Papers
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Objectives
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Setting
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Age/Gender
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Participants
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Study design/Methods
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Data collection instrument
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Analysis
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Q+
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Summary of article
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Asher, Hanlon (47)
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The acceptability and feasibility of CBR in practice, as well as how CBR may improve functioning among people with schizophrenia.
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Ethiopia
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Mean age = 39.5; Males & Females
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Schizophrenia
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Quasi-experimental design/Mixed methods
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· In-depth interviews (IDIs)
· Discrimination and Stigma Scale-12 (DISC-12)
· Alcohol Use Disorders Identification Test (AUDIT)
· Patient Health Questionnaire-9(PHQ-9)
· Involvement Evaluation Questionnaire (IEQ)
· World Health Organisation Disability Assessment Schedule (WHODAS) 2.0
· Clinical Global Impression
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Thematic analysis and Descriptive statistics
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H
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CBR programme has the capacity to improve functioning of people with schizophrenia
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Brooke-Sumner, Lund (26)
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To develop a community based psychosocial rehabilitation programme for service users with schizophrenia
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South Africa
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Maximum= 45; Females
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Schizophrenia
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Quasi-experimental design/ Qualitative
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· In-depth interviews (IDIs)
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Thematic analysis
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H
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The programme improved the lives of service users with schizophrenia – self-esteem, social support, illness knowledge, self-care, and contribution to their households
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Brooke-Sumner, Selohilwe (27)
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Investigated a non-specialist delivered programme for psychosocial rehabilitation for service users with schizophrenia in a low-resource South African setting
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South Africa
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Range = 21–44; Males &Females
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Schizophrenia
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Quasi-experimental design/Mixed methods
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· In-depth interviews (IDIs)
· Brief Psychiatric Rating Scale (BPRS)
· Clinician-administered scale
· World Health Organization Disability Assessment Scale (WHODAS)
· Stigma of Mental Illness Inventory (ISMI)
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Thematic analysis and Inferential statistics
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H
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The programme achieved reduction in ISMI assessment as well as improved psychosocial well-being of service users with schizophrenia
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Browne and Waghorn (54)
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to retrospectively assess the implementation of IPS practices and youth employment outcomes
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New Zealand
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Age range of 16–25 years; Males &Females
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Affective (including comorbid anxiety), Bipolar affective disorder, Generalized anxiety disorder
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Observational design (Retrospective case study)/Quantitative
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· Case review
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Descriptive statistics
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M
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The IPS programme was effective in terms of the proportion of young clients commencing competitive employment, and duration of longest job held
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Burns, White (36)
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The acceptability and effectiveness of IPS in Europe
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Five European countries
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Mean age= 38 years
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schizophrenia or schizoaffective disorder
bipolar disorder
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Randomized controlled trial/Quantitative
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· Questionnaire
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Inferential statistics
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High
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The Individual Placement and Support (IPS) was about two times more effective than vocational
services in returning to open employment
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Catty, Lissouba (52)
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Determine which patients with severe mental illness do well in vocational services and which process and service factors are associated with better outcomes
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Six European centres
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Range (18 to local retirement age);Males &Females
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Schizophrenia
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Randomised controlled trial/ Quantitative
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· Global Assessment of Functioning – Symptoms (GAF–S) and Disability (GAF–D)
· Positive and Negative Syndrome Scale
· Hospital Anxiety and Depression Scale
· Groningen Social Disability Schedule
· Lancashire Quality of Life Profile – European Version
· Rosenberg Self-Esteem Scale
