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\begin{document}

\title{Referral pathways to early intervention services for psychosis and their
influence on perceptions of care: an Interpretive phenomenological
analysis}



\author[1]{Brannon Senger}%
\author[1]{Quinn MacDonald}%
\author[1]{Alissa Pencer}%
\author[1]{Candice E. Crocker}%
\author[2]{Jean  Hughes}%
\author[1]{Philip Tibbo}%
\affil[1]{Dalhousie University}%
\affil[2]{Dalhousie University School of Nursing}%


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  \date{May 29, 2024}


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\begin{abstract}
\textbf{Background:} Most young adults experiencing psychosis enter
early intervention services for psychosis (EIS) via inpatient services
and emergency departments. Referral in this manner is believed to
increase young adults' risk for adverse outcomes while in EIS such as
diminished trust and engagement in services. However, little research
has empirically examined the impact of young adults' referral and
help-seeking experiences on their subsequent views towards EIS and
engagement to services. \textbf{Methods:} This qualitative study
involved semi-structured interviews with 12 young adults (mean age =
24.83) within 3-12 months following acceptance to an EIS. Interviews
aimed to examine their experiences of help-seeking and referral to EIS
as well as the impact of these experiences on their subsequent
perception of, and engagement with EIS. Data were analyzed using the
Interpretative Phenomenological Analysis approach. \textbf{Results:} 3
superordinate themes emerged: \emph{(1) Navigating the Maze of
Healthcare (2) Dignity} and \emph{(3) Impact of Events}. Participants
with referral pathways involving urgent care services, particularly
through involuntary hospitalization, described more adversity during
their referral pathway and were more likely to describe help-seeking
experiences as contributing to negative views towards EIS and diminished
engagement in treatment. \textbf{Conclusions:} The impact of early
negative experiences with healthcare on views towards EIS and engagement
is evident in participants' accounts. Sense making was further
contextualized by participants' illness insight, degree of recovery, and
social support throughout experiences. Emergent themes highlight the
need for psychiatric services to emphasize service users' dignity and
for EIS to provide opportunities for patients to process past negative
healthcare experiences to strengthen engagement.%
\end{abstract}%



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\textbf{Hosted file}

\verb`Aug_16_2023_Manuscript_Senger.docx`  available at \url{https://authorea.com/users/653589/articles/660487-referral-pathways-to-early-intervention-services-for-psychosis-and-their-influence-on-perceptions-of-care-an-interpretive-phenomenological-analysis}

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