bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a mHealth Intervention (TechCare) for First Episode Psychosis: A Focus Group Study With Mental Health Professionals
Authors: Gire Nadeem , Mohmed Naeem , McKeown Mick , Duxbuy Joy , Husain Nusrat 
Published: June 2022

AimsResearch in the area of mHealth, has shown much promise in the development of mobile phone interventions which look at the assessment and treatment in real-time of psychiatric disorders. Within the context of Severe Mental Illnesses (SMI), such as psychosis, communication and understanding between health professionals and service users in the reporting of distress and reoccurrence of symptoms is essential in reducing the chances of relapse. An alternative pathway which uses mobile technology to engage with services, may hold the key to gaining a deeper understanding of the lived experiences of those with mental health difficulties, in particular experiences of recovery from SMI's. AIM: The aim of the study was to explore the perspectives and opinions of health professionals on the development and refinement of the TechCare App for psychosis. A qualitative approach was adopted for data collection, which provided an understanding of factors in relation to the development of the intervention.MethodsA total of two focus groups were held with health professionals to elicit their views on optimising the utility of the TechCare App. The total sample size for the focus groups was n = 16 with a total of 6 males and 10 females. This qualitative study was part of a feasibility study, investigating a novel intervention (TechCare) (Husain et al., 2016; Gire et al., 2021) which monitored participants symptoms and provided a tailored psychosocial response in real-time. Data obtained from the focus groups was transcribed. Framework analysis were used to analyse the data for emerging themes, focusing on feasibility, acceptability and further development.ResultsThe key themes that emerged from the data were; access and usage of digital technologies, implications for clinical practice, challenges & barriers to delivery and development and refinement considerations for the TechCare App.ConclusionResults of the focus group with health professionals provided a unique perspective of conducting mHealth research within an EIS context, and the differing challenges professionals anticipated facing in delivering the TechCare App intervention. The main finding of the focus group was that professionals saw the potential for the TechCare App to increase access to digital technologies, providing service users with an alternative medium to communicate with EIS health professionals. However, the participants felt that despite mHealth Apps being a useful platform to deliver interventions, face-to-face contact should remain an important aspect of routine care.
Breast Feeding Experiences of NHS Staff Returning to Work From Maternity Leave: A National Study
Authors: Hearfield Hollie , Collier Jennie , Paize Fauzia 
Published: June 2022

AimsAnecdotally, NHS staff feel unsupported in breastfeeding when returning to work from maternity leave. The NHS provides clear guidance to employers about provisions required for breastfeeding employees (clean lockable room, adequate time, clean fridge). We aimed to establish if these provisions were provided for NHS staff, and to further explore the difficulties reported.MethodsWe conducted a pilot study of NHS doctors, exploring their experiences of feeding on returning to work. The results highlighted difficulties for many of the 519 cases. We extended the study to encapsulate the experiences of all NHS professionals.The survey was distributed via various professional social media accounts.ResultsWe received 1201 responses.
•79% of women were breastfeeding when they returned to work. 59% wished to continue on return.•78% of women were unaware of the local breastfeeding policy. Of those that were, only 7% were informed of the policy by their employer.•90% of women were unaware that they needed to inform their employer of their intention to breastfeed.•Only 6% of women had a breastfeeding risk assessment on their return to work.•Basic requirements were not consistently met (50% did not have access to a lockable room, 51% to a fridge, 69% to adequate time).•55% were interrupted whilst expressing.•23% of women expressed in changing rooms; 32% in toilets; 25% in their cars; 15% in cupboards.•88% of women did not have their duties adapted. 91% regularly held the bleep whilst expressing.•52% of women reported embarrassment and humiliation at work. 60% reported stress directly due to their difficulties expressing, with a further 15% experiencing mental health problems. 10% of women felt their experiences negatively affected their bond with their child.ConclusionOnly 1% of UK mothers continue to breastfeed at six months. There is a huge NHS drive to improve this statistic. 76.7% of NHS staff are women. These women are also NHS patients. NHS breastfeeding guidelines are not being consistently followed within the organisation. There is a direct impact on mother and child, and on patient care.We must support our NHS family, create a positive breastfeeding culture, and lead UK change.“I was ridiculed… it set me apart from my colleagues.”“Resigning was my only option.”“Subject to eye rolls and whispers… rude, unsupported and unkind.”“He unlocked the door and walked in while I shouted “stop”.”
What Does Current Literature Tell Us About the Mental Health of Looked After Children?
Authors: Herwig Katie 
Published: June 2022

