2) content of physical rehabilitation, 3) tailored care, 4) impact of context, 5) communication and 6) transition. The importance of intensive physical practice was widely supported. The positive can-do mentality was emphasised to create an atmosphere of hope, meaning that every effort would be made to achieve maximum recovery. Intensive involvement of parents is considered essential during subacute rehabilitation including an open and mutual dialogue about the focus of rehabilitation, therapy goals and future participation in their own environment. Conclusions: Our findings highlight the need for an intensive rehabilitation approach, tailored to the individual's needs. The perspectives of children and adolescents and their parents in our study contribute to a better understanding of factors that are important for optimal recovery through physical rehabilitation during the subacute phase. IMPLICATIONS FOR REHABILITATION: Children with acquired brain injury and their parents indicate the potential and thus the importance of intensive physical practice to enhance optimal recovery. Involvement of parents and the potential of their continuous presence during subacute rehabilitation may have a positive impact on the effect of rehabilitation efforts. The positive can-do mentality of rehabilitation professionals creates an atmosphere of hope and is an important requisite to achieve maximum recovery. Open dialogue between clinicians and the family is warranted about the focus of interventions. [ABSTRACT FROM AUTHOR]

Background: Building friendship is crucial for attaining and upholding recovery from problematic substance use. However, how people who have used substances problematically develop friendships needs to be investigated more from a first-person perspective. Aim: To provide insight into how people in long-term recovery find meaning in their experience of building friendships. Method: In semi-structured interviews, 17 people in recovery drew network maps and reflected on how friendships had developed during the long-term process. We analysed the narratives by way of a thematic narrative approach. Results: Participants presented the friendship-formation process through four distinct storylines: (1) 'I don't make friends easily'; (2) overcoming barriers to building friendships; (3) 'birds of a feather flock together'; and (4) 'having "regular" friends makes me feel like an "average" person'. Conclusion: People in long-term recovery from problematic substance use felt haunted and hindered by past experiences when building friendships. These experiences created a social divide between those who had experienced problematic substance use and those who had not. The valuable insights that social workers can gain from this study can support friendship development for people in long-term recovery on multiple levels. By understanding someone's self-perceptions and their perspectives on others, social workers can engage with barriers when people in recovery enter social environments such as work. We emphasise the significance of a long-term approach to overcoming barriers to building new friendships. [ABSTRACT FROM AUTHOR]

Introduction: People who grew up under the care of children's social services are a highly vulnerable group, with 50% of this population meeting the criteria for a mental health problem at any one time. Emerging evidence suggests that there is a disparity between the number of people who require support, and those that receive it, and that they face several barriers to accessing timely and effective mental health support. We have a limited understanding of how to support the mental health of this group as they 'age out' of children's social services, and the transition to independence, which occurs around the age of 18. We aimed to explore how care‐leavers understand their experiences of help‐seeking from formal mental health services. Methods: We used qualitative interviews, and Interpretative Phenomenological Analysis with 9 care‐experienced young people aged between 18 and 25 years old. This work was co‐produced by a team of care‐experienced adults, from the conception of the study to write‐up. Results: Qualitative analysis revealed several themes which centred around: (1) taking reluctant steps towards recovery, (2) challenges with being understood and the importance of gaining an understanding of yourself, (3) navigating trust and (4) the legacy of not having your mental health needs met. Conclusions: We identified several important implications for health and social care practice, across primary and secondary health care settings. This work highlights ways to better support this highly vulnerable group in accessing evidence‐based mental health support, and how to maintain engagement. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has brought about disruptions in healthcare for adults with intellectual and developmental disabilities. There is a need to explore ways to promote proactive healthcare and better prepare individuals for healthcare encounters. Methods: A co‐designed tool, the COVID Check‐in Tool, was introduced as part of a virtual health education programme to encourage proactive healthcare. Implementation of this Health Check‐in was evaluated with 36 adults with intellectual and developmental disabilities and 96 family caregivers who completed the programme using surveys, structured interviews and focus groups. Findings: Forty‐four percent of participants engaged in the Health Check‐in process, resulting in many reported benefits for those who participated. However, there were also barriers to initiating the Check‐in, along with challenges using the COVID Check‐in Tool, according to both the adults with disabilities who were interviewed and the family caregivers. Conclusions: The study underscores the importance of considering ways to integrate tools into routine healthcare practices, to facilitate improved healthcare delivery for people with intellectual and developmental disabilities during pandemic recovery efforts. As well, involving people with lived experience in the development and implementation of healthcare resources is critical. Accessible Summary: Our team worked together to make a tool that would help people with intellectual and developmental disabilities talk to their doctor about health problems after not seeing them a lot because of the pandemic. We called this tool the 'COVID Check‐in'.Then people from our team taught online health courses about how to use the COVID Check‐in Tool and other health topics.After the courses were over, we asked 36 adults with intellectual and developmental disabilities and 96 family caregivers if they had a Health Check‐in with their doctor and how it went, or what problems they had with it.Almost half of the people who took the courses had a Health Check‐in and most of the people thought it was helpful. Some people did not do it or did it but had problems with it.We end the paper with some ideas of how to make it easier to check in with the doctor and why it is important to include people with disabilities and family caregivers when making healthcare tools. [ABSTRACT FROM AUTHOR]

Objectives: Despite expanding knowledge about the internal and external resources that contribute to resilience among individuals who have experienced depression, the long-term accessibility and protectiveness of these resources across different stressors is unknown. We investigated whether and how the resilience resources of individuals who previously recovered from late-life depression remained protective during the COVID-19 pandemic. Methods: We used a sequential explanatory mixed methods design. Quantitative data were derived from two psychiatric case-control cohorts and included twelve repeated measures during the COVID-19 pandemic (n = 465, aged ≥ 60). Qualitative data included two sequential interviews held in 2020 (n = 25) and 2021 (n = 19). We used thematic analysis to determine the protective resources after depression and during the COVID-19 pandemic and linear mixed models to examine the effect of these resources on change in depressive symptoms during the COVID-19 pandemic. Results: While resources of 'Taking agency', 'Need for rest', 'Managing thought processes' and 'Learning from depression' remained accessible and protective during the pandemic, 'Social support' and 'Engaging in activities' did not. 'Negotiating with lockdown measures', 'changing social contact' and 'changing activities' were compensating strategies. Quantitative data confirmed the protectiveness of social contact, social cohesion, sense of mastery, physical activity, staying active and entertained and not following the media. Conclusion: Many of the resources that previously helped to recover from depression also helped to maintain good mental health during the COVID-19 pandemic. Where accessibility and protectiveness declined, compensatory strategies or new resources were used. Hence, the sustainability of resilience is enabled through adaptation and compensation processes. [ABSTRACT FROM AUTHOR]

