The collaborative development through multidisciplinary and advocate consensus of an accessible notice of rights for people with intellectual disabilities in police custody.

Background People with intellectual disabilities are over-represented in the criminal justice system. The United Nations' Convention on the Rights of Persons with Disabilities (UNCRPD) enshrines a right to equal access to justice for persons with disabilities (Article 13, UNCRPD). Accessible information is a key aspect of exercising this right. Yet, many jurisdictions, including Ireland, are yet to develop accessible information for disabled people who may be arrested. Aims This paper describes the collaborative development through multidisciplinary and advocate consensus of an accessible (Easy -to- Read) Notice of Rights (ERNR) for people with intellectual disabilities in police custody in Ireland. Methods Guidelines developed by Ireland's representative organisation for people with intellectual disabilities and examples of international practice were used to develop a draft ERNR by the primary researcher in partnership with an expert from a representative organisation for people with intellectual disabilities. The ERNR was developed thereafter through two focus groups with a view to achieving consensus with a focus on accessibility, accuracy and layout. This included a multidisciplinary focus group with participants from a representative organisation for people with intellectual disabilities, psychology, speech and language therapy, the police force, public health, forensic psychiatry, mental health, law and, subsequently, a focus group of people with lived experience of intellectual disability. Results Progressive development of the ERNR resulted in incremental improvements in textual accuracy as well as the inclusion of more accessible language and imagery. Originality/value This is the first attempt at developing an easy-to-read document relating to the legal rights of suspects in police custody in Ireland and, accordingly, this procedural innovation promises to assist, not just persons with intellectual disabilities, but also those with limited literacy at the point of arrest. The methodology used in the preparation of the document, employing a focus group to achieve consensus with participation from both multiple disciplines and persons with an intellectual disability, is in harmony with the ethos of the UNCPRD. This methodology may usefully be employed by other member states that have ratified the Convention but have yet to develop accessible version of the legal rights and entitlements that extend to arrested persons under their domestic law.

Dental survey of the mentally disabled patients / Értelmi sérültek fogászati állapotának felmérése.

Összefoglaló. Bevezetés: Magyarországon 100 000 olyan értelmi sérült él, akik speciális ellátásra szorulnak. Elozoleg beszámoltunk az akut fogászati ellátás eredményeirol és problémáiról. Ahhoz azonban, hogy a teljes fogászati rehabilitáció felé lépéseket lehessen tenni, ismerni kell az ilyen betegek fogászati állapotát. Célkituzés: Statisztikailag releváns, nagyobb beteganyagon felmérni az értelmi sérült betegek fogászati állapotát, összehasonlítva mind az orvosi rehabilitációs kezelésben részesülo betegek (foleg testi fogyatékosok), mind az általános populáció adataival. Módszer: A fogászati állapot felmérésére két betegcsoport állt rendelkezésünkre. Összesen 325 beteg statusát rögzítettük. A vizsgáltakat 3 csoportba osztottuk: enyhe (36), közepes (247) és súlyos (42) értelmi sérültek. Az értelmi sérült betegek fogászati állapotát DMF-T-indexszel mértük, és összehasonlítottuk az orvosi rehabilitációs kezelésben részesülo betegek és az általános populáció adataival is. Eredmények: A 325 szellemi sérült össz-DMF-T-indexének átlaga ± szórás: 11,04 ± 7,35; a carieses fogak számának átlaga: D = 3,66 ± 4,61; a hiányzó fogak számának átlaga: M = 5,22 ± 5,74. A fogmegtartó kezelés minimális volt: átlag F = 2,16 ± 3,12. Azoknak az értelmi sérülteknek, akik intézetben élnek, rosszabb a fogazati állapotuk, mint azoknak, akik családban vannak. Következtetések: Az eredményekbol látszik, hogy az értelmi sérültek fogai elhanyagoltabbak, mint a normálpopuláció esetében. A DMF-T-index önmagában nem tükrözi ezeket a magállapításokat, csak akkor, ha szétbontva vizsgáljuk az adatokat. Orv Hetil. 2021; 162(42): 1698-1702. INTRODUCTION: There are 100,000 mentally disabled individuals in Hungary requiring special care. Previously, we reported the results and problems of acute dental care. However, in order to take the appropriate measures toward holistic dental rehabilitation, clarity regarding the condition of those mentally disabled individuals is necessary. OBJECTIVE: To measure the dental health of mentally disabled individuals based on a large sample of patients, to compare the results with both differently-abled (i.e., primarily physically disabled) individuals and the general population. METHODS: There were two available patient cohorts for the measurement of dental health. With the two cohorts combined, we recorded data about 325 patients. We split the patients into three groups: mild (36), medium (247), and severe (42) mental disability. We used DMF-T index to measure dental health status, and compared the results with those of physically disabled and the general population. RESULTS: The mean ± deviation of DMF-T index of the disabled patients was 11.04 ± 7.35; the mean of decayed teeth: D = 3.66 ± 4.61; the missing teeth: M = 5.22 ± 5.74; the filled teeth: F = 2.16 ± 3.12. Mentally disabled patients living in institutions showed worse dental health than those living with families. CONCLUSIONS: The results show that the teeth of mentally disabled patients are more neglected than those of the general population. The DMF-T index does not mirror these conclusions unless we examine each data set separately. Orv Hetil. 2021; 162(42): 1698-1702.

