Many mental health professionals have also used mental health services. What role should their personal experience play in their clinical practice - if any? - a commentary
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There is increasing interest in the use of experiential knowledge and the development of experiential expertise in mental health. Yet, little is known about how best to use this expertise in the role of a psychiatrist. This study aims to gain insight into the concerns of psychiatrists using their lived experiences with mental health distress as a source of knowledge for patients, colleagues and themselves. Eighteen psychiatrists with lived experience as patients in mental health care were interviewed with a semi-structured questionnaire. The interviews were analyzed using qualitative narrative thematic analysis. The majority of the respondents use their lived experience implicitly in the contact with patients, which makes the contact more equal and strengthens the treatment relationship. When explicitly using experiential knowledge in the contact with patients, thought should be given at forehand to its purpose, timing and dosage. Recommendations are that the psychiatrist should be able to reflect on his/her lived experience from a sufficient distance and should take patient factors into account. When working in a team, it is advisable to discuss the use of experiential knowledge in advance with the team. An open organizational culture facilitates the use of experiential knowledge and safety and stability in the team are vital. Current professional codes do not always offer the space to be open. Organizational interests play a role, in the degree of self-disclosure as it can lead to conflict situations and job loss. Respondents unanimously indicated that the use of experiential knowledge in the role of a psychiatrist is a personal decision. Self-reflection and peer supervision with colleagues can be helpful to reflect on different considerations with regard to the use of experiential knowledge. Having personal lived experiences with a mental disorder affects the way psychiatrists think about and performs the profession. The perception of psychopathology becomes more nuanced and there seems to be an increased understanding of the suffering. Even though harnessing experiential knowledge makes the doctor-patient relationship more horizontal it remains unequal because of the difference in roles. However, if adequately used, experiential knowledge can enhance the treatment relationship.
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Chronic pain rehabilitation programs are aimed at helping patients to increase their functioning despite being in pain, thereby improving their quality of life. However, conversations between patients and practitioners about how the patient could deal with his/her pain and pain-related disabilities in a different way can be interactionally challenging. This study adopts a discursive psychological perspective to explore how pain-related disability is negotiated by patients and practitioners during consultations. The analysis shows that pain-related disability is treated by both patients and practitioners as negotiable rather than a fixed reality. Moreover, it shows that patients’ and practitioners’ negotiations of disability are subject to issues of agency, accountability, and blame, and it provides insight into the interactional dilemmas that are at stake, both for patients and practitioners. Revalidatieprogramma’s voor patiënten met chronische pijn zijn gericht op het verbeteren van het functioneren ondanks de pijn, waardoor kwaliteit van leven wordt bevorderd. Conversaties tussen patiënten en behandelaars over de manier waarop de patiënt kan omgaan met de pijn en gerelateerde beperkingen kunnen interactionele uitdagingen met zich meebrengen. Dit hoofdstuk verkent vanuit discursief-psychologisch perspectief hoe beperkingen worden onderhandeld door patiënten en behandelaars in consulten. De analyse toont aan dat de beperkingen worden behandeld als onderhandelbaar in plaats van als een onveranderbare werkelijkheid. Bovendien toont de analyse dat in deze onderhandelingen bepaalde issues relevant worden gemaakt, zoals ‘agency’, verantwoordelijkheid en schuld. Inzicht wordt geboden in de interactionele dilemma’s die op het spel staan voor zowel patiënten als behandelaars.
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The concept of immersion has been widely used for the design and evaluation of user experiences. Augmented, virtual and mixed-reality environments have further sparked the discussion of immersive user experiences and underlying requirements. However, a clear definition and agreement on design criteria of immersive experiences remains debated, creating challenges to advancing our understanding of immersive experiences and how these can be designed. Based on a multidisciplinary Delphi approach, this study provides a uniform definition of immersive experiences and identifies key criteria for the design and staging thereof. Thematic analysis revealed five key themes – transition into/out of the environment, in-experience user control, environment design, user context relatedness, and user openness and motivation, that emphasise the coherency in the user-environment interaction in the immersive experience. The study proposes an immersive experience framework as a guideline for industry practitioners, outlining key design criteria for four distinct facilitators of immersive experiences–systems, spatial, empathic/social, and narrative/sequential immersion. Further research is proposed using the immersive experience framework to investigate the hierarchy of user senses to optimise experiences that blend physical and digital environments and to study triggered, desired and undesired effects on user attitude and behaviour.
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Poor work-life balance (WLB) has been linked to negative outcomes such as increased stress, anxiety, depression, and a perceived reduction in the overall quality of life. At an institutional level, these may include lowered employee commitment and decreased productivity at work. The advent of COVID-19 has necessitated fundamental alterations to work experience and the ways in which WLB may be perceived. This phenomenological study employed qualitative, in-depth interviews to explore higher education academics’ lived experiences of remote working and how they perceived this had impacted their well-being (WB) and WLB. Using purposive samplings, respondents were drawn from HE sectors in the Netherlands, and the UK. The findings offered an understanding of how remote and hybrid teaching delivery during the pandemic affected academics’ actual experiences of WB and WLB. These findings serve to enhance policymakers’ understandings of significant occupational health and WB issues within a post-pandemic education service paradigm.
