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Exploring empowerment in online support communities for people living with tic disorders and tourette syndrome : qualitative survey study of user experiences
Full text link©Ella C Ford, Neil S Coulson, E Bethan Davies. Originally published in JMIR Formative Research (https://formative.jmir.org),
09.Oct.2025. This is an open-access article distributed under the terms of the Creative Commons Attribution License
(https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium,
provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information,
a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.BACKGROUND: People with tic disorders (TDs)-such as Tourette syndrome-report poorer quality of life compared to non-TD peers, and experience considerable difficulties, including societal stigmatization and barriers to accessing health care and evidence-based interventions. Peer support can help improve psychological outcomes, and online support communities (OSCs) are one way to access psychological support. Empowerment involves improving an individual's cognitive processes to increase their ability to assert control over their health condition. OSCs have been suggested to facilitate empowerment, but this has not yet been investigated in users of OSCs for TDs. OBJECTIVE: This study aimed to explore empowerment processes and outcomes present in OSCs as perceived and reported by users of OSCs for TDs living with a TD. METHODS: A web-based survey of current users of OSCs for TDs (n=39) was conducted in summer 2022. The survey included four free-text questions about the impact of using OSCs for TDs in relation to empowerment, such as how it has affected their interactions with health care professionals (HCPs), decisions about treatment, and their experiences of living with a TD. Survey responses were analyzed using deductive and inductive reflexive thematic analysis guided by an initial coding structure derived from the empowering processes and outcomes theoretical framework. RESULTS: Analysis of responses identified a range of empowering processes (eg, exchanging information, encountering emotional support, finding recognition, and sharing experiences) and outcomes (eg, being better informed, feeling more confident in the relationship with HCPs and in making treatment decisions, and enhanced well-being) as related to OSC use in people with TDs that were consistent with the theoretical framework. Additionally, the process of changing stereotypes and stigma, the outcomes of raising awareness, and "one size does not fit all" were identified. A small number of disempowering processes and outcomes were identified, notably the outcome of feeling less confident in the relationship with HCPs. CONCLUSIONS: These findings contribute to evidence for empowerment processes and outcomes experienced by users of health OSCs generally and highlight unique aspects of empowerment for users of OSCs with TDs and how these affect their experiences. OSCs appear to be an important tool in improving mental well-being through validation and recognition from peers, related to the acknowledgment of feelings of imposterism. Using OSCs can expand knowledge through exchanging information and experiences they may not have otherwise had access to-increasing empowerment through improvements in self-management and confidence in treatment decisions. However, this can also decrease trust in HCPs and negatively impact relationships due to decreased hope of assistance and fear of stigmatization for using OSCs. The authors suggest that recommendations regarding the use of OSCs are presented in self-management guidelines concerning coping strategies and the importance of peer support in living with tics.https://formative.jmir.org/2025/1/e66912
Living with mental health issues: citizen science project on self-management strategies
Full text linkThis article is licensed under a Creative Commons
Attribution 4.0 International License, which permits use, sharing,
adaptation, distribution and reproduction in any medium or format, as long
as you give appropriate credit to the original author(s) and the source,
provide a link to the Creative Commons licence, and indicate if changes
were made. The images or other third party material in this article are
included in the article’s Creative Commons licence, unless indicated
otherwise in a credit line to the material. If material is not included in the
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by statutory regulation or exceeds the permitted use, you will need to
obtain permission directly from the copyright holder. To view a copy of this
licence, visit http://creativecommons.org/licenses/by/4.0/.
© The Author(s) 2025People living with mental health issues use a range of self-management strategies. Most strategy recommendations have been developed by clinicians and researchers, so they may not reflect the full range of approaches used in practice. A citizen mental health science methodology can address this bias in strategy identification. We co-created a list of 77 pre-defined self-management strategies, and 1116 public contributors (n = 468 mental health service users, n = 497 lived experience not using services, n = 151 no lived experience) living in the United Kingdom completed an online survey identifying their use of each strategy, and identifying extra strategies. A wide range of pre-defined strategies were used by contributors, with differences in usage patterns identified between the three groups. 401 distinct extra strategies were identified. The active use of avoidance as a self-management strategy was more common than anticipated, including avoiding alcohol, social media, thinking about problems, other people, and mental health services.https://www.nature.com/articles/s44184-025-00166-
Alpha-Stim AID Cranial Electrotherapy Stimulation (CES) anxiety and depression treatment for adults in a social prescribing service: anxiety and depression outcomes
Full text linkCopyright © 2025 by author(s) and
Scientific Research Publishing Inc.
