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Lim E, Tate R, Sewell A, Higham K, Ferraz K, Harban K, Murdock J, Delahunty S. Consumers' Experiences of Comprehensive-Prepared Graduate Nurses and Their Nursing Care in Acute Mental Health Settings. Issues Ment Health Nurs 2024; 45:617-623. [PMID: 38593452 DOI: 10.1080/01612840.2024.2330571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Pre-registration nursing education has long moved away from preparing nurses with mental health specialisation to nurses with comprehensive knowledge and skills. However, the consumers' experiences of comprehensive-prepared nurses and their nursing care has not been widely explored. This paper reports on a study with consumers to explore their experiences with comprehensive-prepared graduate nurses and the nursing care that they provide in acute mental health settings. An exploratory qualitative study using semi-structured interviews was chosen as the research method. Purposeful sampling recruited 12 consumers and data saturation was achieved. Braun and Clarke's method of thematic analysis was used to analyse the collected data and three themes emerged. The themes are: (i) You got what it takes to be a mental health nurse, (ii) Slow down and spend quality time with us, and (iii) Read in between the lines when we share our negative lived experiences. The findings are useful for identifying strategies to develop evidence-based nursing education for comprehensive-prepared graduate nurses to improve the consumers' experiences of their nursing care.
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Affiliation(s)
- Eric Lim
- School of Nursing, Curtin University, Perth, Australia
| | - Rebecca Tate
- Service 5, Fremantle Hospital, Palmyra DC, Australia
| | - Amy Sewell
- Service 5, Fremantle Hospital, Palmyra DC, Australia
| | - Kezia Higham
- School of Nursing, Curtin University, Perth, Australia
| | - Kristina Ferraz
- Nursing Education, Fiona Stanley Fremantle Hospitals Group, Murdoch, Australia
| | - Kathryn Harban
- Nursing Education, Fremantle Hospital and Health Service, Palmyra DC, Australia
| | - Jane Murdock
- Service 5, Fremantle Hospital, Palmyra DC, Australia
| | - Sharon Delahunty
- Service 5, Fiona Stanley Fremantle Hospitals Group, Murdoch, Australia
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Richards SJ, O'Connell KA, Dickinson JK. A Missed Opportunity to Cultivate Positive Attitudes about Mental Health Recovery among Undergraduate Nursing Students - A Quasi-Experimental Controlled Study. Issues Ment Health Nurs 2024; 45:391-398. [PMID: 38241519 DOI: 10.1080/01612840.2023.2291653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
INTRODUCTION Mental health recovery is a critical concept that needs to be thoroughly understood and supported by nurses. Undergraduate nurse educators have the opportunity to clarify misconceptions and cultivate positive recovery attitudes. AIM To assess the impact of an undergraduate nursing course on attitudes toward mental health recovery and the relationship between recovery attitudes and prejudice toward those who experience a mental illness. METHODS A quasi-experimental pretest-posttest, nonequivalent-control group study was conducted using a sample of undergraduate nursing students in New York City (N = 126). The intervention group was assigned to an undergraduate mental health nursing course and the control group to a pediatric/maternal health nursing course. Attitudes toward mental health recovery and prejudice were measured at the beginning and end of the semester. Two-way mixed analyses of variance were used to determine the differences in students' attitudes. Pearson product-moment correlation analyses were used to assess the relationship between prejudice toward people who experience a mental illness and attitudes toward recovery. RESULTS The mental health nursing course had no measurable impact on students' recovery attitudes. However, there was a moderate-to-strong inverse relationship between recovery attitudes and prejudice toward those who experience a general mental illness (r = -0.54), depression (r = -0.60), or schizophrenia (r = -0.43). CONCLUSIONS Curriculum reform is needed to optimize the impact of undergraduate education on students' attitudes. Possible changes include a more holistic approach to mental health that does not over accentuate the biomedical model, the use of nontraditional clinical sites that provide students an opportunity to interact with those further along in their recovery, and the inclusion of those in recovery in curriculum development. As there was a moderate-to-strong inverse relationship between recovery attitudes and prejudice, educational interventions that positively impact one may also impact the other. Further research is needed to investigate if the relationship is causal.
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Affiliation(s)
- Stephen J Richards
- Nursing Education, Mount Sinai Phillips School of Nursing, New York City, NY, USA
| | - Kathleen A O'Connell
- Health and Behavior Studies, Teachers College, Columbia University, New York City, NY, USA
| | - Jane K Dickinson
- Health and Behavior Studies, Teachers College, Columbia University, New York City, NY, USA
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Sreeram A, Cross WM, Townsin L. A mixed-method evaluation of peer-led education about attitudes towards consumers' recovery among Mental Health Nurses working in acute inpatient psychiatric units. Int J Ment Health Nurs 2024. [PMID: 38426555 DOI: 10.1111/inm.13311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 02/08/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
Despite integrating the recovery model of care in mental health, mental health professionals still have pessimistic attitudes towards the recovery of people with mental illness. Positive attitudes towards recovery are essential components to integrate recovery-oriented practices in all areas of mental health. Evidence shows that education and training are effective while emphasising the importance of consumer-based interventions to enhance recovery attitudes. This study aimed to evaluate the effectiveness of peer-led education about recovery attitudes towards people with mental illness among Mental Health Nurses working in acute inpatient settings. The methodology used was a sequential explanatory mixed method with pre- and post-test design involving three phases. Phase 1: survey (n = 103), phase 2: post-test survey immediate (n = 17) and follow-up (n = 11) and phase 3: in-depth interviews (n = 12). The results show that Mental Health Nurses have positive recovery attitudes with some room for improvement. Most participants agreed with all items of the Recovery Attitudes Questionnaire. However, the participants had various views on the relationship between faith and recovery. The peer-led education significantly improved RAQ items 1, 2, 3, 4 and 6 statistically. Furthermore, peer-led education effectively enhanced recovery attitudes immediately after the intervention and helped to maintain sustainable attitudes 3 months later. A qualitative exploration of recovery attitudes revealed three main themes: participants' reflections, recovery hurdles and interpersonal relationships.
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Affiliation(s)
- Anju Sreeram
- Federation University Australia, Ballarat, Victoria, Australia
| | - Wendy M Cross
- Federation University Australia, Ballarat, Victoria, Australia
| | - Louise Townsin
- Research Office, Torrens University Australia, Sydney, New South Wales, Australia
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Thomson AE, Mullins S. Environments that promote recovery in acute care mental health: nursing perspectives explored through interpretative description. Contemp Nurse 2024:1-14. [PMID: 38386865 DOI: 10.1080/10376178.2024.2319849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 02/12/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND A significant change in mental health care has involved the need to implement recovery-oriented practices and services. However, recovery-oriented care has been poorly defined within acute care mental health settings. OBJECTIVES The central aims of the study were to increase knowledge about what constitutes a recovery-oriented environment within contemporary acute care units and to inform recovery-oriented nursing practice. METHODS Interpretative description was applied to answer the question: What strategies and resources do nurses identify as being most conducive to fostering a recovery-oriented environment in acute care mental health units? Purposive sampling was used to recruit 11 nurses from 6 acute care units. The inclusion criteria included a minimum of 1-year patients and holding active nursing registration. Nursing experience in community-based or chronic care settings and with children and adolescents were exclusion criteria. Six nurses also participated in a focus group. RESULTS Key aspects of a recovery-oriented acute care environment included understanding the needs of individual patients along with the dynamics of the healthcare team. Nurses had important roles in promoting recovery-oriented environments and reported a need for increased resources to move beyond the bio-medical model and align practice with personal recovery. CONCLUSION A recovery-oriented environment was described as a safe, peaceful and holistic environment with adequate space to balance needs for privacy, interaction and activity. This environment is fostered through respectful communication and healthy relationships among team members, patients, family and formal supports. These nurses had the knowledge, skill and desire to promote recovery-oriented environments, yet resources such as leisure activities and group therapy were required to promote personal recovery.
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Affiliation(s)
- Andrea E Thomson
- Department of Psychiatric Nursing, Faculty of Health Studies, Brandon University, 270 - 18th Street, Brandon, Manitoba, Canada R7A 6A9
| | - S Mullins
- Department of Psychiatric Nursing, Faculty of Health Studies, Brandon University, 270 - 18th Street, Brandon, Manitoba, Canada R7A 6A9
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Hartmann JB, Rego AT, Khoury JV, Bernuci MP, Yamaguchi MU. E-Questionnaire on health knowledge, attitudes and practices (KAP-Health) for Brazilian students in distance learning. Glob Health Action 2023; 16:2153441. [PMID: 36562636 PMCID: PMC9793906 DOI: 10.1080/16549716.2022.2153441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The role of universities in health promotion has been strengthened by institutional policies and the Health Promoting Universities movement. Together they seek to identify behaviours that are harmful to the health of university students and implement programs or interventions to promote the health of students within the physical environment of universities. However, the COVID-19 pandemic rapidly increased the number of students learning by distance. Under these circumstances, there is an increased need to assess the knowledge, attitudes and health practices of students in distance learning. OBJECTIVE To develop a KAP (knowledge, attitude and practice) questionnaire on the health of distance learning students. METHODS Development was carried out in four stages: 1) literature review to identify existing health programs in universities; 2) formulation of questions based on WHO theoretical frameworks, National Health Promotion Policy and the literature review; 3) selection of interdisciplinary expert judges and submission of the KAP-Health questionnaire for analysis of appearance, efficiency/consistency, clarity/understanding, pertinence of content and sequence of items; and 4) content validation by applying the content validity coefficient (CVC). RESULTS The mean CVCs obtained were all equal to or greater than 0.96, 0.95 and 0.93 for the Knowledge, Attitudes and Practices domains, respectively; all comfortably above the cut-off score of 80% (CVCt = 0.80). CONCLUSIONS At this stage of the study, the judges consider the content of the KAP-Health questionnaire adequate to identify issues related to the health of students in distance learning. However, it is important to note that the next step is to test the usefulness of this questionnaire. We believe that our KAP-Health instrument is both original and useful for planning institutional policies in order to implement assertive strategies to promote the health of remote-learning students in Brazil and in other parts of the world.
