Veronica Pearson

What Does Recovery From Schizophrenia Mean? Perceptions of Long-Term Patients

Background: The study investigated the meaning of recovery to eight people with chronic schizophrenia. Method: A qualitative methodology was used based on a 3-hour focus group. The material was transcribed and analysed into 18 subcategories and 4 categories; namely recovery as a multi-dimensional construct, the relationship of medication to recovery, a sense of hopelessness and helplessness about recovery, factors that promoted recovery. Discussion: Respondents believed that full recovery could not be said to have been achieved until they stopped medication and had a steady job. The support and care of family and friends were also vital, although sometimes problematic. Independent living has a different meaning in Chinese culture. Conclusions: Further research directions are suggested as well as ways to change attitudes to the inclusion of medication in recovery.

The relationship between parenting stress and social support in mothers of children with learning disabilities: A Chinese experience

This study examined the relationship between parenting stress and social support in a random sample of 100 mothers with children at a school for children with learning disabilities, and a control group of 75 mothers with similarly aged non-handicapped children. Mothers of children at Zhi Ling school were found to have significantly more stress and significantly less support than those in the control group. Parenting stress in the control group was also found to be relatively high when compared with what are considered to be normal levels in the West. No significant correlation was found between total parenting stress and social support. It is suggested that further studies need to differentiate between satisfaction with support that is actually received and the perceived quality of available support.

Understanding families in their own context: schizophrenia and structural family therapy in Beijing

Evidence from a number of family intervention strategies demonstrates a beneficial impact on the course of schizophrenia. It appears that different family interventions have generic features that aid the patient to avoid relapse and improve functioning. A significant challenge for researchers is to modify these generic strategies to be sensitive to different cultural groups in order to ensure their effectiveness. Chinese culture, with its distinct cultural norms governing family interaction and intense stigma towards the mentally ill, would seem to raise a particular challenge. This paper offers an account of an eclectic model of structural family therapy that incorporates psychoeducation and behavioural treatments for schizophrenia as a theoretical guide to working in a cross–cultural context. A Beijing family, consisting of parents and their daughter with schizophrenia, were seen for sixteen months during a trial of family intervention in China. Through structural family concepts, China’s sociocultural context of treatment resource constraints, population policy and stigma are examined and the impact of the illness on family organization is explored.

What does recovery from psychosis mean? Perceptions of young first-episode patients

Background: This study explored the experience of first-episode psychosis from the patients’ perspective and the meanings they attach to the illness and their recovery. Method: A qualitative methodology was used based on a focus group. Audio tapes were transcribed verbatim and three researchers participated in a content analysis that identified four major themes: the meaning of psychosis and psychotic experience; the meaning of recovery; stigma; and having an optimistic view of recovery. Discussion: Participants’ view of recovery was broader than that often held by psychiatrists, extending beyond symptom control and medication compliance, and they identified positive features that the experience of illness had brought. Their concerns included the side effects of medication and the fear of their illness being disclosed (to employers, university authorities, acquaintances, etc.) in the face of societal stigma. Conclusion: Ideas about what constitutes recovery need to take account of patients’ views and experience in order to emphasize therapeutic optimism rather than pessimism, and to inform treatment contexts and the views of medical staff.

Is something better than nothing? An evaluation of early childhood programs in Cambodia.

This study evaluated the relative effectiveness of home-based, community-based, and state-run early childhood programs across Cambodia. A total of 880 five-year-olds (55% girls) from 6 rural provinces in Cambodia attending State Preschools, Community Preschools, Home-Based Programs, or no programs were assessed twice using the Cambodian Developmental Assessment Test. Controlling for baseline differences, children who participated in any early childhood programs performed significantly better in posttest than those of children who did not participate in any programs. Children in State Preschools scored significantly higher than those in either Community Preschools or Home-Based Programs; scores did not differ as a function of attending Community Preschools or Home-Based Programs. The results indicate that some preschool experience is better than none at all.

Family Burdens, Chinese Health Beliefs, and the Mental Health of Chinese Caregivers in Hong Kong

This study explored the types of family burdens, mental health and Chinese health beliefs of Chinese caregivers with relatives suffering from a serious mental illness. It also examined the impacts of these beliefs on caregivers’ burdens and mental health. A structured questionnaire was administered to 125 Chinese caregivers in out-patient clinics in Hong Kong. Measures included distress (General Health Questionnaire), family burdens and belief in traditional Chinese medicine. Family burdens exerted a significant impact on the mental health of caregivers. Significant differences were found between believers and non-believers of traditional Chinese medical beliefs in terms of financial burdens, disruptions to family interactions and decline in physical health. However, a moderating effect of Chinese health beliefs on family burdens andmental health was found. The lack of a moderating effect of health belief on family burdens may be related to care-givers’ changes in perspectives from a traditional Chinese cultural perspective to a psychosocial and personality perspective. Implications for research and service development are discussed.

