Adele Smith - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych)
<p><strong>Systematic Review of the Literature</p></strong> <p>What psychological interventions are effective for individuals with prolonged post-concussion symptoms of at least 12 months following mild traumatic brain injury? A Systematic Review</p> <p>&l...
| Main Author: | |
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
2024
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| Subjects: |
| _version_ | 1811140445409902592 |
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| author | Smith, A |
| author2 | King, N |
| author_facet | King, N Smith, A |
| author_sort | Smith, A |
| collection | OXFORD |
| description | <p><strong>Systematic Review of the Literature</p></strong>
<p>What psychological interventions are effective for individuals with prolonged post-concussion symptoms of at least 12 months following mild traumatic brain injury? A Systematic Review</p>
<p><strong>Background:</strong> For some, post-concussion symptoms following a mild traumatic brain injury are prolonged in nature, lasting for a minimum of 12 months, and up to many years. There remains limited insight into the effectiveness of psychological interventions for the treat-ment of prolonged post-concussion symptoms (PPCS) following mild traumatic brain injury (mTBI) of 12 months or longer.</p>
<p><strong>Aim:</strong> To conduct a systematic review of the literature to evaluate the effectiveness of psychological interventions for PPCS (>12 months post mTBI).</p>
<p><strong>Method:</strong> A systematic search was performed across five peer-reviewed databases (PsychINFO, Medline, Web of Science, Cumulative Index to Nursing and Allied Health Lit-erature (CINAHL), & PubMed). Two independent researchers assessed the studies against pre-defined eligibility criteria and the studies were quality appraised. Eleven studies were in-cluded in the final selection of papers in this review and underwent narrative synthesis.</p>
<p><strong>Results:</strong> A narrative synthesis across the eleven papers identified four psychological in-tervention approaches for PPCS. 1. Cognitive Behavioural Therapy (CBT). 2. Neurofeedback Therapy. 3. Psychoeducation. 4. Mindfulness-based therapy. The results suggest that psycho-logical interventions may be effective in reducing certain PPCS.</p>
<p><strong>Conclusions:</strong> Psychological interventions appear effective in reducing various PPCS and improving overall quality of life (QoL). CBT appears to have the strongest evidence base and to be the most effective in improving anxiety, anger and overall mental well-being. Further research with more robust methodological designs is required to further explore the effective-ness of psychological interventions for individuals with PPCS following a mTBI.</p></br>
<p><strong>Service Improvement Project</p></strong>
<p>Investigating and understanding how multiple re-referrals can be reduced and support improved for service users with multiple referrals into Berkshire Talking Therapies</p>
<p><strong>Background:</strong> Talking Therapies (TT), previously called Improving Access to Psycho-logical Therapies (IAPT), support individuals with mental health difficulties in England. Re-search suggests that greater clinical complexity increases the likelihood of re-referring to TT, which results in poorer clinical outcomes. Berkshire Talking Therapies (BTT) raised concerns about service users (SUs) with multiple referrals; they wanted to understand the factors sur-rounding re-referral rates.</p>
<p><strong>Method:</strong> A mixed-methods design was used. A binomial logistic regression explored ‘clinical characteristics’ and demographics variables on the likelihood of being a ‘high’ or ‘low’ referrer to BTT. Secondly, interviews with previous SUs with multiple referrals to BTT were conducted, and thematic analysis used to analyse the findings.</p>
<p><strong>Results:</strong> The logistic regression model suggested several variables increased the likeli-hood of being a ‘high referrer’ to BTT (i.e., individuals of ‘other’ religious groups, being sin-gle, having a long-term condition, high scores on the PHQ-9, and being discharged due to hav-ing ‘dropped out of treatment’). Thematic analysis identified four key themes, 1. Support and connectedness, 2. Managing mental health dips, 3. Expectations not met and 4. Barriers to en-gagement.</p>
<p><strong>Conclusions:</strong> This study identified factors which significantly increased the likelihood of re-referring to BTT and explored SUs perspectives on why they re-referred on multiple oc-casions. Recommendations to BTT included additional staff training, utilising the Practical Support Service and liaison with the Long-Term Conditions Pathway.</p></br>
