Comparison of Resilience, Personal Recovery, and Quality of Life Measures Pre- and Post-Discharge from Inpatient Mental Health Units in Alberta: Analysis of Control Group Data from a Randomized Trial.

Ernest Owusu, Reham Shalaby, Hossam Elgendy, Wanying Mao, Nermin Shalaby, Belinda Agyapong, Angel Nichols, Ejemai Eboreime, Nnamdi Nkire, Mobolaji A Lawal, Vincent I O Agyapong
Author Information
  1. Ernest Owusu: Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada. ORCID
  2. Reham Shalaby: Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada. ORCID
  3. Hossam Elgendy: Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada.
  4. Wanying Mao: Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada. ORCID
  5. Nermin Shalaby: Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada.
  6. Belinda Agyapong: Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada. ORCID
  7. Angel Nichols: Queen Elizabeth II Hospital, Alberta Health Services, Grande Prairie, AB T5J 3E4, Canada.
  8. Ejemai Eboreime: Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada. ORCID
  9. Nnamdi Nkire: Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada.
  10. Mobolaji A Lawal: Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada.
  11. Vincent I O Agyapong: Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada. ORCID

Abstract

The transition from hospital to community settings for most mental health service users is often hindered by challenges that affect community adjustment and continuity of care. The first few weeks and days after discharge from mental health inpatient units represent a critical phase for many service users. This paper aims to evaluate the changes in the resilience, personal recovery, and quality of life status of individuals with mental health challenges recently discharged from acute mental health care into the community. Data for this study were collected as part of a pragmatic stepped-wedge cluster-randomized, longitudinal approach in Alberta. A paired sample -test and Chi-squared/Fisher test were deployed to assess changes from baseline to six weeks in the recovery assessment scale (RAS), brief resilience scale (BRS), and EuroQol-5d (EQ-5D), using an online questionnaire. A total of 306 service users were recruited and 88 completed both baseline and six weeks, giving a response rate of 28.8%. There was no statistically significant change in the level of resilience, recovery and quality of life as measured with the brief resilience scale, recovery assessment scale and EQ-5D from baseline to six weeks ( > 0.05). The study showed that there was neither an improvement nor deterioration in resilience, recovery, or quality of life status of service users six weeks post-discharge from inpatient mental health care. The lack of further progress calls into question whether the support available in the community when patient's leave inpatient care is adequate to promote full recovery. The results justify investigations into the effectiveness of innovative and cost-effective programs such as peer and text-based supportive interventions for service users discharged from inpatient psychiatric care.

