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Perspectives of patients, carers and mental health staff on early warning signs of relapse in psychosis: a qualitative investigation

Allan, Stephanie, Bradstreet, Simon, McLeod, Hamish J., Gleeson, John, Farhall, John, Lambrou, Maria, Clark, Andrea, Gumley, Andrew I, Empower Research Group and Mihalopoulos, Cathrine 2020, Perspectives of patients, carers and mental health staff on early warning signs of relapse in psychosis: a qualitative investigation, BJPsych Open, vol. 6, no. 1, pp. 1-7, doi: 10.1192/bjo.2019.88.

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Title Perspectives of patients, carers and mental health staff on early warning signs of relapse in psychosis: a qualitative investigation
Author(s) Allan, Stephanie
Bradstreet, Simon
McLeod, Hamish J.
Gleeson, John
Farhall, John
Lambrou, Maria
Clark, Andrea
Gumley, Andrew I
Empower Research Group
Mihalopoulos, CathrineORCID iD for Mihalopoulos, Cathrine orcid.org/0000-0002-7127-9462
Journal name BJPsych Open
Volume number 6
Issue number 1
Article ID e3
Start page 1
End page 7
Total pages 7
Publisher Cambridge University Press
Place of publication Cambridge, Eng.
Publication date 2020
ISSN 2056-4724
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Psychiatry
Implementation
schizophrenia
clinical decision-making
qualitative research
SHARED DECISION-MAKING
1ST EPISODE
PEOPLE
INDIVIDUALS
EXPERIENCES
MANAGEMENT
SUPPORT
FUTURE
Summary BackgroundRelapse prevention strategies based on monitoring of early warning signs (EWS) are advocated for the management of psychosis. However, there has been a lack of research exploring how staff, carers and patients make sense of the utility of EWS, or how these are implemented in context.AimsTo develop a multiperspective theory of how EWS are understood and used, which is grounded in the experiences of mental health staff, carers and patients.MethodTwenty-five focus groups were held across Glasgow and Melbourne (EMPOWER Trial, ISRCTN: 99559262). Participants comprised 88 mental health staff, 21 patients and 40 carers from UK and Australia (total n = 149). Data were analysed using constructivist grounded theory.ResultsAll participants appeared to recognise EWS and acknowledged the importance of responding to EWS to support relapse prevention. However, recognition of and acting on EWS were constructed in a context of uncertainty, which appeared linked to risk appraisals that were dependent on distinct stakeholder roles and experiences. Within current relapse management, a process of weighted decision-making (where one factor was seen as more important than others) described how stakeholders weighed up the risks and consequences of relapse alongside the risks and consequences of intervention and help-seeking.ConclusionsMental health staff, carers and patients speak about using EWS within a weighted decision-making process, which is acted out in the context of relationships that exist in current relapse management, rather than an objective response to specific signs and symptoms.
Language eng
DOI 10.1192/bjo.2019.88
Indigenous content off
Field of Research 111714 Mental Health
140208 Health Economics
Socio Economic Objective 920410 Mental Health
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30133706

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.