Improving occupational performance of people with a psychotic disorder post discharge from hospital

Student thesis: Doctoral ThesisDoctor of Philosophy

Abstract

Having a diagnosed psychotic disorder affects a persons’ ability to participate in everyday life. An admission to hospital and deterioration of mental health are disruptions in life that can result in further skill loss and decrease in daily routine. The purpose of this study was to develop and pilot an intervention to improve occupational performance for people with a diagnosed psychotic disorder. The intervention aimed to address specific problems with occupational performance following discharge from hospital.
The study consisted of two stages. The first stage of the study combined four sub-studies to develop an intervention using best available evidence. A literature review of occupational performance and psychosis, focus groups with staff and service users, a systematic review of interventions and a literature review of models of occupational performance were completed to gather the evidence to inform the intervention. The second stage of the study used a quasi-experimental controlled study design to evaluate the developed intervention. A process evaluation was also carried out to assess the implementation of the intervention in clinical practice.
This study generated new knowledge regarding what is known about the problems of occupational performance following discharge from hospital and interventions to address these problems. A stepped intensity 16 week manualised intervention Graduating Living skills Outside the Ward, GLOW, was developed. The results of the pilot study indicated that participants in the intervention group, showed a greater improvement on the primary measure when compared to treatment as usual. Barriers to recruitment were encountered in this study.
Results of the pilot study showed that GLOW is an acceptable intervention to both service users and staff. The intervention was shown to have preliminary evidence of effectiveness. This indicates that GLOW merits further investigation to evaluate its effectiveness. The study recommends methods to increase participation of clinical staff in research.
Date of AwardOct 2013
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorMike Slade (Supervisor) & Claire Henderson (Supervisor)

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