Keywords

References

  1. JMIR Form Res. 2022 Jan 11;6(1):e33438 [PMID: 35014972]
  2. Front Psychiatry. 2022 Jun 24;13:921982 [PMID: 35815033]
  3. Healthcare (Basel). 2022 Sep 19;10(9): [PMID: 36141418]
  4. Lancet. 2000 Feb 19;355(9204):594 [PMID: 10696977]
  5. J Clin Nurs. 2014 May;23(9-10):1175-85 [PMID: 23844598]
  6. Qual Life Res. 2021 Mar;30(3):647-673 [PMID: 33284428]
  7. World Psychiatry. 2012 Jun;11(2):123-8 [PMID: 22654945]
  8. J Affect Disord. 2022 Aug 1;310:422-428 [PMID: 35569609]
  9. JMIR Ment Health. 2020 Jun 9;7(6):e15572 [PMID: 32357127]
  10. Arch Clin Neuropsychol. 2016 Sep;31(6):506-16 [PMID: 27475282]
  11. Stress Health. 2016 Apr;32(2):145-56 [PMID: 24962138]
  12. Schizophr Bull. 2009 Jul;35(4):696-703 [PMID: 19491314]
  13. J Biomed Inform. 2009 Apr;42(2):377-81 [PMID: 18929686]
  14. Qual Health Res. 2012 Sep;22(9):1232-46 [PMID: 22745363]
  15. Int J Ment Health Nurs. 2018 Apr;27(2):571-580 [PMID: 28440016]
  16. J Med Internet Res. 2016 Jun 10;18(6):e135 [PMID: 27287668]
  17. Psychiatr Serv. 2014 Apr 1;65(4):442-53 [PMID: 24487405]
  18. J Subst Abuse Treat. 2018 Nov;94:74-80 [PMID: 30243421]
  19. EClinicalMedicine. 2020 Jun 27;24:100442 [PMID: 32775969]
  20. Work. 2018;59(4):585-598 [PMID: 29733044]
  21. BMC Psychiatry. 2014 Feb 05;14:30 [PMID: 24495599]
  22. BMJ. 1994 Dec 10;309(6968):1542-6 [PMID: 7819893]
  23. Psychiatr Serv. 2017 Jul 1;68(7):696-703 [PMID: 28245702]
  24. Psychiatr Q. 2021 Jun;92(2):459-471 [PMID: 32803473]
  25. Health Syst Transit. 2020 Nov;22(3):1-194 [PMID: 33527903]
  26. Psychiatr Rehabil J. 2013 Mar;36(1):28-34 [PMID: 23477647]
  27. Community Ment Health J. 1999 Jun;35(3):231-9 [PMID: 10401893]
  28. Ther Adv Psychopharmacol. 2021 Jun 25;11:20451253211027449 [PMID: 34262690]
  29. Int J Environ Res Public Health. 2021 Jun 09;18(12): [PMID: 34207537]
  30. J Ment Health. 2011 Aug;20(4):392-411 [PMID: 21770786]
  31. Int J Behav Med. 2008;15(3):194-200 [PMID: 18696313]
  32. Qual Life Res. 2011 Dec;20(10):1727-36 [PMID: 21479777]
  33. Psychiatr Serv. 2014 Apr 1;65(4):429-41 [PMID: 24549400]
  34. Psychol Assess. 2016 Mar;28(3):e1-11 [PMID: 26121387]
  35. Curr Psychol. 2022;41(8):5712-5722 [PMID: 33223782]
  36. Br J Psychiatry. 2006 Feb;188:129-34 [PMID: 16449699]
  37. J Psychiatr Ment Health Nurs. 2011 May;18(4):359-67 [PMID: 21418436]
  38. Curr Health Sci J. 2014 Oct-Dec;40(4):271-3 [PMID: 26793324]
  39. Arch Psychiatr Nurs. 2012 Aug;26(4):261-71 [PMID: 22835746]
  40. Psychiatr Rehabil J. 2016 Sep;39(3):197-203 [PMID: 27183186]
  41. J Psychiatr Ment Health Nurs. 2016 Nov;23(9-10):576-584 [PMID: 27624838]
  42. Clin Trials. 2010 Aug;7(4):368-79 [PMID: 20571133]
  43. J Adv Nurs. 2001 Feb;33(4):456-66 [PMID: 11251733]
  44. BMC Health Serv Res. 2022 Mar 12;22(1):332 [PMID: 35279142]
  45. Health Commun. 2019 May;34(6):631-637 [PMID: 29393685]
  46. Am J Psychiatry. 1997 Mar;154(3):337-40 [PMID: 9054780]
  47. Psychiatr Rehabil J. 2004 Spring;27(4):392-401 [PMID: 15222150]
  48. JMIR Ment Health. 2020 Dec 18;7(12):e22423 [PMID: 33296330]
  49. Health Rep. 2013 Sep;24(9):3-9 [PMID: 24258361]
  50. Adm Policy Ment Health. 2019 May;46(3):352-367 [PMID: 30604004]
  51. Glob J Health Sci. 2015 Sep 28;8(5):145-53 [PMID: 26652085]
  52. J Med Internet Res. 2010 Dec 19;12(5):e74 [PMID: 21169177]
  53. Gerontologist. 1990 Oct;30(5):583-94 [PMID: 2276631]
  54. Curr Opin Psychiatry. 2012 Nov;25(6):551-8 [PMID: 22992544]
  55. JMIR Form Res. 2021 Sep 3;5(9):e27137 [PMID: 34477565]
  56. Soc Work Res. 2012 Mar 1;36(1):41-52 [PMID: 24049433]

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