· Camberwell Assessment of Need – European short version
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Inferential statistics
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H
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The IPS services were more effective than the vocational services for every vocational outcome
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Chang, Chen (28)
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Investigated the effect of a music creation group programme on the anxiety, self-esteem, and quality of life of patients with SMI
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Taiwan
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Range (20- 65); Males &Females
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Schizophrenia or affective disorders
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Quasi-experimental design/ Quantitative
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· Demographic data
· Hamilton Anxiety Rating Scale (HAM-A)
· Rosenberg Self-Esteem Scale (RSES)
· World Health Organization Quality of Life-BREF (WHOQOL-BREF)
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Inferential statistics
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H
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Participating in a structured music-creation intervention improved the psychological well-being, self-esteem, quality of life and social relationship of consumers with SMI
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Chiu, Ho (29)
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To test empirically the substance Abuse and mental Health Services administration (SAMHSA) recovery model
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Hong Kong
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Mean age = 41.6 (Average) Males &Females
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Schizophrenia spectrum disorder
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Cross-sectional/Quantitative
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· Internalized Stigma of Mental Illness scale (ISMI)
· Resilience Scale (RS)
· Making Decision Empowerment scale (MDES)
· Exercise of Self-Care Agency Scale
· Mastery Scale (MS)
· Adult State Hope Scale (ASHS)
· Health Care Climate Questionnaire (HCCQ)
· Recovery Attitude Questionnaire (RAQ-7)
· Medical Outcome Study Social Support Survey–Chinese version (EISS-MOS-SSS-C)
· Schizophrenia Quality of Life Scale (SQLS)
· Multidimensional Scale of Perceived Social Support–Chinese version (MSPSS-C)
· World Health Organization Spirituality Religion and Personal Belief Scale–Hong Kong version (WHO-SRPBHK)
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Inferential statistics
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H
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Psychosocial symptoms, respect, resilience, and empowerment were significant contributors of recovery
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Clements (57)
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To pilot a PAR and photovoice project, to facilitate discussions about recovery based on personal and local experience
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Canada
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Participatory action research/Qualitative (eg. photovoice)
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Photo/text pieces, other ‘readers’ or audiences
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Recovery Photo Gallery
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H
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Photovoice proved as a useful research method for the construction of local knowledge about recovery and as a vehicle for sharing that knowledge
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Crain, Penhale (32)
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Application of IPS in a Canadian community mental health team through the study of a competitively employed individual and his support network.
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Canada
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Mean age = 42 years/Males
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Schizophrenia
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Instrumental case study/Qualitative
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· In-depth interviews (IDIs)
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Thematic analysis
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H
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The IPS programme had positive outcomes through securing and maintaining job, changing perceptions, self-confidence, social skills and recovery
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De Heer-Wunderink, Visser (33)
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Investigated levels of social inclusion among service users of two types of psychiatric community housing programs in the Netherlands
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Netherlands
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Mean age 44 years / Males &Females
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Schizophrenia, Anxiety or depression, Personality disorder
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Cross-sectional Design/Quantitative
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· Health of the Nation Outcome Scales (HoNOS)
· Camberwell Assessment of Need Short Appraisal Scale (CANSAS)
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Descriptive and Inferential statistics
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H
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Supported independent living programs seemed to positively influence the level of social inclusion among service users compared with residential programmes
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Fenner, Ryan (58)
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analysed what consumers and staff reported at the end of the project
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Samoa
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Interpretive Phenomenological Design/ Qualitative
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· Focus group Discussion
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IPA
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H
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Art making positively impacts on consumers senses of identity and independence and demonstrates their talents and capacities
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Harpaz-Rotem, Rosenheck (34)
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Observational data comparing 1-year clinical outcomes among women who received RT services and those who did not.