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Affiliation(s)
| | | | | | - Marcelo Picinin Bernuci
- Postgraduate Program in Health Promotion, UNICESUMAR, Cesumar Institute of Science, Technology and Innovation, ICETI, Maringá, Brazil
| | - Mirian Ueda Yamaguchi
- Postgraduate Program in Health Promotion, UNICESUMAR, Cesumar Institute of Science, Technology and Innovation, ICETI, Maringá, Brazil,CONTACT Mirian Ueda Yamaguchi Universidade Cesumar -UNICESUMAR, Avenue Guedner, 1610, Maringá, Paraná87050-900, Brazil
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Badu N, Usher K, Rice K, Schutte N, Islam MS. An exploration of the concept of mental health recovery: Insights from practitioners and trainees. Int J Soc Psychiatry 2023; 69:1176-1184. [PMID: 36786372 DOI: 10.1177/00207640231152752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND Recovery concepts were conceived by, and for, people living with mental health issues. Practitioners are key in translating recovery principles into action. Therefore, practitioners' perceptions should be routinely assessed to facilitate in-service training, professional development, and curriculum redesign. AIM To explore practitioners' and trainees' current perspectives regarding the concept of recovery. METHODS The study used a qualitative exploratory design with in-depth interviews to explore ten fully trained practitioners and eight trainees' perspectives on recovery. RESULTS The findings revealed a shared understanding of recovery among practitioners and trainees. Many responses explained recovery as a process involving internal and external conditions, however, some revealed medically oriented perspectives and/or were unclear about recovery terminologies. CONCLUSIONS There is convergence and growing acceptance of the recovery practice principles among practitioners and trainees. However, the results suggest that the recovery principles/terminologies have not yet been universally adopted. IMPLICATIONS FOR PRACTICE AND RESEARCH Continuous training on recovery principles is needed, incorporating emerging terminologies and principles. Also, education providers are encouraged to continue to review their training to incorporate emerging issues and trends in recovery-oriented practice. Finally, research is needed to enhance the development and delivery of recovery-focused practice.
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Affiliation(s)
- Naomi Badu
- School of Health, Faculty of Medicine and Health, University of New England, Australia
| | - Kim Usher
- School of Health, Faculty of Medicine and Health, University of New England, Australia
| | - Kylie Rice
- School of Psychology, Faculty of Medicine and Health, University of New England, Australia
| | - Nicola Schutte
- School of Psychology, Faculty of Medicine and Health, University of New England, Australia
| | - Md Shahidul Islam
- School of Health, Faculty of Medicine and Health, University of New England, Australia
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Fox J, Griffith J, Smith AM. Exploring the Efficacy of an Online Training Programme to Introduce Mental Health Recovery to Carers. Community Ment Health J 2023; 59:1193-1207. [PMID: 36826695 PMCID: PMC9950698 DOI: 10.1007/s10597-023-01102-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/14/2023] [Indexed: 02/25/2023]
Abstract
Family carers often support people with mental ill-health, however, there is a dearth of research on the importance of recovery to mental health carers. This article describes the delivery and qualitative evaluation of an online training programme on recovery to a group of eleven carers. The participants considered their understanding of the meaning of recovery, differentiating between its personal and clinical nature. They highlighted the importance of carer involvement in the service users' professional support, alongside the need for carers to participate more widely in service development. Finally, the participants found the training useful in enabling them to recognise their own needs in a caring journey, particularly valuing its delivery by a service user and carer trainer. This study is limited by the small number of participants in this programme; however, this series of connected studies suggests its potential to be rolled out more widely, possibly embedded in Recovery Colleges.
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Affiliation(s)
- Joanna Fox
- Anglia Ruskin University, East Road, CB1 1PT, Cambridge, UK.
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Lakshman SJ, Mohd Daud TI, Midin M, Ahmad F, Tommy K. Validation of the Malay-Version of Recovery Knowledge Inventory among mental health providers in Malaysia. Front Psychiatry 2023; 14:1078423. [PMID: 37383615 PMCID: PMC10293667 DOI: 10.3389/fpsyt.2023.1078423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/30/2023] [Indexed: 06/30/2023] Open
Abstract
Background The Recovery Knowledge Inventory (RKI) is a widely used self-report instrument that assesses recovery-oriented knowledge among mental health professionals. The purpose of this study is to translate the RKI into the Malay language (RKI-M) and to examine its psychometric properties among Malaysian health care workers. Methods A cross-sectional study involving 143 participants was conducted at an urban teaching hospital, an urban government hospital, and a rural government hospital. Following the translation of the RKI, its internal reliability was determined using Cronbach's alpha. Construct validity was also determined using confirmatory factor analysis. Results The Malay-Version RKI (RKI-M) has good internal reliability with a Cronbach's alpha of 0.83. However, the Malay-version RKI failed to replicate the original four-factor structure. The final model only achieved the best model fit after the removal of 9 items with two-factor loadings: (GFI = 0.92; AGFI = 0 0.87; CFI = 0.91; RMSEA = 0.074). Conclusion The 20-item RKI-M is reliable but has poor construct validity. However, the modified 11-item Malay-version RKI is a more reliable measure as it has good construct validity, with room for future studies to examine the psychometric properties of the modified 11-item RKI among mental health care workers. More training on recovery knowledge should be done, and a simple worded questionnaire should be developed in keeping with local practitioners.
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Affiliation(s)
- Stella Jane Lakshman
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
- Department of Psychiatry, Hospital Selayang, Batu Caves, Selangor, Malaysia
| | - Tuti Iryani Mohd Daud
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Marhani Midin
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | | | - Kezia Tommy
- Faculty of Business and Economics, University Malaya, Kuala Lumpur, Malaysia
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Tolosa-Merlos D, Moreno-Poyato AR, González-Palau F, Pérez-Toribio A, Casanova-Garrigós G, Delgado-Hito P. Exploring the therapeutic relationship through the reflective practice of nurses in acute mental health units: A qualitative study. J Clin Nurs 2023; 32:253-263. [PMID: 35075705 PMCID: PMC10078778 DOI: 10.1111/jocn.16223] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/20/2021] [Accepted: 01/07/2022] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES To explore the therapeutic relationship through the reflective practice of nurses in acute mental health units. BACKGROUND In mental health units, the therapeutic relationship is especially relevant for increasing the effectiveness of nursing interventions. Reflective practice is considered an essential aspect for improving nursing care. DESIGN Action and observation stages of a participatory action research project. METHODS Data were collected through reflective diaries designed for the guided description and reflection of practice interactions related to the therapeutic relationship and content analysis was applied. A total of 152 nurses from 18 acute mental health units participated. The COREQ guidelines were used. RESULTS The results were classified into three categories as follows: (i) Nursing attitude as a core of the therapeutic relationship. For the nurses, the attitudinal component was key in the therapeutic relationship. (ii) Nursing practices that are essential to the therapeutic relationship. Nurses identified practices such as creating a conducive environment, using an appropriate verbal approach, offering help and working together with the patient as essential for establishing a therapeutic relationship in practice. (iii) Contextual factors affecting the therapeutic relationship. The nurses considered the patient's condition, the care dynamics of the unit and its regulations, as well as the structure and environment of the unit, as contextual factors involved the establishment of an adequate therapeutic relationship in daily clinical practice. CONCLUSIONS This study has provided knowledge of the importance and role of the nurses' attitude in the context of the nurse-patient therapeutic relationship based on the reflections of nurses in mental health units regarding their own practice. RELEVANCE TO CLINICAL PRACTICE These findings help nurses to increase awareness and develop improvement strategies based on their own knowledge and day-to-day difficulties. Moreover, managers can evaluate strategies that promote motivation and facilitate the involvement of nurses to improve the therapeutic relationship with patients.
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Affiliation(s)
- Diana Tolosa-Merlos
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Antonio R Moreno-Poyato
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | - Alonso Pérez-Toribio
- Unitat de Salut Mental de l'Hospitalet, Gerència Territorial Metropolitana Sud, Institut Català de la Salut, L'Hospitalet de Llobregat, Spain
| | | | - Pilar Delgado-Hito
- Department of Fundamental Care and Medical-Surgical Nursing, Nursing School, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain.,GRIN-IDIBELL (Nursing Research Group- Bellvitge Biomedical Research Institute), L'Hospitalet de Llobregat, Spain
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Guha MD, Cutler NA, Heffernan T, Davis M. Developing a Trauma-Informed and Recovery-Oriented Alternative to 'Aggression Management' Training for a Metropolitan and Rural Mental Health Service. Issues Ment Health Nurs 2022; 43:1114-1120. [PMID: 35895900 DOI: 10.1080/01612840.2022.2095471] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
For clinicians working in mental health services, 'aggression management' training is generally prioritised, and often mandated. Traditional 'aggression management' training has the potential to reinforce the perception that violence and aggression are inevitable, and thus defensive and coercive practices are needed. This paper outlines the principles and processes that underpinned the development of two training programs designed as recovery-oriented and trauma-informed alternatives to traditional 'aggression management' training. The focus of the paper is on exploring how 'aggression management' training can be aligned with best practice principles. The programs were developed in a metropolitan and rural mental health service and aimed to reduce the need for defensive and coercive practices by promoting therapeutic engagement. A key feature of both programs is an orientation towards safety rather than risk. By embedding the principles of recovery and trauma-informed care in their development and orienting training towards enhancing safety, clinicians are provided with a new way of conceptualising and responding to 'aggression'. Experiential methods in the delivery of the training, and the co-design and co-delivery with peer (consumer) educators were important in supporting attitudinal change. To promote safety, the language and content of training programs must reflect contemporary principles and approaches such as trauma-informed care and recovery. This paper illustrates that to be effective, these principles and approaches must not just be described, but modelled in the development, design, and delivery of the training.
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Affiliation(s)
| | | | - Tim Heffernan
- Mental Health Commission of NSW and Mental Health Peer Coordinator, South Eastern NSW PHN, NSW, Australia
| | - Martin Davis
- Western NSW Local Health District, Orange, Australia
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Hardy J, Parker S, Hughes I, Anand M. Factors affecting knowledge of recovery-oriented practice amongst mental health nursing and medical staff working on acute mental health inpatient units. Int J Ment Health Nurs 2022; 31:1228-1238. [PMID: 35821364 DOI: 10.1111/inm.13032] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
Over recent decades, the shift to recovery-oriented practice has been central to mental health policy. Despite this emphasis, mental health services can struggle to meet this expectation. This study explores the knowledge and attitudes in relation to the recovery-oriented practice of clinical staff working at an Australian acute inpatient mental health unit. The Recovery Knowledge Inventory (RKI) is a widely used self-report tool that assesses mental health professionals' knowledge and attitudes towards recovery; higher scores indicate higher levels of recovery knowledge and attitudes. Seventy-four staff members (44 nursing staff and 30 medical staff) completed the RKI via an online survey. The study has been reported according to the STROBE checklist for cross-sectional studies. The relationships between the RKI scores and a range of variables were considered using inferential statistics, including multivariate regression. Medical staff had higher mean RKI scores than nursing staff, although this did not meet the predefined threshold for a clinically significant difference. More years of mental health experience were associated with increased mean RKI scores for medical staff. This Australian inpatient staff cohort demonstrated higher mean RKI scores than have been observed in recent international studies of mental health professions. However, the recovery knowledge and attitude levels were disappointingly similar to those shown in earlier Australian research completed over a decade ago. Efforts are needed to further enhance the recovery knowledge of clinicians working in mental health inpatient units.
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Affiliation(s)
- Jonathan Hardy
- Mental Health and Specialist Services, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Stephen Parker
- School of Medicine, Griffith University, Nathan, Queensland, Australia.,The Prince Charles Hospital, Metro North Addiction and Mental Health Service, Chermside, Queensland, Australia
| | - Ian Hughes
- Office for Research Governance and Development, Gold Coast Health, Southport, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Muthur Anand
- Psychiatrist, Auckland District Health Board, Auckland, New Zealand
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12
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Gyamfi N, Bhullar N, Islam MS, Usher K. Models and frameworks of mental health recovery: a scoping review of the available literature. J Ment Health 2022:1-13. [PMID: 35535928 DOI: 10.1080/09638237.2022.2069713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 02/11/2022] [Accepted: 03/01/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The recovery approach involves providing a holistic and integrated service that is centered on and adapts to the aspirations and needs of consumers, who are seen as the expert on their health and well-being. Evidence is needed to address the current ambiguities related to the concept of recovery and its application. AIM A scoping review was conducted to identify papers describing theories, models, and frameworks of recovery to delineate the central domains of recovery. METHODS Three literature search strategies were used: electronic database searching; hand-searching of key journals; and a reference list review of included papers. Inclusion criteria outlined theories, models and frameworks developed to support consumers' recovery and those supporting mental health professionals (MHPs) to deliver recovery-oriented services. RESULTS Twelve studies (eleven articles and one book) were included in the review. The dimensions of recovery were synthesized into a framework named the Consolidated Framework for Recovery-oriented Services (CFRS). There are three domains within the framework: mechanisms/strategies; recovery as an internal process; and recovery as an external process. Each of these domains, as well as their relationships, are discussed. CONCLUSIONS The CFRS can be used by practitioners, researchers, funders, and collaborative members to conceptualize, implement, and evaluate recovery-oriented services.
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Affiliation(s)
- Naomi Gyamfi
- Faculty of Medicine and Health, School of Health, University of New England, Armidale, Australia
| | - Navjot Bhullar
- Faculty of Medicine and Health, School of Psychology, University of New England, Armidale, Australia
| | - Md Shahidul Islam
- Faculty of Medicine and Health, School of Health, University of New England, Armidale, Australia
| | - Kim Usher
- Faculty of Medicine and Health, School of Health, University of New England, Armidale, Australia
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13
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Badu E, O'Brien AP, Mitchell R, Osei A. Factors associated with the quality of mental health services and consumers' functionality using tertiary-based services. Perspect Psychiatr Care 2022; 58:592-607. [PMID: 33942311 DOI: 10.1111/ppc.12820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/25/2021] [Accepted: 04/09/2021] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Assess factors associated with the quality of mental health services. DESIGN AND METHODS Cross-sectional design, quantitative data, and 510 consumers from three psychiatric facilities. RESULTS The average age of consumers was 34 years and 51.57% males. Consumers reported mixed satisfaction with the quality of mental health services (mean = 3.2; SD = 0.56) but were dissatisfied with the range of interventions (mean = 1.57; SD = 0.77). Predisposing (age, education, and primary occupation), enabling (insurance status), and need factors (mental health status) were significantly associated with quality indicators (range of interventions, efficacy, and overall satisfaction). These factors were significantly associated with consumers' functionality (cognition, mobility, self-care, getting along, life activities, and participation). PRACTICE IMPLICATIONS Policymakers and clinicians are encouraged to incorporate the predisposing, enabling, and need factors into mental health planning, monitoring, and advocacy to improve service outcomes.
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Affiliation(s)
- Eric Badu
- School of Nursing and Midwifery, Faculty Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Anthony P O'Brien
- Faculty of Health, Southern Cross University, New South Wales, Australia
| | - Rebecca Mitchell
- Health & Wellbeing Research Unit (HoWRU), Macquarie Business School, Macquarie University, Macquarie Park, New South Wales, Australia
| | - Akwasi Osei
- Ghana Mental Health Authority, Ghana Health Services, Accra, Ghana
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Beckers T, Koekkoek B, Hutschemaekers G, Rudd B, Tiemens B. Measuring personal recovery in a low-intensity community mental healthcare setting: validation of the Dutch version of the individual recovery outcomes counter (I.ROC). BMC Psychiatry 2022; 22:38. [PMID: 35031001 PMCID: PMC8759275 DOI: 10.1186/s12888-022-03697-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 12/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Measuring progress in treatment is essential for systematic evaluation by service users and their care providers. In low-intensity community mental healthcare, a questionnaire to measure progress in treatment should be aimed at personal recovery and should require little effort to complete. METHODS The Individual Recovery Outcome Counter (I.ROC) was translated from English into Dutch, and psychometric evaluations were performed. Data were collected on personal recovery (Recovery Assessment Scale), quality of life (Manchester Short Assessment of Quality of Life), and symptoms of mental illness and social functioning (Outcome Questionnaire, OQ-45) for assessing the validity of the I.ROC. Test-retest reliability was evaluated by calculating the Intraclass Correlation Coefficient and internal consistency was evaluated by calculating Cronbach's alpha. Exploratory factor analysis was performed to determine construct validity. To assess convergent validity, the I.ROC was compared to relevant questionnaires by calculating Pearson correlation coefficients. To evaluate discriminant validity, I.ROC scores of certain subgroups were compared using either a t-test or analysis of variance. RESULTS There were 764 participants in this study who mostly completed more than one I.ROC (total n = 2,863). The I.ROC aimed to measure the concept of personal recovery as a whole, which was confirmed by a factor analysis. The test-retest reliability was satisfactory (Intraclass Correlation Coefficient is 0.856), as were the internal consistency (Cronbachs Alpha is 0.921) and the convergent validity. Sensitivity to change was small, but comparable to that of the OQ-45. CONCLUSIONS The Dutch version of the I.ROC appears to have satisfactory psychometric properties to warrant its use in daily practice. Discriminant validity and sensitivity to change need further research.
