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Qualitative research for education: An introduction to theories and methods

Freud's wish for control and Jung's pugna cious ambition precipitated their final break. In his personal relationships Jung emerges badly. His long marriage survived only because of his wife's forbearance; his notorious womanising with colleagues, pu pils and patients is now well known. His wife was induced to accept a mmnage a trois with one mistress, Toni Wolff. Jung was a charismatic, difficult personality with a â€ ̃¿ mediumistic' intuition, who attracted both men and women throughout his life. As McLynn aptly shows, he clashed with men and kept few male friends, but was always surrounded by loyal female disciples. McLynn is also fair in his treatment of the question of Jung's anti-Semitism and his ambiguous dealings with the Nazis. This biography is informative and com prehensive in its coverage of Jung's personal and public life. However, it emphasises his significance today as guru of New Age interest in Eastern thought, the paranormal and astrology, rather than recognising his place in the contemporary psychoanalytic and psychotherapeutic world.

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A History of Psychiatry: From the Era of the Asylum to the Age of Prozac

Shared decision-making is increasingly advocated as an ideal model of treatment decision-making in the medical encounter. To date, the concept has been rather poorly and loosely defined. This paper attempts to provide greater conceptual clarity about shared treatment decision-making, identify some key characteristics of this model, and discuss measurement issues. The particular decision-making context that we focus on is potentially life threatening illnesses, where there are important decisions to be made at key points in the disease process, and several treatment options exist with different possible outcomes and substantial uncertainty. We suggest as key characteristics of shared decision-making (1) that at least two participants-physician and patient be involved; (2) that both parties share information; (3) that both parties take steps to build a consensus about the preferred treatment; and (4) that an agreement is reached on the treatment to implement. Some challenges to measuring shared decision-making are discussed as well as potential benefits of a shared decision-making model for both physicians and patients.

Shared Decision-making in the Medical Encounter: What Does It Mean? (Or, It Takes at Least Two to Tango)

Background: A growing gap has emerged between people with mental illness and health care professionals, which in recent years has been successfully closed through the adoption of peer support services (PSSs). Peer support in mental health has been variously defined in the literature and is simply known as the help and support that people with lived experience of mental illness or a learning disability can give to one another. Although PSSs date back to several centuries, it is only in the last few decades that these services have formally evolved, grown, and become an integral part of the health care system. Debates around peer support in mental health have been raised frequently in the literature. Although many authors have emphasized the utmost importance of incorporating peer support into the health care system to instill hope; to improve engagement, quality of life, self-confidence, and integrity; and to reduce the burden on the health care system, other studies suggest that there are neutral effects from integrating PSSs into health care systems, with a probable waste of resources.
Objective: In this general review, we aimed to examine the literature, exploring the evolution, growth, types, function, generating tools, evaluation, challenges, and the effect of PSSs in the field of mental health and addiction. In addition, we aimed to describe PSSs in different, nonexhaustive contexts, as shown in the literature, that aims to draw attention to the proposed values of PSSs in such fields.
Methods: The review was conducted through a general search of the literature on MEDLINE, Google Scholar, EMBASE, Scopus, Chemical Abstracts, and PsycINFO. Search terms included peer support, peer support in mental health, social support, peer, family support, and integrated care.
Results: There is abundant literature defining and describing PSSs in different contexts as well as tracking their origins. Two main transformational concepts have been described, namely, intentional peer support and transformation from patients to peer support providers. The effects of PSSs are extensive and integrated into different fields, such as forensic PSSs, addiction, and mental health, and in different age groups and mental health condition severity. Satisfaction of and challenges to PSS integration have been clearly dependent on a number of factors and consequently impact the future prospect of this workforce.
Conclusions: There is an internationally growing trend to adopt PSSs within addiction and mental health services, and despite the ongoing challenges, large sections of the current literature support the inclusion of peer support workers in the mental health care workforce. The feasibility and maintenance of a robust PSS in health care would only be possible through collaborative efforts and ongoing support and engagement from all health care practitioners, managers, and other stakeholders.

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Peer Support in Mental Health: Literature Review

Purpose




As peer support services have become increasingly used in mental health settings as a recovery-oriented practice, so has the body of published research on this approach to care. The purpose of this paper is to provide an update on the current evidence base for peer support for adults with mental illness in two domains: mental health and recovery, and physical health and wellness.




Design/methodology/approach




To provide a robust, non-redundant, and up-to-date review, first the authors searched for meta-analyses and systematic reviews. Second, the authors found individual studies not included in any of the reviews.




Findings




Peer services are generally equally effective to services provided by non-peer paraprofessionals on traditional clinical outcomes. Although some studies found peer services to be effective at reducing hospitalization rates and symptom severity, as a whole, the current evidence base is confounded by heterogeneity in programmatic characteristics and methodological shortcomings. On the other hand, the evidence is stronger for peer support services having more of a positive impact on levels of hope, empowerment, and quality of life.




Research limitations/implications




In addition to the need for further high-quality research on peer support in mental and physical health domains, the authors also question whether measures of hope, empowerment, and integration into the community are more relevant to recovery than traditional clinical outcomes.




