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Baker J, Berzins K, Canvin K, Benson I, Kellar I, Wright J, Lopez RR, Duxbury J, Kendall T, Stewart D. Non-pharmacological interventions to reduce restrictive practices in adult mental health inpatient settings: the COMPARE systematic mapping review. HEALTH SERVICES AND DELIVERY RESEARCH 2021. [DOI: 10.3310/hsdr09050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
ObjectivesThe study aimed to provide a mapping review of non-pharmacological interventions to reduce restrictive practices in adult mental health inpatient settings; classify intervention components using the behaviour change technique taxonomy; explore evidence of behaviour change techniques and interventions; and identify the behaviour change techniques that show most effectiveness and those that require further testing.BackgroundIncidents involving violence and aggression occur frequently in adult mental health inpatient settings. They often result in restrictive practices such as restraint and seclusion. These practices carry significant risks, including physical and psychological harm to service users and staff, and costs to the NHS. A number of interventions aim to reduce the use of restrictive practices by using behaviour change techniques to modify practice. Some interventions have been evaluated, but effectiveness research is hampered by limited attention to the specific components. The behaviour change technique taxonomy provides a common language with which to specify intervention content.DesignSystematic mapping study and analysis.Data sourcesEnglish-language health and social care research databases, and grey literature, including social media. The databases searched included British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CCRCT), Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), EMBASE, Health Technology Assessment (HTA) Database, HTA Canadian and International, Ovid MEDLINE®, NHS Economic Evaluation Database (NHS EED), PsycInfo®and PubMed. Databases were searched from 1999 to 2019.Review methodsBroad literature search; identification, description and classification of interventions using the behaviour change technique taxonomy; and quality appraisal of reports. Records of interventions to reduce any form of restrictive practice used with adults in mental health services were retrieved and subject to scrutiny of content, to identify interventions; quality appraisal, using the Mixed Methods Appraisal Tool; and data extraction, regarding whether participants were staff or service users, number of participants, study setting, intervention type, procedures and fidelity. The resulting data set for extraction was guided by the Workgroup for Intervention Development and Evaluation Research, Cochrane and theory coding scheme recommendations. The behaviour change technique taxonomy was applied systematically to each identified intervention. Intervention data were examined for overarching patterns, range and frequency. Overall percentages of behaviour change techniques by behaviour change technique cluster were reported. Procedures used within interventions, for example staff training, were described using the behaviour change technique taxonomy.ResultsThe final data set comprised 221 records reporting 150 interventions, 109 of which had been evaluated. The most common evaluation approach was a non-randomised design. There were six randomised controlled trials. Behaviour change techniques from 14 out of a possible 16 clusters were detected. Behaviour change techniques found in the interventions were most likely to be those that demonstrated statistically significant effects. The most common intervention target was seclusion and restraint reduction. The most common strategy was staff training. Over two-thirds of the behaviour change techniques mapped onto four clusters, that is ‘goals and planning’, ‘antecedents’, ‘shaping knowledge’ and ‘feedback and monitoring’. The number of behaviour change techniques identified per intervention ranged from 1 to 33 (mean 8 techniques).LimitationsMany interventions were poorly described and might have contained additional behaviour change techniques that were not detected. The finding that the evidence was weak restricted the study’s scope for examining behaviour change technique effectiveness. The literature search was restricted to English-language records.ConclusionsStudies on interventions to reduce restrictive practices appear to be diverse and poor. Interventions tend to contain multiple procedures delivered in multiple ways.Future workPrior to future commissioning decisions, further research to enhance the evidence base could help address the urgent need for effective strategies. Testing individual procedures, for example, audit and feedback, could ascertain which are the most effective intervention components. Separate testing of individual components could improve understanding of content and delivery.Study registrationThe study is registered as PROSPERO CRD42018086985.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full inHealth Services and Delivery Research; Vol. 9, No. 5. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- John Baker
- School of Healthcare, University of Leeds, Leeds, UK
| | | | - Krysia Canvin
- School of Healthcare, University of Leeds, Leeds, UK
| | - Iris Benson
- Mersey Care NHS Foundation Trust, Prescot, UK
| | - Ian Kellar
- School of Psychology, University of Leeds, Leeds, UK
| | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Joy Duxbury
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | | | - Duncan Stewart
- Department of Health Sciences, University of York, York, UK
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Turgut EÖ, Çam MO. The Effect of Tidal Model-Based Psychiatric Nursing Approach on the Resilience of Women Survivors of Violence. Issues Ment Health Nurs 2020; 41:429-437. [PMID: 32186926 DOI: 10.1080/01612840.2019.1672222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study examined the effect of a psychiatric nursing approach based on the Tidal Model. The outcome variable was resilience in women survivors of violence. The experimental and descriptive study was conducted with a control group and a pretest post-test procedure. The research was carried out with 13 women in the intervention and 14 women in the control group. Resilience Scale for Adults Turkish Version (RSA) was used. