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Improving Transitional Care for Individuals with Severe Mental Illness: The Role of Narrative Repair
Description
Traditional healthcare narratives have set the stage for the care of the population with Severe Mental Illness (P-SMI). Thus far, two prevailing health strategies anchor services for mental illnesses, acute psychiatric care, and mental health, psychosocial rehabilitation. Between these, care transitions mediate PSMI’s needs and their movements from the hospital to the community and home. However, as individuals with Severe Mental Illness (i-SMI’s) leave the hospital, time is short with little opportunity to make known authentic narratives born out of self-evidence. After transitional care, maintenance treatment re-centers these individuals back into a playbook with operatives of pathology and disability and inconsistencies with the narratives on recovery and rehabilitation.
This project sought to hear i-SMI’s stories and propose how their experience can be used to create a new “counter” story of transition that empowers these individuals through a better understanding of their “space”: conceptualized here, as all that surrounds them and is dynamic and responsive to their interactions and needs. Underpinning this inquiry is a post-modernist conversation that converges on the critical perspectives in the theory of architecture, philosophy of mind, cognitive science, and the aesthetic practice of psychiatric nursing in the context of transitional care. A qualitative paradigm of narrative repair guides an ethical appraisal, “deprivation of opportunity,” and “infiltrated consciousness,” regarding relational power dynamics that are at work in healthcare master narratives.
Narrative findings of this study reveal that identity and agency come together in a personal space of safety born out of a core sense of self, belonging, and control. Space emerges within the self-narrative as physical sensibilities in the constructs of agency and safety, and as with emotional responses, metaphor and meaning can repair personal transitions.
The counterstory derived from the narrative findings reveals: Equitable relational dynamics attune social space, the physical environment, and meaning, as a response to the dismissiveness and overcontrolling health professional power. Thus, the journey toward narrative repair from the perspective of i-SMI’s uncovers a deeper counternarrative, Ecosystem of Space: the manifestation of a personal architecture for healing, making a systematic organic-space-experience for the core sense of self to transition and flourish.
This project sought to hear i-SMI’s stories and propose how their experience can be used to create a new “counter” story of transition that empowers these individuals through a better understanding of their “space”: conceptualized here, as all that surrounds them and is dynamic and responsive to their interactions and needs. Underpinning this inquiry is a post-modernist conversation that converges on the critical perspectives in the theory of architecture, philosophy of mind, cognitive science, and the aesthetic practice of psychiatric nursing in the context of transitional care. A qualitative paradigm of narrative repair guides an ethical appraisal, “deprivation of opportunity,” and “infiltrated consciousness,” regarding relational power dynamics that are at work in healthcare master narratives.
Narrative findings of this study reveal that identity and agency come together in a personal space of safety born out of a core sense of self, belonging, and control. Space emerges within the self-narrative as physical sensibilities in the constructs of agency and safety, and as with emotional responses, metaphor and meaning can repair personal transitions.
The counterstory derived from the narrative findings reveals: Equitable relational dynamics attune social space, the physical environment, and meaning, as a response to the dismissiveness and overcontrolling health professional power. Thus, the journey toward narrative repair from the perspective of i-SMI’s uncovers a deeper counternarrative, Ecosystem of Space: the manifestation of a personal architecture for healing, making a systematic organic-space-experience for the core sense of self to transition and flourish.
ContributorsTsikopoulos, Zaharenia Vasiliki (Author) / Lamb, Gerri S. (Thesis advisor) / Krahe, Jennifer A.E. (Committee member) / De La Garza, Sarah A. (Committee member) / Arizona State University (Publisher)
Created2020
Description
Advancing medical and surgical care has cause for there to be a rapidly growing population of adults with congenital heart disease (CHD). Now that pediatric patients with CHD are living into adulthood there is a problem with the lack of transitional care these patients receive. The lack of transitional care has led to many issues that adult congenital heart disease (ACHD) patients face such as a lack of autonomy and knowledge, which contributes to an increased chance for a lapse in their care. Lapses in care lead to greater risks of heart failure, arrhythmias, morbidity, and premature death. Research revealed that there is a gap in the transitional care process for patients with CHD from the pediatric to adult healthcare setting that needs to be addressed. Nurses can aid in this process by establishing habits of independence as well as teaching CHD patients about their condition and its care requirements at a younger age. This creative project aims to educate nurses working in the pediatric cardiovascular acute care setting on ways they can aid in the transition process of patients with CHD as they grow out of the pediatric care setting and into the adult care setting in order to establish continuity of care.
ContributorsHauptman, Kristen (Author) / Beals, Jacquelin (Thesis director) / Quillman, Jill (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2020-12