<p><strong>Theory Driven Research Project</p></strong>
<p>Exploring the Prevalence and Impact of Health Anxiety in Chronic Obstructive Pulmo-nary Disease</p>
<p><strong>Background:</strong> Chronic Obstructive Pulmonary Disease (COPD) is a debilitating life-long condition affecting the respiratory system. COPD is a major cause of mortality worldwide, with an ever-increasing prevalence across the population (Devine, 2008). Previous studies indi-cate that people with COPD experience high rates of anxiety, including health anxiety (HA). Studies of other chronic physical health conditions found that high HA leads to greater negative misperceptions of physical functioning and impacts quality of life, mental health, and self-rated disability (Carrigan et al., 2018; Daniels et al., 2017; Diamond et al., 2022; Hayter et al., 2016).</p>
<p><strong>Method:</strong> Participants were recruited from a community-based NHS population. Forty-two participants with COPD were screened for HA and assigned to either a high or a low-health anxiety group. Participants completed a physical functioning task, alongside measures for perception of physical performance, mood, quality of life and disability. Comparisons were made with a healthy control (HC) group.</p>
<p><strong>Results:</strong> COPD participants with high HA misperceived themselves as performing poorer on a physical functioning task. Participants with high HA and COPD reported a greater self-reported disability compared to the HC group.</p>
<p><strong>Conclusion:</strong> HA is highly prevalent within those diagnosed with COPD, which can impact on perceptions of physical performance and self-reported disability. Given this, further research is needed to explore the effectiveness of psychological interventions to reduce HA in individuals with COPD.</p> |
| first_indexed | 2024-09-25T04:22:06Z |
| format | Thesis |
| id | oxford-uuid:6b521e7a-e4c2-4191-b62c-9eff7b25e5cd |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-09-25T04:22:06Z |
| publishDate | 2024 |
| record_format | dspace |
| spelling | oxford-uuid:6b521e7a-e4c2-4191-b62c-9eff7b25e5cd2024-08-19T12:05:58ZAdele Smith - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych) Thesishttp://purl.org/coar/resource_type/c_db06uuid:6b521e7a-e4c2-4191-b62c-9eff7b25e5cdIAPTBrain--Wounds and injuries--ComplicationsPsychologyIllness anxiety disorderLungs--Diseases, ObstructiveEnglishHyrax Deposit2024Smith, AKing, NCarrigan, NJenner, SJell, GDaniel, C<p><strong>Systematic Review of the Literature</p></strong> <p>What psychological interventions are effective for individuals with prolonged post-concussion symptoms of at least 12 months following mild traumatic brain injury? A Systematic Review</p> <p><strong>Background:</strong> For some, post-concussion symptoms following a mild traumatic brain injury are prolonged in nature, lasting for a minimum of 12 months, and up to many years. There remains limited insight into the effectiveness of psychological interventions for the treat-ment of prolonged post-concussion symptoms (PPCS) following mild traumatic brain injury (mTBI) of 12 months or longer.</p> <p><strong>Aim:</strong> To conduct a systematic review of the literature to evaluate the effectiveness of psychological interventions for PPCS (>12 months post mTBI).</p> <p><strong>Method:</strong> A systematic search was performed across five peer-reviewed databases (PsychINFO, Medline, Web of Science, Cumulative Index to Nursing and Allied Health Lit-erature (CINAHL), & PubMed). Two independent researchers assessed the studies against pre-defined eligibility criteria and the studies were quality appraised. Eleven studies were in-cluded in the final selection of papers in this review and underwent narrative synthesis.</p> <p><strong>Results:</strong> A narrative synthesis across the eleven papers identified four psychological in-tervention approaches for PPCS. 1. Cognitive Behavioural Therapy (CBT). 2. Neurofeedback Therapy. 3. Psychoeducation. 4. Mindfulness-based therapy. The results suggest that psycho-logical interventions may be effective in reducing certain PPCS.</p> <p><strong>Conclusions:</strong> Psychological interventions appear effective in reducing various PPCS and improving overall quality of life (QoL). CBT appears to have the strongest evidence base and to be the most effective in improving anxiety, anger and overall mental well-being. Further research with more robust methodological designs is required to further explore the effective-ness of psychological interventions for individuals with PPCS following a mTBI.