Knowledge about social networks and integration: a co-operative research project

Co-Production within Child and Adolescent Mental Health: A Systematic Review

Background: Mental health services are currently experiencing much systemic and organisational change. Many countries have adopted a recovery approach to service provision through the development of national policies and frameworks. Within an Irish context, co-production has been identified as one of the four pillars required for services to become recovery orientated. However, there is a paucity of literature relating to the concept within child and adolescent mental health services. This paper aims to synthesise the peer-reviewed evidence on co-production within such services. Methods: A PRISMA compliant systematic review was undertaken. This includes how the reviewer retrieved, shortlisted, and selected studies for inclusion in the review. It outlines the inclusion/exclusion criteria and how these were further developed through the PICO framework. Finally, the methods also outline how the reviewer assessed bias and quality, as well as the process of data synthesis. Results: Two studies were included in this review, both focusing on co-production, but in different contexts within child and adolescent mental health. Two themes were identified: ‘road less travelled’ and ‘co-producing equality’. These themes and the associated sub-themes describe how co-production works in these services. Discussion: These results highlight the paucity of quality literature in co-production within child and adolescent mental health. Both studies scored poorly in terms of quality. Resulting from this review, a number of actions relating to the therapeutic environment need to be taken into account for co-production to be further implemented. Other: The reviewer has not received any funding for this paper. A protocol was not created or registered for this review.

A Guide for Planning and Implementing Successful Mental Health Educational Programs

INTRODUCTION

Considering the global burden of mental disorders, there is a worldwide need to improve the quality of mental health care. In order to address this issue, a change in how health care professionals are trained may be essential. However, the majority of the few reports published on this field's training programs do not discuss the characteristics associated with the success or failure of these strategies. The purpose of this review was to systematically examine the literature about mental health training programs designed for health care professionals in order to identify the relevant factors associated with their effective implementation.

METHODS

The MEDLINE/PubMed, SciELO, and Virtual Health Library databases were used to search for articles published before February 2017 and reviewed by two double-blind reviewers.

RESULTS

We found 77 original papers about mental health educational programs. Many of these studies were conducted in the USA (39%), addressed depression as the main subject (34%), and applied a quasi-experimental design (52%). Effective interventions were associated with the following characteristics: the use of learner-centered and interactive methodological approaches; a curriculum based on challenges in the trainees' daily routines; the involvement of experts in the program's development; the enrollment of experienced participants; interdisciplinary group work; flexible timing; the use of e-learning resources; and optimizing the implementation of knowledge into the participants' routine work practices.

IMPLICATIONS FOR PRACTICE

These results will be helpful for planning and improving the quality of future educational programs in mental health.

Chronic disease management: implementation and coordination of healthcare systems for depressed elderly persons

The aim of this study was to evaluate the implementation of the research-based Chronic Care Model (CCM), discuss methods and summarise research recommendations for improving the care of depressed elderly persons. Interviews were conducted and state-of-the-art reviews employed. Three important areas emerged: (1) barriers to and facilitating factors in the implementation of the CCM; (2) the challenges involved in re-designing the delivery system and interdisciplinary team collaboration; and (3) empirical evidence pertaining to self-management support and how older persons manage to live with depressive ill-health. In conclusion, implementation research requires evidence-based knowledge, staff involvement and familiarity with the context in which development occurs.

Nurses' and care workers' experiences of spiritual needs in residents with dementia in nursing homes: a qualitative study

Background

The aim of the study was to investigate nurses’ and care workers’ experiences of spiritual needs among residents with dementia in nursing homes. Nurses claim to practice holistic nursing. Nevertheless, there is little knowledge about how to recognise spiritual needs in residents with dementia.

Methods

The study was conducted using a qualitative method with an exploratory design. Eight focus- group interviews in four Norwegian nursing homes were performed from June 2011 – Jan 2012. Using open-ended research questions, a total of 31 participants were asked to share their understanding and experiences regarding residents’ spiritual needs. The interviews were analysed using a phenomenological – hermeneutical method.

Results

The nurses’ and care workers’ experiences of residents’ spiritual needs were related to three main themes; i) The need for serenity and inner peace, described as “contemplative and restful moments” and “calmness due to familiarity”, ii) The need for confirmation, described as “love and proximity” and iii) The need to express faith and beliefs, described as “participate in worship and prayers” and “approaching death”.

The comprehensive analyses revealed that the nurses believe the residents’ spiritual needs were linked to the residents’ previous sources of finding meaning, in relation to inter-personal, intra-personal and trans-personal dimensions in residents’ lives.

Conclusions

Nurses' and care workers’ experiences of spiritual needs in people with dementia are very similar to the findings for the general population regardless of the severity of the dementia. The study’s relevance to clinical practice indicates the importance of developing more knowledge about how people with dementia in nursing homes express spiritual needs and how to observe and interpret such needs.

Patient participation, decision-makers and information flow in surgical treatment

AIMS AND OBJECTIVES

To clarify patient participation by specifying three kinds of information flows between healthcare professionals and patients in four models such as the paternalistic, shared, informed and nonpaternalistic models.

BACKGROUND

The relationship between healthcare professionals and patients has evolved from a traditional paternalistic model where 'doctors know best' and patients are passive recipients, to a partnership where patients act as active participants.

DESIGN

A qualitative study.

METHODS

Qualitative data from interviews with four doctors, seven nurses and seven patients illustrate these relationships.

RESULTS

A 3 × 3 matrix is developed where healthcare professionals can make decisions unilaterally, patients can make decisions unilaterally, or these can make decisions jointly. Information can flow from healthcare professionals to patient, from patient to healthcare professionals or both ways.

CONCLUSIONS

This conceptualisation provides a rich understanding of decision-making and information flow in surgical hospitals.

RELEVANCE TO CLINICAL PRACTICE

The paper illustrates how practice can be assessed empirically to determine how it fits into the structure. Strategies can be implemented to move practice from one part of the structure to another part.

Community mental health centres: a qualitative study of professionals' experiences

This article presents findings from a qualitative study of mental health work in community mental health centres with a multiprofessional workforce and aims of active user participation in the service. User participation implies collaborative relationships and different roles than that of expert professionals and dependent patients. How do professionals working in these services experience their work and professional role? This question was explored in order to highlight important aspects of community mental health work. A group of six experienced professionals from three community mental health centres in a Norwegian city were interviewed twice. The informants highlighted the complexity of community mental health work and the need to be flexible when working to support people with mental health problems in their everyday life situation. To see the service users as people and to facilitate social interaction was important. Their work was described as 'liberating' compared to working in institutions. However, although in their experience they found that professional knowledge and skills were important in their work situation, all had experienced that this was not always acknowledged by professionals in other services.