Purpose: Many factors contribute to persisting post-concussion symptoms (PPCSs), necessitating multi-modal treatment. Quantitative investigations have shown the potential of interdisciplinary intervention to reduce the burden of PPCSs and facilitate return to activities. There are often varied responses to intervention, warranting further investigation of potential factors underlying treatment response. This study aimed to explore participant experiences of i-RECOveR, an interdisciplinary intervention for PPCSs and its impact on symptoms, daily function, and concussion beliefs. Materials and Method: Semi-structured interviews were conducted 1-month post-treatment via videoconferencing with 13 individuals (61% female) with mild traumatic brain injury (Mage=39.77 years, SD = 16.27) who participated in i-RECOveR. Interview transcripts were analysed thematically. Results: Three themes reflected participants' treatment journeys from concussion to life after treatment: (1) Dissatisfaction with Previous Consultations, reflected personal experiences prior to commencing treatment; (2) Perceived Active Ingredients of Intervention, reflected participant experiences of i-RECOveR; and (3) Impact of Interdisciplinary Intervention, reflected a range of positive changes after completing i-RECOveR. Conclusions: Findings highlight current gaps in the acute management of concussion and provide end-user insights into the facilitators and barriers of treatment engagement and response. Responses also highlight the potential positive impact of interdisciplinary treatments. Clinician perspectives should be explored in future research. IMPLICATIONS FOR REHABILITATION: Access to additional training in concussion care and referral pathways may help medical practitioners manage patients after concussion. Clinicians working with individuals with persisting post-concussion symptoms should develop an understanding of the individual's perceived control over their symptoms, and work with them toward increasing autonomy and control and recognition that symptoms are often multifactorial in nature. Persisting post-concussion symptom rehabilitation may be improved by taking an interdisciplinary approach that is integrated individualised, and is specialised for concussion. Telehealth and hybrid treatment models are well tolerated by individuals with persisting post-concussion symptoms and may facilitate treatment engagement, especially for individuals with mild traumatic brain injury who report disabling symptoms made worse by travelling to in-person treatments. [ABSTRACT FROM AUTHOR]

Introduction: The article reports the healing elements of an eclectic life skills programme (ELSP) from the perspective of group members. An ELSP utilising open groups was developed to manage clients with mixed diagnostic profiles and different stages of recovery simultaneously. The aim was to explore the healing elements of an ELSP. Methods: Maximum variation purposive sampling was used to select six participants for the phenomenological inquiry. Data collection is comprised of observations, semistructured interviews, and reflective journals. Data analysis comprised an inductive thematic analysis. Consumer Involvement: Participants all attended groups offered within the ELSP. They participated in two semistructured interviews: the first interview in the week following admission and the second just before discharge. In addition, they documented their experiences in reflective journals for the duration of their participation. Findings: The analogy of a kaleidoscope portrayed the four themes; three pertained to structural dynamics, namely, programme mirror, facilitator mirror, and mirror of other group members. The fourth theme, namely, the magical pattern, pertained to personal sense‐making by individual group members. Conclusions: The dynamic interplay of healing factors, captured in the themes, facilitated healing. Self‐reflection was integral to the creation of a bespoke, facilitated self‐learning process with direct application in group members' own lives. [ABSTRACT FROM AUTHOR]

Background: Equitable care is a fundamental value in the nursing profession. Healthcare workers have both a moral and professional duty to ensure that they do not discriminate. Aim: This study aimed to explore how patients perceive equitable nursing care. Research design, participants, and research context: This descriptive phenomenological qualitative research study used purposeful sampling to select 17 patients from various departments of a general hospital in southern Iran. The participants were then interviewed using a semi-structured in-depth interview format, which aimed to delve into their experiences with equitable nursing care. The collected data were analyzed using Colaizzi's seven-step method and MAXQDA20 software. Ethical considerations: Oral and written information about the study was provided before the participants gave their written consent. The transcribed interviews were de-identified. The study was approved by the Ethics Committee of Jiroft University of Medical Sciences. Findings: The data analysis of the study identified three main themes and six subthemes that were related to the experiences of patients with equitable nursing care. The first theme, equitable care, encompassed subthemes such as nurses' dedicated efforts to facilitate patient recovery and adherence to ethical behavior. The second theme, unconscious causes of inequitable nursing care, included subthemes such as unintentional discrimination stemming from organizational constraints and unconscious biases resulting from a lack of knowledge and skills. The third theme, discriminatory care, comprised subthemes such as deliberate discrimination based on personal traits and selective discrimination. Conclusion: The study findings indicate that achieving equitable nursing care requires a multifaceted approach. This includes effective hospital management, organizational reforms, and regulatory enhancements. Additionally, it is crucial to pay close attention to the needs of patients, enhance nurses' theoretical and practical skills in providing equitable care, fostering a culture of equality within healthcare settings, and consider the personality dimensions and moral characteristics of nurses. [ABSTRACT FROM AUTHOR]

Previous research has mainly focused on self‐harm among women, defining what it is, what functions it has, how to manage and prevent self‐harm, and how to recover from it. A recent review of the literature on self‐harm among men concluded that research need to consider both clinical and personal aspects of recovery and pointed out the need to explore recovery from men's point of view. This study aimed to describe men's experiences of recovery in self‐harm. Data were collected in Sweden in 2020 using semi‐structured interviews. Eleven men who had recovered in self‐harm were interviewed. Interviews were analysed using an abductive approach to qualitative content analysis. The analysis involved the application of an established framework for personal recovery in mental illness: connectedness, hope, identity, meaning, and empowerment (CHIME). The analysis identified one main theme: when the time is right, and five sub‐themes: finding support in others; trusting that change is possible; getting to know yourself; reaching a new understanding; and developing new strategies to manage life. While the cessation of self‐harm might both be a sign of and contribute to recovery, it is not the defining feature of recovery. Mental health professionals should be persistent in providing person‐centred, recovery‐oriented care for men who self‐harm. The CHIME framework can be applied in the context of men's recovery in self‐harm. This study is reported in accordance with the COREQ guidelines. [ABSTRACT FROM AUTHOR]

As part of mental health reform in Australia, new policies were introduced to support recovery‐oriented practice; however, little has changed in hospital settings focused on managing risk and remediating acute symptoms. Previous studies have indicated that patients' experiences of personal recovery, during a hospital admission, may not mirror that of people living in the community, with patients being more likely to experience disconnection, hopelessness and disempowerment. Using a Participatory Health Research approach, eight mental health professionals, a patient advocate and an external researcher formed a research partnership to answer the question: How can staff enhance recovery‐oriented practice in a hospital‐based mental health service? The COREQ checklist was used for reporting the methods, analysis and findings. The methods comprised patient focus groups (n = 16 participants), interviews with managers (n = 7) and an online survey for staff (n = 17). Researchers analysed the feedback from the consultations using inductive thematic analysis, identifying two themes: relational recovery and recovery interventions. The findings indicate that relational recovery is key to recovery during a hospital admission and interventions that increase connectedness or reduce the impact of symptoms enhance personal recovery. [ABSTRACT FROM AUTHOR]

Despite integrating the recovery model of care in mental health, mental health professionals still have pessimistic attitudes towards the recovery of people with mental illness. Positive attitudes towards recovery are essential components to integrate recovery‐oriented practices in all areas of mental health. Evidence shows that education and training are effective while emphasising the importance of consumer‐based interventions to enhance recovery attitudes. This study aimed to evaluate the effectiveness of peer‐led education about recovery attitudes towards people with mental illness among Mental Health Nurses working in acute inpatient settings. The methodology used was a sequential explanatory mixed method with pre‐ and post‐test design involving three phases. Phase 1: survey (n = 103), phase 2: post‐test survey immediate (n = 17) and follow‐up (n = 11) and phase 3: in‐depth interviews (n = 12). The results show that Mental Health Nurses have positive recovery attitudes with some room for improvement. Most participants agreed with all items of the Recovery Attitudes Questionnaire. However, the participants had various views on the relationship between faith and recovery. The peer‐led education significantly improved RAQ items 1, 2, 3, 4 and 6 statistically. Furthermore, peer‐led education effectively enhanced recovery attitudes immediately after the intervention and helped to maintain sustainable attitudes 3 months later. A qualitative exploration of recovery attitudes revealed three main themes: participants' reflections, recovery hurdles and interpersonal relationships. [ABSTRACT FROM AUTHOR]