</p></br> <p><strong>Service Improvement Project</p></strong> <p>Investigating and understanding how multiple re-referrals can be reduced and support improved for service users with multiple referrals into Berkshire Talking Therapies</p> <p><strong>Background:</strong> Talking Therapies (TT), previously called Improving Access to Psycho-logical Therapies (IAPT), support individuals with mental health difficulties in England. Re-search suggests that greater clinical complexity increases the likelihood of re-referring to TT, which results in poorer clinical outcomes. Berkshire Talking Therapies (BTT) raised concerns about service users (SUs) with multiple referrals; they wanted to understand the factors sur-rounding re-referral rates.</p> <p><strong>Method:</strong> A mixed-methods design was used. A binomial logistic regression explored ‘clinical characteristics’ and demographics variables on the likelihood of being a ‘high’ or ‘low’ referrer to BTT. Secondly, interviews with previous SUs with multiple referrals to BTT were conducted, and thematic analysis used to analyse the findings.</p> <p><strong>Results:</strong> The logistic regression model suggested several variables increased the likeli-hood of being a ‘high referrer’ to BTT (i.e., individuals of ‘other’ religious groups, being sin-gle, having a long-term condition, high scores on the PHQ-9, and being discharged due to hav-ing ‘dropped out of treatment’). Thematic analysis identified four key themes, 1. Support and connectedness, 2. Managing mental health dips, 3. Expectations not met and 4. Barriers to en-gagement.</p> <p><strong>Conclusions:</strong> This study identified factors which significantly increased the likelihood of re-referring to BTT and explored SUs perspectives on why they re-referred on multiple oc-casions. Recommendations to BTT included additional staff training, utilising the Practical Support Service and liaison with the Long-Term Conditions Pathway.</p></br> <p><strong>Theory Driven Research Project</p></strong> <p>Exploring the Prevalence and Impact of Health Anxiety in Chronic Obstructive Pulmo-nary Disease</p> <p><strong>Background:</strong> Chronic Obstructive Pulmonary Disease (COPD) is a debilitating life-long condition affecting the respiratory system. COPD is a major cause of mortality worldwide, with an ever-increasing prevalence across the population (Devine, 2008). Previous studies indi-cate that people with COPD experience high rates of anxiety, including health anxiety (HA). Studies of other chronic physical health conditions found that high HA leads to greater negative misperceptions of physical functioning and impacts quality of life, mental health, and self-rated disability (Carrigan et al., 2018; Daniels et al., 2017; Diamond et al., 2022; Hayter et al., 2016).</p> <p><strong>Method:</strong> Participants were recruited from a community-based NHS population. Forty-two participants with COPD were screened for HA and assigned to either a high or a low-health anxiety group. Participants completed a physical functioning task, alongside measures for perception of physical performance, mood, quality of life and disability. Comparisons were made with a healthy control (HC) group.</p> <p><strong>Results:</strong> COPD participants with high HA misperceived themselves as performing poorer on a physical functioning task. Participants with high HA and COPD reported a greater self-reported disability compared to the HC group.</p> <p><strong>Conclusion:</strong> HA is highly prevalent within those diagnosed with COPD, which can impact on perceptions of physical performance and self-reported disability. Given this, further research is needed to explore the effectiveness of psychological interventions to reduce HA in individuals with COPD.</p> |
| spellingShingle | IAPT Brain--Wounds and injuries--Complications Psychology Illness anxiety disorder Lungs--Diseases, Obstructive Smith, A Adele Smith - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych) |
| title | Adele Smith - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych)
|
| title_full | Adele Smith - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych)
|
| title_fullStr | Adele Smith - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych)
|
| title_full_unstemmed | Adele Smith - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych)
|
| title_short | Adele Smith - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych)
|
| title_sort | adele smith thesis submitted in partial fulfilment of the degree of doctor of clinical psychology dclinpsych |
| topic | IAPT Brain--Wounds and injuries--Complications Psychology Illness anxiety disorder Lungs--Diseases, Obstructive |
| work_keys_str_mv | AT smitha adelesmiththesissubmittedinpartialfulfilmentofthedegreeofdoctorofclinicalpsychologydclinpsych |