Recovery-oriented nursing service for people with schizophrenia in the community: An integrative review
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Keywords

schizophrenia
mental health services
mental disorders
recovery
quality of life
nurses

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Thongsalab, J., Yunibhand, J., & Uthis, P. (2023). Recovery-oriented nursing service for people with schizophrenia in the community: An integrative review. Belitung Nursing Journal, 9(3), 198–208. https://doi.org/10.33546/bnj.2632
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Accepted for publication: 2023-05-22
Peer reviewed: Yes

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Abstract

Background: The recovery-oriented service concept has been recognized for its impact on mental health practices and services. As the largest group of mental healthcare providers, mental health nurses are well-positioned to deliver recovery-oriented services but face challenges due to role ambiguity and identity issues. Therefore, clarifying the role and principles of mental health nursing is essential.

Objective: This study aimed to identify essential nursing practices for individuals with schizophrenia in recovery-oriented mental health services.

Design: The study utilized a five-step integrative review approach, including problem identification, literature search definition, critical analysis of methodological quality, data analysis, and data presentation.

Data Sources: Multiple databases, such as ScienceDirect and Scopus, as well as online libraries and journals/publishers, including Sage journals, APA PsyNet, SpringerLink, PsychiatryOnline, Taylor & Francis Online, and Wiley Online Library, were searched. The search spanned from the inception of the recovery-oriented services concept in 1993 to 2022.

Review Methods: Content and thematic analysis were employed to analyze and synthesize the findings from the included studies.

Results: Twenty-four articles met the inclusion criteria. Two themes were identified: 1) Direct nursing care, consisting of six sub-themes: therapeutic nurse-patient relationship (TNPR), psychoeducation (PE), coping skill training (CST), cognitive behavioral techniques (CBT), interventions to improve medication adherence (IMA), and social functioning (SF); and 2) Indirect nursing care.

Conclusion: This study highlights the crucial role of nursing and nursing practices in recovery-oriented services. Mental health nurses prioritize person-centered care, therapeutic relationships, and collaboration with peer support workers to enhance treatment effectiveness. In addition, they focus on improving medication adherence, providing coping support, and promoting social capabilities, ultimately improving individuals’ quality of life. Aligning actions with recovery-oriented principles, mental health nurses emphasize empowerment and holistic care. Further research in this area will enhance the healthcare system and better support individuals on their recovery journey.

https://doi.org/10.33546/bnj.2632
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Copyright (c) 2023 Jutharat Thongsalab, Jintana Yunibhand, Penpaktr Uthis

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Declaration of Conflicting Interest

The authors declared that there is no conflict of interest in this study.

Acknowledgment

The authors acknowledge the Faculty of Nursing, Chulalongkorn University, for the support.

Authors’ Contributions

JT conceived the presented idea, conducted the literature search, and modified and designed the figures and table. JY helped shape the research and was in charge of overall direction and planning, verified the content analytical methods, encouraged JT to extract the data, contributed to interpreting the results, and supervised the findings of this work. PU encouraged JT and verified the analytical methods. JT wrote the manuscript with support and reviewed it from JY and PU. All authors provided critical feedback, discussed the results, and contributed to the final manuscript. All authors agreed with the article’s final version and were accountable for each part of this study.

Data Availability

Data for content and thematic analysis can be seen in the supplementary file.

Ethical Consideration

This paper is part of the dissertation of Miss Jutharat Thongsalab, a PhD student in the Faculty of Nursing at Chulalongkorn University, Thailand, entitled “Factors predicting personal recovery among persons with schizophrenia living in community, Thailand.”

Declaration of Use of AI in Scientific Writing

Nothing to disclose.


References

Abt, M., Lequin, P., Bobo, M. L., Vispo Cid Perrottet, T., Pasquier, J., & Ortoleva Bucher, C. (2022). The scope of nursing practice in a psychiatric unit: A time and motion study. Journal of Psychiatric and Mental Health Nursing, 29(2), 297-306. https://doi.org/10.1111/jpm.12790

American Nurses Association (ANA). (2007). Psychiatric-mental health nursing: Scope and standards of practice. Silver Spring, Maryland: American Nurses Publishing.

Ayano, G. (2016). Schizophrenia: a concise overview of etiology, epidemiology diagnosis and management: Review of literatures. Journal of Schizophrenia Research, 3(2), 2-7.

Badu, E., O’brien, A. P., & Mitchell, R. (2021). An integrative review of recovery services to improve the lives of adults living with severe mental illness. International Journal of Environmental Research and Public Health, 18(16), 8873. https://doi.org/10.3390/ijerph18168873

Bäuml, J., Froböse, T., Kraemer, S., Rentrop, M., & Pitschel-Walz, G. (2006). Psychoeducation: A basic psychotherapeutic intervention for patients with schizophrenia and their families. Schizophrenia Bulletin, 32(suppl_1), S1-S9. https://doi.org/10.1093/schbul/sbl017

Bond, G. R., & Drake, R. E. (2015). The critical ingredients of assertive community treatment. World Psychiatry, 14(2), 240-242. https://doi.org/10.1002%2Fwps.20234

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa

Butcher, H. K., Bulechek, G. M., Dochterman, J. M., & Wagner, C. M. (2018). Nursing interventions classification (NIC)-E-Book (7th ed.). St. Louis, Missouri: Elsevier Health Sciences.

Camann, M. A. (2010). The psychiatric nurse's role in application of recovery and decision-making models to integrate health behaviors in the recovery process. Issues in Mental Health Nursing, 31(8), 532-536. https://doi.org/10.3109/01612841003687316

Canacott, L., Moghaddam, N., & Tickle, A. (2019). Is the Wellness Recovery Action Plan (WRAP) efficacious for improving personal and clinical recovery outcomes? A systematic review and meta-analysis. Psychiatric Rehabilitation Journal, 42(4), 372-381. https://doi.org/10.1037/prj0000368

Cavelti, M., Homan, P., & Vauth, R. (2016). The impact of thought disorder on therapeutic alliance and personal recovery in schizophrenia and schizoaffective disorder: An exploratory study. Psychiatry Research, 239, 92-98. https://doi.org/10.1016/j.psychres.2016.02.070

Chan, K. K. S., Yip, C. C. H., & Tsui, J. K. C. (2023). Self-compassion mediates the impact of family support on clinical and personal recovery among people with mental illness. Mindfulness, 14(3), 720-731. https://doi.org/10.1007/s12671-023-02088-6

Chan, R. C. H., Mak, W. W. S., & Lam, M. Y. Y. (2018). Self-stigma and empowerment as mediating mechanisms between ingroup perceptions and recovery among people with mental illness. Stigma and Health, 3(3), 283-293. https://doi.org/10.1037/sah0000100

Chester, P., Ehrlich, C., Warburton, L., Baker, D., Kendall, E., & Crompton, D. (2016). What is the work of recovery oriented practice? A systematic literature review. International Journal of Mental Health Nursing, 25(4), 270-285. https://doi.org/10.1111/inm.12241

Chinman, M., Young, A. S., Hassell, J., & Davidson, L. (2006). Toward the implementation of mental health consumer provider services. The Journal of Behavioral Health Services & Research, 33(2), 176-195. https://doi.org/10.1007/s11414-006-9009-3

Compton, M. T., Reed, T., Broussard, B., Powell, I., Thomas, G. V., Moore, A., Cito, K., & Haynes, N. (2014). Development, implementation, and preliminary evaluation of a recovery-based curriculum for community navigation specialists working with individuals with serious mental illnesses and repeated hospitalizations. Community Mental Health Journal, 50, 383-387. https://doi.org/10.1007/s10597-013-9598-2