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Affiliation(s)
- Thijs Beckers
- Research Group Social Psychiatry and Mental Health Nursing, Hogeschool Van Arnhem Nijmegen (University of Applied Sciences), Nijmegen, Netherlands. .,Primary Mental Healthcare, MET ggz, Roermond, Netherlands. .,Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.
| | - Bauke Koekkoek
- grid.450078.e0000 0000 8809 2093Research Group Social Psychiatry and Mental Health Nursing, Hogeschool Van Arnhem Nijmegen (University of Applied Sciences), Nijmegen, Netherlands ,grid.491369.00000 0004 0466 1666Pro Persona Research, Wolfheze, Netherlands
| | - Giel Hutschemaekers
- grid.5590.90000000122931605Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands ,grid.491369.00000 0004 0466 1666Pro Persona Research, Wolfheze, Netherlands ,Indigo Service Organization, Utrecht, Netherlands
| | - Bridey Rudd
- Penumbra, Edinburgh, United Kingdom ,grid.44361.340000000103398665Department of Psychology, Abertay University, Dundee, Scotland
| | - Bea Tiemens
- grid.5590.90000000122931605Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands ,grid.491369.00000 0004 0466 1666Pro Persona Research, Wolfheze, Netherlands ,Indigo Service Organization, Utrecht, Netherlands
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15
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Hawsawi T, Stein-Parbury J, Orr F, Roche M, Gill K. Exploring recovery-focused educational programmes for advancing mental health nursing: An integrative systematic literature review. Int J Ment Health Nurs 2021; 30 Suppl 1:1310-1341. [PMID: 34231293 DOI: 10.1111/inm.12908] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2021] [Indexed: 01/10/2023]
Abstract
Recovery-focused educational programmes have been implemented in mental health services in an attempt to transform care from a purely biomedical orientation to a more recovery-oriented approach. Mental health nurses have identified the need for enhancing their abilities and confidence in translating recovery knowledge into mental health nursing practice. However, recovery-focused educational programmes have not fully address nurses' learning needs. Therefore, this review synthesized the evidence of the effectiveness of recovery-focused educational programmes for mental health nurses. A systematic search of electronic databases and hand-searched references was conducted. It identified 35 programmes and 55 educational materials within 39 studies. Synthesizing the literature revealed three themes and nine subthemes. The first theme, a framework for understanding and supporting consumers' recovery, had four subthemes: consumers' involvement, multidisciplinary approach, profession-specific training, and performance indicators. The second theme, contents of educational materials, included the subthemes: knowledge development and recovery-focused care planning. The final theme, nurses' learning experiences, included the subthemes: understanding recovery, the positive effects of recovery-focused educational programmes, and implementation of recovery-oriented practices. Based on these findings, a mental health nursing recovery-focused educational programme framework is proposed. Further research should investigate the effectiveness of the framework, especially in relation to recovery-focused care planning and consumer and carer involvement in the development, delivery, participation, and evaluation of these educational programmes.
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Affiliation(s)
- Tahani Hawsawi
- Faculty of Nursing, King Abdul-Aziz University, Jeddah, Saudi Arabia
| | - Jane Stein-Parbury
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Fiona Orr
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Michael Roche
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
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16
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Badu E, O'Brien AP, Mitchell R, Osei A. A qualitative study of evidence-based therapeutic process in mental health services in Ghana- context-mechanisms-outcomes. BMC Health Serv Res 2021; 21:1013. [PMID: 34563183 PMCID: PMC8466714 DOI: 10.1186/s12913-021-06993-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 09/07/2021] [Indexed: 02/03/2023] Open
Abstract
Background Evidence-based clinical practice is an inherent component of mental health professional practice in developed countries. However, little is known about professional perspectives of evidence-based practice in mental in developing countries such as Ghana. This paper describes the processes involved in the delivery of best practice in Ghana. The paper reports on a realistic evaluation of mental health nurses and allied health professionals’ views on the evidence-based therapeutic process in Ghana. Methods A purposive sample of 30 mental health professionals (MHPs) was recruited to participate in semi-structured, in-depth interviews. Thematic analysis was used to analyse the data. A program theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis. Results The thematic analysis identified two contexts, mechanism and outcome configurations (themes): 1) technical competency stimulates evidence-based mental health services, and 2) therapeutic relationship building ensures effective interaction. The study demonstrates that contextual factors (technical competencies and therapeutic relationship building) together with mechanisms (intentional and unintentional) help to promote quality in mental health service provision. However, contextual factors such as a lack of sign language interpreters yielded unintended outcomes including barriers to communication with providers for consumers with hearing impairment and those from linguistic minority backgrounds. Conclusion Government stakeholders and policymakers should prioritise policies, periodic monitoring and adequate financial incentives to support the mechanisms that promote technical competence in MHPs and the building of therapeutic relationship. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06993-1.