In 2019, the World Health Organization urged a global shift towards recovery‐focused practices in mental health care. In Western nations, this transition often prioritised individualism over collectivism. In contrast, collectivist societies prioritise recovery through community and social support. This study explored mental health recovery from the perspectives of consumers, carers and registered nurses in a mainly collectivist society (Saudi Arabia) using a qualitative exploratory descriptive design. Sixteen consumers, ten carers and eight registered nurses participated in online semi‐structured interviews. Inductive thematic analysis was employed to analyse English‐translated versions of the 34 interviews. Consolidated criteria for reporting qualitative studies 32‐item checklist were used. The study found that recovery was perceived as a process of transforming towards living a meaningful life of goals and values supported by trusted people who share moments of comfort and empowerment. A unique finding was the 'bond of recovery' a collectivist value that aid consumers' community integration in society. Saudi consumers' experiences of recovery were similar to consumers' movement narratives of recovery. Future research should establish a recovery‐focused educational program that incorporates our findings into a recovery‐oriented approach. This will facilitate providing a collaborative care between consumers, carers and nurses that centres around consumers' recovery goals and values. [ABSTRACT FROM AUTHOR]

High‐risk behaviours are sometimes encountered in Child and Adolescent inpatient mental health units and can prompt the use of coercive practices to maintain safety. Coercive practices may lead to re‐traumatisation of young people and deteriorating therapeutic relationships. Trauma‐informed practice (TIP) has successfully reduced coercive practices. While education is identified as foundational to implementation, evaluations of programmes remain minimal. The aim of this study was to explore mental health professionals' views and experiences of a trauma‐informed education programme and its likely impact on their approach to practice. Five mental health professionals agreed to participate, four contributed in a focus group and one in an individual interview. Data were analysed thematically using the Braun and Clarke Framework. Three main themes were identified. Firstly, shifting attitudes and perceptions of trauma‐informed practice. Participants believed they had developed more compassion towards clients and these attitudes were reflected in their clinical practice. Secondly, challenges associated with trauma‐informed practice educational intervention. Staffing issues and shift work made it difficult for participants to attend education sessions regularly. Participants identified barriers to practicing in a trauma‐informed manner in the current clinical environment. Finally, the need for interdisciplinary communication and support was identified. Participants saw the need for all professionals, not only nurses, to take responsibility for changing practice, and for stronger support at the organisational level. Trauma‐informed practice is crucial to recovery‐focused mental health nursing practice. These findings highlight the importance of TIP education and suggest areas for further improvement to enhance positive mental health outcomes for young people. [ABSTRACT FROM AUTHOR]

The Active Recovery Triad (ART) model provides a framework for recovery-oriented care in long-term mental health settings. The aim of this study is to gain insight into the experiences and views of service users and their significant others regarding care and support they receive from teams working with the ART model. Semi-structured interviews were performed with nineteen service users and five significant others of teams operating in Dutch long-term mental health care. Data were analyzed using thematic analysis. The three core principles of the ART model formed the deductive basis of the analysis and for every principle themes were identified inductively. Under the principle 'Active', service users mentioned that they feel motivated, work actively on personal recovery goals and have dreams for the future. Service users valued the service as a safe environment, but several service users also preferred to live more independently. Under the principle 'Recovery', participants reported how the dimensions of recovery (health, personal identity, daily life and community functioning) were addressed in care and support. Also, specific conditions for recovery-oriented care were identified, for example regarding specific expertise of care providers. Under the principle 'Triad' the support from significant others, contact with care workers and with other service users were identified as important. The insights regarding what is important for service users and their significant others may contribute to the improvement of care and support in long-term mental health care. In addition, the findings of this study provide directions for the further development of the ART model. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mental health recovery is acknowledged as a process of transformation and a way of living a meaningful life despite the presence of mental ill‐health.Experiencing hope has been articulated as intrinsic to service users experience of a meaningful life.The social construction of mental illness and stigma are recognised as barriers to experiencing hope.Mental health professionals have responsibility to positively influence the experience of hope. What this article adds to existing knowledge?: Individuals in mental health recovery experience hope as the embodiment of having a sense of possibility in life.Individuals' sense of possibility in life is underpinned by a belief and confidence that they will be ok. This belief is informed by 'feeling safe' and 'feeling connected'.This article generates an increased understanding of the dynamic relational processes that unpin hope generation. What are the implications for mental health nursing practice?: Mental health stakeholders need to be more explicit in exploring 'hope' and uncovering its therapeutic potential.Mental health practitioners need skill in enabling individuals to feel safe and connected while understanding its role in cultivating hope. Introduction: The experience of hope is widely acknowledged and empirically supported as a key catalyst of mental health recovery. Lived experience accounts of hope are critical in accessing data on what has been termed a nebulous concept. This article is the second presentation of data from this study and provides further context to improve understanding of hope and optimise its therapeutic potential. Aim: To explore how individuals describe and make sense of their experience of hope in mental health recovery. Method: A qualitative Interpretative Phenomenological Analysis (IPA) approach was used. Results: This article explores the second of three experiential group themes: Hope as Having a sense of possibility 'I will be ok' which is informed by feeling safe and feeling connected. Discussion: Having a sense of possibility is easier when basic needs are met and people feel connected to self, others and the universe. The use of creativity as a pathway to the imagination is positively experienced. The role of family, friends and healthcare professionals as hope reservoirs is critical. Finally, the framing of medication use emerged as significant. Implications for Practice: It is important that all stakeholders appreciate the interpretation of hope and use the understanding and skill in harnessing its therapeutic potential. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: At the outset of the COVID‐19 pandemic, little was known about ways of delivering registered nurse practice within CMHTs under restrictions associated with a global pandemic.Emerging research focused on broad healthcare staff wellbeing during the pandemic. Qualitative research explored the overall response of COVID‐19 on people with existing health needs or remote working more specifically.Over the past 2 years studies have emerged detailing experiences but no studies have used qualitative research to understand community mental health nurses and service users experience of services. What the paper adds to existing knowledge?: This co‐produced qualitative study is the first to explore the changes to CMHT care from the experience of service users and nurses later in the COVID‐19 pandemic.The study questions whether recovery‐based approaches are possible in a hybrid way of working.The findings identify challenges for nurses' well‐being and work–life boundaries when working from home.The study adds to historical professional narratives of mental health nursing. What are the implications for practice: While hybrid approaches developed in response to COVID‐19 restrictions may offer more choice these approaches need further co‐produced evaluation on the impact of recovery‐focused care and therapeutic relationships.Mental health nurses need to review how future hybrid working continues to impact nurses' mental health and emotional safety.Nurses and service users need to raise awareness within society and policy on the impact that COVID‐19 had on people with existing mental health conditions. Introduction: Community Mental Health Team responses to COVID‐19 included fundamental service delivery adaptations. Aim/Question: Our co‐produced study sought to understand which service delivery changes experienced by service users and registered nurses were helpful or unhelpful to caregiving and receiving. Method: Qualitative semi‐structured interviews were undertaken with 10 service users and 13 registered nurses from 3 NHS England sites. Co‐produced throughout, people with lived experience of mental health services and nurses wishing to improve their research experience undertook interviews following training. Data were analysed thematically. Findings: Care radically changed from in‐person to large phone or video contact. This reportedly altered therapeutic relationship building and raised questions about whether recovery‐focused care was possible. Hybrid working was viewed as helpful but raised challenges for nurse wellbeing. Discussion: Changes to care delivery challenged the fundamentals of recovery‐focused interventions and therapeutic relationships. Service users and nurses well‐being consequently suffered. The impact of the pandemic on people with existing mental health conditions was poorly acknowledged in the media. Implications for Practice: Recovery‐focused interventions and relationship building need evaluating in the light of ongoing hybrid working. Teams need to consider the well‐being of nurses engaged in complex service‐user interactions from home. [ABSTRACT FROM AUTHOR]