This work is licensed under the Creative
Commons Attribution International
License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/Background: Generalised anxiety disorder (GAD) is common and can negatively impact people’s wellbeing and functioning. GAD treatment includes psychotherapy and/or anti-anxiety medication, which are not acceptable to or effective for many people experiencing GAD. Alpha-Stim AID cranial electrotherapy stimulation (CES) has evidence of effectiveness in the treatment of anxiety and depression. Purpose: Evaluation of Alpha-Stim AID on anxiety and depression for adults with GAD symptoms using a social prescribing service. Methods: An open-label patient cohort design with no control group. Twenty-six adult patients, 22 females and 4 males, with an age range of 24 to 68 years and an average age of 49 years, completed 6 weeks of Alpha-Stim AID use. Pre- and post-intervention assessments were undertaken using participant self-report measures: Generalised Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9). Results: Reliable improvement and remission rates were 42% and 19% for GAD-7; 38% and 27% for PHQ-9. GAD-7 and PHQ-9 significantly improved with large effect sizes. Conclusions: A social prescribing service can offer, and patients will choose to use Alpha-Stim AID, which may be useful in the treatment of anxiety and depression. This study addresses the need for real-world data on Alpha-Stim AID in relation to response rates. It contributes to how Alpha-Stim Aid can be used in social prescribing services, including through a group-based pathway.https://www.scirp.org/journal/paperinformation?paperid=14001
Healthcare Professionals' experience with the implementation of a recovery-oriented approach across in-patient units and assertive community treatment
No full textINTRODUCTION: Recovery-oriented approaches in mental health emphasize personal growth, agency, and meaningful community integration. While endorsed by policies and reforms, the practical implementation of such approaches remains challenging, particularly in settings like Denmark, where structural fragmentation, professional hierarchies, and resource constraints may limit the adoption of holistic recovery principles. METHODS: This qualitative study employed focus group interviews with 21 health professionals from inpatient units and Assertive Community Treatment (ACT) teams in Danish mental health services. Using inductive content analysis, we examined participants' perceptions, understandings, and experiences in implementing personal recovery-oriented practices. RESULTS: Four categories emerged: (1) "Creating New Control in Recovery" highlighted the importance of personal agency and collaborative care involving patients, families, and community stakeholders; (2) "Recovery-Oriented Practice within Professional Parameters" underscored efforts to balance patient preferences with clinical responsibilities; (3) "Barriers to Implementing Recovery-Oriented Practice" revealed systemic constraints, resource limitations, and emotional strain on staff; and (4) "Advocating for a Paradigm Shift towards Recovery-Oriented Approaches" emphasized the desire for interprofessional collaboration, the inclusion of peer workers, and structural reforms. DISCUSSION/CONCLUSION: The findings demonstrate that while Danish health professionals recognize the value of personal recovery-oriented care, their capacity to realize this approach is constrained by organizational structures, professional hierarchies, and limited resources. Strengthening systemic support, enhancing interprofessional collaboration, and integrating peer expertise are critical to fostering more equitable, person-centered mental health services. These insights contribute to a nuanced understanding of recovery-oriented implementation in European contexts and may inform strategies that better support professionals and service users in achieving sustained, meaningful recovery.https://www.tandfonline.com/doi/10.1080/01612840.2025.2456180?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubme
Complete resolution of catatonia following a single intravenous lorazepam challenge test: an early intervention in psychosis case report.
No full texthttps://medworksmedia.com/product/complete-resolution-of-catatonia-following-a-single-intravenous-lorazepam-challenge-test-an-early-intervention-in-psychosis-case-report/
The Promising Role of Probiotics in the Prevention of Cardiovascular Risk Factors and Their Implication in Reducing Coronary Artery Disease: A Literature Review.
Full text linkCoronary artery disease (CAD) remains one of the most common causes of mortality across the globe, which is strongly associated with modifiable risk factors such as hypertension, hyperlipidemia, type 2 diabetes, and obesity. The role of the gut microbiota in influencing these factors has been established recently. Probiotics, which can modulate gut microbiota, have been investigated as a potential strategy to reduce cardiovascular risk. This review aims to evaluate current evidence on the role of probiotics in reducing CAD risk factors and to explore the mechanisms through which probiotics may support cardiovascular health. This narrative review was conducted using studies published within the last five years. The search included databases such as PubMed, Google Scholar, Medline, and ResearchGate. The selection focused on randomized controlled trials (RCTs), meta-analyses, and reviews that examined the impact of probiotics on CAD and its associated risk factors. Findings from several RCTs and meta-analyses show that probiotic supplementation is associated with improved lipid profiles (including lower LDL-C and triglycerides), better glycemic control, reduced inflammatory markers, and modest reductions in blood pressure and obesity measures. However, results across studies vary due to differences in sample size, duration, probiotic strains, and measured outcomes. Probiotics may offer a beneficial, non-pharmacological option to support conventional CAD therapies, particularly by targeting key modifiable risk factors. While early results are encouraging, further large-scale, long-term studies are necessary to confirm their clinical effectiveness and guide standardized recommendations
Birth trauma: the elephant in the nursery
No full textMethod The current study used a multiperspectival (dyadic) IPA approach to interview eight participants (N = 4 heterosexual couples) where one parent was help-seeking for the experience of birth trauma. Results Analysis resulted in four superordinate themes: (1) From perfect plan to shattered reality, (2) Trauma in the healthcare system, (3) Trauma in the family system and (4) The post-trauma family: Navigating the new normal. Discussion Parents described a shared experience of birth trauma during birth. However, fathers’ perceived trauma ended in the delivery room whilst mothers’ continued far beyond this. The dyadic focus showed a divergence of experience postnatally: differing levels of awareness to distress existed between partners, mothers experienced bonding difficulties and parents took to separate coping mechanisms. The trauma remained invisible and unspoken as couples avoided discussions about the birth, coped silently and separately. The parents identity changed following the trauma as individuals, couples and as a family. Conclusion The time following a traumatic birth is experienced differently by mothers and fathers. Parents seldom discuss the trauma, hold differing perceptions of roles and needs, and struggle to support each postnatally. Clinical implications and recommendations are discussed.https://www.tandfonline.com/doi/full/10.1080/02646838.2023.226487
Health professionals on cross-sectoral collaboration between mental health hospitals and municipalities: A critical discourse analysis
Full text linkThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly
cited.