Vitamins K and D deficiency in severe motor and intellectually disabled patients.

OBJECTIVES: We aimed to determine serum 25-hydroxyvitamin D (25(OH)D) and undercarboxylated osteocalcin (ucOC) levels in severe motor and intellectual disabilities (SMID) patients and their association with bone turnover biomarkers. METHODS: We assessed vitamin D and K levels as indicators of osteoporosis in institutionalized adults with SMID. From December 2019 to February 2020, 93 institutionalized patients (48 men, 45 women; median age, 49 years) underwent annual routine examinations. Serum ucOC, 25(OH)D, bone-specific alkaline phosphatase (BAP), and tartrate-resistant acid phosphatase A 5b (TRACP-5b) levels as bone formation and resorption markers and calcium and phosphorous levels were measured. Vitamin K deficiency was indirectly assessed based on ucOC levels. RESULTS: Mean ucOC levels were higher than normal (i.e., vitamin K deficiency). Serum 25(OH)D levels were markedly diminished. Overall, 86% of patients had deficient 25(OH)D levels. These 25(OH)D-deficient patients had higher ucOC levels. Multiple linear regression analysis revealed an inverse correlation between 25(OH)D and ucOC levels. ucOC levels were significantly higher and 25(OH)D levels were significantly lower in tube feeding. TRACP-5b levels were significantly higher in elderly than in young women. BAP and TRACP-5b levels were normal in adults. No relationship existed between vitamin D and antiepileptic drug use. CONCLUSIONS: Vitamin K and D co-deficiency was common in SMID patients. Vitamin K and D deficiencies were worse in tube-fed patients than in oral intake patients. SMID patients should undergo regular monitoring of vitamin D and K levels and supplementation of these vitamins.

Intervenções Assistidas por Animais na expressão psíquica de Deficientes Intelectuais Adultos (IAA e Deficiência intelectual) / Intervenciones Asistidas por Animales en la expresión psíquica de Deficientes Intelectuales Adultos (IAA e Deficientes Intelectuales) / Animal-Assisted Interventions in the Psychic Expression of Intellectually Disabled Adults (IAA and Intellectually Disabled)

INTRODUÇÃO: Esta pesquisa problematiza a interação entre sujeitos adultos com Deficiência Intelectual e cães, sob a perspectiva das Intervenções Assistidas por Animais (IAA). OBJETIVO: Descrever os efeitos da IAA na expressão verbal e não verbal de conteúdos psíquicos em sujeitos adultos com deficiência intelectual. MÉTODO: Pesquisa de natureza qualitativa. Participaram 04 sujeitos do sexo feminino, idades entre 39 a 63 anos, com deficiência intelectual. Cão co-terapeuta: Amin, da raça Golden Retriever, 7 anos, selecionado de acordo com critérios de protocolos internacionais, conduzido pela pesquisadora. Foram realizadas 07 sessões de IAA, em grupo, com duração de 35 minutos cada, no decorrer de 03 meses. Foram aplicados os testes HTP e Wartegg realizados pré e pós sessões de IAA, cujos resultados foram analisados comparativamente intra sujeito. RESULTADOS: Na população estudada verificou-se em todos os sujeitos a expansão da personalidade e a redução da ansiedade pós IAA, além do aumento de verbalização e o cão como forte instrumento motivador. CONCLUSÃO: Os resultados desta pesquisa indicam a ocorrência de modificações psíquicas, verbais e não verbais, em diferentes graus, nos sujeitos com DI estudados.

