recovery conceptualization and treatment preferences: choices for clients with psychosis in northern...
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![Page 1: Recovery conceptualization and Treatment preferences: Choices for Clients with Psychosis in Northern Malawi By: Charles Masulani Mwale 1, 1 St John of](https://reader035.vdocuments.net/reader035/viewer/2022071807/56649e7d5503460f94b7f42f/html5/thumbnails/1.jpg)
Recovery conceptualization and
Treatment preferences: Choices for Clients with Psychosis in Northern
Malawi By:
Charles Masulani Mwale1, 1St John of God Community Services, Mzuzu;
2013-Mental Health Dissemination Conference-Mzuzu
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INTRODUCTION• 14% of the global burden of disease attributed to
chronically disabling nature of psychoses and other mental health problems
• Traditional research approaches to psychosis have been concerned primarily with biopharmaceutical treatment aspects
• This medical approach, is seen as limiting, as it does not address the wider personal, psychological and social dimensions so central to the broader conceptualisation of recovery
• Studies have shown the growing recognition that recovery does not simply mean the absence of symptoms, cure or a return to the former self.
• Such definitions include the concept of personal change in which the development of a new sense of self can lead to the establishment of a fulfilling life, whether or not symptoms are present
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INTRODUCTION 2• Provision of quality & acceptable care to patients,
need consulting patients living with psychoses by: – getting a broader understanding of recovery from the
clients’ perspective – determining treatments that they prefer & prioritise so
that the providers can be sensitive when proving services to such clients.
• This is important due to significant differences between the priorities of clients and the professionals treating them.
• This study, therefore, proposed to explore clients’ understanding of recovery (from available options); and their respective treatment preferences in Malawi.
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OBJECTIVES
• To list treatment preferences of clients’ living with psychotic illnesses in Malawi.
• To list common stipulations that constitute recovery from perspective of clients living with psychotic illnesses in Malawi.
• To establish association of treatment preferences and recovery conceptualization among clients living with psychotic illnesses in Malawi. (To be done in the final report).
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METHODS 1• Cross-sectional descriptive study design. • Done at two main mental health outpatients’
clinics in Mzuzu, and Karonga (plans to finalise data collection in Bwaira and Zomba mental Hospitals) .
• Clients having a Psychotic diagnosis attending the above clinics (but meeting inclusion criteria) were requested to take part in the study.
• Formula by Lwanga & Lameshow (1992) for calculating sample size for a cross sectional survey, 384 patients are to be interviewed by end of study. But presentation is based on data for 104 patients interviewed so far.
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METHODS 2• Data collection done using a questionnaire based on
priority preferences for Treatment by Byrne et al. and common recovery conceptualisation by Pitt et al. from psychosis: a user-led project.
• After piloting the data collection tool, and training two research assistants, the study Questionares was administered to consenting participants.
• This study was cleared by the National Health Sciences Research Committee and adhered to all ethical principles as detailed in the Helsink declaration.
• Frequencies computed by SPSS was used to analyse data to determine the common conceptualization of recovery; most preferred treatments
• Chi-tests will be used to determine the association between the two.
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RESULTS 1• On preferred treatment options:
– 96% participants prioritized medical treatment options (Medication prescribed sufficiently & low-dose medication).
– 85% prioritized advisory treatment options (advice on coping with psychosis; Supportive counselling and family advice on coping with clients’ behaviour).
– 78% prioritized relational treatment options (Continuity of caregiver and help with re-socialization
– Very few (37%) prioritized environmental treatments aspects(quiet environment and practical help in the clinical environment).
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RESULTS 2
• On areas identified by clients as constituting recovery, more than 80% of the participating clients chose reduction in symptoms of psychosis e .g. Preoccupation with psychotic experiences and loudness of voices.
• Very few patients who chose options under Emotional change; behavioural change; Occupational change; Relationships and social behaviour; Support and treatment; Understanding and control as signs for recovery from psychosis.
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Discussion
• On treatment preferences contrasted with a study by Crane-Ross, D., Roth, D., & Lauber, B.G. (2000) where clients prioritized privacy during treatment. All other preferences similar to similar studies
• Findings on recovery similar to most studies carried in other developed countries apart from perceived occupational change & empowerment.
• Limitation: Use of close ended questionnaire limiting compared to use of use of mixed methods
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RECOMMENDATIONSThese study findings re-affirm the
importance that: • Health care workers do a lot on
medical aspects of clients’ care they also need to more on relational and advisory counselling aspects of care for individuals with psychotic problems.
• Health care workers should be sensitive with other aspects of care that clients with psychosis prioritise
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St John of God for sponsoring the studyAgatha Nyirenda& Mrs Chimalilo for
data collectionStudy participants
Thanks for attention!!!
Acknowledgement