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O'Donohue E, Aguey-Zinsou M, Yule E, Fairhurst I, Debaets M. Mental health consumer perspectives of a person-centred multidisciplinary care planning meeting on a rehabilitation inpatient unit. Int J Ment Health Nurs 2023; 32:1701-1712. [PMID: 37477147 DOI: 10.1111/inm.13192] [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] [Received: 04/11/2022] [Revised: 06/14/2023] [Accepted: 06/28/2023] [Indexed: 07/22/2023]
Abstract
Mental health consumers are seeking genuine involvement in the planning regarding their treatment and care; however for many consumers in inpatient mental health settings, there is not the opportunity to participate. Current research evaluating person-centred multidisciplinary care planning initiatives in inpatient settings from the consumer perspective is limited. The aim of this study was to explore the consumer perspective of a person-centred multidisciplinary care planning meeting implemented in an Australian inpatient mental health rehabilitation unit. This study used a focused ethnographic design with data collection including fieldnotes, observations of meetings and interviews. Ten individuals participated in the study, with two participating in meeting observations and eight participating in structured interviews. Participants were consumers with a mental health diagnosis admitted to a mental health rehabilitation unit for assistance with achieving their goals for community living. Findings were analysed utilizing thematic analysis. Findings showed that consumers' experiences of the care planning meetings were positive. Themes included; 'It's about you', 'Making decisions and expressing opinions', 'Staff involvement in care planning' and 'Supporting consumer recovery'. These findings add the consumer perspective to the existing evidence base and support the implementation of person-centred multidisciplinary care planning meetings in inpatient mental health settings.
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Affiliation(s)
- Eliza O'Donohue
- Occupational Therapy, School of Allied Health, Faculty of Health Sciences, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Melissa Aguey-Zinsou
- Occupational Therapy, School of Allied Health, Faculty of Health Sciences, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Elisa Yule
- Occupational Therapy, School of Allied Health, Faculty of Health Sciences, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Ian Fairhurst
- South Eastern Sydney Local Health Service, Sydney, New South Wales, Australia
| | - Marcie Debaets
- South Eastern Sydney Local Health Service, Sydney, New South Wales, Australia
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2
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Shue SA, Traylor M, Kukla M, Salyers MP, Rollins AL, Henry N, Eliacin J, Garabrant J, McGuire AB. Exploring Factors Impacting the Implementation of Recovery-Oriented Treatment Planning on Acute Inpatient Mental Health Units. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:283-295. [PMID: 36495371 DOI: 10.1007/s10488-022-01237-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 11/05/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE The current literature on operationalizing and implementing recovery-oriented inpatient care in diverse settings remains limited. The present study systematically examined factors affecting the implementation of one aspect of recovery-oriented care in a large and diverse national sample of Veterans Health Administration (VHA) inpatient mental health units. METHOD VHA inpatient mental health units were scored on the Recovery-Oriented Acute Inpatient scale (RAIN). Sites scoring either one standard deviation above (n = 8; i.e., high-scoring sites) or one standard deviation below (n = 5; i.e., low-scoring sites) the mean on the RAIN factor of inpatient treatment planning subscale were included for additional analyses (N = 13). We used a qualitative approach known as emergent thematic analysis to assess the implementation of inpatient treatment planning elements (e.g., goal setting, shared decision-making) from qualitative interviews, observation notes, and chart reviews collected for the 13 sites. The analysis was guided by Normalization Process Theory. RESULTS The eleven themes that emerged across the elements of recovery-oriented inpatient treatment planning mostly represented commonalities across sites, such as a shared treatment philosophy of acute care. However, five themes emerged as "differentiators" that distinguished high- and low-scoring sites and included veteran input, elicitation of recovery goals, the value of group programming, and the purpose of family involvement. CONCLUSION Findings provide insight into contextual factors and processes that impacted the implementation of recovery-oriented treatment planning at these VHA inpatient mental health units. To further facilitate the implementation of recovery-oriented inpatient treatment planning elements, future research should examine staff's collective understanding of recovery-oriented inpatient care.