INTRODUCTION: This research problematizes the interaction between adult subjects with Intellectual Disability and dogs, from the perspective of Animal-Assisted Interventions (IAA). OBJECTIVE: To describe the effects of IAA on verbal and nonverbal expression of psychic contents in adults with intellectual disabilities. METHOD: Qualitative research. Four female subjects, aged between 39 and 63 years, with intellectual disability participated. Dog co-therapists: Amin, Golden Retriever, 7 years old, selected according to criteria of international protocols, conducted by the researcher. There were 07 IAA sessions, in a group, lasting 35 minutes each, during the course of 03 months. The HTP and Wartegg tests were performed before and after IAA sessions, the results of which were analyzed comparatively. RESULTS: In the studied population, all subjects showed personality expansion and reduction of anxiety after IAA, in addition to increased verbalization and the dog as a strong motivating instrument.. CONCLUSION: The results of this research indicate the occurrence of psychic, verbal and nonverbal expression changes in different degrees in subjects with DI studied.

INTRODUCCIÓN: Esta investigación problematiza la interacción entre sujetos adultos con discapacidad intelectual y perros, desde la perspectiva de las intervenciones asistidas por animales (IAA). OBJETIVO: Describir los efectos de la IAA en la expresión verbal y no verbal de contenidos psíquicos en sujetos adultos con discapacidad intelectual. MÉTODO: Investigación de naturaleza cualitativa. Participaron 04 sujetos del sexo femenino, edades entre 39 a 63 años, con discapacidad intelectual. Perro co-terapeutas: Amin, de la raza Golden Retriever, 7 años, seleccionado de acuerdo con criterios de protocolos internacionales, conducido por la investigadora. Se realizaron 7 sesiones de IAA, en grupo, con una duración de 35 minutos cada una, en el transcurso de 03 meses. Se aplicaron las pruebas HTP y Wartegg realizadas pre y post sesiones de IAA, cuyos resultados se analizaron comparativamente. RESULTADOS: En la población estudiada se verificó en todos los sujetos la expansión de la personalidad y la reducción de la ansiedad post IAA además de una mayor verbalización y el perro como un fuerte instrumento de motivación.. CONCLUSIÓN: Los resultados de esta investigación indican la ocurrencia de modificaciones psíquicas, expresión verbal y no verbal en diferentes grados en los sujetos con DI estudiados.

"Moving on" through the locked ward system for women with intellectual disabilities.

BACKGROUND: The move to community support for all people with intellectual disabilities is an aspiration with international significance. In this article, we draw on rich accounts from women with intellectual disabilities detained under the Mental Health Act (E&W) 1983 and staff at an National Health Service secure setting in England to explore how "moving on" is defined and perceived. METHODS: The study reports on an ethnographic study using the field-notes and the 26 semi-structured interviews with detained women and staff on three wards. RESULTS: We first explore staff conceptions of moving on, which include behavioural change and utilizing coping strategies. Then, we discuss the areas of analysis that women discussed: taking back responsibility, success in arranged relationships, acceptance of regime and resistance to progression. CONCLUSION: The concepts of moving on were not determined by the women but by the service. We recommend further research which explores women's own rehabilitation requirements.

A mixed-methods, randomized controlled feasibility trial of Eye Movement Desensitization and Reprocessing (EMDR) plus Standard Care (SC) versus SC alone for DSM-5 Posttraumatic Stress Disorder (PTSD) in adults with intellectual disabilities.

OBJECTIVE: To report the results of the first randomized feasibility trial of Eye Movement Desensitization and Reprocessing (EMDR) plus Standard Care (SC) versus SC alone for DSM-5 posttraumatic stress disorder (PTSD) in adults with intellectual disabilities. METHOD: A total of 29 participants were randomized to either to EMDR + SC (n = 15) or SC (n = 14). Participants completed measures on traumatic stress (PCL-C) and comorbid distress at baseline, 1 week post-treatment and 3-month follow-up. RESULTS: In the EMDR + SC group, 9 (60%) participants at post-treatment and 7 (47%) participants at 3-month follow-up were diagnosis free. In SC, 4 (27%) at post-treatment and follow-up were diagnosis free. At post-treatment, three participants (20%) dropped out from the EMDR + SC group, and 1 (7%) dropped out from the SC group. CONCLUSIONS: It is feasible, acceptable and potentially effective to deliver EMDR in this population group.