Cook, J. A., Copeland, M. E., Hamilton, M. M., Jonikas, J. A., Razzano, L. A., Floyd, C. B., Hudson, W. B., Macfarlane, R. T., & Grey, D. D. (2009). Initial outcomes of a mental illness self-management program based on wellness recovery action planning. Psychiatric Services, 60(2), 246-249. https://doi.org/10.1176/ps.2009.60.2.246

Cook, J. A., Steigman, P., Pickett, S., Diehl, S., Fox, A., Shipley, P., MacFarlane, R., Grey, D. D., & Burke-Miller, J. K. (2012). Randomized controlled trial of peer-led recovery education using Building Recovery of Individual Dreams and Goals through Education and Support (BRIDGES). Schizophrenia Research, 136(1), 36-42. https://doi.org/10.1016/j.schres.2011.10.016

Davidson, L., & Guy, K. (2012). Peer support among persons with severe mental illnesses: A review of evidence and experience. World Psychiatry, 11(2), 123-128. https://doi.org/10.1016/j.wpsyc.2012.05.009

Doughty, C., Tse, S., Duncan, N., & McIntyre, L. (2008). The wellness recovery action plan (WRAP): Workshop evaluation. Australasian Psychiatry, 16(6), 450-456. https://doi.org/10.1080/10398560802043705

Färdig, R., Lewander, T., Melin, L., Folke, F., & Fredriksson, A. (2011). A randomized controlled trial of the illness management and recovery program for persons with schizophrenia. Psychiatric Services, 62(6), 606-612. https://doi.org/10.1176/ps.62.6.pss6206_0606

Frost, B. G., Tirupati, S., Johnston, S., Turrell, M., Lewin, T. J., Sly, K. A., & Conrad, A. M. (2017). An Integrated Recovery-oriented Model (IRM) for mental health services: Evolution and challenges. BMC Psychiatry, 17(1), 1-17. https://doi.org/10.1186/s12888-016-1164-3

Fujita, E., Kato, D., Kuno, E., Suzuki, Y., Uchiyama, S., Watanabe, A., Uehara, K., Yoshimi, A., & Hirayasu, Y. (2010). Implementing the illness management and recovery program in Japan. Psychiatric Services, 61(11), 1157-1161. https://doi.org/10.1176/ps.2010.61.11.1157

Fukui, S., Starnino, V. R., Susana, M., Davidson, L. J., Cook, K., Rapp, C. A., & Gowdy, E. A. (2011). Effect of Wellness Recovery Action Plan (WRAP) participation on psychiatric symptoms, sense of hope, and recovery. Psychiatric Rehabilitation Journal, 34(3), 214-222. https://doi.org/10.2975/34.3.2011.214.222

Gates, L. B., & Akabas, S. H. (2007). Developing strategies to integrate peer providers into the staff of mental health agencies. Administration and Policy in Mental Health and Mental Health Services Research, 34, 293-306. https://doi.org/10.1007/s10488-006-0109-4

Grant, P. M., Bredemeier, K., & Beck, A. T. (2017). Six-month follow-up of recovery-oriented cognitive therapy for low-functioning individuals with schizophrenia. Psychiatric Services, 68(10), 997-1002. https://doi.org/10.1176/appi.ps.201600413

Grant, P. M., Huh, G. A., Perivoliotis, D., Stolar, N. M., & Beck, A. T. (2012). Randomized trial to evaluate the efficacy of cognitive therapy for low-functioning patients with schizophrenia. Archives of General Psychiatry, 69(2), 121-127. https://doi.org/10.1001/archgenpsychiatry.2011.129

Grove, S. K., Burns, N., & Gray, J. (2012). The practice of nursing research: Appraisal, synthesis, and generation of evidence (7th ed.). St.Louis, Missouri: Elsevier Health Sciences.

Harris, B., & Panozzo, G. (2019). Barriers to recovery‐focused care within therapeutic relationships in nursing: Attitudes and perceptions. International Journal of Mental Health Nursing, 28(5), 1220-1227. https://doi.org/10.1111/inm.12611

Heffernan, C. J. (1988). Social foundations of thought and action: A social cognitive theory, Albert Bandura Englewood Cliffs, New Jersey: Prentice Hall, 1986, xiii+ 617 pp. Hardback. US $39.50. Behaviour Change, 5(1), 37-38. https://doi.org/10.1017/S0813483900008238

Hercelinskyj, G., Cruickshank, M., Brown, P., & Phillips, B. (2014). Perceptions from the front line: Professional identity in mental health nursing. International Journal of Mental Health Nursing, 23(1), 24-32. https://doi.org/10.1111/inm.12001

Hewitt, J., & Coffey, M. (2005). Therapeutic working relationships with people with schizophrenia: Literature review. Journal of Advanced Nursing, 52(5), 561-570. https://doi.org/10.1111/j.1365-2648.2005.03623.x

Higgins, A., Callaghan, P., DeVries, J., Keogh, B., Morrissey, J., Nash, M., Ryan, D., Gijbels, H., & Carter, T. (2012). Evaluation of mental health recovery and Wellness Recovery Action Planning education in Ireland: A mixed methods pre–postevaluation. Journal of Advanced Nursing, 68(11), 2418-2428. https://doi.org/10.1111/j.1365-2648.2011.05937.x

Hopia, H., Latvala, E., & Liimatainen, L. (2016). Reviewing the methodology of an integrative review. Scandinavian Journal of Caring Sciences, 30(4), 662-669. https://doi.org/10.1111/scs.12327

Jackson-Blott, K., Hare, D., Davies, B., & Morgan, S. (2019). Recovery-oriented training programmes for mental health professionals: A narrative literature review. Mental Health & Prevention, 13, 113-127. https://doi.org/10.1016/j.mhp.2019.01.005

Kaewprom, C., Curtis, J., & Deane, F. P. (2011). Factors involved in recovery from schizophrenia: A qualitative study of Thai mental health nurses. Nursing & Health Sciences, 13(3), 323-327. https://doi.org/10.1111/j.1442-2018.2011.00621.x

Kakushi, L. E., & Évora, Y. D. M. (2014). Direct and indirect nursing care time in an intensive care unit. Revista Latino-Americana de Enfermagem, 22, 150-157. https://doi.org/10.1590/0104-1169.3032.2381

Kopelowicz, A., Liberman, R. P., & Zarate, R. (2006). Recent advances in social skills training for schizophrenia. Schizophrenia Bulletin, 32(suppl_1), S12-S23. https://doi.org/10.1093/schbul/sbl023

Kukla, M., Salyers, M. P., & Lysaker, P. H. (2013). Levels of patient activation among adults with schizophrenia: Associations with hope, symptoms, medication adherence, and recovery attitudes. The Journal of Nervous and Mental Disease, 201(4), 339-344. https://doi.org/10.1097/NMD.0b013e318288e253

Kvrgic, S., Cavelti, M., Beck, E.-M., Rüsch, N., & Vauth, R. (2013). Therapeutic alliance in schizophrenia: The role of recovery orientation, self-stigma, and insight. Psychiatry Research, 209(1), 15-20. https://doi.org/10.1016/j.psychres.2012.10.009

Le Boutillier, C., Chevalier, A., Lawrence, V., Leamy, M., Bird, V. J., Macpherson, R., Williams, J., & Slade, M. (2015). Staff understanding of recovery-orientated mental health practice: A systematic review and narrative synthesis. Implementation Science, 10, 1-14. https://doi.org/10.1186/s13012-015-0275-4

Lee, C. C., Liem, S. K., Leung, J., Young, V., Wu, K., Kenny, K. K. W., Yuen, S. K., Lee, W. F., Leung, T., & Shum, M. (2015). From deinstitutionalization to recovery-oriented assertive community treatment in Hong Kong: What we have achieved. Psychiatry Research, 228(3), 243-250. https://doi.org/10.1016/j.psychres.2015.05.106