While positive impacts of recovery capital and social capital in facilitating substance use disorder (SUD) recovery is increasingly documented, research has shown that low-income and marginalized individuals have lower social capital and may rely on different networks. A more comprehensive approach is needed to understand the social capital of low-income individuals with SUD and how these relationships impact their treatment and recovery. Qualitative data were gathered through semi-structured interviews and analyzed employing thematic analysis. Participants included individuals with SUD (n = 10), clinicians (n = 12), and policy leaders (n = 13). Three themes emerged: 1) Patients' positive and negative interpersonal relationships with friends and family influenced decisions to seek treatment; 2) strong patient-provider relationships, often defined by the quality of SUD providers and treatment settings, were perceived as crucial for staying in treatment; and 3) justice involvement facilitated treatment access yet deteriorated treatment engagement. Themes emphasized social and structural factors that inhibit patients from fostering support and treatment engagement. Our study underscores the importance of interpersonal relationships in SUD treatment-seeking and recovery and the need for positive interactions across the care continuum within broader social networks. Opportunities for positive interpersonal relationships include increasing access to language-concordant treatment; provider training to enhance cultural humility and patient-provider relationships; and mechanisms that improve interpersonal relationships between patients, parole officers, and other justice system members. Accentuating the role of interpersonal relationships and expanding social support interventions can pave the way for structural changes that improve recovery by harnessing different types of social capital. [ABSTRACT FROM AUTHOR]

There is emerging evidence that post-traumatic growth is a relevant concept in addiction recovery. However, existing measures, such as the post-traumatic growth inventory, were designed to measure post-traumatic growth in general trauma populations. It is unclear if the post-traumatic growth inventory is suitable for individuals in recovery from substance-related addiction. The current study aimed to qualitatively assess the content validity of the post-traumatic growth inventory for individuals in addiction recovery. The think-aloud method was applied, and semi-structured interviews utilized, to collect data from 20 individuals in recovery from unhealthy alcohol and/or drug use. Reflexive thematic analysis was used to analyze data in relation to item interpretation and experience of post-traumatic growth. Qualitative assessment supported three out of five subscales on the post-traumatic growth inventory (new possibilities, personal strength and appreciation of life). Modifications were suggested on some items from the relating to others domain and responses to the spiritual change domain possibly reflected a cultural influence. There was an identified need to include items that account for positive changes in health behavior. The current study highlights domains of post-traumatic growth for those in addiction recovery and how the post-traumatic growth inventory may understate some forms of positive life change. Future research should focus on validating a revised version of the post-traumatic growth inventory for this population. [ABSTRACT FROM AUTHOR]

Background: StrokeLine is a stroke‐specific helpline used by stroke survivors and their families in Australia to access professional support. There has been little research exploring stroke survivors' experiences of using helplines and their perceived impact on their stroke recovery. Aim: The aim of this study is to explore the reasons prompting stroke survivors to call StrokeLine and their experiences and to describe the perceived impact of calling StrokeLine on their recovery. Methods: An exploratory descriptive qualitative study was undertaken using thematic analysis of data collected through semi‐structured interviews of stroke survivors between December 2020 and May 2022. Participants were recruited using purposive sampling. Interviews were conducted via audio‐recorded Zoom conference calling and transcribed verbatim for thematic analysis. Results: A total of eight callers (four men and women women) participated, with the time since stroke ranging from 3.5 months to 5 years. Four major themes were identified, including 17 sub‐themes. Key themes included (1) factors prompting use of StrokeLine; (2) experience of using StrokeLine; (3) perceived impact of using StrokeLine; and (4) conceptualising StrokeLine service provision. Conclusions: Participants perceived their experience of contacting StrokeLine as having a positive impact on their stroke recovery, leaving them feeling empowered and motivated to self‐manage their condition. Patient or Public Contribution: Stroke survivors with lived experience influenced the conceptualisation of this study through conversations with consumers and the Stroke Foundation. Eight stroke survivors were involved as participants in the research study. [ABSTRACT FROM AUTHOR]

Overnight observations of mental health inpatients have been criticised for interrupting inpatients' sleep and potentially undermining recovery. No studies have examined the perceptions of mental health nurses who complete overnight observations, limiting key information necessary to guide improvements. This study aims to understand mental health nurses' perceptions on overnight observations and views on practice re-evaluations, as well as assess whether nurses' perceptions align with inpatients as reported in previous research. To fulfil the aims ten mental health nurses working on mental health inpatient units engaged in semi-structured interviews which were analysed using Content Analysis. Nine themes were identified and grouped into three categories: (1) staff and inpatient experiences, (2) impacts on treatment, recovery, and risk management, and (3) opinions on change. Majority of participants were critical of overnight observations, describing their negative impacts on inpatients' sleep and wellbeing. This aligns with previously reported inpatient views. There is scope for reassessment on how overnight observations are conducted to promote inpatients' sleep, recovery, and safety. [ABSTRACT FROM AUTHOR]

To examine feasibility and acceptability of providing stepped collaborative care case management targeting posttraumatic stress disorder (PTSD) and pain symptoms after major traumatic injury. Participants were major trauma survivors in Victoria, Australia, at risk of persistent pain or PTSD with high baseline symptoms. Participants were block-randomized, stratified by compensation-status, to the usual care (n = 15) or intervention (n = 17) group (46% of eligible patients). The intervention was adapted from existing stepped collaborative care interventions with input from interdisciplinary experts and people with lived experience in trauma and disability. The proactive case management intervention targeted PTSD and pain management for 6-months using motivational interviewing, cognitive behavioral therapy strategies, and collaborative care. Qualitative interviews explored intervention acceptability. Intervention participants received a median of 7 h case manager contact and reported that they valued the supportive and non-judgmental listening, and timely access to effective strategies, resources, and treatments post-injury from the case manager. Participants reported few disadvantages from participation, and positive impacts on symptoms and recovery outcomes consistent with the reduction in PTSD and pain symptoms measured at 1-, 3- and 6-months. Stepped collaborative care was low-cost, feasible, and acceptable to people at risk of PTSD or pain after major trauma. After hospitalization for injury, people can experience difficulty accessing timely support to manage posttraumatic stress, pain and other concerns. Stepped case management-based interventions that provide individualized support and collaborative care have reduced posttraumatic stress symptom severity for patients admitted to American trauma centers. We showed that this model of care could be adapted to target pain and mental health in the trauma system in Victoria, Australia. The intervention was low cost, acceptable and highly valued by most participants who perceived that it helped them use strategies to better manage post-traumatic symptoms, and to access clinicians and treatments relevant to their needs. [ABSTRACT FROM AUTHOR]

The priorities of individuals with chronic stroke are not always reflected in clinical practice. This study provides insight into meaningful factors related to long-term motor recovery in stroke survivors. Thirty individuals with chronic stroke participated in semi-structured interviews about movement, recovery, and barriers to and facilitators of mobility and paretic arm use. The interviews were analyzed using inductive thematic analysis. Three categories, the individual, environment, and task, defined five emergent themes. Individual: (1) mindset is a strong and consistent influencer of daily physical activity and overall recovery; (2) severe physical impairment limits physical activity and recovery, regardless of other factors; and (3) a negative perception of disability impacts mindset and willingness to move in public. Environment: (4) social and physical environments influence physical activity and recovery. Task: (5) participation in meaningful activities increases physical activity and promotes long-term recovery. Strategies to incorporate paretic arm use, exercise, and encouragement from others facilitate physical activity. Insufficient paretic limb function, environmental obstacles, and fear are barriers to physical activity. Neurorehabilitation must address the factors that are meaningful to stroke survivors. Building motor capacity is essential and must be integrated with factors such as a positive mindset and proper environment. Individual differences reinforce the need for personalized care. [ABSTRACT FROM AUTHOR]