What does recovery from schizophrenia mean? Perceptions of medical students and trainee psychiatrists.

Background: The attitudes of medical professionals towards recovery from schizophrenia are key in defining the therapeutic encounter and may change as they move through their medical career. Method: A qualitative methodology was used based on three focus groups of medical students and trainee psychiatrists in Hong Kong. Both held pessimistic attitudes towards recovery in schizophrenia. Four major categories and one central theme emerged, with little difference between students and doctors. The four categories were: (1) recovery is defined by the cessation of medication and the resumption of normal psychosocial functioning; (2) formal recovery requires medical confirmation plus the patient’s admission of illness; (3) recovery should be discussed, but largely in terms of the contribution of drug compliance; and (4) participants recognized that stigma was an impediment to recovery while holding attitudes that were as unaccepting towards people with schizophrenia as lay people’s. Conclusions: Traditional medical education over-emphasizes symptomatic recovery and ignores the need for a more flexible construction of the concept. Professional knowledge must incorporate both quantitative and qualitative data and inculcate humanitarian concern through active contact with users, and acceptance of the legitimacy of their expert experience. Medical education should seek effective ways to change entrenched negative attitudes in students about schizophrenia and the possibility of recovery. Further large-scale research should be carried out to establish attitudes of medical professionals towards recovery from schizophrenia and how this changes during typical career trajectories. This information could then be used to devise effective means within medical education to combat stigma and change attitudes.

The Structure and Content of Social Inclusion: Voices of young adults with learning difficulties in Guangzhou

The aim of the research described here was to examine the issue of social inclusion in relation to young people with a learning difficulty in Guangzhou. Ten families were included in this study based on their willingness to participate. The young people had to be over the age of 16 and not attending school. In each family the young person and a family carer (usually one of the parents) was interviewed separately. The article focuses mainly on the experience and words of the young people who express their feelings towards work and other social contacts. The conclusion is that despite greater government awareness of the needs of people with a disability, and the formulation of social and economic policies designed to encourage inclusion this is far from happening at grassroots level.

Mission Possible; Building Social Work Professional Identity through Fieldwork Placements in China

Social work training programmes in China have increased rapidly in the last decade. Their growth mirrors the increase in social problems that China faces as its economy develops and the disparities between rich and poor multiply. There is little recognition either by the government or citizens of the profession of social work and so no clear idea of what it might achieve. Thus the development of social work in China faces many difficulties among which is a dearth of professionally qualified social workers to teach, and to supervise fieldwork placements. This paper discusses a collaborative MSW programme between the University of Hong Kong and Fudan University in Shanghai. It analyses the growth in professional identity of nine students in the programme undertaking their first supervised fieldwork placement in Shanghai. They were asked to write 500‐word statements before and after their placement about their understanding of the role of social workers and their sense of professional identity. An analysis of these statements forms the basis of this article. The article addresses the issue of whether the construction of a professional identity will rest with members of the embryonic profession or with government bureaucrats largely concerned with the maintenance of stability and the management of social change.

Competing philosophies in the classroom: a challenge to Hong Kong teachers

The present paper examines the experiences of teachers in teaching children with special needs in mainstream schools and how they see and evaluate the feasibility of the new integration initiatives in Hong Kong. The data are based on individual and focus group interviews with general class teachers, resource class teachers and principals of mainstream schools admitting students with special needs. Teachers reported difficulties and problems in maintaining classroom discipline and ambivalence in meeting the competing demands between students with and without special needs. The structural constraints of implementing a rigidly defined curriculum and being accountable for good academic results regardless of student competence pose formidable obstacles in achieving the goals of integrated education. There is a conflict at the systemic level between the philosophy of academic excellence defined by grades on the one hand and the philosophy of equality and inclusion on the other. Improving parent participation, having an ample supply of funds, the provision of necessary equipment and facilities, the availability of pre‐ and in‐service training to teachers, and additional manpower in counselling are the most urgently needed resources in facilitating teachers to engage in teaching students with special needs alongside others.