Dr Cathy Clifton
Academic and research departments
Clinical Intervention and Practice Research Group, School of Psychology.About
My research project
Understanding how partners of those with Locked-in syndrome experience changes in familyLocked-in syndrome (LIS) is a rare neurological condition, where an individual experiences quadriplegia, mutism and lower cranial nerve paralysis, but is awake and conscious and does not experience cognitive impairment. An individual with LIS may have upper eyelid movement and vertical gaze, but experiences significant communication difficulties. Although there is a limited amount of research exploring the area, literature suggests that family members of those with LIS are more likely to experience feelings of anxiety and depression compared to the general population. In other patient groups, including family members of those with a Traumatic Brain Injury (TBI) and relatives of those who have experienced a stroke, it has been found that feelings of depression are linked to social support and family functioning. Previous research has illustrated that changes in family functioning in families of those with a TBI may be linked to changes in cognitive functioning. However, changes in family dynamics have not been explored in family members of those with LIS, where there are significant physical changes but no changes in cognitive functioning. This study aims to address these gaps in the literature by using an Interpretative Phenomenological Analysis (IPA) approach to explore how partners of those with LIS experience changes in family dynamics after their partner becomes ‘locked-in’. IPA is a method of analysis in psychological qualitative research with an idiographic focus, which means that it aims to offer insights into how a given person in a particular context makes sense of a certain phenomenon. IPA is concerned with the detailed examination of human lived experience. It is hoped using IPA will provide helpful detailed insight into the experiences of partners of those with LIS, which may inform future support and interventions to support the spouses of those with LIS.
Supervisors
Locked-in syndrome (LIS) is a rare neurological condition, where an individual experiences quadriplegia, mutism and lower cranial nerve paralysis, but is awake and conscious and does not experience cognitive impairment. An individual with LIS may have upper eyelid movement and vertical gaze, but experiences significant communication difficulties. Although there is a limited amount of research exploring the area, literature suggests that family members of those with LIS are more likely to experience feelings of anxiety and depression compared to the general population. In other patient groups, including family members of those with a Traumatic Brain Injury (TBI) and relatives of those who have experienced a stroke, it has been found that feelings of depression are linked to social support and family functioning. Previous research has illustrated that changes in family functioning in families of those with a TBI may be linked to changes in cognitive functioning. However, changes in family dynamics have not been explored in family members of those with LIS, where there are significant physical changes but no changes in cognitive functioning. This study aims to address these gaps in the literature by using an Interpretative Phenomenological Analysis (IPA) approach to explore how partners of those with LIS experience changes in family dynamics after their partner becomes ‘locked-in’. IPA is a method of analysis in psychological qualitative research with an idiographic focus, which means that it aims to offer insights into how a given person in a particular context makes sense of a certain phenomenon. IPA is concerned with the detailed examination of human lived experience. It is hoped using IPA will provide helpful detailed insight into the experiences of partners of those with LIS, which may inform future support and interventions to support the spouses of those with LIS.
Publications
Aims and objectives: The aims of this study were to understand the emotional and psychological experiences of patients with heart failure in a busy NHS service and make recommendations for how best to support this population. Background: People with heart failure often experience depression, anxiety and other emotional and psychological difficulties. Their quality of life is reduced. Qualitative studies attempting to understand this have reported conflicting findings. Design: A qualitative approach was taken, with some supporting quantitative data. Methods: Ten participants were asked to complete the PHQ–9 and GAD–7, and rate their level of concern about their mood, anxiety, quality of life and social functioning. They completed a semi-structured interview about their experience of living with heart failure and the emotional and psychological impact of this. The interview was analysed thematically. Results: Participants scored in the moderate range on both depression and anxiety measures. They were more concerned about their mood, anxiety, quality of life and social functioning now than before the onset of heart failure. The themes present in the interview data were: changes to self and others; emotional reactions; thoughts about death; expectations for the future; and hospital experiences. Conclusions: Some people with heart failure report moderate levels of depression and anxiety, and significant changes in their lives; they display varying emotional reactions to these. People have clear expectations for the future and impose limits on their life. Services can make changes to support this population. Suggestions for doing this are made.
Individuals with comorbid severe mental illness (SMI) and diabetes experience an average mortality gap of 20 years compared to individuals without these conditions. There has been some recognition by policies that there is a gap between mental healthcare and physical healthcare for SMI patients. Despite this, there are still no defined care pathways for individuals with SMI and diabetes. The aim of this study was to explore healthcare professionals' (HCPs) perspectives of barriers and solutions to supporting people with SMI and diabetes. HCPs in areas of South London were invited to attend a workshop event to discuss their views of SMI and diabetes pathways. Fifty participants were recruited using the Local Care Network. HCPs included GPs, mental health nurses, psychiatrists, diabetologists and care co-ordinators. The main themes were as follows: (a) poor coordination of care and care planning between services; (b) key techniques to improve integrated care; (c) perceived difficulties achieving better care and (d) supporting patient empowerment. The findings and recommendations from this workshop may provide some insight into key factors in providing and improving integrated SMI and diabetes care for patients in South East London and further afield.