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Affiliation(s)
- Eric Badu
- School of Nursing and Midwifery, Faculty Health and Medicine, The University of Newcastle, Callaghan, Australia.
| | | | - Rebecca Mitchell
- Macquarie Business School, Macquarie University, Sydney, Australia
| | - Akwasi Osei
- Ghana Mental Health Authority, Ghana Health Services, Accra, Ghana
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17
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Gyamfi N, Bhullar N, Islam MS, Usher K. A systematic review of measures assessing mental health professionals' perspectives of recovery. Int J Ment Health Nurs 2021; 30:847-874. [PMID: 34129745 DOI: 10.1111/inm.12895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/12/2021] [Accepted: 05/10/2021] [Indexed: 11/27/2022]
Abstract
Recovery is internationally recognized as a concept to improve the well-being of consumers. Compared with the numerous measures assessing consumer perspectives of recovery, only a few measures have been developed to assess Mental Health Professionals' (MHPs) perspectives of recovery to inform practice. The present study aims to systematically review the literature to identify existing measures designed to assess MHPs' perspectives of recovery and evaluate their psychometric properties, and the methodological considerations of the design and use of these measures. We searched literature across eight electronic databases: MEDLINE, Web of Science, PsycINFO, PsyArticles, CINAHL, Scopus, EMBASE, and Google scholar. We identified 2631 articles across all databases. Of these, 40 articles met the inclusion criteria, which comprised 14 original measures assessing mental health recovery and 26 articles reassessing the psychometric properties of the original 14 measures. Our results suggested that while there are existing measures for assessing MHPs' perspectives of recovery, only a few of these measures met standard evaluation criteria for psychometric properties. Specifically, the validation of the identified measures is still in its infancy. For example, the easiness of applying the measures differs among the studies, and only a few of the measures fully involved consumers in the scale development phase. The implication of the findings for future use and development of recovery measures in mental health practice and research are discussed and recommended.
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Affiliation(s)
- Naomi Gyamfi
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Navjot Bhullar
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Md Shahidul Islam
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Kim Usher
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
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18
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Zuaboni G, Elmer T, Rabenschlag F, Heumann K, Jaeger S, Kozel B, Mahlke CI, Theodoridou A, Jaeger M, Rüsch N. Psychometric evaluation of the German version of the Opening Minds Stigma Scale for Health Care Providers (OMS-HC). BMC Psychol 2021; 9:86. [PMID: 34016166 PMCID: PMC8139058 DOI: 10.1186/s40359-021-00592-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/12/2021] [Indexed: 12/29/2022] Open
Abstract
Background Healthcare professionals can be a source of stigma and discrimination for people with mental illness, and anti-stigma programs are needed for this target group. However, there is no validated German language scale to assess attitudes of healthcare professionals towards people with mental illness. This study had the aim to validate the German language version of the Opening Minds Stigma Scale for Health Care Providers (OMS-HC), a self-report measure of stigmatizing attitudes. Methods Staff (n=392) on general psychiatric inpatient wards (excluding child, forensic and geriatric psychiatry) at five psychiatric hospitals in Switzerland (n=3) and Germany (n=2) participated in the study. The internal consistency of the OMS-HC was examined as well as its factor structure using exploratory and confirmatory factor analyses. To assess the scales concurrent validity, we used the Social Distance Scale. Results Internal consistency for the OMS-HC total score was good (=0.74), acceptable for the subscales Attitudes (=0.62) and Social Distance (=0.69), and poor for the Disclosure subscale (=0.55). The original three-factor structure fit our data well. The OMS-HC total score and the Social Distance subscale score were significantly correlated with the Social Distance Scale, supporting concurrent validity. Conclusion The German version of the OMS-HC demonstrated satisfactory psychometric properties and can be recommended for future research and intervention evaluation. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00592-9.
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Affiliation(s)
- Gianfranco Zuaboni
- Sanatorium Kilchberg AG, Psychiatric and Psychotherapy Hospital, Alte Landstrasse 70, 8802, Kilchberg, Switzerland.
| | - Timon Elmer
- University of Groningen, Groningen, The Netherlands
| | | | - Kolja Heumann
- Department of Psychiatry and Psychotherapy, Medical University Brandenburg, Neuruppin, Germany
| | - Susanne Jaeger
- Department of Psychiatry and Psychotherapy I, Ulm University, ZfP Südwürttemberg, Ravensburg, Germany
| | - Bernd Kozel
- University Psychiatric Services Bern, Bern, Switzerland
| | - Candelaria I Mahlke
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Anastasia Theodoridou
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Matthias Jaeger
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland.,Psychiatrie Baselland, Liestal, Switzerland
| | - Nicolas Rüsch
- Department of Psychiatry and Psychotherapy II, Ulm University and BKH Günzburg, Ulm/Günzburg, Germany
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19
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Molloy L, Guha MD, Scott MP, Beckett P, Merrick TT, Patton D. Mental health nursing practice and Aboriginal and Torres Strait Islander people: an integrative review. Contemp Nurse 2021; 57:140-156. [PMID: 33989117 DOI: 10.1080/10376178.2021.1927773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: For nearly thirty years, significant concerns have been raised about the public-provided mental health services for Aboriginal and Torres Strait Islander peoples. Staff have been identified as having little understanding of Indigenous culture, and this had resulted in inappropriate treatment. In attempting to understand what specialist knowledge exists to guide mental health nursing practice with Aboriginal and Torres Strait Islander peoples, the authors have turned to published peer-reviewed literature.Methods: The approach chosen to explore this area was an integrative review. This provided a method to identify, analyse, and synthesise a wide range of literature.Results: The available evidence points to the need that treatment planning must be focused on the promotion of social and emotional wellbeing and not simply the treatment of symptoms. It also emphasises the importance of cultural safety informed by awareness and understanding of social, cultural and historical factors that can impact the health and treatment of Aboriginal and Torres Strait Islander peoples. Within the literature, staff reported difficulty in understanding how knowledge about social and emotional wellbeing could translate into practice. Nurses working in mental health contexts reported not feeling adequately prepared for, or confident in this area of practice.Conclusions: There is a paucity of current literature on mental health nursing practice for Aboriginal and Torres Strait Islander peoples, with the literature available not providing clear guidance for effective and meaningful practice.
