Introduction: Nowadays the Western mental health system is in transformation to recovery-oriented and trauma informed care in which experiential knowledge becomes incorporated. An important development in this context is that traditional mental health professionals came to the fore with their lived experiences. From 2017 to 2021, a research project was conducted in the Netherlands in three mental health organizations, focussing on how service users perceive the professional use of experiential knowledge. Aims: This paper aims to explore service users’ perspectives regarding their healthcare professionals’ use of experiential knowledge and the users’ perceptions of how this contributes to their personal recovery. Methods: As part of the qualitative research, 22 service users were interviewed. A thematic analysis was employed to derive themes and patterns from the interview transcripts. Results: The use of experiential knowledge manifests in the quality of a compassionate user-professional relationship in which personal disclosures of the professional’s distress and resilience are embedded. This often stimulates users’ recovery process. Conclusions: Findings suggest that the use of experiential knowledge by mental health professionals like social workers, nurses and humanistic counselors, demonstrates an overall positive value as an additional (re)source.
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Objective: This article explores the use of experiential knowledge by traditional mental health professionals and the possible contribution to the recovery of service users. Design and Methods: The review identified scientific publications from a range of sources and disciplines. Initial searches were undertaken in databases PsycINFO, PubMed, and Cochrane using specific near operator search strategies and inclusion and exclusion criteria. Results: Fifteen articles were selected. These were published in a broad range of mental health and psychology journals reporting research in western countries. In the selected articles, a varying conceptualization of experiential knowledge was found, differing from therapeutic self-disclosure embedded in psychotherapeutic contexts to a relational and destigmatizing use in recovery-oriented practices. Nurses and social workers especially are speaking out about their own experiences with mental health distress. Experiential knowledge stemming from lived experience affects the professional’s identity and the system. Only a few studies explored the outcomes for service users’ recovery. Conclusion: A small body of literature reports about the use of experiential knowledge by mental health professionals. The mental health system is still in transformation to meaningfully incorporate the lived experience perspective from traditional professionals. There is little data available on the value for the recovery of service users. This data indicates positive outcomes, such as new understandings of recovery, feeling recognized and heard, and increased hope, trust, and motivation. More research about the meaning of experiential knowledge for the recovery of service users is desirable.
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This study evaluates psychometric properties of the Individual Recovery Outcomes Counter (I.ROC) in a Dutch population of participants with a schizophrenia spectrum disorder (SSD). B. Esther Sportel1*† , Hettie Aardema1†, Nynke Boonstra2 , Johannes Arends1 , Bridey Rudd3 , Margot J. Metz4 , Stynke Castelein5 and Gerdina H.M. Pijnenborg6
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Introduction The Integrated Recovery Scales (IRS) was developed by the Dutch National Expertise board for routine outcome monitoring with severe mental illnesses. This board aimed to develop a multidimensional recovery measure directed at 1. clinical recovery, 2. physical health, 3. social recovery (work, social contacts, independent living) and 4. existential, personal recovery. The measure had to be short, suited for routine outcome monitoring and present the perspective of both mental health professionals and service users with severe mental illnesses. All aspects are assessed over a period of the pas 6 months. Objectives The objective of this research is validation of the Integral Recovery Scales and to test the revelance for clinical practice and police evaluation. Methods The instrument was tested with 500 individuals with severe mental illnesses (80% individuals with a psychotic disorder), of whom 200 were followed up for 1 year. For the questions concerning clinical recovery, physical health and social recovery mental health care workers conducted semi structured interviews with people living with serious illnesses. The questions concerning personal health were self-rated. We analyzed interrater reliability, convergent and divergent validity and sensitivity to change. Results The instrument has a good validity and is easy to complete for service users and mental health care workers and appropriate for clinical and policy evaluation goals. Conclusions The Integrated Recovery Scales can be a useful instrument for a simple and meaningful routine outcome monitoring. Page: 121
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The Integrated Recovery Scale IRS was developed by Dutch National Expertise board for Routine Outcome Monitoring. Recovery is multi dimensional: 1. Symptomatic recovery 2. Physical health, 3. Societal recovery 4. Existential: personal recovery. The validation process and first outcomes of the instrument are described.