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USA
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Psychiatric/substance abuse problems
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Quasi-experimental design/ Quantitative
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· Self-report interview
· psychiatric, Alcohol, and Drug composite scales
· Short Form Health Survey (SF-12)
· Symptom Checklist-30 (SCL)
· Posttraumatic Stress Disorder (PTSD) Symptom Checklist (PCL)
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Descriptive & Inferential statistics
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H
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Placement in Residential treatment was associated with significantly improved clinical outcomes in a variety of domains
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Hultqvist, Markstrom (37)
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Comparing users of two approaches to psychosocial rehabilitation in Sweden, community-based mental health day centres (DCs) and clubhouses
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Sweden
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Mean age = 48.7 years; Males &Females
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Psychoses, Mood and anxiety disorders, Autism/neuropsychiatric disorders
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Quasi-experimental design/Quantitative
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· Manchester Short Assessment of Quality of Life (MANSA)
· Self-esteem Rosenberg
· Global Assessment of Functioning (GAF)
· MOS 36-item short-form health survey
· Social Interaction (ISSI)
· Satisfaction with daily occupations (SDO)
· Swedish version of the CSQ-8
· The EPM-DC
· Socio-demographic and clinical factors
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Descriptive & Inferential statistics
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The study showed that visiting clubhouses appears to be more beneficial for improved QOL in a longer-term perspective
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Hultqvist, Markström (64)
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compared DC and clubhouses, concerning the users’ perceptions of unit and programme characteristics, and aspects of everyday occupations in terms of engagement and satisfaction
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Sweden
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Mean age = 48.7 years; Males &Females
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Psychoses, Mood and anxiety disorders, Autism/neuropsychiatric disorders
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Combined cross-sectional and longitudinal comparative study/ Quantitative
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· Evaluation of Perceived Meaning in Day Centres (EPM-DC)
· Productive occupations (POES-P)
· Satisfaction with Daily Occupations (SDO) scale
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Descriptive & Inferential statistics
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The users of clubhouse performed better than day center users various on social network sub-scales (feeling valued by others, feelings of inclusion and belonging to a group)
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Iancu, Zweekhorst (56)
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Analysed and compared experiences of recovery on prevocational services, in order to assess if users make progress towards recovery, relative to a staged recovery model
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Netherlands
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Mean age =42.5 years; Males &Females
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Schizophrenia and personality disorders, depressive and anxiety disorders
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Interpretive Phenomenological Design/ Qualitative
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· Semi-structured interviews
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Thematic analysis
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H
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The prevocational services provide the needed services for people with mental disorders who desire to engage in recovery (create strong internal motivation for change)
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Iwasaki, Coyle (48)
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The role of leisure generated meanings (LGMs) experienced by culturally diverse individuals with mental illness in potentially helping them better cope with stress, adjust to and recover
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USA
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Mean age= 48 years; Males &Females
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Bipolar disorder, major depression, schizophrenia, bipolar/schizophrenic, Schizoaffective disorder, substance abuse, panic disorder, borderline personality
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Cross-sectional/Quantitative
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· Colorado Symptom Index (CSI
· Recovery Assessment Scale (RAS
· Psychosocial Adjustment to Illness Scale (PAIS
· Leisure Meanings Gained Scale (LMGS
· Leisure Coping Scale (LCS
· Leisure Satisfaction Scale (LSS
· Leisure Boredom Scale (LBS
· Perceived Active Living Scale (PALS)
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Descriptive & Inferential statistics
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H
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Leisure can contribute to stress-coping, recovery, adjustment, and active living for individuals with mental illness.
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Ketch, Rubin (61)
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Art appreciation for veterans with severe mental illness in a VA Psychosocial Rehabilitation and Recovery Center
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USA
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Quasi-experimental design/Qualitative
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· Photos and interviews
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Thematic analysis
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H
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The programme had positive effects on mood, self-esteem, socialization community participation and recovery process of veterans with SMI
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Kilian, Lauber (62)
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Analyses the relationships between employment hours, psychopathological symptoms and the days of inpatient treatment detected
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Six European centres
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Mean age =37.8 years; Males &Females
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Schizophrenia/schizoaffective disorders, Bipolar disorder
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Randomized controlled trial/Quantitative
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· Positive and Negative Symptoms Scale (PANSS)
· OPCRIT
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Descriptive & Inferential statistics
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M
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IPS intervention through its effect on the time spent in competitive employment leads to a reduction of the need for psychiatric inpatient care
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Koletsi, Niersman (50)
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Explore clients’ experiences of the support received from their IPS or Vocational Service workers and the perceived impact of work on clients’ lives
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Six European centres
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Age range from 18 to 57 years; Males &Females
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Schizophrenia/schizoaffective disorders, Bipolar disorder
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Randomised controlled trial /Qualitative
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· Semi-structured interviews
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Thematic analysis
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H
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The IPS programme improved financial stability, illness, social life, increased self-esteem, integration into society, self-improvement, coping strategy and reduced loneliness
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Lee, Liem (30)
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Explored the effectiveness of Assertive Community Treatment (ACT) for severely ill mental patients during a period of rapid deinstitutionalization in Hong Kong
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Hong Kong
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Age range from 18 to 65 years; Males &Females
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Psychotic disorders
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Flanking historical control design/ Quantitative
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· World Health Organization Quality of Life(WHOQOL-) Hong Kong Chinese Version
