Helen Kirkpatrick

How People With SCHIZOPHRENIA Build Their HOPE

1. Both clinicians and consumers identified the importance of maintaining relationships and experiencing success as helpful in building and nurturing hope for consumers. 2. To provide holistic care, clinicians need to discuss spirituality and meaning with clients. 3. Because being hopeful is an active process, clinicians need to talk to clients about hope, openly, realistically, and strategically.

Hope and schizophrenia: clinicians identify hope-instilling strategies

Nurses have many opportunities to assist individuals with schizophrenia because of the frequency and nature of their contacts. The nurses in this study believed that they can make a difference and can identify hope-instilling strategies. Strategies for rehabilitation include assisting persons with schizophrenia to set goals, seeing them as people, and joining with them on their journey of recovery. Recognizing that the establishment of the relationship is central in assisting the development of client hope, and (hopefully) eventual recovery, may help nurses to persevere despite what may be a challenging and lengthy process.

The Importance of Relationships in Fostering Hope

1. A person with mental illness, such as schizophrenia, can be mobilized to maintain hope. 2. A relationship seems to be the catalyst that allows hope to develop exponentially. 3. A belief in the clients abilities can be a powerful motivator for change.

Fidelity and Recovery-Orientation in Assertive Community Treatment

There has been increasing commentary about the degree to which Assertive Community Treatment (ACT) teams provide recovery-oriented services, often centered around the question of the use of coercion. The present study was designed to contribute to this discussion through an examination of recovery-oriented service provision and ACT fidelity among 67 teams in the province of Ontario, Canada. The findings indicated a moderate to high degree of recovery orientation in service provision, with no significant relationship between ACT fidelity and consumer and family/key support ratings of recovery orientation. A significant relationship was found, however, between the ‘nature of services’ domain of the Dartmouth Assertive Community Treatment Scale (DACTS) and ratings of recovery orientation provided by staff and ACT coordinators. These findings extend the existing dialogue regarding the evaluation of ACT intervention process factors and indicate that current measures of fidelity may not be adequately addressing dimensions of recovery-oriented service provision.

Factors Influencing Staff Hopefulness in Working with People with Schizophrenia

This qualitative study identifies factors that influence staff hopefulness in their work with individuals with schizophrenia. Fifteen mental health professionals from both inpatient and community settings were interviewed via a semi-structured questionnaire. Subjects described the following as important to their hopefulness: knowing clients as people, sharing client successes, and receiving recognition for their accomplishments. Several educational, research, and system issues were also identified as influencing hopefulness. Respondents also described barriers to hopefulness arising from clients, coworkers and public attitudes. The relevance of these findings to promoting hopeful working environments is discussed.

Getting to know Mark, a homeless alcohol-dependent artist, as he finds his way out of the river

Managed Alcohol Programs (MAPs) are a relatively recent addition to the repertoire of harm reduction approaches for persons experiencing severe alcohol dependence. In these settings, clients, who are typically homeless, are provided with a maintenance amount of alcohol while residing in a shelter setting. This case study examines the living experience of a homeless alcohol-dependent client of a MAP in an effort to articulate the process factors related to engagement with this form of treatment. The participant, a 48-year-old white male, participated in a series of qualitative interviews that took place prior to admission, immediately following admission, following re-admission, and after completion of the program over the course of 18 months. A grounded theory approach to data analysis was undertaken. The findings suggest that the primary utility of the MAP was in stabilizing a range of problems such that he was provided with the time, energy, and resources necessary to engage in the critically important task of constructing valued identity, place, and meaning and purpose in life.

The Reasons to Go On Living Project: stories of recovery after a suicide attempt

ABSTRACT Qualitative research in suicidology has become increasingly common in the literature. Lakeman and FitzGerald (2008) conducted a review of qualitative works specifically on suicide and recovery. Five interconnected themes—suffering/psychache, struggle, connection, turning points, and suicide and coping—were identified. The Reasons to Go On Living Project (RTGOL) project was a web-based narrative research project that sought to understand the transition from making a suicide attempt to choosing life. This article reports the findings of a secondary analysis of the narratives. By using Lakeman and FitzGerald’s themes as a starting point, one hundred and thirteen submissions were thematically analyzed using a deductive approach. The findings are mostly consistent with the interconnected themes identified by Lakeman and FitzGerald. Moreover, subthemes were identified to better reflect the lived experience of the participants. Clinical and research implications of this project will be discussed.

The Hope Research Community of Practice: Building Advanced Practice Nurses’ Research Capacity

Background Clinical nurses have multiple challenges in conducting high-quality nursing research to inform practice. Theoretically, the development of a community of practice on nursing research centered on the concept of hope is an approach that may address some of the challenges. Purpose This article describes the delivery and evaluation of a hope research community of practice (HRCoP) approach to facilitate research expertise in a group of advanced practice nurses in one hospital. It addressed the question: Does the establishment of a HRCoP for master’s prepared nurses increase their confidence and competence in leading nursing research? Method Using interpretive descriptive qualitative research methodology, five participants were interviewed about their experiences within the HRCoP and facilitators engaged in participant observation. Results At 13 months, only four of the original seven participants remained in the HRCoP. While all participants discussed positive impacts of participation, they identified challenges of having protected time to complete their individual research projects, despite having administrative support to do so. Progress on individual research projects varied. Conclusion Nurse-led research remains a challenge for practicing nurses despite participating in an evidence-based HRCoP. Lessons learned from this project can be useful to other academic clinical partnerships.