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Exeter, United Kingdom

Hodge S.,Center for Quality Improvement | Doncaster E.,Center for Quality Improvement | Moniz-Cook E.,University of Hull | Purandare N.,Mental Health Research Group | Orrell M.,University College London
Aging Health | Year: 2013

Aim: To evaluate patients' and carers' experiences of attending UK memory services. Methods: As part of their enrollment in the Memory Services National Accreditation Programme, memory services sent questionnaires to patients and carers about their experiences of attending the service. Results: A total of 298 carers and 280 individuals with dementia from 21 memory services responded. People were very satisfied with the diagnostic processes and staff courtesy; however, there was a lack of written information across a range of key areas. In general, carers were better informed than patients but lacked information on respite care or how to get a carers' assessment. Carers were more likely than patients to feel pressurized into making decisions about treatment. Conclusion: This study provides the first profile of the experiences of patients and carers attending memory services. Although in general they were very satisfied with the care received, more needs to be done to improve the provision of information. © 2013 Future Medicine Ltd.

McCabe R.,Queen Mary, University of London | Healey P.G.T.,Queen Mary, University of London | Priebe S.,Queen Mary, University of London | Lavelle M.,Queen Mary, University of London | And 4 more authors.
Patient Education and Counseling | Year: 2013

Objective: Effective doctor-patient communication, including a shared understanding, is associated with treatment adherence across medicine. However, communication is affected by a diagnosis of schizophrenia and reaching a shared understanding can be challenging. During conversation, people detect and deal with possible misunderstanding using a conversational process called repair. This study tested the hypothesis that more frequent repair in psychiatrist-patient communication is associated with better treatment adherence in schizophrenia. Methods: Routine psychiatric consultations involving patients with (DSM-IV) schizophrenia or schizoaffective disorder were audio-visually recorded. Consultations were coded for repair and patients' symptoms and insight assessed. Adherence was assessed six months later. A principal components analysis reduced the repair data for further analysis. Random effects models examined the association between repair and adherence, adjusting for symptoms, consultation length and the amount patients spoke. Results: 138 consultations were recorded, 118 were followed up. Patients requesting clarification of the psychiatrist's talk and the clarification provided by the psychiatrist was associated with adherence six months later (OR 5.82, 95% CI 1.31-25.82, p= 0.02). Conclusion: The quality of doctor-patient communication also appears to influence adherence in schizophrenia. Practice implications: Future research should investigate how patient clarification can be encouraged among patients and facilitated by psychiatrists' communication. © 2013 The Authors.

Darvill R.,Mental Health Research Group | Skirton H.,University of Plymouth | Farrand P.,Mental Health Research Group
Midwifery | Year: 2010

Objective: childbearing is a significant transition, especially for first-time mothers. The objectives of this study were to explore the maternal transition from womens' perspectives and to identify any unmet needs for support. Design: grounded theory was chosen as the most appropriate method of analysis due to its ability to identify social processes in an inductive way. Semi-structured interviews were used to collect data from the participants, and the interview transcripts were analysed using the constant comparative method. Setting: communities within one region of the UK. Participants: 13 women (aged ≥16 years) who had delivered their first child six to 15 weeks prior to the interview were recruited to the study. Findings: three main themes (control, support and forming a family) all contributed to the core category: 'changes in the woman's self-concept'. Women felt that they had lost some control over their lives in the early stages of pregnancy and after the birth. The early changes in their self-image and the shift in focus from themselves to the needs of the fetus indicate that the transition may begin at a very early stage in the first trimester. The unfamiliar territory of pregnancy and early motherhood created a need for a mentor or mentors to help guide them through the transition, and to 'normalise' their feelings and experiences. Finally, the women recognised that the act of childbearing fundamentally transformed them and their partners from individuals or a couple into founding members of a new family. Key conclusions: first-time mothers start to undergo a transition at an early stage in their pregnancy. They face difficult periods both early in the pregnancy and after the birth, and have unmet needs for support in those periods, particularly the support of other new mothers. Implications for practice: providing more information about early pregnancy before conception may enable women to form more accurate expectations of this period. Facilitating contact between pregnant mothers would help them to establish a more appropriate support network prior to the birth. © 2008 Elsevier Ltd.

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