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Affiliation(s)
- Luke Molloy
- School of Nursing, University of Wollongong, Wollongong, Australia.,School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Monica D Guha
- Western New South Wales Local Health District, Bloomfield, Orange, NSW, Australia
| | - Matthew P Scott
- Wiradjuri Nation, Clinical Nurse Specialist- Aboriginal Mental Health, Western New South Wales Local Health District, Bloomfield, Orange, NSW, Australia
| | - Paul Beckett
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Australia
| | | | - Declan Patton
- School of Nursing and Midwifery. Royal College of Surgeons in Ireland, Dublin, Ireland.,Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia.,University of Wollongong, Wollongong NSW, Australia
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20
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Gyamfi N, Badu E, Mprah WK, Mensah I. Recovery services and expectation of consumers and mental health professionals in community-based residential facilities of Ghana. BMC Psychiatry 2020; 20:355. [PMID: 32631367 PMCID: PMC7339466 DOI: 10.1186/s12888-020-02768-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 06/29/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND In the past decades, considerable global attention has been drawn to recovery services that seek to promote the personal recovery journey of consumers with mental illness. However, in most settings, including Ghana, limited empirical studies have attempted to explore, from the perspectives of Mental Health Professionals (MHPs) and consumers, the effectiveness of recovery services and expectation towards the recovery. This study, therefore, explored consumers' and MHPs perspectives concerning recovery services and expectations towards recovery in two community-based residential facilities in Ghana. METHODS A qualitative method, involving in-depth interviews and observations, were used to collect data from 24 participants (5 MHPs and 19 consumers). Thematic analysis was used to analyze the data. RESULTS The study identified three global themes and nine organizing themes. The global themes were recovery services offered to consumers, expectation regarding personal recovery and challenges in achieving recovery. The study found that recovery services were expected to improve the internal and external recovery processes of consumers. The internal recovery process was independent living whilst the external recovery process were management of illness, economic empowerment and social inclusion. Several systemic and consumer-related factors influenced consumers' and MHPs expectation concerning the recovery journey. CONCLUSION The study concludes that the government should prioritize the use of recovery services through policies, financial incentives, infrastructure support, and adequate training of MHPs.
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Affiliation(s)
- Naomi Gyamfi
- grid.9829.a0000000109466120Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana ,grid.1020.30000 0004 1936 7371School of Health, University of New England, Armidale, Australia
| | - Eric Badu
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. .,School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia.
| | - Wisdom Kwadwo Mprah
- grid.9829.a0000000109466120Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaac Mensah
- Department of Special Education, University of Education, Winneba, Ghana
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21
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Badu E, O’Brien AP, Mitchell R, Osei A. Mediation and moderation effects of health system structure and process on the quality of mental health services in Ghana - structural equation modelling. PLoS One 2020; 15:e0233351. [PMID: 32442192 PMCID: PMC7244180 DOI: 10.1371/journal.pone.0233351] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/04/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Incorporating consumers' perspectives into the quality of mental health service measurement is a growing priority among mental health professionals' and policymakers. Despite this, there is limited empirical evidence related to consumer perspectives of quality of mental health services. This study, therefore, aims to measure the mediation and moderation effects of health system structure and process on mental health quality in Ghana. METHODS A random sample of 510 consumers were recruited to complete the Verona Satisfaction Scale (54-items), together with the WHO Disability Assessment Instrument (36 items) using the Redcap application. Confirmatory factor analysis (CFA) and Structural Equation Modelling were used to test the hypothesised theory using STATA 15. RESULTS The CFA showed that the hypothesised model had a good fit to the data. The findings confirmed the hypothesis that the process constructs mediate the relationship between the health system structure and the outcome of mental health services. Specifically, the health system structure had a positive and significant causal relationship with the mediator-process (β = 0.60; p<0.01) and outcome (β = 0.47; p<0.01). Additionally, the mediator-process had a positive causal relationship with the outcome of the mental health services (β = 0.32; p<0.01). Insurance status (β = 0.07; p>0.05) and type of services (β = 0.025; p>0.05) had a positive moderating effect on the relationship between health system structure and outcome but were not significant. CONCLUSION Improvements to mental health system structure and the process could promote the quality of services as experienced by consumers. Government stakeholders are encouraged to accordingly strengthen health systems with the aim of improving the mental health outcomes for consumers.
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Affiliation(s)
- Eric Badu
- School of Nursing and Midwifery, Faculty Health and Medicine, The University of Newcastle, Newcastle, Australia
- * E-mail: ,
| | - Anthony Paul O’Brien
- School Nursing and Midwifery, Faculty Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Rebecca Mitchell
- Macquarie Business School, Macquarie University, Sydney, Australia
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