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Affiliation(s)
- Sarah A Shue
- Center for Health Information and Communication, Health Services Research & Development, Richard L. Roudebush VA Medical Center, Indianapolis, USA.
| | - Morgan Traylor
- Center for Health Information and Communication, Health Services Research & Development, Richard L. Roudebush VA Medical Center, Indianapolis, USA
| | - Marina Kukla
- Center for Health Information and Communication, Health Services Research & Development, Richard L. Roudebush VA Medical Center, Indianapolis, USA
- Department of Psychology, Indiana University-Purdue University at Indianapolis, Indianapolis, USA
| | - Michelle P Salyers
- Department of Psychology, Indiana University-Purdue University at Indianapolis, Indianapolis, USA
| | - Angela L Rollins
- Center for Health Information and Communication, Health Services Research & Development, Richard L. Roudebush VA Medical Center, Indianapolis, USA
- Department of Psychology, Indiana University-Purdue University at Indianapolis, Indianapolis, USA
| | - Nancy Henry
- Center for Health Information and Communication, Health Services Research & Development, Richard L. Roudebush VA Medical Center, Indianapolis, USA
- Department of Psychology, Indiana University-Purdue University at Indianapolis, Indianapolis, USA
| | - Johanne Eliacin
- Center for Health Information and Communication, Health Services Research & Development, Richard L. Roudebush VA Medical Center, Indianapolis, USA
- Department of Psychology, Indiana University-Purdue University at Indianapolis, Indianapolis, USA
| | - Jennifer Garabrant
- Center for Health Information and Communication, Health Services Research & Development, Richard L. Roudebush VA Medical Center, Indianapolis, USA
- Department of Psychology, Indiana University-Purdue University at Indianapolis, Indianapolis, USA
| | - Alan B McGuire
- Center for Health Information and Communication, Health Services Research & Development, Richard L. Roudebush VA Medical Center, Indianapolis, USA
- Department of Psychology, Indiana University-Purdue University at Indianapolis, Indianapolis, USA
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Salberg J, Ekselius L, Hursti T, Öster C. Staff experiences related to implementation of a recovery-oriented nursing programme in psychiatric inpatient care. Int J Ment Health Nurs 2022; 31:731-742. [PMID: 35315194 PMCID: PMC9311143 DOI: 10.1111/inm.12995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 02/28/2022] [Accepted: 03/11/2022] [Indexed: 11/28/2022]
Abstract
Nursing in psychiatric inpatient care is peripheral to a dominating biomedical model of care. Efforts are being made to implement nursing models based on core values and theories for nursing, such as recovery-oriented practices. The aim of the study was to explore experiences of a recovery-oriented nursing programme (Steps Towards Recovery, STR) among nursing staff in psychiatric inpatient care and their ratings of stress (Maslach Burnout Inventory scores), quality of care (Quality of Psychiatric Care - Inpatient staff scores) and satisfaction with nursing care (Satisfaction with Nursing Care and Work scale scores), before and after the implementation-and compare with ratings from reference wards. A quasi-experimental and prospective, pretest-post-test design was used. Specific questions about the nursing programme were answered by staff at the intervention wards. Staff reported predominantly positive experiences of the nursing programme. At follow-up, higher ratings were reported in two dimensions of quality of care in the STR group, and lower ratings in one dimension of stress were evident in the reference group. No differences in ratings between the STR and reference wards were found. Staff members' positive experiences of STR and higher ratings regarding participation and secure environment after implementation suggest that STR is a well-accepted and promising nursing programme. It is important to implement and evaluate recovery-oriented interventions in psychiatric inpatient care, where a focus on symptom relief still prevails. The results indicate that there is potential for further exploration of STR in this context.
