Family Involvement in Early Intervention Services for Psychosis in Canada
Bibliographic record
Abstract
Background: Despite being beneficial, family involvement is inconsistently implemented in early psychosis care and poorly studied from the perspective of patients, families and clinicians.Addressing these gaps, this thesis aimed to synthesize and appraise family-focused recommendations in early psychosis guidelines; explore patients', families', and clinicians' views about involving families in early psychosis care; and examine forms of and attitudes towards family involvement as reported by patients, families, and clinicians over two years of early psychosis care.Methods: Study 1 involved a systematic search for Canadian early psychosis guidelines.Two reviewers screened records; extracted, content-analyzed and mapped family-focused recommendations onto an engagement framework; and appraised guidelines.Study 2 used a modified nominal group technique.Three patients, three family members and three clinicians from a Canadian early psychosis service participated in a one-day group discussion and then ranked statements generated from that discussion.Qualitative thematic analysis was used to analyze discussion data.Ranks were grouped to identify most, moderately and least important statements.Study 3 included data from patients, families and clinicians on six questions about concrete forms of and attitudes towards family involvement at months 1, 12 and 24 after entering two Montreal early psychosis services.Generalized estimating equations and proportional odds models were used to examine change over time and between patients (n=82), families (n=113) and clinicians (with respect to 147 patients).Results: Study 1 included seven guidelines.Ninety-six specific family-focused recommendations were extracted and classed into twenty-one themes.Only two themes were endorsed by five of seven guidelines.Most recommendations were about direct care, and few about engaging families in design, governance and policy.Quality was lower for family-focused recommendations than for overall guidelines.Families' values and preferences were rarely elicited in developing guidelines.In Study 2, three themes were identified: meaning and value of family involvement; factors influencing family involvement (including consent and confidentiality); and preferred ways and methods of family Contribution of AuthorsThis dissertation comprises six chapters and three manuscripts.I, Helen Martin, was responsible for the conception and writing of all components of this thesis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.014 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.017 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".