Biomedical subjects

C Brooker

Publications and source records attributed to C Brooker.

14 recordsLinked to original sources

PubMed1992

Training community psychiatric nurses for psychosocial intervention. Report of a pilot study.

Community psychiatric nurses were trained to deliver psychosocial intervention to clients with a diagnosis of schizophrenia living at home with relatives. The training package consisted of family assessment, health education, and family stress management strategies. In a 'quasi-experimental' design, a sample of families (n = 54) were recruited to either a control or experimental condition and followed up for 12 months. A number of favourable outcomes were observed in the experimental group, including improvements in the client's target symptoms, personal functioning, and social adjustment. Relatives' satisfaction with services increased and reports of their own minor psychiatric morbidity improved.

Adolescent↗

PubMed1992

Sleep patterns and health.

Explore the source record for details and available documents.

Circadian Rhythm↗

PubMed1991

Working with families caring for a relative with schizophrenia: the evolving role of the community psychiatric nurse.

This paper describes the effect on the role and function of the community psychiatric nurse (CPN) after training to deliver psychosocial intervention to families caring for a relative with schizophrenia living at home. The study was undertaken as part of a larger investigation, commissioned by the Department of Health, which is examining outcome in families after CPNs have received training in psychosocial intervention strategies. In the last decade four major controlled studies have shown that relapse in schizophrenia can be improved if families receive; detailed assessments of individual need, health education about schizophrenia, and family stress management programmes, often defined as "psychosocial intervention". Whilst these research programmes have been underway, CPN services have been developing closer links with Primary Health Care and individual CPN's work with clients with severe and long-term mental illness has, as a consequence, been reducing. This trend has been rightly criticized, as has the tendency for CPN work to focus on the individual rather than the family with whom the client often lives. Informal carers willingly accept the burden of care for their relatives but their own needs are all too often neglected. The pilot phase of the outcome study demonstrated that after CPNs had received experimental training in psychosocial intervention, families reported a number of positive benefits when followed up for 12 months. First, for the clients there were improvements in the symptoms of their illness and in their social functioning. Second, carers' satisfaction with the service received showed a marked improvement as did their estimates of minor psychiatric morbidity. These changes in outcome entailed a cost. Experimental CPNs reported that undertaking family intervention was more time-consuming than "traditional" CPN care of the client with schizophrenia. Further, the data reveal that the training led to CPNs extending their role in a variety of other ways even though they received only a modicum of support from colleagues within their own health authorities. This preliminary paper concludes that although family work undertaken by CPNs should be seen as an important priority, problems may arise as services attempt to juggle finite resources with ever growing demands. Guidance on the future role of the CPN from the Department of Health is essential and would greatly enable planners and managers alike to rank order service priorities.

Community Health Nursing↗

PubMed1990

Expressed emotion and psychosocial intervention: a review.

For thirty years research has been consistently demonstrating the validity of the concept of 'High Expressed Emotion' (HEE). After early pioneering work by Brown it was established that environmental influences, particularly, the emotion expressed by relatives to sufferers of schizophrenia, are strongly implicated in relapse. Consequently, the predictive validity of HEE has been revealed in a number of cross-cultural studies around the world. In addition, there is strong evidence from well designed intervention studies, that relapse, in schizophrenic clients living at home, can be prevented by the manipulation of social and environmental factors. The combined body of research that has now accumulated allows an hypothesis to be made about the aetiology of the illness, schizophrenia, itself. This theory has been described as the 'stress vulnerability' model. The paper concludes that psychosocial intervention strategies are effective but that, unfortunately, to date, their application has been mostly restricted to the intervention studies themselves.

Cross-Cultural Comparison↗

PubMed1990

The application of the concept of expressed emotion to the role of the community psychiatric nurse: a research study.

The previous article examined the development of the concept of 'expressed emotion', argued that controlled studies had successfully demonstrated the value of psychosocial intervention, but demonstrated that such a therapeutic approach had been mostly limited to the research studies themselves. In the light of the demonstrable efficacy of psychosocial intervention, the psychiatric nursing literature is reviewed in order to establish how far nurses have capitalized on the utility of the 'expressed emotion' concept, to date, in their work with schizophrenic clients and their families. In addition, a brief historical overview of the Community Psychiatric Nurses' (CPNs) role with schizophrenic clients is presented which relates to current ongoing research in this area which is described. In brief, the research project, which is funded by the Department of Health, is evaluating the outcome of teaching CPNs to deliver psychosocial interventions to families caring for a schizophrenic relative at home.

Community Mental Health Services↗

PubMed1990

The standing advisory group for community psychiatric nursing: grasping the nettle?

This paper reports on the work of the Standing Advisory Group for Community Psychiatric Nursing Education (SAGCPNE). A precis of the historical development CPN education is provided and a stronger relationship with the Mental Nurses Committee is proposed. It is argued that the educational preparation of community psychiatric nurses is the sine qua non of desirable, high quality, community mental health services and that methods for the identification and protection of adequate financial resources for such preparation must be found.

Community Health Nursing↗

PubMed1990

The health education needs of families caring for a schizophrenic relative and the potential role for community psychiatric nurses.

Community care policies for the mentally ill rely, to a large extent, on the informal contribution that often seems to be made willingly by families. In financial terms alone, it has been calculated by the British Government that families caring for a relative with schizophrenia at home save the country 25 billion pounds a year. Nearly 15 years ago, it was argued that community mental health services were failing to monitor the relationships in homes where this situation prevailed and provide the support mechanisms that were required. Further, it has been noted that when there is an over-emphasis on community care, family crises can become severe and remain undetected. This paper reviews the literature relating to the needs of families caring for a schizophrenic relative at home. It concludes that a major service that should be offered to families is education about the illness, schizophrenia, itself. Strategies for undertaking this role are examined within the overall context of 'psychosocial interventions' and the literature on 'high expressed emotion'. Finally, an experimental course, funded by the Department of Health, and located in the Department of Nursing at Manchester University, is described. Here, community psychiatric nurses are being taught to recognize the value of health education for those living with a schizophrenic relative. As a consequence, a number of valuable initiatives have been developed and these are briefly outlined.

Community Health Nursing↗

PubMed1990

A new role for the community psychiatric nurse in working with families caring for a relative with schizophrenia.

Over the last 20 years research has convincingly demonstrated that the illness, schizophrenia, is amenable to social and environmental influence (Leff et al. 1982; Falloon et al. 1985; Hogarty et al. 1986). The impetus for the research is the fact that, at best, genetic inheritance explains only 70% of the disorder's aetiology. The findings of the studies allow certain basic but important principles to be formulated. These are that some people inherit a genetic predisposition or "vulnerability" to schizophrenia which develops either in response to the acute stress of "life events" or the chronic stress encountered in some families. Originally the term "Expressed Emotion" was coined to describe emotional atmosphere at home which was thought to consist particularly of criticism, hostility or emotional over-involvement (Brown et al. 1962). Intervention strategies have arisen from the studies which demonstrates that stress in families caring for a relative with schizophrenia can be reduced, leading to not only a smaller risk of relapse in the relative with the illness, but also an improvement in the carer's own mental health status (Tarrier et al. 1988). Intervention consists of health education for carers and family stress management techniques which may help to lessen over-stimulation in family life. Community Psychiatric Nurses (CPNs) are a rapidly expanding sector of most mental health service provision in the United Kingdom but the evidence is that their role with the sufferer from schizophrenia consists largely of the administration of depot medication and very little else.(ABSTRACT TRUNCATED AT 250 WORDS)

Behavior Therapy↗

PubMedDate not supplied