Psychoeducational assessment of students with intellectual disability: professional-action framework analysis.

BACKGROUND: The right to educational inclusion for students with intellectual disability (SWID) requires the development of good assessment and intervention practices from holistic perspectives not exclusively focused on the academic limitations that SWID may present. These practices are settled in Spain, via regulations drawn up by each Autonomous Community (AC). The variety of existing regulations demands a critical review of the decisions taken to promote the inclusion of those students. METHOD: current regulations-in-force in each AC that regulate attention to diversity (AD) have been were analyzed by using a checklist that includes the variables that defining each stage of the AD process and the ways of providing supports that favor the development, learning and participation of SWID. RESULTS: attention to diversity measures in each AC emphasize organizational and curricular issues, with no AC following holistic approaches in both assessment and intervention, but rather neglecting self-determination and the promotion of quality of life for SWID. CONCLUSIONS: guidelines for the development of new legal frameworks and professional practices based on the latest evidence-based models of attention to SWID and on the results are discussed.

Music for All: Including young people with intellectual disability in a university environment.

We investigated a continuing education course in creative music making, initiated to promote the inclusion of young people with intellectual disability in a university setting. Despite organizers' attempts to foster diversity within the student cohort, enrolments were almost exclusively from students who had intellectual disability. Being in the university environment, and in a place of higher learning, seemed to be valued by some. However, students' main focus was on group musicking in a dedicated music room rather than interacting with the wider university community. Those who did not identify as disabled believed it was important to continue to address the barriers to wider inclusion. While acknowledging the risks around mediating the social interactions of young people with intellectual disability, we argue that future courses should include activities specifically designed to bring them to classes with typical students and to the wider activities of the university.

Low-Intensity Cognitive Behavioural Therapy-Based Music Group (CBT-Music) for the Treatment of Symptoms of Anxiety and Depression: A Feasibility Study.

BACKGROUND: Music has the potential to be an effective and engaging therapeutic intervention in the treatment of mental illness. This research area remains underdeveloped. AIMS: This paper reports the feasibility of an innovative low-intensity CBT-based music (CBT-Music) group targeted to symptoms of depression and anxiety. METHOD: A total of 28 participants with symptoms of depression and anxiety who were attending community mental health services were recruited for the study and randomized into TAU (treatment as usual) plus low-intensity CBT-Music (treatment) or to TAU alone (control). The treatment group consisted of a 9-week music group that incorporated various components of CBT material into a musical context. Feasibility was the primary outcome. The secondary outcomes were a reduction in depression, anxiety (Hospital Anxiety and Depression Scale) and disability (WHO Disability Assessment Schedule 2.0) assessed at baseline and 10 weeks. RESULTS: Recruitment proved feasible, retention rates were high, and the participants reported a high level of acceptability. A randomized control study design was successfully implemented as there were no significant differences between treatment and control groups at baseline. Participants in the treatment group showed improvement in disability (p = 0.027). Despite a reduction in depression and anxiety scores, these differences were not statistically significant. CONCLUSIONS: A low-intensity CBT-based music group can be successfully administered to clients of community mental health services. There are indications of effectiveness in reducing disability, although there appears to be negligible effect on symptoms of anxiety and depression. This is the first report of a trial of a low-intensity CBT-based music group intervention.

Current evidence on antenatal care provision for women with intellectual disabilities: A systematic review.

BACKGROUND: changing attitudes, alongside integration, more independent living and recognition of rights to family life have meant a steady rise in women with intellectual disabilities becoming pregnant. However, existing evidence shows that women with intellectual disabilities are less likely to seek or attend for regular antenatal care. This population experiences poorer maternal wellbeing and worse pregnancy outcomes compared to the general population, including preterm and low-birthweight babies. PURPOSE: to identify and review the existing evidence on the provision of antenatal care among women with intellectual disabilities. METHODS: a systematic search strategy was formulated using key Medical Sub-Headings terms and related text words for pregnancy, antenatal care and intellectual disability. Comprehensive searches dating back to 1980 using pre-determined criteria followed by a hand search of reference lists and citations were undertaken. Data were extracted using a data extraction form and methodological quality assessed using the framework developed by Caldwell et al. (2011). A three stage textual narrative synthesis was used to integrate the findings from the included studies. RESULTS: searches identified 16 papers that met the inclusion criteria. A majority of the papers focused on women's experience of pregnancy and antenatal care with a paucity of papers identified on midwives knowledge and experience. The four broad themes of the analysis and synthesis performed included: In the Family Way ('I've a baby inside. I've got a life inside of me.׳); Knowledge and advocacy ('...everyone was looking at one another and no one was talking to me...'); Midwives educational needs ('...helpful to have guidance...') and Midwives Attitudes ('...women with [intellectual disabilities]...should not be pregnant'). KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: significant gaps in the evidence base were apparent, however evidence was identified which showed that intellectually disabled pregnant women struggle to understand antenatal information communicated during pregnancy which was often text based. Maternity care providers need to make adjustments to their services so that antenatal communication, information and care is appropriate for this group of women. Midwives identified that they lacked knowledge in this area and wanted antenatal guidance on how to meet the care and communication needs of women with intellectual disabilities.

Congregational Participation of a National Sample of Adults With Intellectual and Developmental Disabilities.

Supporting people with intellectual and developmental disabilities (IDD) to thrive requires careful consideration of multiple avenues of community involvement. Yet little attention has focused on the place of faith community participation in the lives of adults with IDD. We examined attendance at religious services using National Core Indicator data for a sample of 12,706 adults with IDD residing in 24 states. Almost half of adults (48.3%) reported attending a religious service in the past month, and more than one third (34.6%) attended 3 or more times. Religious involvement varied considerably based on a variety of individual (e.g., race, disability type, behavioral support needs, communication mode) and contextual factors (e.g., geographic locale, residential type). Moreover, monthly involvement in religious activities was much less common than participation in other community activities (i.e., exercise, entertainment, eating out, shopping). We offer recommendations for supporting the spiritual lives of adults with IDD, as well as highlight areas for future research and practice.

Non-pharmacological interventions for people with epilepsy and intellectual disabilities.

BACKGROUND: Approximately 30% of patients with epilepsy remain refractory to drug treatment and continue to experience seizures whilst taking one or more antiepileptic drugs (AEDs). Several non-pharmacological interventions that may be used in conjunction with or as an alternative to AEDs are available for refractory patients. In view of the fact that seizures in people with intellectual disabilities are often complex and refractory to pharmacological interventions, it is evident that good quality randomised controlled trials (RCTs) are needed to assess the efficacy of alternatives or adjuncts to pharmacological interventions.This is an updated version of the original Cochrane review (Beavis 2007) published in The Cochrane Library (2007, Issue 4). OBJECTIVES: To assess data derived from randomised controlled trials of non-pharmacological interventions for people with epilepsy and intellectual disabilities.Non-pharmacological interventions include, but are not limited to, the following.• Surgical procedures.• Specialised diets, for example, the ketogenic diet, or vitamin and folic acid supplementation.• Psychological interventions for patients or for patients and carers/parents, for example, cognitive-behavioural therapy (CBT), electroencephalographic (EEG) biofeedback and educational intervention.• Yoga.• Acupuncture.• Relaxation therapy (e.g. music therapy). SEARCH METHODS: For the latest update of this review, we searched the Cochrane Epilepsy Group Specialised Register (19 August 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) via CRSO (19 August 2014), MEDLINE (Ovid, 1946 to 19 August 2014) and PsycINFO (EBSCOhost, 1887 to 19 August 2014). SELECTION CRITERIA: Randomised controlled trials of non-pharmacological interventions for people with epilepsy and intellectual disabilities. DATA COLLECTION AND ANALYSIS: Two review authors independently applied the inclusion criteria and extracted study data. MAIN RESULTS: One study is included in this review. When two surgical procedures were compared, results indicated that corpus callosotomy with anterior temporal lobectomy was more effective than anterior temporal lobectomy alone in improving quality of life and performance on IQ tests among people with epilepsy and intellectual disabilities. No evidence was found to support superior benefit in seizure control for either intervention. This is the only study of its kind and was rated as having an overall unclear risk of bias. The previous update (December 2010) identified one RCT in progress. The study authors have confirmed that they are aiming to publish by the end of 2015; therefore this study (Bjurulf 2008) has not been included in the current review. AUTHORS' CONCLUSIONS: This review highlights the need for well-designed randomised controlled trials conducted to assess the effects of non-pharmacological interventions on seizure and behavioural outcomes in people with intellectual disabilities and epilepsy.