© 2024 The Author(s). Nursing Inquiry published by John Wiley & Sons Ltd.This study investigates the role of language in cross-sector collaboration between mental health hospitals and municipalities, focusing on the challenges of maintaining continuity of care and integrating patient-centered approaches. Using Fairclough's framework for critical discourse analysis, we examined focus group interviews with 21 healthcare professionals, including nurses, social workers, and psychiatrists, to identify key themes and patterns in how cross-sector collaboration is discussed. The analysis revealed a dominant medicalized discourse in hospital settings, which often emphasized structured care processes like treatment plans and medication management, overshadowing more flexible, patient-centered approaches common in community-based services. Power dynamics were evident, with hospital professionals frequently positioned as active agents, while patients and community-based workers were portrayed in more passive roles. Although efforts to involve patients in decision-making were noted, these were often controlled by professionals, reflecting a mediated approach to patient empowerment. The findings highlight the cultural and structural divides between hospital and community services and suggest the need for improved communication strategies, integrated care pathways, and a shift toward more inclusive, patient-centered care models. Addressing these discursive barriers is crucial for achieving more effective, integrated, and patient-centered care, ultimately improving outcomes for patients.https://onlinelibrary.wiley.com/doi/full/10.1111/nin.1268
An exploration of the utilisation and impact of restraint practices in acute paediatric settings: A narrative review of global literature
Full text linkPurpose: The purpose of this paper will be to ascertain the underpinning reason for restraint use in the acute paediatric setting. In the UK, presentations for mental health-related needs within paediatric settings have increased. These admissions can be associated with patients with significant mental health and trauma histories who present with behaviours that challenge, risking exposure to higher levels of restrictive practice. Design/methodology/approach: A literature review was conducted across five databases, PsychINFO, EMCARE, EMBASE, MEDLINE and CINAHL. Search terms related to “paediatrics” and “restraint” were used. In all, 116 studies were screened with 78 studies being retrieved for analysis. A total of eight studies were included for review. All studies were quality assessed using the appropriate tool that adhered to each respective design. Findings: Five themes were extracted from the analysis and presented. These themes were identified as “restraint as part of the role of paediatric nursing”, “culture and attitudes”, “lack of guidance and agreed terminology”, “lack of other alternatives” and “training”. Restraint in paediatrics is unregulated not only in the UK but also globally. Positive behaviour support is highlighted as an approach for restraint reduction in paediatric settings. Originality/value: This literature review identifies a significant lack of research regarding restraint for young people with mental health presentations in the paediatric setting. This paper sets forth the need for future research both in the UK and globally.https://www.emerald.com/insight/content/doi/10.1108/jmhtep-07-2024-0064/full/htm
Presenting Symptoms Define Time to Diagnosis in Degenerative Cervical Myelopathy: Process Mapping From a Musculoskeletal Triage Unit in the UK.
Full text linkSTUDY DESIGN: Retrospective cohort study. OBJECTIVE: Tackling delayed diagnosis in degenerative cervical myelopathy (DCM) is a global research priority. On average, it takes 2-5 years, leading to worse outcomes from surgery and greater disability. Many countries in the UK use interface triage units run by specialist physiotherapists that sit between primary and secondary care termed musculoskeletal services. Their role in the efficient diagnosis of DCM is unknown. The aim of this study was to map the journey of the patient in the musculoskeletal service and to establish the presenting signs and symptoms. METHODS: A retrospective review of 2.5 years of clinical notes was performed in a musculoskeletal service. Process mapping was utilised to visualise the patient's journey and identify delays to diagnosis and presenting signs and symptoms. RESULTS: Twenty-seven cases were reviewed. Patients spent an average of three months in the service. There was a wide variety of presenting symptoms. DCM was more often suspected if patients had both upper limb symptoms and gait disturbance or pathological reflexes. Delays occurred when patients had no gait disturbance or a normal or incomplete neurological assessment. Longest delays occurred when patients received electrophysiology tests for differential diagnosis of peripheral neuropathies. Delays were also seen with incorrect triaging of MRI results. CONCLUSIONS: Where DCM is the principal differential diagnosis, diagnosis was faster. Incomplete examination, misinterpretation of MRI findings or delays in other investigations contributed to delays. Improved awareness and protocols of care within musculoskeletal services represent an opportunity to accelerate diagnosis in DCM.https://onlinelibrary.wiley.com/journal/1557068