Examinando por Autor "Penas, Patricia"
Mostrando 1 - 10 de 10
Resultados por página
Opciones de ordenación
Ítem Adaptation and validity evidence of REE (Recovery Enhancing Environment): a system for assessing recovery in the assisstance of people suffering from a severe mental disorder(Universidad de Deusto, 2020-09-11) Penas, Patricia; Iraurgi Castillo, Ioseba; Facultad de Psicología y Educación; Programa de Doctorado en Psicología por la Universidad de DeustoEl modelo de recuperación personal, definido como la capacidad de la persona en vivir una vida satisfactoria a pesar de los posibles síntomas, es una perspectiva en auge en la atención a personas con trastorno mental grave (TMG). A través de una revisión realizada se ha observado una falta de unicidad en el concepto, además de una escasez de instrumentos adaptados a nuestro entorno. Por ello, en la presente tesis se expone la adaptación y validación psicométrica de la versión española del instrumento REE (Recovery Enhancing Environment, Ridgway & Press, 2004). Una herramienta que permite evaluar tanto el proceso de recuperación individual, como conocer cómo los servicios de salud mental promueven este modelo recuperación. Para ello, se cuenta con una muestra de 312 usuarios representativa de la Red de Salud Mental de Bizkaia estratificada por sexo, edad y centro asistencial. Se han llevado a cabo análisis para probar su validez interna y concurrente, además de la unidimensionalidad de las cuatro subescalas que componen el instrumento, ofreciendo así la posibilidad de ser utilizado de forma independiente. Asimismo, se ha comprobado la estructura factorial de la herramienta en base al modelo conceptual (CHIME) más utilizado para la explicación del concepto, obteniendo el modelo bifactorial unos índices adecuados. Tras probar que se trata de una medida adecuada para su uso, se presentan dos herramientas útiles para los clínicos, que les permiten conocer de forma sencilla la evolución de los individuos en su proceso y el posible cambio organizativo. Por último, se ha observado que esta perspectiva de recuperación se relaciona negativamente con la recuperación clínica más tradicional, relación que es mediada por el autoestigma. En conclusión, el REE se trata de un instrumento adecuado para la evaluación del modelo y la adaptación de los recursos asistenciales al mismo. The personal recovery model, defined as the person's ability to build a satisfying life despite possible symptoms of the disease, is a growing perspective in the care of people with severe mental disorder (SMI). Through a review, a lack of unicity in the concept has been observed, as well as a scarce of instruments adapted to our environment. Therefore, this thesis presents the adaptation and psychometric validation of the Spanish REE measure (Recovery Enhancing Environment, Ridgway & Press, 2004). An instrument that allows the evaluation of both, the individual recovery process and how mental health services promote this recovery model. For this purpose, a sample of 312 representative users of the Mental Health Network of Biscay stratified by sex, age and care centre have participated. Analyses have been carried out to prove its internal and concurrent validity, as well as the unidimensionality of the four subscales of the instrument; those offer the possibility of being used independently. Likewise, the factorial structure of the measure has been checked based on most used conceptual model CHIME, in which the bifactorial structure has obtained adequate indexes. After proving that the Spanish REE is an adequate measure for its use, two useful methodologies are presented for clinicians, which would allow them to know easily the evolution of individuals in their process and the possible organizational change. Finally, it has been observed that this perspective of recovery is negatively related to the traditional perspective of clinical recovery, a relationship that is mediated by self-stigma. In conclusion, the REE is an adequate instrument for assessing the recovery model and the adaptation of care resources to it.Ítem Design and evaluation of a positive intervention to cultivate mental health: preliminary findings(Springer Science and Business Media Deutschland GmbH, 2021-02-24) Gorbeña, Susana; Govillard Garmendia, Leila ; Gómez Marroquín, Ignacio; Sarrionandia Vadillo, Sare; Macía Guerrero, Patricia ; Penas, Patricia; Iraurgi Castillo, IosebaThe past two decades have witnessed a proliferation of positive psychological interventions for clinical and non-clinical populations, and recent research, including meta-analyses, is providing evidence of its effectiveness. Most interventions have focused on increasing life satisfaction, positive affect, and psychological well-being. Manualized, multi-component interventions based on a comprehensive theory are scarce. Keyes’ concept of mental health and flourishing (subjective, psychological, and social well-being) is an overarching theoretical framework to guide the design of a multi-component psychological intervention to cultivate well-being and personal development. Therefore, the purpose of this study was to design a theory-driven positive intervention and to pilot test the intervention. The manual presents an 8-week group program that includes homework activities. A sample of 56 young adults completed the intervention. Participants were assessed at base line, after termination, and at a 6-month follow-up session. Standardized instruments were used to assess the dimensions of mental health proposed by Keyes. Pre- and post-test measures of subjective, psychological, and social well-being showed significant differences, as did the total mental health scores. At 6-month follow-up, differences remained in subjective and psychological well-being and in positive mental health, with smaller effect sizes. Limitations of these preliminary findings as well as future lines of research and improvements in this manualized intervention are proposed in the light of current research on positive interventions.