· Brief Psychiatric Rating Scale (BPRS)
· Clinical Data Analysis and Reporting System (CDARS)
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Descriptive and Inferential Statistics
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H
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The ACT had positive effect over and above the conventional treatment models – outcome parameters (Bed days, readmission episodes, days of missing psychiatric appointments, BPRS and Quality of Life) improved
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Lindstrom, Hariz (35)
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To evaluate clients’ activities of daily living (ADL) ability and health factors outcomes following their participation in occupation-centred interventions in home and community settings
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Sweden
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Mean age= 48 years; Males &Females
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Schizophrenia, Schizoaffective disorder, Bipolar disorder, Asperger syndrome, Obsessive compulsive disorder
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Quasi-experimental design / Quantitative
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· Goal Attainment Scaling (GAS)
· Assessment of Motor and Process Skills (AMPS)
· Assessment of Social Interaction (Swedish version BSI-II)
· Satisfaction with Daily Occupations (SDO)
· ADL-taxonomy
· Symptom Checklist–90 (SCL-90)
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Descriptive and Inferential Statistics
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H
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The occupational therapy services integrated in to sheltered or supported housing achieved positive lifestyle, meaningful occupations and participation in society
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Lopez-Navarro, Del Canto (46)
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The effectiveness of group mindfulness-based intervention (MBI) in patients diagnosed with severe mental illness
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Balearic Islands
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Mean age =38.44years
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Schizophrenia, Bipolar disorder, Delusional disorder
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Randomised controlled trial/ Quantitative
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· World Health Organization Quality of Life-BREF (WHOQOL-BREF)
· Positive and Negative Syndrome Scale (PANSS)
· Mindfulness Attention Awareness Scale (MAAS)
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Descriptive and Inferential Statistics
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H
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Mindfulness intervention in rehabilitation has potential to enhance quality of life and reduce negative symptoms
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Luk (39)
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Investigate the long-term effects of a holistic care programme for the rehabilitation of persons with serious mental illness
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Hong Kong
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Mostly aged 35 or above; Males &Females
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Schizophrenia, Manic Depressive, Depression
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Cross-sectional/Quantitative
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· World Health Organization Quality of Life Measure (WHOQOL-BREF(HK)
· General Health Questionnaire (GHQ)
· Rosenberg Self-esteem Scale (ESTEEM)
· Social Support Questionnaire-6 (SSQ-6)
· Purpose in Life Questionnaire (PIL)
· Hopelessness Scale (HOPE)
· SSQ-Satisfaction
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Descriptive and Inferential Statistics
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H
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The programme is effective to provide positive changes – support, encouragement, self-confidence, spiritual assistance and reflection of values
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Malinovsky, Lehrer (40)
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Evaluate the effectiveness of a recovery-oriented transformation carried out by a large, private, not-for-profit psychiatric rehabilitation organization serving individuals with SM
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USA
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Mean age =46.42 years; Males &Females
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Schizophrenia, Mood disorder (unipolar/bipolar), Other psychotic disorder
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Longitudinal study/Quantitative
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· Multnomah Community Ability Scale–Revised Clinician Rated (MCAS-R)
· Self-Report (MCAS-SR)
· Competency Assessment Instrument (CAI)
· State Hope Scale (SHS)
· Client Version (WAI-C) and Therapist Version (WAI-T)
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Descriptive and Inferential Statistics
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H
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Recovery-oriented services are effective to reduce hospitalizations and improve quality of life
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Mizock, Russinova (59)
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Describe the development and feasibility of the Recovery Narrative Photovoice intervention
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USA
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Serious mental illnesses
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Community-based participatory research/ Quantitative
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· Ryff Scale of Psychological Well-Being
· Empowerment Scale
· Community Integration Measure
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Descriptive Statistics
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The programme has the potential to facilitate recovery-related outcomes, including empowerment, positive identity, and community integration
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Mizock, Russinova (60)
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Explore the meaning of recovery for individuals with serious mental illness
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USA
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Serious mental illness
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Community-based participatory research/ Qualitative
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· Photos and archival data
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Thematic analysis
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H
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The study identify several internal and external recovery strategies and outcomes
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Panczak and Pietkiewicz (53)
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Explore personal experiences of people employed in Vocational Development Centers
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Poland
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Age range from 28–58 years; Males &Females
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Schizophrenia spectrum disorders
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Interpretative phenomenological design/ Qualitative
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· Semi-structured interviews
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Consecutive analytical
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H
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The programme improved the economic and social well-being of people with schizophrenia – economic empowerment, empowerment, functioning and social inclusion
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Raeburn, Schmied (63)
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Explore how recovery practices are implemented in a psychosocial clubhouse
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Australia
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Mean age= 47 years; Males &Females
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Schizophrenia, bipolar disorder or schizoaffective disorder
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Case study/ Qualitative
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· In-depth interviews (IDIs)
· Observations – Spradley’s field note domains, and the Recovery and Promotion Fidelity Scale (RPFS)
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Theoretical thematic analysis
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H
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The psychosocial clubhouse is a community that provide opportunity to participate in a personal recovery journey
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Salyers, McGuire (41)
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To rigorously test Illness Management and Recovery (IMR) against an active control group in a sample that included veterans.