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Affiliation(s)
- Johanna Salberg
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Lisa Ekselius
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Timo Hursti
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Caisa Öster
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
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Khan N, Tracy DK. The challenges and necessity of situating 'illness narratives' in recovery and mental health treatment. BJPsych Bull 2022; 46:77-82. [PMID: 33597058 PMCID: PMC9074157 DOI: 10.1192/bjb.2021.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In mental health services, recovery constitutes a guiding principle that is endorsed in professional medical guidelines and has become central to mental health policies across the world. However, for many clinicians, it can be a challenge to effectively embed recovery concepts into professionally directed treatment of disease without distortion, and ostensibly away from what matters to those who use the services. We discuss the evolving and multifaceted concept of 'recovery', including illness narratives to frame our discussion. We demonstrate how integration between a person-directed management of illness and a professionally directed treatment of disease can converge, resulting in positive outcomes for people with mental illness.
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Affiliation(s)
| | - Derek K Tracy
- Oxleas NHS Foundation Trust, UK.,King's College London, UK
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Albutt A, Berzins K, Louch G, Baker J. Health professionals' perspectives of safety issues in mental health services: A qualitative study. Int J Ment Health Nurs 2021; 30:798-810. [PMID: 33728730 DOI: 10.1111/inm.12838] [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] [Received: 08/05/2020] [Revised: 11/04/2020] [Accepted: 12/20/2020] [Indexed: 11/29/2022]
Abstract
The study aimed to explore mental health professionals' perceptions of patient safety issues across community and inpatient mental health services. Fourteen mental health professionals across community and inpatient settings participated in qualitative interviews. Framework analysis, guided by the Yorkshire Contributory Factors Framework - Mental Health, was used to analyse the data. Safety issues identified by mental health professionals mapped on to 19 of the 21 factors in the Yorkshire Contributory Factors Framework - Mental Health. The factors most frequently mentioned by participants were 'safety culture' which focused on raising concerns, learning from incidents and the influence of targets; 'communication systems' to support effective communication between staff; 'service user factors' including a perceived increase in illness acuity; 'service process' including how patients access and interact with services; and 'staff workload' perceived being as unmanageable. Mental health professionals consider there to be a broad range of safety issues associated with mental health services. Future research should aim to develop interventions to improve safety focused across the factors raised by professionals.
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Affiliation(s)
- Abigail Albutt
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | | | - Gemma Louch
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - John Baker
- School of Healthcare, University of Leeds, Leeds, UK
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Motta-Ochoa R, Lencucha R, Xu J, Park M. A matter of time: grappling with everyday ethical tensions at the confluence between policy and practice in a psychiatric unit. JOURNAL OF MEDICAL ETHICS 2019; 47:medethics-2019-105423. [PMID: 31831526 DOI: 10.1136/medethics-2019-105423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 08/07/2019] [Accepted: 11/27/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To provide insights on emergent ethical tensions experienced by mental health practitioners during system re-organisation, which is sufficiently grounded in empirical data at the local level to inform policy on recovery at institutional and provincial levels. METHOD Ethnographic methods using narrative and critical phenomenological resources over 24 months. FINDINGS Everyday ethical tensions emerged at the confluence of different experiences of time, for example, how a context of increasing pressure to decrease patients' length of stay at the hospital (service-defined time) challenged efforts to listen to and advocate for what mattered to patients (personal time) and maintain the integrity of interventions (clinical time). In this context, practitioners drew on clinical language and that of personal recovery to strategically 'push back', 'play with' or 'take back' time. DISCUSSION Examining everyday practices through ethnographic methods can illuminate the everyday ethical tensions that arise when mental health professionals and psychiatrists grapple with, often competing, goods. Critical phenomenological resources can help expand the structural considerations in empirical ethics, excavate underground practices and raise questions about the conceptual categories undergirding normative ethics. Experiencing-with practitioners in clinical contexts as they encounter and creatively resolve ethical tensions also propose a normative ethics of possibility, to help bridge the gap between empirical and normative ethics. CONCLUSION Focus on the relationship between policy, temporal practices and ethics suggests a reconfiguration of time and re-imagination of ethics in institutional settings in ways that can ultimately benefit patients and professionals alike.
