Title |
Barriers to the sustainability of an intervention designed to improve patient engagement within NHS mental health rehabilitation units: a qualitative study nested within a randomised controlled trial
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Published in |
BMC Psychiatry, September 2015
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DOI | 10.1186/s12888-015-0592-9 |
Pubmed ID | |
Authors |
Melanie Lean, Gerard Leavey, Helen Killaspy, Nicholas Green, Isobel Harrison, Sarah Cook, Thomas Craig, Frank Holloway, Maurice Arbuthnott, Michael King |
Abstract |
We undertook a cluster randomised controlled trial to assess the effectiveness of a staff training intervention to improve patient engagement in activities in inpatient mental health rehabilitation units. Concurrently, we undertook a qualitative study to investigate the experiences of staff within the intervention units and the contextual issues that may have influenced the effectiveness of the intervention. We conducted focus groups with staff working in the inpatient units that received the intervention, sampled using a maximum variation strategy. The intervention was accepted by staff. However, the skills gained, and changes to the unit's processes and structures that were agreed with the intervention team were not sustained after they left. The main reasons for this were a) external factors (economic recession, resource limitations); b) organisation level factors (lack of senior staff support; competing priorities); c) limitations of the intervention itself (length of intensive training period; reinforcement of skills). This study illustrates some of the inter-related factors which operate at different levels within and outside of NHS organisations that may impact on the success of complex interventions. These factors need to be considered when designing interventions to ensure adequate buy-in from senior staff. Current Controlled Trials ISRCTN25898179 (Registered 23 April 2010). |
X Demographics
Geographical breakdown
Country | Count | As % |
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United Kingdom | 2 | 40% |
United States | 1 | 20% |
Unknown | 2 | 40% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 5 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 1 | <1% |
Unknown | 167 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 25 | 15% |
Student > Ph. D. Student | 22 | 13% |
Researcher | 21 | 13% |
Student > Bachelor | 18 | 11% |
Student > Doctoral Student | 13 | 8% |
Other | 27 | 16% |
Unknown | 42 | 25% |
Readers by discipline | Count | As % |
---|---|---|
Nursing and Health Professions | 41 | 24% |
Medicine and Dentistry | 25 | 15% |
Psychology | 17 | 10% |
Social Sciences | 13 | 8% |
Business, Management and Accounting | 5 | 3% |
Other | 18 | 11% |
Unknown | 49 | 29% |