Studies Completed in 2009: Projects Initiated and Led by Trust Staff and Honorary Appointees

NIHR Portfolio

An Investigation of the Ethical Concerns of Mentally Ill Patients, Carers, and Staff in Using Financial Incentives for Medication Adherence

UK CRN no. 5285

R&D ref. no. N0708/1

Chief Investigator: Professor Stefan Priebe – 020 7540 4210 - s.priebe@qmul.ac.uk

The aim of the study is to investigate the ethical concerns of patients, carers, staff and other important stakeholder groups regarding paying patients to take their medication who are seriously mentally ill and who consistently fail to take their medication in the community.

The study has the following specific objectives:

  1. To provide insights into the attitudes of different stakeholders of the practice of paying patients to take their medication;
  2. To describe differences between stakeholders regarding the advantages and disadvantages of the practice;
  3. To discuss the ethical concerns of stakeholders regarding the practice particularly in relation to the ethical principle of respect for people;
  4. To discuss the ethical concerns of stakeholders regarding the practice particularly in relation to the ethical principle of beneficence (doing good and helping others); and
  5. To generate information that is necessary to advise future experimental research on the effectiveness of this practice.

 

Outcomes of Involuntary Hospital Admission in England (INVOLVE)

UK CRN no. 2145

R&D ref. no. K0606/7

Chief Investigator: Professor Stefan Priebe – 020 7540 4210 - s.priebe@qmul.ac.uk

The study will provide empirical evidence about the practice of involuntary hospital admissions and their outcomes in England. It will benchmark outcomes of involuntary hospital admissions for different patient groups and in different contexts, and identify what patient characteristics and processes are associated with more or less positive outcome.

The study will be conducted at four sites that represent different regions across England and different types of catchment areas, including those characterised as inner-city, suburban and rural areas, in addition to ethnic mix. A total of 616 sectioned patients will be assessed within one week of admission, and followed up four weeks later. Clinical staff will also be interviewed about practice and events of coercive treatment. Most interviews will be conducted by user researchers.

The main outcome is patients' retrospective assessment of involuntary treatment, secondary outcomes, include satisfaction with treatment, clinical change and quality of life. Patients' socio-demographic and clinical characteristics, their initial assessments, and practices of coercion are putative independent predictors. In addition, a better understanding of the processes leading to different outcomes as viewed by users, will be explored using qualitative analysis of interviews in a sub-group of patients.

 

Own Account Studies

Moral distress of psychiatric nurses in Japan and the UK

R&D ref. no. K0809/3

Chief Investigator: Professor Len Bowers - 020 7040 5824 - L.Bowers@city.ac.uk

Is moral distress of psychiatric nurses in the UK different from that in Japan?  Is moral distress related to burnout?

 

Statistical and computational methods for genetic studies in multi factorial disorder

R&D ref. no. K60-SfS115-I

Chief Investigator: Professor David Curtis - 020 7377 7729 - davidcurtis@nhs.net

To find better ways to map disease genes

 

Older Adult Service Users Experiences of Psychological Therapy: A Qualitative Study.

R&D ref. no. N0802/2

Chief Investigator: Mrs Maureen Gardiner - 0208 525 4475 - maureen.gardiner@eastlondon.nhs.uk

This study is proposed to explore the Service Users' experience of therapy in an Older Adult service, in order to enhance our knowledge and understanding of what is known about their experiences of the therapeutic process. The aim is to allow the clients to express their thoughts and feelings thereby revealing through the categories and themes that emerge by way of grounded analysis, views that can contribute to the growth of a better 'quality' of service (Atwal & Calwell, 2005, p.10)for Older Adults. 'Evidence-based' Psychological therapies have shown efficacy in its treatment of older adults (Scogin, 2007, p.1). Generating feedback from this client group could lead to an outcome that facilitates a more efficient service that meets the needs of Older Adults. It is hoped that by highlighting the meaning within the older adults’' story of therapy through qualitative enquiry, a rich source of data will be added to the body of research that exists. Within this study there is potential for 'establishing best practice'(Howe, 1996, p.374), value and for providing a better match of the Older Adults understanding and expectations of Psychology to Service provision and delivery (Atwal & Caldwell, 2005). This not only helps the service to be cost effective but it also meets the needs of our elderly client population. The utility and outcome of this research is that it will offer a broader view of therapy from the Older Adult perspective. This can be incorporated into service planning so that it informs the way Psychology Services deliver treatments, which could lead to Clinicians and Commissioners providing better value services to Older Adults. This study will also add to a body of research that is already meagre (Bowman & Fine, 2000; McLeod, 1998), and it will contribute to how we as practitioners understand how Older Adults 'perceive, experience and make sense' of their journey through therapy (Gordon, 2000; Howe, 1996, p.520).