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USA
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Mean age =47.7 years; Males &Females
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Schizophrenia, Schizoaffective disorder
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Randomized controlled trial/ Quantitative
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· Structured Clinical Interview for DSM-IV
· Positive and Negative Syndrome Scale (PANSS)
· Quality of Life Scale (QLS)
· Patient Activation Measure
· Morisky Scale
· Recovery Assessment Scale (RAS)
· State Hope Scale
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Descriptive and Inferential Statistics
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H
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Improved significantly in a number of domains related to illness management – symptoms, psychosocial functioning, self-rated illness management, and emergency department use
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Svanberg, Gumley (55)
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Explore the experience of recovery from mental illness in the context of two emerging social firms
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Scotland
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Age range from 19–64 years; Males &Females
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Bipolar disorder, depression, psychosis, anxiety, addictions
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Social constructionist (Grounded theory)/ Qualitative
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· Open-ended interview questions
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Thematic analysis
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H
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The social firms are effective to enhance self-confidence, acceptance and inclusion of people with mental illness
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Swildens, van Busschbach (65)
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Investigate the effect of the Boston Psychiatric Rehabilitation (PR) Approach on attainment of personal rehabilitation goals, social functioning, empowerment, needs for care, and quality of life in people with severe mental illness (SMI) in the Netherlands
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Netherlands
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Mostly aged 41 or above; Males &Females
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Schizophrenia or schizoaffective disorder, Bipolar disorder, Depressive or anxiety disorder, Personality, Addiction, Cognitive disorder
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Randomized Controlled Trial/ Quantitative
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· Self-report Social Functioning Scale
· Camberwell Assessment of Need Short Appraisal Schedule
· WHOQOL-BREF
· Personal Empowerment Scale
· BPRS—Extended version
· GAF—symptoms and disabilities
· Client Socio-demographic and Service Receipt Inventory—European version
· PR Beliefs, Goals and Practices scale
· Working Alliance Inventory
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Descriptive and Inferential Statistics
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H
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Psychiatric rehabilitation has a significant impact on goal attainment, societal participation and social contacts
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Tjornstrand, Bejerholm (38)
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Gaining knowledge regarding the occupations performed in day centres, in terms of the participants’ descriptions of what they were doing
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Sweden
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Mean age =45.3 years; Males &Females
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Schizophrenia, other psychoses
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Interpretative phenomenological design/ Qualitative
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· Time-use diary
· Profiles of Occupational Engagement POES
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Content analysis
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H
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The study showed that social interaction and occupations formed the two foundations of the day centres
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Tsang, Ng (31)
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Effects of the ‘clubhouse’ model of rehabilitation on various psychosocial issues for Chinese patients with schizophrenia living in the community
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Hong Kong
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Mean age =40.5 years; Males &Females
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Chronic Schizophrenia
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longitudinal, case-controlled and naturalistic design/ Quantitative
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· Demographic and clinical variables
· Positive and Negative Syndrome Scale
· Beck Depression Inventory
· World Health Organization Quality of Life–Brief Version
· Rosenberg Self-esteem Scale
· Levenson Internality, Powerful Others and Chance Scale of Locus of Control
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Descriptive and Inferential Statistics
|
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The programme improve the psychological, social relationship and environmental quality of life of participants
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Tondora, O'Connell (42)