AimsLooked after children (LAC) are one of the most vulnerable groups in our society. Often, after experiences of neglect and abuse, they are more likely to experience poor mental health, attachment difficulties and problems in educational progress. This review aims to explore literature published over the past decade which addresses the mental health needs and management of LAC within CAMHS in the UK.MethodsA literature review was performed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 structure. Selection criteria was used. The total number of papers identified after this initial search was thirty-six across the database.Literature titles and abstracts were then screened to exclude papers with an irrelevant focus. Full-texts of the remaining twenty-two papers were then assessed for relevant and conclusive information. The total number of full papers included in the research was thirteen.To analyse the literature identified, a framework of three themes has been highlighted. These include:
•the mental health needs of LAC,•factors relevant to the assessment of LAC in mental health services•considerations associated with the management of LAC with mental health conditions.ResultsMental health needs of LAC included numerous emotional, behavioural and social problems. These were largely focused around substance misuse, emotional disorders and poor relationships with peers.The main themes which have come out of research in relation to the treatment of LAC include:
•the importance of supporting healthy social relationships with primary care-givers, peers and teachers•maximising the informal support of family, friends and pets•the provision of early, holistic and flexible mental health services, rather than disjointed agenciesConclusionThe literature published over the past decade has indicated the great number of adverse outcomes amongst LAC and has made useful suggestions for the assessment and treatment of these children within a CAMHS setting.Through targeted support into residential placements, offering intensive and direct psychological input at an early stage and continuing even after they have been adopted, as well as, working alongside schools to promote peer interaction could significantly reduce the adverse outcomes of LAC.Additionally, by referring patients along with their carers for psycho-education can be extremely beneficial. Alongside this, the young people ought to be directed to support groups with other LAC to meet peers who are in similar situations as themselves.
Service User Involvement in Recovery-Oriented Care Planning: A Realist Synthesis
Authors: John Thomas , Billings Jenny , Wilson Patricia 
Published: June 2022

AimsService user involvement (SUI) in recovery-oriented care planning (ROCP) warrants more sophisticated theorisation and explanation to support practice improvement. This study investigated which changes to practice work best, in what circumstances, and to what extent, to embed an active role for service users’ involvement in ROCP during the acute inpatient mental health care pathway.MethodsA realist synthesis, combined with qualitative methods, was conducted to theoretically explore the causal mechanisms that underlie SUI in ROCP and how contextual factors influence the link between these causal mechanisms and outcomes. The study was conducted in three stages: theory-gleaning, theory-refinement and theory-consolidation. Initial programme theories were developed in the theory-gleaning stage. Theories were refined iteratively in the theory-refinement stage, using evidence from a realist review and interview data. With stakeholder involvement, refined programme theories were finely tuned using ‘if-then’ statements in the consolidation stage.ResultsFive programme theories relating to the acute care pathway were identified following the realist synthesis:
1)‘Provider-controlled care transition’ (admission to acute inpatient mental health units), referring to limitations to service users’ active involvement. The focus of care and access to acute inpatients units should be needs-led, rather than resource-led or demand-driven;2)‘Care plan as a recovery tool?’ – addressing infrastructural and organisational limitations to active SUI in care-plan formulation. The use of multidisciplinary meetings as a forum for care-plan formulation can create a cohesive approach and facilitate shared ownership;3)‘Ward rounds as a non-inclusive arena for shared decision making’, highlighting their unfulfilled potential for shared decision making about treatment. Professionals should focus on preparing service users for the ward-round process. Opportunities and access for service users to build therapeutic relationships with treating doctors are vital components;4)‘Peer support worker intervention' as a key factor in service users’ recovery’, concerning their positive impact. Their presence in ward rounds and care-planning meetings might create a more user-friendly atmosphere for service users; and5)‘Provider-controlled care transition’ (discharge from acute inpatient mental health units), increasing focus on preparing service users for transition into the community, and constraints on resources should not dictate or anticipate decisions on discharging service users.ConclusionThe study identified practices required to embed an active role for service users to be involved in ROCP, namely multi-contextual interventions at various levels (macro, meso and micro) of the mental health system. The study uncovered barriers that restrain SUI in ROCP, impacting desirable outcomes.
Insight to Psychological Aspects of Cancer
Authors: Kunhikkandy Ashkar Ali 
Published: June 2022