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This publication is a result of an international research project which took place from 2012-2014. Among the participators were four universities, number of service providers, NGOs and people with psychiatric and learning disabilities from Amersfoort and Maastricht in the Netherlands, Budapest in Hungary and Tallinn in Estonia. The aim of the project was to explore the wishes and needs of persons with psychiatric or learning difficulties with regard to community participation, and how services could be (more) supportive in order to meet these needs. We also looked at local policies, especially from the perspective of the UN Convention on the Rights of Persons with Disabilities (CRPD). From the research we learn that regardless of the country where people live, persons with disabilities have similar struggles to cope with vulnerability and deprivation. They also share the same desires as any other human being: the wish to live a good and valued life, to have meaningful activities and to belong to a social community. The stories in this book were selected from the interviews which were conducted by researchers during the project. The portraits illustrate experiences of illness, disability and recovery. They also reflect experiences of using social- and mental health services, exclusion and inclusion. By reading these stories we see, how multifaceted life can be, and what are the challenges towards the real participation in community
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It is of utmost importance to collect organic waste from households as a separate waste stream. If collected separately, it could be used optimally to produce compost and biogas, it would not pollute fractions of materials that can be recovered from residual waste streams and it would not deteriorate the quality of some materials in residual waste (e.g. paper). In rural areas with separate organic waste collection systems, large quantities of organic waste are recovered. However, in the larger cities, only a small fraction of organic waste is recovered. In general, citizens dot not have space to store organic waste without nuisances of smell and/or flies. As this has been the cause of low organic waste collection rates, collection schemes have been cut, which created a further negative impact. Hence, additional efforts are required. There are some options to improve the organic waste recovery within the current system. Collection schemes might be improved, waste containers might be adapted to better suit the needs, and additional underground organic waste containers might be installed in residential neighbourhoods. There are persistent stories that separate organic waste collection makes no sense as the collectors just mix all municipal solid waste after collection, and incinerate it. Such stories might be fuelled by the practice that batches of contaminated organic waste are indeed incinerated. Trust in the system is important. Food waste is often regarded as unrein. Users might hate to store food waste in their kitchen that could attract insects, or the household pets. Hence, there is a challenge for socio-psychological research. This might also be supported by technology, e.g. organic waste storage devices and measures to improve waste separation in apartment buildings, such as separate chutes for waste fractions. Several cities have experimented with systems that collect organic wastes by the sewage system. By using a grinder, kitchen waste can be flushed into the sewage system, which in general produces biogas by the fermentation of sewage sludge. This is only a good option if the sewage is separated from the city drainage system, otherwise it might create water pollution. Another option might be to use grinders, that store the organic waste in a tank. This tank could be emptied regularly by a collection truck. Clearly, the preferred option depends on local conditions and culture. Besides, the density of the area, the type of sewage system and its biogas production, and the facilities that are already in place for organic waste collection are important parameters. In the paper, we will discuss the costs and benefits of future organic waste options and by discussing The Hague as an example.
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Background: A user-centered design approach for eHealth interventions improves their effectiveness in stroke rehabilitation. Nevertheless, insight into requirements of end-users (patients/informal caregivers and/or health professionals) for eRehabilitation is lacking. The aim of this study was to identify end-user requirements for a comprehensive eHealth program in stroke rehabilitation. Methods: Eight focus groups were conducted to identify user requirements; six with patients/informal caregivers and two with health professionals involved in stroke rehabilitation (rehabilitation physicians, physiotherapists, occupational therapists, psychologists, team coordinators, speech therapist). The focus groups were audiotaped and transcribed in full. Direct content analysis was used to identify the end-user requirements for stroke eHealth interventions concerning three categories: accessibility, usability and content. Results: In total, 45 requirements for the accessibility, usability and content of a stroke eRehabilitation program emerged from the focus groups. Most requirements concerned content (27 requirements), followed by usability (12 requirements) and accessibility (6 requirements). Patients/informal caregivers and health professionals each identified 37 requirements, respectively, with 29 of them overlapping. Conclusions: Requirements between stroke patients/informal caregivers and health professionals differed on several aspects. Therefore, involving the perspectives of all end users in the design process of stroke eRehabilitation programs is needed to achieve a user-centered design.
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Introduction F-ACT is a flexible version of Assertive Community Treatment to deliver care in a changing intensity depending on needs of individuals with severe mental illnesses (Van Veldhuizen, 2007). In 2016 a number of the FACT-teams in the Dutch region of Utrecht moved to locations in neighborhoods and started to work as one network team together with neighborhood based facilities in primary care (GP’s) and in the social domain (supported living, social district teams, etc.). This should create better chances on clinical, social and personal recovery of service users. Objectives This study describes the implementation, obstacles and outcomes for service users. The main question is whether this Collaborative Mental Health Care in the Community produces better outcome than regular FACT. Measures include (met/unmet) needs for care, quality of life, clinical, functional and personal recovery, and hospital admission days. Methods Data on care utilization regarding the innovation are compared to regular FACT. Qualitative interviews are conducted to gain insight in the experiences of service users, their family members and mental health care workers. Changes in outcome measures of service users in pilot areas (N=400) were compared to outcomes of users (matched on gender and level of functioning) in regular FACT teams in the period 2015-2018 (total N=800). Results Data-analyses will take place from January to March 2019. Initial analyses point at a greater feeling of holding and safety for service users in the pilot areas and less hospital admission days. Conclusions Preliminary results support the development from FACT to a community based collaborative care service.
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Patients undergoing major surgery are at risk of complications and delayed recovery. Prehabilitation has shown promise in improving postoperative outcomes. Offering prehabilitation by means of mHealth can help overcome barriers to participating in prehabilitation and empower patients prior to major surgery. We developed the Be Prepared mHealth app, which has shown potential in an earlier pilot study.
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