Levitt, A. J., Mueser, K. T., DeGenova, J., Lorenzo, J., Bradford-Watt, D., Barbosa, A., Karlin, M., & Chernick, M. (2009). Randomized controlled trial of illness management and recovery in multiple-unit supportive housing. Psychiatric Services, 60(12), 1629-1636. https://doi.org/10.1176/ps.2009.60.12.1629

Luciano, A., Bond, G. R., & Drake, R. E. (2014). Does employment alter the course and outcome of schizophrenia and other severe mental illnesses? A systematic review of longitudinal research. Schizophrenia Research, 159(2-3), 312-321. https://doi.org/10.1016/j.schres.2014.09.010

Lyman, D. R., Kurtz, M. M., Farkas, M., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Skill building: Assessing the evidence. Psychiatric Services, 65(6), 727-738. https://doi.org/10.1176/appi.ps.201300251

Macias, C., Kinney, R., Farley, O. W., Jackson, R., & Vos, B. (1994). The role of case management within a community support system: partnership with psychosocial rehabilitation. Community Mental Health Journal, 30, 323-339. https://doi.org/10.1007/BF02207486

Mak, W. W. S., Chan, R. C. H., Pang, I. H. Y., Chung, N. Y. L., Yau, S. S. W., & Tang, J. P. S. (2016). Effectiveness of wellness recovery action planning (WRAP) for Chinese in Hong Kong. American Journal of Psychiatric Rehabilitation, 19(3), 235-251. https://doi.org/10.1080/15487768.2016.1197859

Moran, G. S., Russinova, Z., Gidugu, V., & Gagne, C. (2013). Challenges experienced by paid peer providers in mental health recovery: A qualitative study. Community Mental Health Journal, 49, 281-291. https://doi.org/10.1007/s10597-012-9541-y

Mueser, K. T., Corrigan, P. W., Hilton, D. W., Tanzman, B., Schaub, A., Gingerich, S., Essock, S. M., Tarrier, N., Morey, B., & Vogel-Scibilia, S. (2002). Illness management and recovery: A review of the research. Psychiatric Services, 53(10), 1272-1284. https://doi.org/10.1176/appi.ps.53.10.1272

Nowak, I., Sabariego, C., Świtaj, P., & Anczewska, M. (2016). Disability and recovery in schizophrenia: A systematic review of cognitive behavioral therapy interventions. BMC Psychiatry, 16(1), 1-15. https://doi.org/10.1186/s12888-016-0912-8

O'Carroll, R. (2000). Cognitive impairment in schizophrenia. Advances in Psychiatric Treatment, 6(3), 161-168. https://doi.org/10.1192/apt.6.3.161

Pai, N., Dark, F., & Castle, D. (2021). The importance of employment for recovery in people with severe mental illness. Journal of Psychosocial Rehabilitation and Mental Health, 8, 217–219. https://doi.org/10.1007/s40737-021-00245-5

Petros, R., & Solomon, P. (2021). How adults with serious mental illness learn and use wellness recovery action plan’s recovery framework. Qualitative Health Research, 31(4), 631-642. https://doi.org/10.1177/1049732320975729

Repper, J., & Carter, T. (2011). A review of the literature on peer support in mental health services. Journal of Mental Health, 20(4), 392-411. https://doi.org/10.3109/09638237.2011.583947

Rossi, A., Amore, M., Galderisi, S., Rocca, P., Bertolino, A., Aguglia, E., Amodeo, G., Bellomo, A., Bucci, P., & Buzzanca, A. (2018). The complex relationship between self-reported ‘personal recovery’and clinical recovery in schizophrenia. Schizophrenia Research, 192, 108-112. https://doi.org/10.1016/j.schres.2017.04.040

Salyers, M. P., McGuire, A. B., Kukla, M., Fukui, S., Lysaker, P. H., & Mueser, K. T. (2014). A randomized controlled trial of illness management and recovery with an active control group. Psychiatric Services, 65(8), 1005-1011. https://doi.org/10.1176/appi.ps.201300354

Shalaby, R. A. H., & Agyapong, V. I. O. (2020). Peer support in mental health: Literature review. JMIR Mental Health, 7(6), e15572. https://doi.org/10.2196/15572

