title: A conceptual framework for improving well-being in people with a diagnosis of psychosis.
abstract: Background. Well-being is important for people with severe mental illness, such as psychosis. So far, no clear concept of well-being exists for this client group. A recent systematic review and narrative synthesis developed a static framework of well-being components. The present study aims to validate the static framework and to illuminate the processes by which well-being is experienced by people with psychosis. Methods. Semi-structured interviews were conducted with 23 service users with psychosis exploring their experience of well-being. Thematic analysis was used to analyse the data employing techniques taken from grounded theory to enhance the rigour of the analysis. Respondent validation was undertaken with 13 of the 23 participants. Results. Three superordinate categories of well-being were identified: current sense of self; transition to enhanced sense of self and enhanced sense of self. In the dynamic process of improving well-being the current sense of self undergoes a transition to an enhanced sense of self. The four factors influencing the transition are consistent with the static framework of well-being, hence validating the static framework. In addition, we identified three determinants of current sense of self and seven indicators of enhanced sense of self, which represent the achievement of improved well-being. Conclusions. This study provides an empirically defensible framework for understanding well-being in terms of determinants, influences and indicators. The influences are targets for interventions to improve well-being, and the indicators are outcome domains to assess the effectiveness of services in supporting well-being.
authors: Health Service and Population Research Department,King's College London, Institute of Psychiatry,London,UK.
authors: B
authors: B
authors: Schrank
authors: Health Service and Population Research Department,King's College London, Institute of Psychiatry,London,UK.
authors: S
authors: S
authors: Riches
authors: Health Service and Population Research Department,King's College London, Institute of Psychiatry,London,UK.
authors: V
authors: V
authors: Bird
authors: Health Service and Population Research Department,King's College London, Institute of Psychiatry,London,UK.
authors: J
authors: J
authors: Murray
authors: Health Service and Population Research Department,King's College London, Institute of Psychiatry,London,UK.
authors: A
authors: A
authors: Tylee
authors: Health Service and Population Research Department,King's College London, Institute of Psychiatry,London,UK.
authors: M
authors: M
authors: Slade
references: Epidemiol Psichiatr Soc. 2007 Jan-Mar;16(1):10-5
references: 17427599
references: BMC Health Serv Res. 2010 Jan 26;10:26
references: 20102609
references: Int J Behav Med. 2014 Apr;21(2):230-9
references: 23436184
references: BMC Public Health. 2012 Sep 10;12:758
references: 22963588
references: Trials. 2012 Jul 24;13:115
references: 22827885
references: Psychiatr Serv. 2011 Dec;62(12):1470-6
references: 22193795
references: Am Psychol. 2013 Apr;68(3):124-33
references: 23586488
references: Psychiatr Serv. 2006 Jan;57(1):120-2
references: 16399972
references: Br J Psychiatry. 2011 Dec;199(6):445-52
references: 22130746
references: BMC Health Serv Res. 2013 Mar 04;13:80
references: 23452404
references: Clin Psychol Rev. 2011 Mar;31(2):236-48
references: 20447745
references: Aging Ment Health. 2014;18(1):4-10
references: 23452097
references: Clin Rehabil. 2013 Apr;27(4):291-8
references: 22843353
references: J Med Internet Res. 2012 Jun 25;14(3):e63
references: 22732765
references: Epidemiol Psychiatr Sci. 2012 Dec;21(4):371-9
references: 22794790
references: Curr Opin Psychiatry. 2009 Jan;22(1):55-60
references: 19122536
references: Psychol Rev. 1977 Mar;84(2):191-215
references: 847061
references: Soc Sci Med. 2013 Sep;92:9-21
references: 23849274
references: BMC Psychiatry. 2011 Nov 23;11:185
references: 22112008
references: AIDS Behav. 2013 Jun;17(5):1785-95
references: 23456594
references: Epidemiol Psychiatr Sci. 2013 Dec;22(4):363-74
references: 23445538
references: Epidemiol Psychiatr Sci. 2011 Dec;20(4):303-5
references: 22201206
references: Psychiatr Serv. 2012 Jul;63(7):702-4
references: 22752033
references: Epidemiol Psychiatr Sci. 2013 Mar;22(1):47-62
references: 22794315
references: Br J Psychiatry. 2014;204:256-61
references: 24692752
references: Epidemiol Psichiatr Soc. 2010 Jan-Mar;19(1):63-71
references: 20486425
references: Epidemiol Psychiatr Sci. 2011 Mar;20(1):29-31
references: 21657112
references: J Clin Psychol. 2012 May;68(5):490-501
references: 22498950
references: Behav Cogn Psychother. 2012 Jan;40(1):105-9
references: 21902854
references: Epidemiol Psychiatr Sci. 2013 Jun;22(2):147-50
references: 23098565
references: Epidemiol Psychiatr Sci. 2012 Dec;21(4):367-9
references: 22794112
references: Epidemiol Psychiatr Sci. 2012 Dec;21(4):353-64
references: 22794507
references: Science. 2012 Sep 21;337(6101):1505-10
references: 22997331
references: Rehabil Psychol. 2013 Feb;58(1):1-9
references: 23437995
references: Soc Work Public Health. 2012;27(5):441-68
references: 22873935
references: Psychiatr Rehabil J. 2004 Winter;27(3):205
references: 14982325
references: Cogn Behav Ther. 2012;41(3):185-202
references: 22074317
references: Epidemiol Psychiatr Sci. 2013 Jun;22(2):131-46
references: 22831843
references: Psychol Sci. 2002 Mar;13(2):172-5
references: 11934003
references: Epidemiol Psychiatr Sci. 2013 Mar;22(1):21-8
references: 23114056
references: Epidemiol Psychiatr Sci. 2012 Mar;21(1):27-9
references: 22670409