Surprisingly complex life: Sue Leung's story.

INTRODUCTION: While numerous studies relating to the lives of intellectually challenged people have been published previously, most have been from the caregiver's perspective and lack an insider's view. In addition, none of them were conducted in a Chinese context. Our purpose is to fill this gap by studying the life of Sue Leung, an intellectually disabled Chinese woman in Hong Kong. METHODS: Using a narrative approach that combined interviews and observational data collected over an extended time period, the research sought a holistic understanding of her life, how she interacts with others and the challenges and difficulties she faces. RESULTS: Sue Leung's life proved to be complex with social, spiritual, psychological, sexual and financial dimensions. Her story, in which she herself and other mentally impaired people are the actors, reflects to some degree the world of mentally impaired people, at least in Hong Kong. Their world is just as complex as that of anyone else. Violence, dangers, romances, friendships and goodwill also exist in that world. DISCUSSION: Sue Leung's story has helped to unravel the various dimensions of her life and enabled a deeper understanding of the challenges and difficulties a mildly intellectually disabled woman has to face in her life in Hong Kong. Social implications are discussed, and recommendations are made for future research.

The 'placement' of people with profound impairments across the lifespan: re-thinking age criteria.

BACKGROUND: Advances in lifesaving technologies and treatments make it possible for children with profound physical and cognitive impairments to survive into adulthood. Questions regarding how and where they should live are discussed rarely and, when they are, primarily focus on safety and/or containing costs. Since models of long-term care provision are age-based, children who reside in institutions are 'discharged' to adult facilities when they reach an arbitrary age. Such transfers may not be in the best interests of these young people or their families. Our aim in this debate is to highlight why age is a problematic criterion for placement decisions, with the goal of stimulating further research and inquiry. DISCUSSION: Transfers from pediatric to adult institutions are driven primarily by funding arrangements and underpinned by stage-based theories of human development. Arguments supporting such transfers point to the value of communal living with same age peers, and engagement in age-appropriate activities. These goals are questionable for individuals who are minimally interactive and/or where equally worthy interactions are feasible in intergenerational settings. Instead their accommodation needs might more closely align with palliative care principles of supporting individuals and families to enjoy what they bring to each other's lives and minimize suffering. Innovative models of 'vertical care' and 'lifetime homes', which enable continuous flexible services across the lifespan, are discussed as examples of alternative approaches requiring further debate and research. SUMMARY: Entrenched funding and service models that require the transfer of profoundly impaired young people from pediatric to adult facilities need to be re-examined with considerations of best interests, needs, and preferences of individuals and their families. Questions of what constitutes a 'good life' for these individuals are tenacious and require further thought and research. Nevertheless, they need to be regarded as citizens of our human community deserving of a good life in whatever form that may take, in settings that enable them to flourish.

Wadaiko performance enhances synchronized motion of mentally disabled persons.

People with mental disabilities tend to lack communication skills and have difficulty with interpersonal relationships. Interpersonal communication skills were examined in two people with Down Syndrome with regard to playing wadaiko (Japanese drum). Motion analysis compared single play and two-person play in which one participant was more skillful than the other. The effect of wadaiko play was quantified using two different methodologies: motion delay and hit-timing analysis and visual analog-scale (VAS) ratings before and after play. The motion analysis indicated that the study participants became mutually synchronized in playing wadaiko, and that a participant played more accurately when he played with a senior member. VAS ratings indicated that participants felt more positive after practicing wadaiko than before and self-confidence improved. Synchronized gestures of wadaiko performance may be an effective therapy for people with limited communication skills.

An integrative review of what contributes to personal recovery in psychiatric disabilities.

The aim of this integrated literature review is to identify what people with psychiatric disabilities experience as contributing to their personal recovery. The study design is based on Whittemore and Knafl's integrative review and includes 14 qualitative peer-reviewed articles. The analysis reveals three main themes: recovery as an inner process; recovery as a contribution from others; and recovery as participating in social and meaningful activities. If mental health nurses adhere to the personal recovery perspective, nursing practice will focus on the patients' needs, conveying hope and supporting the patient in the recovery process.