Recovery Research into Action
Research type
Research Study
Full title
Recovery Research into Action.
IRAS ID
279735
Contact name
Lindsay Thomson
Contact email
Sponsor organisation
The State Hospitals Board for Scotland
Duration of Study in the UK
1 years, 10 months, 31 days
Research summary
Summary of Research
Detailed data regarding the recovery journey, personal and social recovery of individuals who experienced high secure care within The State Hospital has been amassed through ‘The Recovery approach for patients within high secure care: A 20+ Year follow’. This new proposed study aims to build upon those findings to establish thoughts surrounding recovery from the current inpatient population within the State Hospital. This would be established by administering the Questionnaire about the Process of Recovery (QPR) and SAFER to all gatekeeper(consultant) approved patients. By using a test-retest approach involving N = 44 patients the most appropriate recovery tool for use in a high secure forensic cohort could be finalised and a recommendation made.
Data from the QPR and qualitative information (Recovery study) indicated that patients within the State Hospital did not consider themselves to part of a community and therefore removed from the benefits that community dwelling offers in terms of connectedness and social support. Again supported by qualitative data there appeared to be a lack of a sense of empowerment and life with purpose and meaning. To address this it is proposed that Participatory Action Research (PAR) involving the Patient Partnership Group and a small number of staff, an approach best interpreted as an enhanced patient and public (staff) Involvement (PPI) exercise, be undertaken with a view to the PPG creating a piece of peer to peer early intervention/introductory material based on new qualitative interview data. PAR is a research framework which recognizes the knowledge and experience of community members (patients) as equal to those of stakeholders (staff) and researchers and together through a cyclical process, address a ‘problem’ (lack of community) through data collection, analysis and the cogeneration of knowledge.Summary of Results
This study looked at recovery in patients in a high secure setting. It had two elements; a quantitative (measurable) aspect and a qualitative (language focussed) aspect which was undertaken using a Participatory Action Research (patients collaborating equally with the researcher) approach. The whole study was undertaken with patients resident in The State Hospital, the high secure psychiatric hospital for Scotland and Northern Ireland.
Quantitative aspect
Between August 2020 and November 2021, during the COVID pandemic and while following local restrictions, all patients who had capacity the capacity to consent and were well enough to take part were invited to complete two measures (recovery tools) which examined the extent of individuals’ recovery; the Questionnaire about the Process of Recovery-15 (QPR-15) and the Scale for Assessing the Forensic Experience of Recovery (SAFER). Those who agreed completed the measures with the researcher at baseline and again two weeks later.
As defined by the QPR-15, current high secure forensic patients returned a slightly higher average recovery score, with higher scores indicative of recovery, than the QPR reference sample which was composed of people living in the community dwelling who had experienced psychosis. When compared to the 20+ year longitudinal cohort who had previously experienced high secure care in The State Hospital, there were only small differences between the self-rated recovery of those currently in high security as opposed to those who had been in high security care over 20+ years ago. In considering the performance of the QPR and SAFER among a high secure forensic cohort the SAFER provided slightly higher test-retest reliability (score are similar when measured on different occasions) and good internal consistency (it measures recovery well). However, the QPR 15 also performed well indicating that there may be a place for both tests. The QPR offers a quick self-complete tool which may be suitable around psychological course delivery. The SAFER which contains a qualitative element may be more suitable for use within a keyworker discussion or when more in depth exploration of recovery is warranted.
Qualitative aspect (completed in collaboration with patients) The researcher then worked together on an equal basis with patients to create a topic guide about recovery which the researcher used to conduct qualitative interviews with seven other current high secure patients.
Analysis was supported by the collaborators and quotes from the newly conducted interviews along with quotes from the 20+ year longitudinal cohort who had previously experienced high secure care were used to develop a leaflet for patients by patients. The booklet, Get On and Get Out - an easy guide to getting on and moving on from The State Hospital, was fully designed and illustrated by the collaborators, to reflect their story. The collaborators used a river metaphor to convey their pathways and experience of progressing through and becoming ready to move on from the State Hospital. The booklet delivers a lived experience patient perspective of recovery which provides newly admitted patients with advice and words of wisdom. Plans are being finalised for patients to deliver this leaflet in person to new patients in conjunction with the Patient Advocacy Service.
The qualitative aspect of the project, which was presented to the State Hospital Board, was well received. In particular, the positive engagement of patients for patients was commended.REC name
South East Scotland REC 02
REC reference
20/SS/0060
Date of REC Opinion
16 Jun 2020
REC opinion
Further Information Favourable Opinion