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Immersive technologies are redefining and revolutionizing the staging of experiences and co-creation of value, implicating the management of customer experiences. However, limited studies have looked at the role of immersive technologies as part of the customer experience management (CXM) process. Incorporating the concepts of experience economy and value co-creation, this study proposes a dynamic CXM framework that highlights the emerging field of immersive technologies like augmented and virtual reality as part of business and marketing research. The framework acts as a guide for researchers and industry practitioners to initiate immersive technology ventures that are rooted in the co-creation and management of customer experiences
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Regenerative forms of higher education are emerging, and required, to connect with some of the grand transition challenges of our times. This paper explores the lived experience of 21 students learning to navigate a regenerative form of higher education in the Mission Impact course at The Hague University of Applied Sciences. This semester-length course ran for two iterations with the intention of connecting the students with local transitions towards a more circular society, one where products are lasting and have multiple lives when they are shared, refurbished, or become a source for a new product. At the end of each iteration, the students reflected on their experience using the Living Spiral Framework, which served as basis for an interpretative phenomenological analysis of their journey navigating this transformative course. The results of this study include four themes; (1) Opting in—Choosing RHE, (2) Learning in Regenerative Ways, (3) Navigating Resistance(s), and (4) Transformative Impacts of RHE. These themes can be used by practitioners to design and engage with regenerative forms of higher education, and by scholars to guide further inquiry. van den Berg B, Poldner KA, Sjoer E, Wals AEJ. ‘Sweet Acid’ An Interpretative Phenomenological Analysis of Students’ Navigating Regenerative Higher Education. Education Sciences. 2022; 12(8):533. https://doi.org/10.3390/educsci12080533
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Background: A paradigm shift in health care from illness to wellbeing requires new assessment technologies and intervention strategies. Self-monitoring tools based on the Experience Sampling Method (ESM) might provide a solution. They enable patients to monitor both vulnerability and resilience in daily life. Although ESM solutions are extensively used in research, a translation from science into daily clinical practice is needed. Objective: To investigate the redesign process of an existing platform for ESM data collection for detailed functional analysis and disease management used by psychological assistants to the general practitioner (PAGPs) in family medicine. Methods: The experience-sampling platform was reconceptualized according to the design thinking framework in three phases. PAGPs were closely involved in co-creation sessions. In the ‘understand’ phase, knowledge about end-users’ characteristics and current eHealth use was collected (nominal group technique – 2 sessions with N = 15). In the ‘explore’ phase, the key needs concerning the platform content and functionalities were evaluated and prioritized (empathy mapping – 1 session with N = 5, moderated user testing – 1 session with N = 4). In the ‘materialize’ phase, the adjusted version of the platform was tested in daily clinical practice (4 months with N = 4). The whole process was extensively logged, analyzed using content analysis, and discussed with an interprofessional project group. Results: In the ‘understand’ phase, PAGPs emphasized the variability in symptoms reported by patients. Therefore, moment-to-moment assessment of mood and behavior in a daily life context could be valuable. In the ‘explore’ phase, (motivational) functionalities, technological performance and instructions turned out to be important user requirements and could be improved. In the ‘materialize’ phase, PAGPs encountered barriers to implement the experience-sampling platform. They were insufficiently facilitated by the regional primary care group and general practitioners. Conclusion: The redesign process in co-creation yielded meaningful insights into the needs, desires and daily routines in family medicine. Severe barriers were encountered related to the use and uptake of the experience-sampling platform in settings where health care professionals lack the time, knowledge and skills. Future research should focus on the applicability of this platform in family medicine and incorporate patient experiences.
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Aim. To report the expectations and experiences of general practitioners and practice nurses regarding the U-CARE programme, to gain a better understanding of the barriers and facilitators in providing proactive, structured care to frail older people and to determine whether implementation is feasible. Background. Care for older patients with complex care needs in primary care is fragmented, reactive and time consuming. A structured, proactive care programme was developed to improve physical functioning and quality of life in frail older patients. Design. An explanatory mixed-methods study nested in a cluster-randomized trial. Methods. The barriers to and needs for the provision of structured, proactive care, and expectations regarding the U-CARE programme were assessed with prequestionnaires sent to all participating general practitioners (n = 32) and practice nurses (n = 21) in October 2010. Postquestionnaires measured experiences with the programme after 5 months. Twelve months later, focus group meetings were conducted. Results. Practice nurses and general practitioners reported that it was difficult to provide proactive and structured care to older patients with multi-morbidity, different cultural backgrounds and low socioeconomic status. Barriers were a lack of time and financial compensation. Most general practitioners and practice nurses indicated that the programme added value for the coordination of care and allowed them to provide structured care. Conclusion. This explanatory mixed-methods study showed that general practitioners and practice nurses perceived the U-CARE programme as feasible in general practice. A transition was made from reactive, ad hoc care towards a proactive and preventive care approach
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Objective: The majority of parents with a disabled child experience chronic sorrow, characterized by recurrent feelings of grief and loss related to their child’s disability. There is a significant lack of research on parents’ lived experiences of chronic sorrow, which limits our ability to understand parents’ needs and provide proper support. Design: Interpretative Phenomenological Analysis (IPA) was conducted based on in-depth interviews with six parents of severely disabled children. Results: In the literature on chronic sorrow, an important aspect has been consistently overlooked: the particular position of being a parent, experiencing an awareness of being ultimately responsible for their children. The analysis revealed how this awareness, experienced as a deeply felt ethical commitment, unconditional, largely in isolation, and without a limit in time, shaped the experience of chronic sorrow. Because of this awareness, the parents experienced themselves facing a Herculean task of navigating their intricate motions while struggling to maintain their ability to function. Conclusions: By revealing the importance of considering the unique parental position, the study enriches the concept of chronic sorrow, simultaneously offering insights into what it means to be a parent of a disabled child. These insights can improve care professionals’ responsiveness to parental needs.
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