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Affiliation(s)
- Rossio Motta-Ochoa
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Raphael Lencucha
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Jiameng Xu
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Melissa Park
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Culture and Mental Health Research Unit, Institute of Community and Family Psychiatry, Montreal, Quebec, Canada
- Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
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Coffey M, Hannigan B, Barlow S, Cartwright M, Cohen R, Faulkner A, Jones A, Simpson A. Recovery-focused mental health care planning and co-ordination in acute inpatient mental health settings: a cross national comparative mixed methods study. BMC Psychiatry 2019; 19:115. [PMID: 30991971 PMCID: PMC6469117 DOI: 10.1186/s12888-019-2094-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 03/27/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Involving mental health service users in planning and reviewing their care can help personalised care focused on recovery, with the aim of developing goals specific to the individual and designed to maximise achievements and social integration. We aimed to ascertain the views of service users, carers and staff in acute inpatient wards on factors that facilitated or acted as barriers to collaborative, recovery-focused care. METHODS A cross-national comparative mixed-methods study involving 19 mental health wards in six service provider sites in England and Wales. This included a survey using established standardised measures of service users (n = 301) and staff (n = 290) and embedded case studies involving interviews with staff, service users and carers (n = 76). Quantitative and qualitative data were analysed within and across sites using descriptive and inferential statistics, and framework method. RESULTS For service users, when recovery-oriented focus was high, the quality of care was rated highly, as was the quality of therapeutic relationships. For staff, there was a moderate correlation between recovery orientation and quality of therapeutic relationships, with considerable variability. Staff members rated the quality of therapeutic relationships higher than service users did. Staff accounts of routine collaboration contrasted with a more mixed picture in service user accounts. Definitions and understandings of recovery varied, as did views of hospital care in promoting recovery. Managing risk was a central issue for staff, and service users were aware of measures taken to keep them safe, although their involvement in discussions was less apparent. CONCLUSIONS There is positive practice within acute inpatient wards, with evidence of commitment to safe, respectful, compassionate care. Recovery ideas were evident but there remained ambivalence on their relevance to inpatient care. Service users were aware of efforts taken to keep them safe, but despite measures described by staff, they did not feel routinely involved in care planning or risk management decisions. Research on increasing therapeutic contact time, shared decision making in risk assessment and using recovery focused tools could further promote personalised and recovery-focused care planning. This paper arises from a larger study published by National Institute for Health Research (Simpson A, et al, Health Serv Deliv Res 5(26), 2017).
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Affiliation(s)
- Michael Coffey
- Department of Public Health, Policy and Social Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP, UK.
| | - Ben Hannigan
- School of Healthcare Sciences, Cardiff University, Cardiff, CF24 0AB, UK
| | - Sally Barlow
- Centre for Mental Health Research, School of Health Sciences, City, University of London, Northampton, Square, EC1V 0HB, UK
| | - Martin Cartwright
- Centre for Health Services Research, School of Health Sciences, City, University of London, Square, EC1V 0HB, Northampton, UK
| | - Rachel Cohen
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Clifton, Bristol, BS8 2BN, UK
| | | | - Aled Jones
- School of Healthcare Sciences, Cardiff University, Cardiff, CF24 0AB, UK
| | - Alan Simpson
- Centre for Mental Health Research, School of Health Sciences, City, University of London, Northampton, Square, EC1V 0HB, UK.,East London NHS Foundation Trust, 9 Alie St, London, E1 8DE, UK
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Hornik-Lurie T, Shalev A, Haknazar L, Garber Epstein P, Ziedenberg-Rehav L, Moran GS. Implementing recovery-oriented interventions with staff in a psychiatric hospital: A mixed-methods study. J Psychiatr Ment Health Nurs 2018; 25:569-581. [PMID: 30411432 DOI: 10.1111/jpm.12502] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/28/2018] [Accepted: 11/02/2018] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Recovery-oriented care is a means of providing mental health treatment, focused on the patient's individual needs and active involvement in one's own care. However, this approach presents with challenges, particularly in psychiatric hospitals, which tend to be focused on symptom reduction. WHAT DOES THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study examines the influence of three different recovery-oriented training programmes/interventions (namely, illness management and recovery, peer support, and psychiatric advance directives) on the attitudes and practice of mental health staff (including nurses) in an inpatient setting, using a mixed-methods methodology. We quantitatively assess the knowledge, attitudes and practices developed following recovery-oriented training, compared to staff not trained in these interventions. We interviewed staff exposed to the different interventions to learn about their personal views and characterized the benefits and challenges they experienced. Mainly, the illness management and recovery training created a positive change in the work attitude and some work-related practices of mental health staff and the increased presence of a person-centred approach supporting patient autonomy. However, and contrary to expectations, there was no increase in practices that support personal goals or provide individually tailored services. Peer support had an experiential impact among mental health staff, initiating a more humane, positive approach to patients. Psychiatric advance directives were reported as more challenging to implement and with limited impact. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Recovery-oriented trainings can be internalized and implemented by staff in medical model psychiatric settings. Despite recovery-oriented training, challenges do occur-notably, they are hardest to implement in acute wards/patient states and by psychiatric nurses. Using multiple recovery-oriented programmes/interventions can accelerate the momentum for change in traditional settings and promote positive practice. Ongoing comprehensive mental health staff training on recovery-oriented care programmes is essential in order to sustain change over time. Training is not enough in itself-hospital administrations need to be actively involved in promoting recovery-oriented policies. ABSTRACT: Introduction Developing person-centred recovery-oriented care is a challenge in mental health systems, particularly psychiatric hospitals. Aim To assess the knowledge, attitudes and practices developed following recovery-oriented training of nurses and other staff; to identify the benefits and challenges involved in the implementation of recovery-oriented intervention in psychiatric wards. Method A mixed-methods study compared recovery knowledge, attitudes and practices of 37 mental health ward staff trained in recovery-oriented intervention, against 35 staff not trained. Fifteen staff were interviewed about their experiences, and protocols were qualitatively analysed. Results The quantitative outcomes partially confirmed positive changes in attitudes and some practices. Qualitative interviews complemented these findings, revealing greater use of a person-centred approach and support for patient autonomy. However, we did not find differences between groups in quantitative outcomes pertaining to personal goals or providing individually tailored services. Discussion This study validates the implementation of recovery training and practices in psychiatric settings, and identifies the challenges involved. We discuss psychiatric nurse conflicts in implementation in acute wards. Implications for practice Our findings support the need for broader staff training in recovery-oriented interventions. Recruiting the support of the hospital administration for recovery-oriented intervention programmes is key, both ethically and structurally.
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Affiliation(s)
- Tzipi Hornik-Lurie
- The Falk Institute for Mental Health Studies, Kfar Shaul Hospital, Jerusalem, Israel
| | - Anat Shalev
- Spitzer Department of Social Work, Ben Gurion University of the Negev, Beer-Sheva, Israel.,Beer-Sheva Mental Health Center, Beer Sheva, Israel
| | - Lior Haknazar
- Spitzer Department of Social Work, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | | | | | - Galia S Moran
- Spitzer Department of Social Work, Ben Gurion University of the Negev, Beer-Sheva, Israel
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Berzins K, Baker J, Brown M, Lawton R. A cross-sectional survey of mental health service users', carers' and professionals' priorities for patient safety in the United Kingdom. Health Expect 2018; 21:1085-1094. [PMID: 30120809 PMCID: PMC6250880 DOI: 10.1111/hex.12805] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2018] [Indexed: 11/30/2022] Open
Abstract
Background Establishing patient safety priorities in psychiatry has received less international attention than in other areas of health care. This study aimed to identify safety issues as described by people in the United Kingdom identifying as mental health service users, carers and professionals. Methods A cross‐sectional online survey was distributed via social media. Identified safety issues were mapped onto the Yorkshire Contributory Factors Framework (YCFF) which categorizes factors that contribute to patient safety incidents in general hospital settings. Service user and carer responses were described separately from professional responses using descriptive statistics. Results One hundred and eighty‐five responses from 95 service users and carers and 90 professionals were analysed. Seventy different safety issues were identified. These were mapped onto the 17 existing categories of the YCFF and two additional categories created to form the YCFF‐MH. Most frequently identified issues were as follows: “Individual characteristics” (of staff) which included competence and listening skills; “Service process” that contained concerns about waiting times; “Management of staff and staffing levels” dominated by staffing levels; and “External policy context” which included the overall resourcing of services. Professionals identified staffing levels and inadequate community provision more frequently than service users and carers, who in turn identified crisis care more frequently. Conclusions This study updates knowledge on stakeholder perceived safety issues across mental health care. It shows a far broader range of issues relating to safety than has previously been described. The YCFF was successfully modified to describe these issues and areas for further coproduced research are suggested.