 

Strengthening research capacities and evaluation of mental health services in Bosnia and Herzegovina (EVIDENCE)

Chief Investigator: Professor Stefan Priebe – 020 7540 4210 - s.priebe@qmul.ac.uk

The project had the following aims:

  1. To promote and conduct mental health services research in Bosnia and Herzegovina.
  2. To establish collaborative networks of services to conduct research in Bosnia and Herzegovina as well as the wider Western Balkan region.
  3. To consolidate and further develop a Research unit of international excellence at the Department of Psychiatry which is a part of Medical Centre, University of Sarajevo; this was achieved through development/exchange programmes for existing and new staff and PhD programmes.
  4. To develop evidence based guidelines for health and social care that are of national, regional and international importance.
  5. To build capacity and infrastructure for attracting external funding independently and in cooperation with regional and international partners.

 

Efficacy and therapeutic process of Group Music Therapy as an intervention for people suffering from Post-Traumatic Stress Disorder (PTSD) who are treatment-resistant

R&D ref. no. N0707/7

Chief Investigator: Professor Stefan Priebe – 020 7540 4210 - s.priebe@qmul.ac.uk

We will investigate the effectiveness of group music therapy in the treatment of patients with PTSD who have enduring symptoms after current recommended treatments, and explore the mediating processes. The principle research questions are:

  1. Can group music therapy reduce symptoms in PTSD patients who have previously received other recommended treatments?
  2. Can group music therapy help patients to re-engage with current recommended treatments?
  3. What is the effect of group music therapy on patients’ quality of life and socialisation?
  4. What are the patients’ subjective experiences of group music therapy?

 

Effectiveness and therapeutic processes of body oriented psychological therapy (BPT) in the treatment of negative symptoms in schizophrenia - a controlled trial at two different sites with a waiting group design

R&D ref. no. K0608/1

Chief Investigator: Professor Stefan Priebe – 020 7540 4210 - s.priebe@qmul.ac.uk

We will investigate the effectiveness of a novel, manualised psychological intervention strategy (BPT) in the treatment of drug-refractory negative symptoms of patients with chronic schizophrenia, and explore the mediating processes. The principal research questions are:

  1. Do patients, who are treated with BPT at different sites by different therapists, show improvement of negative symptoms (treatment given in addition to treatment as usual)?
  2. Do patients receiving BPT show improvement of quality of life and social functioning?
  3. Do changes in affective states or motor behaviour or both mediate outcomes on negative symptoms?

 

A National Survey of Housing Services for People with Mental Health Problems

R&D ref. no. K0611/2

Chief Investigator: Professor Stefan Priebe – 020 7540 4210 - s.priebe@qmul.ac.uk

The survey aims to identify what models of housing services are provided for people with mental health problems in England and to establish the characteristics of the users of the different models including the costs of their care.

 

European network for promoting the health of residents in psychiatric and social care institutions (HELPS)

R&D ref. no. N0901/2

Chief Investigator: Professor Stefan Priebe – 020 7540 4210 - s.priebe@qmul.ac.uk

The aim of the HELPS project is to improve the physical health status of people with mental health problems staying in mental health inpatient units and social care residential settings.

HELPS will develop and implement a physical health intervention tool to help promote the physical health of mentally ill patients staying in mental health inpatient units and social care residential settings.

  1. Establish a database on the physical health status of patients and health related living conditions in mental health inpatient units
  2. Collect systematic information on how staff members and patients in mental health inpatient units and social care residential settings perceive individual and environmental physical health risks and the potential for control of such risk factors
  3. Establish a set of standardised methods for the assessment of physical health status, health relevant lifestyle and health related attitudes among people with mental disorders and for the examination of characteristics of mental health inpatient units
  4. Develop a catalogue of effective and cost effective intervention programmes in the fields of nutrition, physical exercise, oral health, smoking cessation, alcohol, and illicit drug prevention which can be routinely applied in mental health inpatient units and social care residential settings
  5. Develop a tool kit of assessment instruments, an algorithm for the selection of suitable intervention strategies, a description of intervention strategies, their implementation and a methodological procedure for the evaluation of effects
  6. Raise awareness of the health promoting tool kit in mental health inpatient units and social care residential settings.

 

Educational Projects

To What Extent Are Psychiatric In-Patients Affected by A Transfer of Services - A Qualitative Analysis

R&D ref. no. N0707/6

Chief Investigator: Ms Rebecca Lingard - 02081215060 - rebecca.lingard@eastlondon.nhs.uk

The principle objective of this research is to gain a fuller understanding of how psychiatric in-patients are affected when the hospital in which they usually receive their in patient treatment is relocated to a new premises. 

The secondary objective of this piece of research is to gain a more comprehensive understanding about the relationship between a psychiatric in-patient, and the hospital in which they have received most of their psychiatric care, particularly if the client has been known to the hospital for a number of years.

Additionally, details of clients past hospital admissions, and the level of support during the transfer of services offered, and whether that support met their needs will also be explored.