Hospitality project (HY): Combining peer support and home-based skill training in people with schizophrenia (Netherlands)

Plain English Summary

Background and study aims
Psychotic disorders are a group of serious mental health problem that affect how a person thinks, feels and behaves. One of the most common examples of a psychotic disorder is schizophrenia. Psychotic disorders cause a range of symptoms including hallucinations (seeing or hearing things that aren’t there), delusions (beliefs that are not based on reality) and changes in behaviour. These symptoms can lead to problems socialising with others, often leading to loneliness and isolation. Attempts have been made during the last decade to improve skills for social and community functioning in patients with psychotic disorders, but clinic-based social skill training is not necessarily directly transferable to real-life situations. Home-based programs are expected to be more effective, because skills are learned in the same context as needed in daily life. Research showed that home-based skills programs in schizophrenia led to more improvement in social and community functioning than traditional clinic-based ones. However, more research is needed to look at the overall effect of home-based training on patients’ functioning. Peer support groups have been shown to have positive effects on social networks, social support, recovery, empowerment and hope. They involve working with trained “peers” who have gone through a process of recovery, assisting other people with mental health issues. The aim of this study is to look at the effectiveness of a nurse-led program that combines home-based skill training combined with nurse guided peer support.

Who can participate?
Adults who have been diagnosed with schizophrenia and other psychotic disorders.

What does the study involve?
Participants are randomly allocated to one of two groups. Those in the first group take part in the nurse-led program. This program is structured around an eating club, providing opportunities to practice skills in the living environment. Over 18 weeks, three patients take it in turns to organise nine dinners at home with support from a nurse. Having dinner together creates a peer support setting and organizing a dinner offers many naturally occurring opportunities to work on social- and community living skills in patients’ personal environment. During the main course of dinner, participants start off by exchanging positive experiences they had during the past two weeks. The group then chooses an illness-related discussion topic during dessert that afterwards is discussed in a twenty-minute session. The nurse concludes each meeting by reinforcing the participants for their efforts and reiterating the next dinner appointment. Each dinner takes approximately two hours. Participants also receive skills training in self-management (e.g. cooking, planning, cleaning) or social skills (e.g. complimenting, assertiveness, listening), which can be delivered on the telephone or face-to-face. Those in the second group are placed on a waiting list and receive the program after the study has finished. At the start of the study and after eight and 12 months, participants in both groups complete a range of questionnaires to assess their mental wellbeing and social functioning.

http://www.isrctn.com/ISRCTN14282228

http://www.hyproject.net/

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