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Affiliation(s)
| | - John Baker
- School of Healthcare, University of Leeds, Leeds, UK
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10
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Ådnanes M, Melby L, Cresswell-Smith J, Westerlund H, Rabbi L, Dernovšek MZ, Šprah L, Sfetcu R, Straßmayr C, Donisi V. Mental health service users' experiences of psychiatric re-hospitalisation - an explorative focus group study in six European countries. BMC Health Serv Res 2018; 18:516. [PMID: 29970098 PMCID: PMC6029175 DOI: 10.1186/s12913-018-3317-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 06/21/2018] [Indexed: 12/04/2022] Open
Abstract
Background Psychiatric re-hospitalisation is considered costly and disruptive to individuals. The perspective of the mental health service user is largely unexplored in literature. The purpose of our study was to explore service users’ experiences of psychiatric re-hospitalisation across six countries in Europe. Method Eight focus groups were conducted in Romania, Slovenia, Finland, Italy, Austria and Norway. Results A total of 55 service users participated in the study. All participants had been in receipt of mental health services for at least 1 year, and had experienced more than one psychiatric hospitalisation. The experience of re-hospitalisation was considered: (1) less traumatising than the first hospitalisation, (2) to be necessary, and a relief, (3) occurring by default and without progress, (4) part of the recovery process. Conclusions Psychiatric re-hospitalisation was considered inevitable by the study participants, in both positive and negative terms. Striking similarities in service user experiences were found across all of the six countries, the first experience of psychiatric hospitalisation emerging as especially significant. Findings indicate the need for further action in order to develop more recovery and person-centred approaches within hospital care. For psychiatric inpatient care to be a positive part of the recovery process, further knowledge on what therapeutic action during the hospital stay would be beneficial, such as therapy, activities and integration with other services. Electronic supplementary material The online version of this article (10.1186/s12913-018-3317-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M Ådnanes
- Department of Health Research, SINTEF Technology and Society, PO Box 4760, 7465, Trondheim, Norway.
| | - L Melby
- Department of Health Research, SINTEF Technology and Society, PO Box 4760, 7465, Trondheim, Norway
| | - J Cresswell-Smith
- Mental Health Unit, National Institute for Health and Welfare (THL), PL 30, 00271, Helsinki, Finland
| | - H Westerlund
- KBT Foundation (Competence center for experiential knowledge and service development), PO Box 934, 7409, Trondheim, Norway
| | - L Rabbi
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, P.le L.A. Scuro, 10, 37134, Verona, Italy
| | - M Z Dernovšek
- Institute Karakter, Ježa 90, 1000, Ljubljana, Slovenia
| | - L Šprah
- Research Centre of the Slovenian Academy of Sciences and Arts, Sociomedical Institute, Novi trg 2, 1001, Ljubljana, Slovenia
| | - R Sfetcu
- National School of Public Health, Management and Professional Development, Bucharest (NSPHMPD), Faculty of Psychology and Educational Sciences, SHU Bucharest, Vaselor Street, No 31 Sector 2, 02125, Bucharest, Romania
| | - C Straßmayr
- IMEHPS.research - Forschungsinstitut für Sozialpsychiatrie, Glasergasse 24/23, A-1090, Vienna, Austria
| | - V Donisi
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, P.le L.A. Scuro, 10, 37134, Verona, Italy
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