AimsThe baseline of this study
1)What is the type of psychiatric disturbances in oncology settings?2)Is there any importance in cancer education?3)How to manage psychiatric disturbances?MethodsAs of lockdown concerning COVID-19, this study is conducted online among 20 cancer patients. This is a cross-sectional study where Each patient has explained the purpose of the study, procedures, and consent was taken from patients then a questionnaire was given, and this was assessed. Among the profile of the study population, 50% were males and 50% were females of the total study population, 60% were married and 40% were unmarried, Participants were aged between 22 and 63 years. The study population also consists of 20% are breast cancer, 25% lung cancer,10% lung cancer, and the rest are other types of cancers. Patient details are collected from the Facebook groups for cancer patients. Assessment has 2 parts, one is based on CES-D Test where each individual was each patient answered 20 question and next part is based on 5 questions regarding Financial Depression, Behavioral changes, Feelings, Education about cancer and Psychiatric support.ResultsIt is found that 60% population are normal, 25% had mild Depression, 10% have moderate Depression followed by 5% with severe depression.Among associations between marital status and various disorders, it was found that psychological disturbances are 2 times fold more in married people while compared to unmarried. There is also an association between treatment modalities are observed, in that anxiety is prevalent with people who had chemotherapy. Based on education and financial status, those who are with less education about cancer and less financially stable have also prominent disturbances.ConclusionThe study was based on other research study related to the spectrum of psychological disturbance based on treatment stage, financial status, awareness of cancer among patients, and role of marital status among individuals Offering mental health services to patients with cancer is becoming an integral part of oncologic treatments because psychological problems harm cancer management. The most common psychiatric disorders in cancer patients are depression, anxiety disorders, and adjustment disorders. Psychiatrists should be involved in the multidisciplinary treatment team that works with cancer patients. Further research is needed to determine the effectiveness of different psychological and psychopharmacological interventions in psycho-oncology and palliative medicine
Journey From Acute In-Patient to Community-Based Mental Health Rehabilitation: Outcome of Ayu-Psychiatry Care Initiative
Authors: Sharma Neha , Voegeli Maël , Joshi Venkata , Lakshmanan Skanthesh 
Published: June 2022

AimsIn developing countries specially in sub-urban or rural areas, most patients with psychiatric crisis phase don't access intensive care. In India, AYUSH system of medical care is widely used, including crisis resolution and community treatment. However, evidence to support their effectiveness has remained very low. Present study is designed as community based participatory research, where Ayurveda management from acute in-patient care to a community-focused treatment and rehabilitation was studied.MethodsIn this evaluation study, we trace the journey of Ayu-Psychiatry Care project, set up as community based mental health rehabilitation program in rural and sub-urban areas of Rajasthan, India, from acute in-patient care to a community-focused treatment and rehabilitation.ResultsWhile receiving Ayu-Care and promoting early treatment and rehabilitation, community-based treatment demonstrated considerable improvement in maintaining family relationships and employment. Increased treatment adherence, improved self-efficacy, and reduced stigma were all made possible because to this community-based strategy.ConclusionThe connection between UK and Indian organisations is also explored during the journey. The findings of the study and the principles of long-term international cooperation are laid out by the authors.
Psychosis and the Dissonance in the Doctor-Patient Relationship; a Thematic Analysis
Authors: Lawton Aimee 
Published: June 2022

AimsWithin psychiatry, relationships between doctors and patients with psychosis are significant determinants of attitudes, adherence, and therapeutic outcomes. Current research focuses on communication within psychiatrist-patient interactions with limited evaluation of the patient's perspective. Understanding the components underpinning the patient's relationship with their doctor could help improve outcomes for individuals with psychosis.MethodsEight participants, recruited through advocacy programmes, were interviewed. All had a diagnosis of psychosis or its subtypes. Interviews lasted between forty and eighty minutes. Thematic analysis of semi-structured interviews allowed exploration of important themes within doctor-patient relationships. Ethical procedures were implemented in accordance with British Psychological Society guidelines.ResultsParticipants’ narratives identified three salient themes perceived to influence doctor-patient relationships. Participants explored ‘Interactions with Medical Professionals’, focusing on communication and discussion styles. Doctors were not perceived as empathic, open listeners, reducing trust and limiting conversation during interactions. Participants described reduced engagement due to perceived misunderstanding and highlighted the impact of time constraints, guidelines, and limited medical training on relationships.Secondly, participants discussed the ‘Diagnostic Process’, suggesting it had a negative influence on the relationship due to delivery methods.Finally, participants explored ‘Treatment’, highlighting an overwhelming reliance on medication, lack of explanations, and lack of psychological therapies, which contradicted with patients’ preferences.ConclusionThe narratives describe a relationship in which patients feel misunderstood, furthering patient disengagement and resulting in a vicious cycle of dissonance that limits health outcomes. Findings suggest a need to incorporate psychological therapies into doctor-patient interactions to allow increased communication and understanding.
Why Should ACT Work When CBT Has Failed? a Study Assessing Acceptability and Feasibility of Acceptance and Commitment Therapy (ACT) for Paediatric Patients With Chronic Fatigue Syndrome/myalgic Encephalomyelitis (CFS/ME)
Authors: Leveret Jamie , Starbuck Jen , Chapple Kate , Gubb Sam , Kwuo Hannah , Burge Sarah , Li Morain , Clery Philippa , Crawley Esther 
Published: June 2022

AimsPaediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) effects 0.5–3.28% of children. NICE guidance recommends Activity Management, Graded Exercise Therapy or Cognitive Behavioural Therapy for fatigue (CBT-f). Approximately 15% of patients do not achieve full recovery within one year with current treatments. Acceptance and Commitment Therapy (ACT) is an effective treatment in many chronic illnesses. There are no studies investigating ACT for paediatric CFS/ME. This feasability study aimed to assess if ACT is a feasible and acceptable alternative treatment when current treatment has not led to recovery.MethodsThis feasability cohort study aimed to enrol a minimum of 12 participants aged 11–18 yearswith CFS/ME attending the Royal United Hospitals Bath NHS Foundation Trust Specialist Paediatric CFS/ME Service, who were still symptomatic after 12 months or 12 sessions of standard treatment and were offered six to 12 sessions of ACT. Retention and recruitment data were analysed. Participants were asked to complete questionnaires before, during and after treatment. A selection of participants and their parents were interviewed about their experience of the study. Interviews were analysed using thematic analysis.Results19 participants (95% of those approached) were recruited. Only 4 participants of this hard-to-reach group did not complete treatment.In almost all sessions participants reported that they felt ‘totally’ listened to in post session questionnaires (31/33 sessions).Preliminary interviews (n = 12) indicate acceptability of ACT, with all young people and their parents stating that they thought ACT should be offered to this population. Participants particularly commented that the absence of thought challenging (used in CBT-f) was a positive element of ACT. Participant's openness to try new approaches and altruistic desire to be in a study was noted.ConclusionRecruitment data indicate that it is feasible to recruit and retain 11–18-year-olds with CFS/ME to a study offering ACT. Interviews with participants and parents were broadly positive suggesting ACT is an acceptable treatment in this population.Results indicated that it is both feasible and acceptable to offer ACT to 11–18-year-olds with CFS/ME using this protocol, supporting the prospect of an RCT in this area.
Examining Grey Matter Structural Abnormalities in Young People Exposed to Childhood Maltreatment and Peer Victimisation
Authors: Lim Lena 
Published: June 2022

AimsEarly-life interpersonal stress, particularly childhood maltreatment (CM), is associated with neurobiological abnormalities. However, few studies have investigated the neural effects of peer victimisation (PV). This study examines the common and specific associations between CM, PV and brain structural alterations in healthy youths.MethodsGrey matter volume (GMV) and cortical thickness (CT) data were collected from 105 age-and gender-matched healthy youths (34 CM, 35 PV and 36 controls). Region-of-interest (ROI) and whole-brain analyses were conducted.ResultsFor the ROI, the CM group had smaller GMV than controls in left IFG, bilateral anterior insula, postcentral and lingual regions, which were associated with higher emotional abuse, along with smaller insular GMV than the PV group. The PV group had smaller left lingual GMV than controls, which was positively associated with age of bully onset. At the whole-brain level, both CM and PV groups had smaller GMV than controls in a cluster comprising left post/pre-central, inferior frontal, insula, superior parietal and supramarginal gyri. The PV group alone had increased CT in a cluster comprising left superior frontal, anterior cingulate and medial orbitofrontal gyri, which was related to greater cyberbullying.ConclusionEarly-life interpersonal stress from carers and peers is associated with common structural alterations of the inferior frontal-limbic, sensory and lingual regions involved in cognitive control, emotion and sensory processing. The findings of a CM-specific reduced anterior insular GMV and a PV-specific increased CT in the left medial prefrontal cluster is intriguing and underscores the unique negative effects of CM and PV, particularly cyberbullying.