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Purpose: Self-disgust appears to be a prominent feature in anorexia nervosa (AN), which might help explain why AN is often such a persistent disorder. Little is known about how this emotion can impact on recovering from this disorder. This study aims to develop our understanding of how people experience the emotion of self-disgust after physical recovery from AN. Design/methodology/approach: Twelve female participants who reported previously having had a clinical diagnosis of AN but had physically recovered according to their EDE-Q scores took part in a semi-structured interview to explore their experiences of recovery and the role self-disgust played within this. Interpretative phenomenological analysis was used to explore the data. Findings: Three themes were identified within the data to explain the experiences of self-disgust in those with AN: continued self-disgust following physical "Recovery", multiple manifestations of self-disgust in recovery and increasing self-disgust in recovery as a driver for relapse. Practical implications: Self-disgust was something each participant appeared to experience often, despite being physically recovered from AN. Disgust-based reactions to the self are enduring and highly resistant to change even whilst other aspects of the disorder become less potent. Self-disgust is multi-faceted and may trigger relapse as the signs of improvement and behaviours inherent in recovering were generally viewed as disgusting to the individuals. Originality/value: Self-disgust is an emotion that continues to affect people with AN despite physical recovery. The recovery process itself is not linear and self-disgust is enduring and may cause those affected to relapse. Considering this emotion within therapeutic intervention may encourage those with AN to accept their recovered self. [ABSTRACT FROM AUTHOR]

In this article, we present findings from a qualitative study examining how young women experience being long‐term bedridden with myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome (CFS), during childhood and adolescence. The aim is to explore how young women who fell ill with ME/CFS during childhood and adolescence look back on their lived experience of being long‐term bedridden from the vantage point of being fully or partially recovered. Informed by a phenomenological theoretical perspective, the researchers applied a narrative methodological approach involving the analysis of interviews with 13 women, aged 16–29 years at the time of the interview. Attention was particularly paid to how participants structured their narratives and to the events (telling moments) they identified as important. Four major storylines were developed: Ambivalent responses to the presence of others; A body on the edge of life; An eternity in the dark; and Recasting painful memories of being bedridden and alone. Based on our findings, we argue that the experience of being long‐term bedridden with ME/CFS during childhood and adolescence can be understood and communicated as a plot in which individuals find themselves pushed to the extreme limit of suffering and loneliness. [ABSTRACT FROM AUTHOR]

Background: Return to school supports are recommended to facilitate adolescents' re‐entry to school following a concussion. However, little is known as to what school stakeholders prefer for a return‐to‐school process. This study sought to describe the preferences of high school students, parents, and educators for a Return‐to‐School Framework for adolescents following a concussion. Methods: We conducted qualitative semi‐structured, 1‐on‐1 or group interviews with high school students (n = 6), parents (n = 5), and educators (n = 15) from Calgary, Canada. Interviews aimed to describe participants' preferences for a Return‐to‐School Framework for students following a concussion. Interviews were analyzed using conventional content analysis. Results: We organized the data into 4 main themes: (1) purpose of the Return‐to‐School Framework; (2) format and operation of the Return‐to‐School Framework; (3) communication about a student's concussion; and (4) necessity of concussion education for students and educators. Implications for School Health Policy, Practice, and Equity: A Return‐to‐School Framework following concussion should be developed in consultation with families, educators, and students and supports should be tailored to each student. Conclusions: Participants preferred a standardized and consistent Return‐to‐School Framework including ongoing communication between stakeholders as well as feasible and individualized school supports. [ABSTRACT FROM AUTHOR]

This study was designed to explore experiences of high school athletes in order to understand their occupational engagement after sustaining a sports-related concussion. The study explored the role occupational therapists (OTs) can play in post-concussion care while supporting adolescents in returning to meaningful occupations. The study utilized a qualitative, phenomenological approach by conducting interviews with high school athletes to understand their participation in occupations during recovery. Six student-athletes from 14–18 years of age were interviewed. The five identified themes from the study included impacts on ADL performance, school performance, sleep, mental health, and driver safety. Student-athletes reported feelings of loneliness and loss of identity. Dressing, showering, grooming, and driving were disturbed due to balance deficits, headaches, and nausea. Participants reported decreased participation in social, sports, and leisure occupations due to heightened symptoms. Due to the considerable variability of disturbance in occupational participation post-concussion, occupational therapists can assist in creating and implementing individualized treatment plans to support high school athletes while recovering from a sports-related concussion. [ABSTRACT FROM AUTHOR]

To understand experiences and perceptions on non-pharmacological treatment of vertebral fractures and virtual-care from the perspective of care professionals' (HCPs) We conducted semi-structured interviews with 13 HCPs within Canada (7 F, 6 M, aged 46 ± 12 years) and performed a thematic and content analysis from a post-positivism perspective. Two themes were identified: acuity matters when selecting appropriate interventions; and roadblocks to receiving non-pharmacological interventions. We found that treatment options were dependent on the acuity/stability of fracture and were individualized accordingly. Pain medication was perceived as important, but non-pharmacological strategies were also considered helpful in supporting recovery. Participants discussed barriers related to the timely identification of fracture, referral to physiotherapy, and lack of knowledge among HCPs on how to manage osteoporosis and vertebral fractures. HCPs reported positive use of virtual-care, but had concerns related to patient access, cost, and comprehensive assessments. HCPs used and perceived non-pharmacological interventions as helpful and selected specific treatments based on the recency of fracture and patient symptoms. HCPs' also believed that virtual-care that included an educational component, an assessment by a physiotherapist, and an exercise group was a feasible alternative, but concerns exist and may require further evaluation. Non-pharmacological strategies in combination with pain medication may be a more effective strategy to support recovery than pain medication alone but should be informed by fracture acuity and patient symptoms. To improve access to physiotherapy and other non-pharmacological treatment options during the acute or chronic management of vertebral fractures, it may be worthwhile to explore the effectiveness and feasibility of virtual-care. [ABSTRACT FROM AUTHOR]

Purpose: To understand how barriers and facilitators interact over time to support or disrupt breastfeeding among women on opioid maintenance therapy for opioid use disorder. Background: Breastfeeding has additional benefits for newborns with prenatal opioid exposure. Up to 80% of women on opioid maintenance therapy plan to breastfeed, but many do not beyond the first 7 to 10 days. Methods: A qualitative, longitudinal design was used. Semi-structured interviews occurred during the third trimester of pregnancy and again between 1 and 6 weeks postpartum. Thematic analysis was conducted using the Breastfeeding in a Life Course Context model as a framework. The design and methods were informed by a post-positivist, critical realist perspective. Results: Thirteen participants were enrolled, and 19 interviews were completed. Five themes were identified. It Will Work Out was the primary theme that describes participants' sense of self-efficacy, stemming from their experiences of managing addiction recovery. Women considered breastfeeding to support their own health and that of their newborn while in recovery, summarized by Being Healthy. Making the choice to breastfeed, represented by Weighing the Options, was influenced by their perinatal health care providers. During the Sensitive Period, challenges could overwhelm their self-efficacy. Of 9 women, 4 were still breastfeeding when interviewed postpartum, exemplified by Moving On. Conclusions and Implications for Practice: Participants' self-efficacy and motivation to be healthy played a significant role in managing breastfeeding challenges over time. Nursing interventions must empower women's self-efficacy to help them achieve their breastfeeding goals. [ABSTRACT FROM AUTHOR]

