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Young People and Illness Management and Recovery (IMR)

2022年9月29日 更新者:Anne-Lise Holmesland、University Hospital, Akershus

Young People's Experiences of Illness Management and Recovery (IMR) - an Explorative Study

The study is a combined clinical patient outcome study and a health-services research sub-study. Illness management and recovery (IMR) constitutes an evidence-based practice with 11 modules focusing on personal recovery developed for adults with severe mental health illnesses. IMR can be offered in groups or individually, once a week for 10-12 months.

Little is known about how young people experience the utility of IMR treatment groups in child and adolescent mental health outpatient clinics. The primary aim is to explore in-depth how the participants experience the utility of the IMR approach. The health research sub-study will provide new insights into the IMR implementation process in outpatient clinics for adolescents.

調査の概要

詳細な説明

IMR has previously been implemented for adolescents in an inpatient unit in the hospital's catchment area. In order to offer the same treatment to all young patients, IMR treatment groups will be established in 4 out of 7 outpatient clinics in the hospital's catchment area. Participants belonging to the clinics in which no IMR treatment groups are being established will be invited to participate in IMR groups in clinics nearby.

The primary aim is to gain new insight into how young people experience the utility of IMR treatment groups conducted in outpatient practices and, if relevant, which changes could be made to adapt IMR more to young people. To explore how the participants experience the utility of IMR treatment groups, a qualitative focus-group study, consisting of a maximum of 5 focus-group interviews will be conducted. The participants in each IMR treatment group will be offered treatment once a week up to 10-12 months. To establish an IMR treatment group a minimum of 4 patients and a maximum of 8 participants must participate. Participants are mainly being included in the IMR treatment groups at the two primary admissions to each treatment group. Thus, some of the participants in the focus-groups may have participated in IMR groups for less than 10-12 months.

Secondary outcomes are related to fidelity to the model and the extent to which IMR treatment groups are implemented at an organizational level. The treatment groups will be led by trained IMR-therapists employed in inpatient units, together with therapists in training who are employed in outpatient clinics. Leaders and other clinicians in the outpatient clinics will contribute knowledge about the extent to which core components of IMR are being implemented, as well as information relating to quality improvement and individual adjustment. Two of the out-patient clinics in which no IMR group is being established will be included in the sub-study. The clinics will receive written feedback after each measurement time to support quality improvement.

The goal is to include up to 48 participants receiving IMR treatment in outpatient clinics. Up to 8 hospitalized participants will participate in a pilot focus-group interview. In the sub-study, a maximum of 16 IMR therapists, trained and in training, and up to 24 staff members will be invited to participate.

研究の種類

観察的

入学 (実際)

10

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

13年~17年 (子)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

サンプリング方法

非確率サンプル

調査対象母集団

Patients between 13-17 years of age suffering from or having symptoms of psychosis or bipolar disorders, and who participate in an IMR treatment group at one of the 4 (out of 7) outpatient clinics in the hospitals catchment area, and who are able to give informed consent. Up to 8 inpatients or previous inpatients between 13- 17 years of age suffering from various diagnoses will be invited to participate in a pilot focus-group interview. Trained clinicians and clinicians in training contribute to the implementation in the outpatient clinics together with clinic leaders and other clinicians.

説明

Inclusion Criteria Patients:

Outpatient units:

  • Included in the IMR group in one of the outpatient clinics
  • Able to give informed consent

Inpatient unit (focus group):

  • 13-17 years of age
  • Current or previous patient
  • Able to understand and speak Norwegian
  • Able to give informed consent

Exclusion criteria (inpatient unit)

  • Younger than 13 years
  • Mental retardation
  • Manic phase

Inclusion Criteria: IMR therapists:

  • IMR therapist leading IMR treatment groups in one of the participating outpatient clinics
  • Trained or training in IMR
  • Employed at the Department for Child and Adolescent Mental Health Services at Akershus University Hospital.