Ítem Discrepancy between experience and importance of recovery components in the symptomatic and recovery perceptions of people with severe mental disorders(BioMed Central Ltd, 2021-12) Penas, Patricia; Uriarte, José Juan; Gorbeña, Susana; Slade, Mike; Moreno-Calvete, María Concepción; Iraurgi Castillo, IosebaBackground: Personal recovery has become an increasingly important approach in the care of people with severe mental disorders and consequently in the orientation of mental health services. The objective of this study was to assess the personal recovery process in people using mental health services, and to clarify the role of variables such as symptomatology, self-stigma, sociodemographic and treatment. Methods: Standardised measures of personal recovery process, clinical recovery, and internalized stigma were completed by a sample of 312 participants in a Severe Mental Disorder program. Results: Users valued most the recovery elements of: improving general health and wellness; having professionals who care; hope; and sense of meaning in life. Significant discrepancies between perceived experience and relative importance assigned to each of the components of the REE were observed. Regression modeling (χ2 = 6.72, p =.394; GFI =.99, SRMR =.03) identified how positive discrepancies were associated with a higher presence of recovery markers (β =.12, p =.05), which in turn were negatively related to the derived symptomatology index (β = −.33, p <.001). Furthermore, the relationship between clinical and personal recovery was mediated by internalized stigma. Conclusions: An improvement in psychiatric services should be focused on recovery aspects that have the greatest discrepancy between importance and experience, in particular social roles, basic needs and hope. Personal and clinical recovery are correlated, but the relationship between them is mediated by internalized stigma, indicating the need for clinical interventions to target self-stigma.Ítem Effects of a multi-component psychological intervention to cultivate mental health in older adults(Dove Medical Press Ltd, 2022-10-11) Sarrionandia Vadillo, Sare; Gorbeña, Susana; Gómez Marroquín, Ignacio; Penas, Patricia ; Macía Guerrero, Patricia; Iraurgi Castillo, IosebaPsychological interventions to cultivate mental health in older adults are scarce and tend to focus on and use a limited number of activities. The aim of this study was to test the effects of an intervention based on Keyes’ concept of positive mental health. The intervention was conducted with 24 self-selected participants, while 34 were part of the control group. Positive mental health and distress outcomes were measured at baseline and at the end of the intervention. ANCOVA analysis and effect sizes were calculated. Results showed that the intervention increased mental health (F= 18.22, p< 0.001, η2= 0.334, d= 1.45, power 0.986) and decreased psychiatric symptomatology in the experimental group versus the control group (F= 7.07, p= 0.011, η2= 0.16, d= 0.87, power= 0.736), which showed no change. Despite study limitations, the intervention effectively promoted older people’s well-being. Future research, should evaluate the long-term effects of the intervention with varied older adult populations.Ítem The effects of an intervention to improve mental health during the COVID-19 quarantine: comparison with a COVID control group, and a pre-COVID intervention group(Routledge, 2022) Gorbeña, Susana; Gómez Marroquín, Ignacio; Govillard Garmendia, Leila; Sarrionandia Vadillo, Sare; Macía Guerrero, Patricia; Penas, Patricia; Iraurgi Castillo, IosebaObjectiveThe COVID-19 pandemic has constituted an unprecedented challenge to society and science and it has provided an unexpected opportunity to explore the effects of a positive intervention in times of adversity and confinement. The goal was to evaluate the effects of a theory driven group intervention to cultivate mental health and flourishing. Design: A pre post design with three groups (151 individuals) was conducted, including an experimental group that received the intervention during the pandemic, a pre-COVID intervention group, and a COVID control group. Main Outcome Measures: Based on Keyes’ concept of positive mental health, measures of subjective, psychological and social well-being were obtained, as well as an indicator of psychological distress (GHQ12). Results: Intervention groups showed an increase in well-being and the COVID control group a decrease. Change scores revealed significant differences. Overall percentage of individuals at risk of ill health in baseline was 25.2%, but after the intervention, the COVID control group reached 64.1%. Conclusions: Despite the limitations, the present findings suggest that interventions to sustain and improve mental health in times of crisis and adversity can be an effective approach.