Background: The concept of recovery capital refers to the sum of resources that a person has available to initiate and continue a recovery process. This concept has not been greatly explored with people with persistent substance use disorder (SUD), whose recovery is often quite long. Method: We conducted 19 qualitative interviews with 19 people (9 men, 10 women) with persistent SUD to understand the personal strengths they use in their recovery. A gender-differentiated thematic analysis of the transcripts was conducted. Findings: The analysis paints a portrait of people who, despite their difficulties, managed to use their skills and develop new ones to confront their problems: introspection, perseverance, self-belief, knowledge about recovery, etc. For women in particular, the ability to assert themselves appears to have been a survival tool in their trajectory. For most of the participants, material and financial resources were most lacking in their recovery process. Faced with a precarious financial situation, several women spoke of the need to get organized and be proactive in finding ways to support themselves. Conclusion: Contrary to a deficit-focused perspective, the concept of recovery capital leads us to focus on what is going well in these people's lives. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Gender‐based violence (GBV) has long‐term devastating effects on psychological health, resulting in depression, anxiety and posttraumatic stress disorder.Beyond physical and mental health symptoms, GBV can affect survivors on many personal, social, and spiritual levels, impacting their ability to connect to themselves, others, and the world around them.While most research on recovery following GBV has focused on recognizing factors associated with distress or adverse outcomes, there is limited information about how they recover. What the paper adds to existing knowledge?: We know little about the internal characteristics that enable or support the healing journey (factors) or what the survivors do to build capacity or support for health and change (strategies). Therefore, this study discovered the main factors or strategies that GBV survivors used throughout their recovery process which included; social connection, self‐care, self‐understanding and spiritual connection. What are the implications for practice?: Mental health nurses always encounter and deal with the GBV survivors as they always suffer from mental health issues related to their trauma. Therefore, mental health nurses can utilize our research findings to establish nursing interventions or psychoeducational programs with the aim of facilitating trauma recovery among the survivors. Introduction: Gender‐based violence (GBV) is a severe worldwide phenomenon mainly affecting women. Little studies focus on the details of the recovery process that survivors of GBV go through. Aim: To identify the enabling factors that facilitate recovery among survivors of GBV. Method: We used the thematic qualitative analysis approach to analyse 20 interviews with the women survivors of GBV. Results: Our study resulted in four factors that survivors used in their recovery process (social connection, self‐care, self‐understanding and spiritual connection). Discussion: Recovering from an abusive relationship is a social, spiritual, cultural and psychological process. Current study confirmed the positive impact of our identified enabling factors in the recovery process of GBV survivors. Implications for Practice: The current study illustrates findings that provide a deeper understanding of the journey to recovery following GBV, which can be helpful when guiding and supporting women who have suffered GBV to start and pursue their journey toward recovery. [ABSTRACT FROM AUTHOR]

The relationship between trauma and subsequent substance use has been extensively studied. Substance dependence and its consequences are a source of further traumatization. This explorative qualitative study is an analysis of the recovery narratives of persons with polydrug dependence, using mainly novel psychoactive substances (NPSs). NPS use, with its unpredictability and major health risks poses a challenge to treatment systems, but only few studies are available on NPS users' recovery processes. In this longitudinal study, authors explore processes of identity reconstruction in the emotionally valent episodes of 10 respondents' life interviews. The interviews had been conducted with 77 patients at the beginning of their residential treatment and were repeated a year later with those in recovery and available for the study, altogether 10 persons. Narrative Oriented Inquiry was used as a framework, focusing on the key themes and changes in the narrative mode. Our results support the findings on previous and subsequent NPS use-related traumatization. In this perspective, NPS use corresponds to revictimization. Contrary to available but sporadic evidence suggesting a marked difference between the recovery processes of users of classical substances and NPS users, the respondents in this study could utilize the traditional cultural stock of recovery stories during their treatment. Changes involved more reflective and responsible attitudes and the broadening of a healing social network. Contents describing care/self-care and the emergence of hopeful attitudes were also identified. Further research, involving larger samples and cross-cultural comparisons, could deepen our understandings of NPS users' recovery processes. [ABSTRACT FROM AUTHOR]

Background: This qualitative enquiry explores the experiences and perspectives of individuals with an eating disorder (ED) regarding their perceptions of yoga as an adjunct intervention to psychotherapy. It also explores the feasibility, acceptability, and safety of yoga from their perspectives. Methods: This study used a practice-based evidence framework and employed semi-structured interviews with 16 females with an ED. Participants were asked about their perspectives on the use of yoga as an adjunct intervention in ED recovery, perceived risks and what factors supported or hindered engagement. Thematic template analysis was used. Results: Three topic areas were elaborated. The first included participants' perceptions of how yoga enhanced their ED recovery. The second included how and when participants came to find yoga in their ED recovery. The final topic explored factors that supported participants with ED to engage in yoga. These resulted in the development of guiding principles to consider when designing a yoga intervention for EDs. Conclusions: This study adds further to the emerging evidence that yoga can bring complementary benefits to ED recovery and provides a biopsychosocial-spiritual framework for understanding these. Findings provide an understanding of how yoga programs can be adapted to improve safety and engagement for people with an ED. Yoga programs for people with EDs should be co-designed to ensure that the physical, social, and cultural environment is accessible and acceptable. [ABSTRACT FROM AUTHOR]

Stroke survivors regularly report experiencing boredom during inpatient rehabilitation which may detrimentally affect mood, learning and engagement in activities important for functional recovery. This study explores how stroke survivors meaningfully occupy their non-therapy time and their experiences of boredom, to further our understanding of this complex phenomenon. Secondary analysis of transcripts from semi-structured interviews with stroke survivors exploring activity during non-therapy time. Transcripts were coded and analysed using a hybrid approach of inductive and deductive thematic analysis, guided by a published boredom framework. Analysis of 58 interviews of 36 males and 22 females, median age 70 years, revealed four main themes: (i) Resting during non-therapy time is valued, (ii) Managing "wasted" time, (iii) Meaningful environments support autonomy and restore a sense of normality, and (iv) Wired to be social. Whilst limited therapy, social opportunities and having "nothing to do" were common experiences, those individuals who felt in control and responsible for driving their own stroke recovery tended to report less boredom during their rehabilitation stay. Creating rehabilitation environments that support autonomy, socialisation and opportunities to participate in activity are clear targets to reduce boredom during non-therapy time, increase meaningful engagement and possibly improve rehabilitation outcomes post-stroke. Stroke survivors with a low sense of autonomy are at greater risk of boredom and may benefit from person-centred strategies to support participation in meaningful activities during non-therapy time whilst undertaking inpatient rehabilitation. Review and reduction of paternalistic practices within traditional models of care, to increase patient autonomy, may empower stroke survivors to drive their own activity and reduce boredom. The redesign and reorganisation of rehabilitation environments to increase opportunities for socialisation and access to nature and the outdoors may reduce boredom during inpatient rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Few studies have examined patient experiences of the Patient Centred Medical Home (PCMH). This qualitative study explores the experiences of patients of an urban Aboriginal Community Controlled Health Service during its transition to a model of a PCMH. Methods: Twenty-eight community members who were registered as patients of an urban Aboriginal Community Controlled Health Service were purposively recruited to participate in yarning interviews. Yarns were conducted using a guide containing open-ended questions in the same domains as those used in patient satisfaction surveys at the participating clinic. Data from yarns were analysed by Aboriginal and non-Indigenous researchers using thematic analysis. The interpretations of Aboriginal and Torres Strait Islander researchers were privileged in the analysis. Results: Key themes highlighted the importance of relationships, connectedness, and personal growth and empowerment to community members' health and wellbeing, which they described as a journey of healing and recovery. Delays in implementing a process to empanel patients in a care team meant that most community members were unaware a PCMH had been implemented. However, community members commonly reported a more welcoming environment, more contact with the same doctor and more involvement of Aboriginal Health Workers in their care. Conclusions: Aboriginal and Torres Strait Islander community members' narratives of their experiences bear evidence of the acceptability of a PCMH model for delivery in Aboriginal Community Controlled Health Services to improve relational care between patients and health staff. A patient-directed empanelment process has been implemented to better connect patients to their care team in the clinic, and the role of the Aboriginal Health Worker reshaped to strengthen connections between patients and their care team in and outside the clinic. The Patient Centred Medical Home (PCMH) aims to deliver primary healthcare based on what matters most to patients and their families.This study addressed the lack of published research i examining implementation of this model of care in Aborignal Community Controlled Health Services. The PCMH was acceptable to Aboriginal and Torres Strait Islander patients and strengthened their relationships with health care providers. This provides an acceptable model of primary health care for other Aboriginal Community Controlled Health Services, with flexbility for tailoring to local context.. [ABSTRACT FROM AUTHOR]