Originality/value




This paper provides an original, robust, and up-to-date review of the evidence for peer services.

An update on the growing evidence base for peer support

Objective Given the burgeoning role of peer specialists in the mental health workforce, more information is needed about their work roles, tasks, settings, training, compensation, and work satisfaction. Method Using both purposive and snowball sampling, the authors recruited a national sample of individuals employed as peer specialists and a variety of other peer provider positions. They conducted an online survey to query respondents about various aspects of their work life. A total of 608 participants completed the survey, of which 597 responses were usable for these analyses. Results Results suggest that individuals in the United States identifying themselves as peer specialists (or similar titles) work in a wide variety of settings and spend the majority of their work time providing direct peer support. However, a significant number of individuals also reported performing nondirect peer support tasks such as administrative work, teaching skills, and systems-level advocacy. Average compensation ranged from $10 to $20 per hour. Peer specialists reported a significant amount of satisfaction with their work but still perceive a lack of recognition for their roles. Conclusions and implications for practice Results of this survey provide critical information about the job characteristics of peer specialists and data that should be informative for mental health authorities as they address the needs of this workforce. However, our findings also suggest that ambiguity remains regarding the roles, tasks, and training of peer specialists, which could benefit from further study that would help to clarify the unique role of these professionals within the mental health arena. (PsycINFO Database Record

The peer support workforce: Results of a national survey.

Athletes with cardiac disorders frequently pose an ethical and medical dilemma to physicians assessing their eligibility to participate in sport. In recent decades, patient empowerment has been gaining increasing recognition in clinical decision-making. Empowerment is a process through which people are involved over the decisions and actions that affect their own lives. In the context of a cardiac disorder, empowerment means giving an athlete the chance to participate in the decision about whether or not to remain active in competition. Three models of treatment decision-making are described in this article, with progressive levels of empowerment: the paternalistic model (the athlete has a passive role), the shared-decision making model (both athlete and physician participate in the decision), and the informed-decision making (the decision is made by the athlete while the role of the physician is solely to provide information). This article critically discusses the issues involved in disqualification of athletes with cardiovascular disorders and suggests possible ways of incorporating patient empowerment in potentially career-ending decisions. The authors propose a model of empowerment, which gives patients the opportunity to choose how much, and if, they would like to be involved in the decision-making process.

Empowerment of athletes with cardiac disorders: a new paradigm.

Recent changes in the psychiatric paradigm related to the deinstitutionalization process presuppose the development of services of community integration. Studies conducted in other countries show better results in psychosocial rehabilitation programs than treatment in psychiatric hospitals. However, in Portugal mental health services are not consistent with the state of the art in the area. In this sense, the main goal of this work is to know and to analyse an experience, which is unique for its characteristics, of psychosocial rehabilitation in the area of mental illness, in our region. This research is a case study and the unity of analysis is a Private Institution of Social Solidarity, the Association of Social Rehabilitation and Deinstitutionalization of Psychiatric Patients (ARSDOP), in which we have sought to describe its global functioning model and, more specifically, its work and residential rehabilitation models.

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Reabilitação Psicossocial de Pessoas com Esquizofrenia: Estudo de Caso

Sudden cardiac death (SCD) in young athletes is a rare and dramatic event. Initial consensus guidelines from 2005 recommend restriction from competitive sports for all athletes with hereditary cardiomyopathies and channelopathies, with very minor exceptions.1 

After decades of a conservative sports cardiology approach, recent findings call these universal restrictions into question. First, data on the use of automatic external defibrillators (AEDs) for witnessed sudden cardiac arrest (SCA) in sports have been reassuring.2 When SCA is properly recognised and an AED immediately available, survival from SCA during sport is largely possible.

Second, two reports, one focusing on long QT syndrome in athletes,3 and another on catecholaminergic ventricular tachycardia,4 have suggested that the risk of competition may be acceptable if athletes are well-informed and fully compliant with therapy. A recent task force of the American Heart Association and American College of Cardiology has suggested that competitive sports practice may be permissible in some athletes with channelopathies, assuming that appropriate precautionary measures are in place. Specifically, avoidance of exacerbating drugs, avoidance of dehydration, appropriate electrolyte replenishment (with drinks containing Mg2+ and K+) and establishment of an emergency action plan with staff trained in cardiopulmonary resuscitation and access to an AED.5 

Third, in a recently analysis of 184 consecutive deaths in patients with hypertrophic cardiomyopathy referred to a single cardiac pathology …

https://bjsm.bmj.com/content/bjsports/51/14/1056.full.pdf

Is it time to loosen the restrictions on athletes with cardiac disorders competing in sport

Objective:This study examined job endings and work trajectories among participants in a study comparing the effects of adding cognitive remediation to supported employment among individuals who had...

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Carina Teixeira

Papers

The peer support workforce: Results of a national survey.

Empowerment of athletes with cardiac disorders: a new paradigm.

Reabilitação Psicossocial de Pessoas com Esquizofrenia: Estudo de Caso

Is it time to loosen the restrictions on athletes with cardiac disorders competing in sport

Job Endings and Work Trajectories of Persons Receiving Supported Employment and Cognitive Remediation