Ítem Evidencias de adecuación psicométrica de la versión española de la Escala HoNOS(Asociación Iberoamericana de Diagnóstico y Evaluación, 2024) Uriarte, José Juan; Iglesias López, Nerea; Penas, Patricia; Moreno-Calvete, María Concepción; Álvarez, Alexander; Iraurgi Castillo, IosebaOutcome evaluation in mental health intervention programs is presented as an alternative of choice for assessing the effectiveness of treatments. For its implementation, it is necessary to have measuring instruments adequately adapted and validated to the context of application. The aim of the study is to provide evidence of the psychometric adequacy of HoNOS adapted to Spanish. A total of 281 users selected by probabilisticstratified sampling participated in the study. The HoNOS scale was used and the dimensional structure that best fits the data to the theoretical model of symptom clustering was tested using confirmatory factor analysis techniques. Evidence was presented showing the HoNOS scale as an appropriate instrument for result assessment in severe mental illnesses. These results make it possible to propose both the use of an overall assessment index and the use of the specific dimensions proposed by the instrument’s authorsÍtem Institutional injustice: implications for system transformation emerging from the mental health recovery narratives of people experiencing marginalisation(Public Library of Science, 2021-04-16) Hui, Ada; Rennick-Egglestone, Stefan; Franklin, Dona; Walcott, Rianna; Llewellyn-Beardsley, Joy; Ng, Fiona; Roe, James; Yeo, Caroline; Deakin, Emilia; Brydges, Sarah; Penas, Patricia; McGranahan, Rose; Pollock, Kristian; Thornicroft, Graham; Slade, MikeBackground Institutional injustice refers to structures that create disparities in resources, opportunities and representation. Marginalised people experience institutional injustice, inequalities and discrimination through intersecting personal characteristics and social circumstances. This study aimed to investigate sources of institutional injustice and their effects on marginalised people with experience of mental health problems. Methods Semi-structured interviews were conducted with 77 individuals from marginalised groups with experience of mental health problems, including psychosis, Black, Asian and minority ethnic (BAME) populations, complex needs and lived experience as a work requirement. These were analysed inductively enabling sensitising concepts to emerge. Findings Three processes of institutional injustice were identified: not being believed because of social status and personal backgrounds; not being heard where narratives did not align with dominant discourses, and not being acknowledged where aspects of identity were disregarded. Harmful outcomes included disengagement from formal institutions through fear and mistrust, tensions and reduced affiliation with informal institutions when trying to consolidate new ways of being, and damaging impacts on mental health and wellbeing through multiple oppression. Conclusions Institutional injustice perpetuates health inequalities and marginalised status. Master status, arising from dominant discourses and heuristic bias, overshadow the narratives and experiences of marginalised people. Cultural competency has the potential to improve heuristic availability through social understandings of narrative and experience, whilst coproduction and narrative development through approaches such as communities of practice might offer meaningful avenues for authentic expression.Ítem Psychometric adequacy of Recovery Enhancing Environment (REE) measure: CHIME framework as a theory base for a recovery measure(Frontiers Media S.A., 2020-06-30) Penas, Patricia; Uriarte, José Juan; Gorbeña, Susana; Moreno-Calvete, María Concepción; Ridgway, Priscilla; Iraurgi Castillo, IosebaPurpose: The aim of this study was to assess to what extent the recovery elements of the Recovery Enhancing Environment (REE) instrument measured the dimensions proposed by the CHIME framework, (Connectedness, Hope and optimism about future, Identity, Meaning in life and Empowerment dimensions), so as to evaluate personal recovery in people with severe mental illness. Methods: Two processes were conducted. Firstly, five experts matched the elements of recovery evaluated by the REE items with the CHIME domains and subdomains. Then, the resulting structure from those experts agreement was analyzed with different confirmatory factor analyses (CFA) using responses to the recovery elements dimension of the REE of 312 mental health service users. Results: The percentage of agreements and the kappa coefficients were adequate taking into account the CHIME dimensions (κ = 0.57 to 0.69, total κ = 0.74); however, lower agreement was found at the subdimensions level. Some indexes of the CFA were acceptable for a second order factor analysis [χ2(242)= 346.03, p < 0.001, CFI= 0.931, RMSEA= 0.037 (0.028 to 0.046)] and the most adequate solution was obtained from the bi-factorial structure (χ2(223)=233.19, p=0.306, CFI= 0.993, RMSEA= 0.012 [0.000 to 0.027]). Conclusions: Despite the subjective and complex nature of the personal recovery construct, the REE measure can be a valid instrument to verify the existing CHIME conceptual framework, since two of the models tested have resulted in adequate indexes and were also congruent with the theoretical framework and the statistical solution. Thus, REE can be used to obtain a global index of Personal Recovery dimension, and the five indicators proposed by the CHIME framework.