Objective: Increasing service user involvement and collaboration with providers has become an important facet of the recovery movement. This study explored perspectives on the implementation and delivery of an intervention (Just Do You [JDY]) designed to improve treatment engagement among marginalized young adults diagnosed with serious mental illnesses. Method: Informed by the Consolidated Framework for Implementation Research (CFIR), we conducted in-depth interviews (N = 11) with nine participants that included agency leaders, clinical providers, and researchers involved with the planning, delivery, and evaluation of JDY. We used grounded theory coding techniques and constant comparison to develop themes that capture the data on implementation and collaboration related to the delivery of JDY. Results: Two broad themes emerged: (a) collaboration between the clinician and person with lived experience and (b) collaborative culture within and between organizations. Findings capture how collaboration occurred between providers within the clinical encounter (e.g., combined strengths of clinicians and peers) and within and between organizations, clustering around several CFIR domains (e.g., inner setting, process, characteristics of individuals, intervention characteristics). Findings speak to the importance of a "culture of collaboration" in which collaboration is occurring across multiple levels of an organization to support the delivery and implementation of JDY. Conclusions and Implications for Practice: JDY can complement other collaborative approaches given its focus on improving initial engagement. Findings point to the perceived benefits of interventions that are facilitated by a clinician and a person with lived experience along with how their combined expertise can support recovery. Impact and Implications: This study examines the perspectives of agency leaders, clinical providers, and researchers on the implementation and delivery of an engagement intervention for young adults diagnosed with serious mental illnesses. Results point to the benefits of initial engagement interventions that are facilitated by a clinician and a person with lived experience, as a step toward participation in more long-term treatment decision making. Their combined expertise can support recovery and can complement other treatments. [ABSTRACT FROM AUTHOR]

This paper aims to provide an overview of the lived experience of a group of individuals who participated in an adventure therapy project, as an adjunct to their routine clinical care with an Early Intervention Service (EIS) for psychosis. We hope it will support the growing literature in this field as well as encourage other services to adopt these approaches within their settings. A group of individuals who had experienced a First Episode of Psychosis (FEP) participated in a programme of outdoor activities, culminating in a six-day residential sailing adventure (N = 5). A semi-structured interview was used to explore their experiences, and an inductive thematic analysis was undertaken to identify themes. Four key themes emerged from the analysis of the transcripts. The themes centred around what people learnt about themselves from taking part in the project: "enhanced self-perception"; "building friendships and being part of a shared experience"; "navigating and overcoming new challenges"; and "working together as a team". Adventure-based approaches offer the opportunity to enhance standard treatment outcomes in EIS, and the unique context in which they occur provides a platform to support social and occupational recovery from psychosis. [ABSTRACT FROM AUTHOR]

Pre-registration nursing education has long moved away from preparing nurses with mental health specialisation to nurses with comprehensive knowledge and skills. However, the consumers' experiences of comprehensive-prepared nurses and their nursing care has not been widely explored. This paper reports on a study with consumers to explore their experiences with comprehensive-prepared graduate nurses and the nursing care that they provide in acute mental health settings. An exploratory qualitative study using semi-structured interviews was chosen as the research method. Purposeful sampling recruited 12 consumers and data saturation was achieved. Braun and Clarke's method of thematic analysis was used to analyse the collected data and three themes emerged. The themes are: (i) You got what it takes to be a mental health nurse, (ii) Slow down and spend quality time with us, and (iii) Read in between the lines when we share our negative lived experiences. The findings are useful for identifying strategies to develop evidence-based nursing education for comprehensive-prepared graduate nurses to improve the consumers' experiences of their nursing care. [ABSTRACT FROM AUTHOR]

Psychiatric Day Hospitals offer time-limited active treatment programmes that are therapeutically intensive, coordinated, and with structured clinical services within a stable environment. No previous studies have described patients' experiences of recovery-oriented care at a Psychiatric Day Hospital in a Swedish or Nordic healthcare context. The aim of the study was to explore patients' experiences of a Psychiatric Day Hospital with focus on patient recovery. A qualitative method was used; 12 in-depth interviews were performed with patients all analysed with content analysis. The theme that emerged was "A safe haven." To do something routinely and meaningful during the days, feelings of security, and to gain increased knowledge about mental ill health were concepts which felt important and contributed to recovery. Feelings of belonging and prevention of loneliness were also highlighted. [ABSTRACT FROM AUTHOR]

To examine the applicability and process of change of Cognitive Functional Therapy (CFT) in the management of pain and disability in people with knee osteoarthritis who were offered knee replacement surgery and had risk factors for poor response to surgery. Single-case experimental design with a mixed-methods, repeated measures approach was used to investigate the process of change through CFT in four participants. Qualitative interviews investigated beliefs, behaviours and coping responses, and self-reported measures assessed pain, disability, psychological factors, and function at 25 timepoints. Study registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12619001491156). Qualitative data indicate that CFT promoted helpful changes in all participants, with two responses observed. One reflected a clear shift to a biopsychosocial conceptualisation of osteoarthritis, behavioural re-engagement and the view that a knee replacement was no longer necessary. The other response reflected a mixed conceptualisation with dissonant beliefs about osteoarthritis and its management. Psychological and social factors were identified as potential treatment barriers. Overall, quantitative measures supported the qualitative findings. The process of change varies between and within individuals over time. Psychological and social barriers to treatment have implications for future intervention studies for the management of knee osteoarthritis. Cognitive Functional Therapy is applicable in the management of knee osteoarthritis. Reconceptualisation of osteoarthritis reflected a helpful change. Psychological and social factors emerged as barriers to recovery. [ABSTRACT FROM AUTHOR]

Purpose: Social support is essential for postpartum well-being, but little is known about the postpnatal social support preferred by primiparous women. This study aimed to comprehensively understand and describe the meaning of postnatal social support experience in primiparous women. Methods: The participants were seven primiparous women who were within 1 year after childbirth, recruited through purposive and snowball sampling from an online parenting community. The data were collected through in-depth interviews from November 14 to 28, 2022. Participants were interviewed face-to-face or via phone or online platform, according to their choice. Colaizzi's phenomenological qualitative research method was applied to analyze the meaning of the participants' experience. Results: Five theme clusters and fourteen themes were identified from the data. The five theme clusters are as follows: (1) Shortcomings of the childbirth and postpartum care system I learned through my experience; (2) Government policies focusing on childbirth and child-rearing rather than postpartum recovery; (3) Driving force of postpartum recovery: Shared childbirth process; (4) Childcare on my own; and (5) Conflicted between being a stay-at-home mom and a working mom under inadequate maternity protection policies. Conclusion: Despite postpartum support from the government that was perceived as inadequate, first-time mothers regained confidence and motivation for parenting with the help of family, peers, and social networks. First-time mothers need support from professionals and reliable online communities for postpartum recovery and parenting. [ABSTRACT FROM AUTHOR]