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Rationale, design, and lessons learned during the implementation of a randomized clinical trial testing the effect of using peer facilitative advocates to promote culturally responsive person-centred care planning on QOL variables, community connections, and coping for people of colour with psychotic disorders
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USA
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Mean age =43.5 years; Males &Females
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Schizophrenia, schizoaffective disorder, or affective disorder
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Randomized clinical trial/ Quantitative
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· Treatment Planning Questionnaire
· Sense of Community Index
· NEO-Five-Factor Inventory
· Multigroup Ethnic Identity Measure
· Scale of Ethnic Experiences
· Africultural Coping System Inventory
· Brief COPE
· Working Alliance Inventory – Short Form Revised (WAISFR)
· Health-Care Climate Questionnaire
· Recovery Self-Assessment
· Full Harmonized Social Capital Inventory
· Empowerment Scale
· Hope Scale
· Interpersonal Support Evaluation List
· Rosenberg Self-Esteem Scale
· MHSIP Consumer Satisfaction Survey
· QOL interview
· Paranoid Ideation and Psychoticism Subscales of the Symptom Checklist (SCL)-90
· SCL-90 anxiety dimension
· Global Assessment of Functioning – Modified Version
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Descriptive and Inferential Statistics
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H
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The project suggest the need to make a cultural modifications, longer engagement period with participants
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Twamley, Vella (49)
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To evaluate the efficacy of supported employment for middle-aged or older people with schizophrenia.
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USA
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Mean age =51 years; Males &Females
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Schizophrenia or schizoaffective disorder aged
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Randomized controlled trial/ Quantitative
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· UCSD Performance-Based Skills Assessment (UPSA)
· Positive and Negative Syndrome Scale (PANSS)
· Hamilton Rating Scale for Depression
|
Descriptive and Inferential Statistics
|
H
|
Individual Placement and Support (IPS) was effective for people with schizophrenia compared with conventional vocational rehabilitation (CVR)
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Waghorn, Dias (51)
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This investigation compared the utility of two approaches to measuring the effectiveness of a supported employment programme
|
Australia
|
Mean age =34.1 years; Males &Females
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Schizophrenia, schizoaffective disorder, schizophreniform disorders, bipolar affective disorder, major depression and anxiety disorders
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Non-randomised trial/ Quantitative
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· IPS fidelity scale
· Socially Valued Role Classification Scale (SRCS)
· Scale for the Assessment of Positive Symptoms (SAPS)
· Scale for the Assessment of Negative Symptoms (SANS)
· Demographic information
|
Descriptive and Inferential Statistics
|
H
|
The non-RCT IPS cohort were more effective in gaining competitive employment compared with RCT IPS
|
Whitley, Harris (43)
|
Explore and elucidate whether components of these communities appeared to assist recovery from the point of view of consumers, and if so which were the most important factors
|
USA
|
|
|
Grounded theory approach/ Qualitative
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· Focus groups
· Observations
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grounded theory approach
|
H
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The community is perceived as a place of safety, surrogate family, socialization and individual growth
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Zemore and Kaskutas (45)
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explores whether services received differed by program modality (i.e., day hospital vs. residential)
|
USA
|
Adults aged ≥ 18 years; Males &Females
|
Alcohol dependent only Drug dependent only
Alcohol and drug dependent
|
Randomized controlled trial/ Quantitative
|
· Treatment Services Review (TSR
· Demographics and other covariates
|
Descriptive and Inferential Statistics
|
H
|
Residential participants showed greater participation in sober recreational events and informal socialization with peers. Higher participation in optional or extracurricular 12-step meetings was associated with better treatment outcomes
|
Zhou, Zhou (44)
|
Effectiveness of the rehabilitation services provided at the ‘Sunshine Soul Park’ on the psychotic symptoms and social functioning of individuals with schizophrenia
|
China
|
Mean age =39.2 years; Males &Females
|
Schizophrenia
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Non- Randomize Controlled trial/ Quantitative
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· PANSS
· Quality of Life Inventory-74 (GQOLI-74)
· Social Disability Screening Schedule (SDSS)
· Insight and Treatment Attitude Questionnaire (ITAQ)
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Descriptive and Inferential Statistics
|
H
|
The intervention is effective in improving the social functioning of patients with schizophrenia and in helping them understand and manage their illness
|