Ítem Recorded mental health recovery narratives as a resource for people affected by mental health problems: development of the narrative experiences online (NEON) intervention(JMIR Publications Inc., 2021-05-27) Slade, Mike; Rennick-Egglestone, Stefan; Llewellyn-Beardsley, Joy; Yeo, Caroline ; Roe, James; Bailey, Sylvia; Smith, Roger Andrew; Booth, Susie; Harrison, Julian; Bhogal, Adaresh; Penas, Patricia ; Hui, Ada ; Quadri, Dania; Robinson, Clare; Smuk, Melanie ; Farkas, Marianne; Davidson, Larry; van der Krieke, Lian; Slade, Emily; Bond, Carmel; Nicholson, Joe; Grundy, Andrew; Charles, Ashleigh; Hare-Duke, Laurie; Pollock, Kristian ; Ng, FionaBackground: The internet enables sharing of narratives about health concerns on a substantial scale, and some digital health narratives have been integrated into digital health interventions. Narratives describing recovery from health problems are a focus of research, including those presented in recorded (eg, invariant) form. No clinical trial has been conducted on a web-based intervention providing access to a collection of Recorded Recovery Narratives (RRNs). Objective: This study presents knowledge produced through the development of the Narrative Experiences Online (NEON) Intervention, a web-based intervention incorporating the algorithmic recommendation of RRNs. Methods: Knowledge was gathered through knowledge integration (KI) activities. KI1 synthesized previous studies to produce the NEON Impact Model describing how accessing RRNs produces health-related outcomes. KI2 developed curation principles for the NEON Collection of RRNs through consultation with the NEON Lived Experience Advisory Panel and the curation of a preliminary collection. KI3 identified harm minimization strategies for the NEON Intervention through consultation with the NEON International Advisory Board and Lived Experience Advisory Panel. The NEON Intervention was finalized through 2 research studies (RS). In RS1, mental health service users (N=40) rated the immediate impact of randomly presented narratives to validate narrative feedback questions used to inform the recommendation algorithm. In RS2, mental health service users (n=25) were interviewed about their immediate response to a prototype of the NEON Intervention and trial procedures and then were interviewed again after 1 month of use. The usability and acceptability of the prototype and trial procedures were evaluated and refinements were made. Results: KI1 produced the NEON Impact Model, which identifies moderators (recipient and context), mechanisms of connection (reflection, comparison, learning, and empathy), processes (identification of change from narrative structure or content and internalization of observed change), and outcomes (helpful and unhelpful). KI2 identified 22 curation principles, including a mission to build a large, heterogeneous collection to maximize opportunities for connection. KI3 identified seven harm minimization strategies, including content warnings, proactive and reactive blocking of narratives, and providing resources for the self-management of emotional distress. RS1 found variation in the impact of narratives on different participants, indicating that participant-level feedback on individual narratives is needed to inform a recommender system. The order of presentation did not predict narrative feedback. RS2 identified amendments to web-based trial procedures and the NEON Intervention. Participants accessed some narratives multiple times, use reduced over the 4-week period, and narrative feedback was provided for 31.8% (105/330) of narrative accesses. Conclusions: RRNs can be integrated into web-based interventions. Evaluating the NEON Intervention in a clinical trial is feasible. The mixed methods design for developing the NEON Intervention can guide its extension to other clinical populations, the design of other web-based mental health interventions, and the development of narrative-based interventions in mental health.Ítem The role of personal recovery and internalised stigma on the expression of symptomatology in severe mental disorders: mediating and moderating effects(Elsevier Ltd, 2024-9-1) Penas, Patricia; Uriarte, José Juan; Álvarez, Alexander; Moreno-Calvete, María Concepción; Garay, María Asunción; Iraurgi Castillo, IosebaObjective: Given the relevance of internalised stigma in people suffering from a mental disorder, in the present study, the possible mediating and moderating role of self-stigma in the relationship between personal recovery and symptomatology has been studied. Method: 265 participants with severe mental disorder completed the following instruments: ISMI (self-stigma), REE (personal recovery) and HoNOS, CGI, GAF and EuroQol (symptomatology). Results: both the mediation and moderation analyses show significant results, which would indicate that internalised stigma has an effect on the relationship between personal recovery and symptomatology. Also, people with lower level of personal recovery and greater self-stigma have greater symptomatology than those who are in more advanced personal recovery processes and have a lower perception of internalised stigma. Discussion: the findings of this study suggest that self-stigma has an effect, and the improvement at personal recovery and symptomatology is accentuated when people with a severe mental disorder have a better management of internalised stigma. Therefore, it may be interesting to include this variable in recovery interventions.