Inpatients with substance use disorders often go unheard. Through qualitative interviews, this study lends voice to their views and beliefs about the factors that affect their recovery. In-depth interviews were conducted from February 10 to 11, 2020 with 15 in- patients with methamphetamine use disorder residing at the Marikina Rehabilitation Center in the Philippines. Semi-structured qualitative interviews were thematically analyzed to determine the factors that promote and hinder methamphetamine use disorder treatment and recovery. We identified six barriers to recovery: homesickness, lack of family visitation and support, fear of treatment, financial stress, social stigma and criticism, and boredom. Four motivating factors that influenced treatment and recovery included the therapeutic community treatment program, familial relationships, and visitations, belief in God, and hope. A treatment integration program that combines psychotherapy and cognitive behavioral therapy, as well as strong familial support, is imperative for patients' recovery from methamphetamine use disorder. [ABSTRACT FROM AUTHOR]

Photo-experiencing and Reflective Listening (PEARL) is a trauma-informed intervention developed to promote recovery engagement in survivors of gender-based violence (GBV). This study aimed to understand the feasibility and acceptability of PEARL and identify potential healing elements. GBV survivors were recruited in Philadelphia through an online survey (n = 20). Participants completed the PEARL intervention, a postintervention survey, and a follow-up interview. Results revealed PEARL to be both feasible and acceptable, with thematic analysis revealing its ability to facilitate purposeful reflection, connection to the present, and progress toward healing goals. PEARL shows promise as an engaging strategy to promote healing for survivors of GBV. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic influenced the way individuals conducted their lives, with consequences relating to mental health deterioration. Whilst researchers explored this outcome in the general population and athletic populations, less focus was on athletes with disabilities. The aim of this study was to investigate how the pandemic influenced the mental health of elite para-athletes in the United Kingdom. Nine elite-level athletes with disabilities participated in semi-structured interviews. Three broad themes were interpreted from the data using reflexive thematic analysis, two themes reflected the negative impact of COVID-19 on mental health and one theme reflected positive outcomes of the pandemic. Athletes explained that losing face-to-face interactions and delays in major sporting events were significant factors in their mental health decline. This population group reported different challenges to able-bodied communities. Differences included increased susceptibility to contract the virus, difficulties in communication where face masks and online interactions became necessary and perceptions of vulnerability relating to shielding protocols. Finally, positive outcomes related to the additional time to recover, to prepare for major events and time to reassess their values. Exploring experiences of a pandemic on this population group warrants further exploration to enhance the effectiveness of mental health support services in para-sporting organisations. [ABSTRACT FROM AUTHOR]

Individuals from culturally and linguistically diverse (CALD) backgrounds experience poorer outcomes following traumatic brain injury (TBI), including poorer quality of life. The reasons for these poorer outcomes are unclear. Therefore, this study aimed to qualitatively investigate the experience of injury, rehabilitation, and recovery amongst individuals from a CALD background following TBI. Fifteen semi-structured interviews were conducted, and qualitatively analysed using reflexive thematic analysis. It was demonstrated that: (a) the cognitive and behavioural consequences of TBI were accompanied by stigma and loss of independence; (b) participants held many beliefs related to their TBI, ranging from bad luck to acceptance. Participants' personal values and beliefs provided strength and resilience, with many viewing the injury as a positive event in their lives; (c) participants were appreciative of the high standard of care they received in hospital and rehabilitation, although communication barriers were experienced; (d) many participants identified with Australian culture, and few believed their cultural background negatively impacted their experience of TBI; (e) external support, particularly from family, was considered central to recovery. These findings offer insight into the challenges CALD individuals face and factors that may facilitate their recovery and improve functional outcomes. Access to family support is very important to individuals with traumatic brain injury (TBI) from culturally and linguistically diverse (CALD) backgrounds. Education of family and close others is important to minimise stigma following TBI. Healthcare services should provide competent and qualified interpreters for individuals with TBI who cannot speak English. Rehabilitation professionals should receive cultural competency training, to maximise cultural sensitivity of their care provision to individuals from CALD backgrounds. [ABSTRACT FROM AUTHOR]

Background: Almost all paramedics encounter workplace violence (WPV) during their careers. The most common form of WPV is verbal, and the perpetrator is usually the patient. It is known that paramedics suffer from post-traumatic stress disorder and other mental health problems, and WPV is one of the reasons behind that. Nevertheless, little is known about the recovery processes paramedics have had after encountering WPV. The research question was: What kind of recovery processes have paramedics had after encountering WPV? Methods: A qualitative, narrative interview study was done. Data was collected in individual interviews with Finnish paramedics (n = 18). Paramedics were from different parts of Finland, and their ages varied from 24 to 49 years. They had been working in EMS for an average of 10.5 years (range 1.5 to 25 years). Interviews were conducted with a narrative approach, which enabled paramedics to narrate their experiences and speak on their own terms about the subject to the extent of their choosing. The data was analyzed using thematic analysis. Results: Ten recovery process themes were identified: Strong psychological and physical reactions in a short time frame, Questioning one's profession and actions, Various support structures aided in recovery, Dysfunctional processes hindered recovery, Personal resources provided support, The support of the workcommunity as a lifeline, Left to cope alone, Permanent changes to work routines, Resulting in professional growth and Eternal crack in the shell. Conclusions: Many internal and external factors affect paramedics' recovery processes. While some receive adequate help, others struggle to get appropriate support, especially from their organization and supervisors. The findings of this study suggest that clear protocols should be established to help paramedics recover after encountering WPV and that an individual aspect should be kept in mind, as not everybody reacts in the same way. [ABSTRACT FROM AUTHOR]

This study assessed the potential effectiveness, acceptability and feasibility of a tailored mindfulness-based intervention (MBI, REMIND 2.0) for personal recovery among people with mental illness during the COVID-19 pandemic. In this pilot mixed methods randomized controlled trial, participants were assigned to either the MBI (n = 14) or the relaxation training (RT) (n = 14). Quantitative measures were used to assess primary outcomes, including personal recovery, mindfulness, self-compassion, resilience, and secondary outcomes, including depression, stress, anxiety, positive and negative moods, quality of life and general health at baseline (T0), post-intervention (T1) and one-month follow-up (T2). Quantitative interviews were conducted to explore the experiences and perceptions toward the MBI. Results indicated significant group and time interactions for all outcomes except anxiety and stress. MBI participants showed significant improvements in all outcomes at T1, which were maintained at T2, except for positive mood. RT participants showed a significant decline in resilience but significant improvements in all secondary outcomes at T1, but all outcomes significantly declined at T2, except for anxiety and stress. MBI participants were receptive toward the programme in all aspects of personal recovery. The tailored MBI is a potentially effective, feasible and acceptable approach to facilitate personal recovery among people with mental illness. Differences between MBI and RT are discussed. [ABSTRACT FROM AUTHOR]

Sexual revictimization can have a negative impact on many facets of women's wellbeing, yet limited evidence exists regarding specific interventions that support healing and the reduction of further revictimization. This paper will explore regional and rural women's experience of a group-based empowerment program, the Shark Cage program, in Victoria, Australia. The "Shark Cage" program aims to address revictimization by empowering women and girls to build personal boundaries and assertiveness within the context of gender equality and human rights. Data were collected via participant observations across the 8-week program, in combination with semi-structured interviews with participants (N = 11) pre and post intervention. All participants had access to therapeutic support outside of the program. Findings indicate that the program fostered connections among women with shared experiences of sexual revictimization, reducing feelings of isolation. Participants detailed the benefit of developing and practicing skills in reducing revictimization, such as assertiveness and boundary setting. Program learning and recovery was embedded within a network of embodied emotions, social connections, cultural norms and place-based relations that influenced how participants recovery could be understood, processed and addressed. [ABSTRACT FROM AUTHOR]