Sirriyeh, R., Lawton, R., Gardner, P., & Armitage, G. (2012). Reviewing studies with diverse designs: The development and evaluation of a new tool. Journal of Evaluation in Clinical Practice, 18(4), 746-752. https://doi.org/10.1111/j.1365-2753.2011.01662.x

Slade, M. (2010). Mental illness and well-being: The central importance of positive psychology and recovery approaches. BMC Health Services Research, 10(1), 1-14. https://doi.org/10.1186/1472-6963-10-26

Slade, M., Amering, M., Farkas, M., Hamilton, B., O'Hagan, M., Panther, G., Perkins, R., Shepherd, G., Tse, S., & Whitley, R. (2014). Uses and abuses of recovery: Implementing recovery‐oriented practices in mental health systems. World Psychiatry, 13(1), 12-20. https://doi.org/10.1002/wps.20084

Slade, M., Bird, V., Clarke, E., Le Boutillier, C., McCrone, P., Macpherson, R., Pesola, F., Wallace, G., Williams, J., & Leamy, M. (2015). Supporting recovery in patients with psychosis through care by community-based adult mental health teams (REFOCUS): A multisite, cluster, randomised, controlled trial. The Lancet Psychiatry, 2(6), 503-514. https://doi.org/10.1016/S2215-0366(15)00086-3

Slade, M., Bird, V., Le Boutillier, C., Williams, J., McCrone, P., & Leamy, M. (2011). REFOCUS Trial: protocol for a cluster randomised controlled trial of a pro-recovery intervention within community based mental health teams. BMC Psychiatry, 11(1), 1-13. https://doi.org/10.1186/1471-244X-11-185

Stanard, R. P. (1999). The effect of training in a strengths model of case management on client outcomes in a community mental health center. Community Mental Health Journal, 35, 169-179. https://doi.org/10.1023/A:1018724831815

Tasijawa, F. A., Suryani, S., Sutini, T., & Maelissa, S. R. (2021). Recovery from ‘schizophrenia’: Perspectives of mental health nurses in the Eastern island of Indonesia. Belitung Nursing Journal, 7(4), 336-345. https://doi.org/10.33546/bnj.1621

Tondora, J., Miller, R., Slade, M., & Davidson, L. (2014). Partnering for recovery in mental health: A practical guide to person-centered planning. Oxford: John Wiley & Sons.

Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing & Health Sciences, 15(3), 398-405. https://doi.org/10.1111/nhs.12048

van Gestel-Timmermans, H., Brouwers, E. P. M., van Assen, M. A. L. M., & van Nieuwenhuizen, C. (2012). Effects of a peer-run course on recovery from serious mental illness: A randomized controlled trial. Psychiatric Services, 63(1), 54-60. https://doi.org/10.1176/appi.ps.201000450

Vita, A., Gaebel, W., Mucci, A., Sachs, G., Barlati, S., Giordano, G. M., Nibbio, G., Nordentoft, M., Wykes, T., & Galderisi, S. (2022). European Psychiatric Association guidance on treatment of cognitive impairment in schizophrenia. European Psychiatry, 65(1), e57. https://doi.org/10.1192/j.eurpsy.2022.2315

Walby, G. W. (2007). Associations between individual, social, and service factors, recovery expectations and recovery strategies for individuals with mental illness [Dissertation, University of South Florida]. Florida.

Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52(5), 546-553. https://doi.org/10.1111/j.1365-2648.2005.03621.x

Xu, Z.-Y., Zu, S., Xiang, Y.-T., Wang, N., Guo, Z.-H., Kilbourne, A. M., Brabban, A., Kingdon, D., & Li, Z.-J. (2013). Associations of self-esteem, dysfunctional beliefs and coping style with depression in patients with schizophrenia: A preliminary survey. Psychiatry Research, 209(3), 340-345. https://doi.org/10.1016/j.psychres.2013.02.012


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