Inclusion Criteria: Other staff members

• Employed at the Department for Child and Adolescent Mental Health Services at Akershus University Hospital.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

コホートと介入

グループ/コホート
介入・治療
IMR patients
Patients from outpatient clinics receiving IMR from trained IMR therapists and IMR therapists in training.
Treatment given in groups, weekly for 10-12 months.
他の名前:
  • IMR
IMR therapists and other staff
Clinic leaders, IMR therapists and other staff participating in semi-structured individual or group interviews.
Semi-structured individual or group interviews conducted three times with staff on each participating outpatient clinic.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Focus-group interview aiming to explore the significance of the participant's own understanding of and knowledge about the disorder.
時間枠:End of treatment group, on average 11 months.
Focus-group interviews when the treatment group has come to an end aimed at exploring different perspectives on IMR treatment.
End of treatment group, on average 11 months.
Focus-group interview aiming to explore the impact of the IMR treatment on dealing with everyday life.
時間枠:End of treatment group, on average 11 months.
Focus-group interviews when the treatment group has come to an end aimed at exploring different perspectives on IMR treatment.
End of treatment group, on average 11 months.
Focus-group interview aiming to explore the importance of meeting other young people in the same situation.
時間枠:End of treatment group, on average 11 months.
Focus-group interviews when the treatment group has come to an end aimed at exploring different perspectives on IMR treatment.
End of treatment group, on average 11 months.

二次結果の測定

結果測定
メジャーの説明
時間枠
The Illness Management and Recovery Scale (IMRS)
時間枠:Baseline (0 months), 6 and 12 months.
A 15-item scale that assesses illness self-management on a 5-point Likert scale where 5 indicates full self-management and 0 indicates no self-management. The scale measures consumer behavior relating to core components in the IMR program. The scale includes parallel clinician and consumer versions. Participants participating in IMR groups for less than 10-12 months will attend fewer measuring times.
Baseline (0 months), 6 and 12 months.
The Illness Management Fidelity Scale
時間枠:Baseline (0 months), 6 and 12 months.
Assesses the degree of fidelity with 13 items on a 5-point Likert scale where 5 indicates full implementation and 0 indicates no implementation. Filled in by researchers on the basis of a semistructured interview with staff members.
Baseline (0 months), 6 and 12 months.
General Organizational Index
時間枠:Baseline (0 months), 6 and 12 months.
A 12-item scale measuring organizational outcome of implementation, on a 5-point Likert scale where 5 indicates full implementation and 0 indicates no implementation. The scale is filled in by researchers on the basis of a semi-structured interview with staff members.
Baseline (0 months), 6 and 12 months.
Attendance registration
時間枠:Baseline (0 months), 3, 6, 9 and 12 months.
The number of sessions the patients are attending in the IMR treatment group.
Baseline (0 months), 3, 6, 9 and 12 months.

その他の成果指標

結果測定
メジャーの説明
時間枠
Mapping the total number of patients identified receiving a psychosis-related diagnosis within the categories F 20-39 (ICD 10) for the years 2021-2023.
時間枠:End of treatment group, on average of 11 months.
The numbers will be displayed in the form of statistics obtained in the hospital. The numbers will be compared to what has been reported in the annual reports for the clinics from 2015 to 2020.
End of treatment group, on average of 11 months.

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

捜査官

  • 主任研究者:Anne-Lise Holmesland, PhD、University Hospital, Akershus

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2021年3月9日

一次修了 (実際)

2022年6月30日

研究の完了 (実際)

2022年6月30日

試験登録日

最初に提出

2021年2月14日

QC基準を満たした最初の提出物

2021年2月26日

最初の投稿 (実際)

2021年3月2日

学習記録の更新

投稿された最後の更新 (実際)

2022年9月30日

QC基準を満たした最後の更新が送信されました

2022年9月29日

最終確認日

2022年9月1日

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いいえ

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