The relationship between processes of mental health recovery and lifelong learning is an area of increasing international interest. Experiences of transformation, positive effects on self-esteem, self-insight, and empowerment have been identified regarding both endeavors. Recognition of these benefits has stimulated collaborative development of educational programs in personal development, self-efficacy, and recovery principles. The importance of evaluating this educational provision has been emphasized; however, there has been little detailed exploration of students' experiences and perceptions of recovery and learning in the context of recovery education programs. In this article, we present a participatory arts-based inquiry with 14 women, including mental health service users, who undertook a recovery training program to support their roles as mental health support workers in Ireland. Participatory visual analysis revealed three recurring themes; the interrelatedness of learning and recovery journeys, knowledge as a source of stability and rescue and the need for resilience in learning and recovery.
Vivian Mercier described Waiting for Godot as a play which: has achieved a theoretical impossibility - a play in which nothing happens, that yet keeps audiences glued to their seats. On a wider philosophical level, Beckett is suggesting that people try to achieve meaning in a chaotic world through imposing their own formulated patterns and habitual behaviour and that they cling to these diversions as a means of avoiding the reality that their situation is hopelessly incomprehensible. In the early to middle stages of dementia people with dementia experience difficulty in carrying out activities of daily living without help. Disturbed sleep can also be a feature. These features and behaviours are common to many people in the early to mid-stages of dementia. Like many carers of people with dementia, Vladimir invariably takes responsibility for maintaining conversation, constantly trying to stimulate linguistic connection and responses that will sustain him.
Chronic Kidney Disease (CKD) is a complex disease that requires lifelong treatment. Transplantation is the goal standard treatment, however; it is not without its challenges. While previous research has demonstrated that transplantation increases survival rates and enhances young people's quality of life, little is known about the impact of kidney transplantation on adolescents' self-identity development. This presentation will discuss the struggles that adolescent transplant recipients experience as they endeavour to incorporate a new kidney into their embodied self. These findings were identified as a predominant theme from a narrative inquiry of embodiment experiences among young people living with CKD in Ireland.
Methods
This study employed a narrative inquiry research design. Using an ethnographic approach data were gathered through multi-media approaches including: visual body maps (i.e. life-size human body images), oral informal conversations and observational field notes. Five adolescents (10–17 years) participated in the study, which took place over a period of 18 months as adolescents experienced living with CKD in both hospital and home settings.
Results
A nuanced finding identified from this study was a disrupted sense of self and identity arising from adolescents' encounters with a foreign body part (i.e. kidney). Adolescent participants experienced a tension between their body, self and identity as a consequence of transplant surgery. They struggled to adjust to the presence of a foreign organ from a deceased donor and they were concerned about developing personality characteristics of the donor As one participant described, the kidney was not viewed as her own but was conceptualized as 'a dead persons kidney'. Another participant described the prospective of acquiring the personal qualities or characteristics of the donor as 'disgusting'. Findings also revealed that adolescents engaged in different individualised ways to cope with the transplanted organ.
Discussion
The findings from this study provide an understanding of the struggles adolescents endure as they attempt to incorporate a foreign organ within their bodies and the potential impact on their self-identity. Clinicians need to be aware that substituting kidneys with donor organs is much more than a complex technical procedure; it requires an amalgamation of 'other' and 'self'. From a clinical perspective, a multifaceted and holistic person-centred care approach is needed to equip adolescents with the individual skills required to adapt to a new kidney.
The aim of this study was to explore the COVID-19 pandemic as it was experienced by people on the front line in residential care settings for older people in the Republic of Ireland (ROI).The COVID-19 pandemic had a disproportionate effect in residential care settings for older people in Ireland.A two-phased mixed methods study was conducted, consisting of an online survey administered shortly after the first wave of the virus to staff, residents and family members and one-to-one interviews with family members shortly after wave 2 of the virus.Isolation, loss of connectedness as well as a reduction in the level/quality of care provision led to significant adverse impacts for both residents and their families. Staff reported high levels of stress, trauma and burnout. Family input to care was suspended, with adverse consequences.The pandemic had an extremely adverse impact on residents, family members and staff in care settings for older people.Strategies to ensure that residents' physical, emotional and social needs and staffs' professional and personal needs are appropriately supported during future waves of the pandemic should now be implemented.
Accessible Summary What is known on the subject? Mental health support workers (MHSWs) are frequently employed in mental health services in order to augment and diversify the workforce and to promote recovery centred care Research shows that while MHSWs positively support service user mental health recovery, these roles are often unclear or not well understood by MHSWs and other mental health practitioners What the paper adds to existing knowledge? Through arts‐based research methods, three MHSWs communicated their personal vulnerabilities and anxieties in supporting others with mental health issues; these insights are rarely presented in mental health research. MHSW experiences of not having recovery‐oriented expertise recognized or valued by healthcare team were powerfully conveyed through arts narrative. These findings promote recognition of the strengths and contributions of MHSWs to mental health practice. Arts‐based inquiry is a means of providing additional depth to what is already known and contributes novel insights regarding the occupational experiences and perceptions of MHSWs. What are the implications for practice? Mental health nurses and healthcare teams need to engage fully with recovery‐oriented principles acknowledging the vulnerabilities of all practitioners and establishing adequate supervision and support. There needs to be greater clarity concerning roles/scope of practice for MHSWs to enable productive working partnerships in mental health teams. This can be achieved through open communication, education and planning among the wider mental healthcare team. Abstract Introduction Mental health support workers (MHSWs) make positive contributions to mental health recovery practice yet their roles and support needs are often unclear. This research explored the occupational lived experiences of three MHSWs working in Irish mental healthcare services. Aim The study examined the experiences and perceptions of MHSWs regarding their mental health recovery work. Method A narrative design was used incorporating participatory art‐based inquiry as a collaborative means of engaging participants. This innovative methodology enabled exploration and evocative expression of participants’ occupational experiences and stories. Results Participants revealed feelings of vulnerability and anxiety regarding personal mental health and supporting the mental health of others; a finding not commonly explored in previous research. MHSW skills and knowledge were evident; however, this expertise and recovery focus was not valued in mental health services. Discussion The strengths and challenges of MHSW engagement in service provision are discussed. Interdisciplinary team integration is explored in terms of contrasting recovery philosophies, practitioner vulnerability and professional demands and imperatives. Implications for practice Mental health teams need to engage with recovery principles, acknowledging strengths and vulnerabilities of all practitioners and establishing adequate supervision and support. Greater clarity and education is required concerning roles/scope of practice for MHSWs to enable productive interdisciplinary partnerships.
There is a lack of nursing research in relation to how people with mental health problems make sense of their experiences of mental distress. Furthermore, few nursing related studies have conveyed service user's understandings and meanings for their experiences of mental ‘disorder’. Narrative psychology claims that people make sense of the world and their lives by using narrative structures to organize diverse experiences. By sharing these stories with others, interpretations are negotiated and personal and cultural meanings are formed. This study used a tried and tested approach to narrative analysis to analyse the transcribed narrative of one man, Gary, who was experiencing mental health problems. The study explores Gary's process of meaning making as it appears in his narrative; the frameworks and metaphors that he uses to help him make sense of his experiences. The tensions between Gary's internal voices and beliefs and the external voices of surrounding culture and psychiatry are highlighted. Emphasis is placed on the importance of attending and responding to personal meanings embedded in narratives as a means of developing sensitive nursing care and enriching nursing research.
Effective clinical supervision is increasingly recognised as essential in supporting staff who are working in the field of social care. Using a case study approach, this paper illustrates the processes involved in planning and implementing a group supervision pilot with a team working in a homeless service. The supervision models used to inform and guide this initiative are described and the style and structure of the supervision sessions are discussed. The paper additionally provides a reflective analysis of group dynamics and group processes observed during this work. Subsequent conclusions identify the key features of this process and may provide guidance for other practice settings.
Homeless service users were screened for autism spectrum disorder through one of Ireland's leading not for profit service providers. Keyworkers acted as proxy informants; their caseloads were screened using the DSM-5-Autistic Traits in the Homeless Interview (DATHI). Client current and historical health and behaviour data was collated. A representative sample of 106 eligible keyworkers caseloads were screened, identifying 3% "present" and 9% "possibly present" for autistic traits with the DATHI. These findings suggest a high estimate of autism prevalence and support emerging evidence that, people with autism are overrepresented in the homeless population, compared to housed populations. Autism may be a risk factor for entry into homelessness and a challenge to exiting homeless and engaging with relevant services.
This paper is concerned with the methods, processes, and experiences of using arts-based inquiry within the context of an undergraduate nursing curriculum. Exploration of these phenomena was achieved through an ethnographic study that involved participatory research among twenty second year students as they engaged in a Nursing Humanities option module. The capacity of arts-based approaches in the nursing curriculum to foster inquiry and critical thinking; essential attributes in contemporary nursing, is explored through re-presentation and analysis of student artwork/art-making processes, contextual discussions and researcher field notes. The challenges encountered in using arts-informed pedagogical approaches within current nursing curricula are made visible and possibilities for integrating aesthetic inquiry into nurse education programmes are discussed.
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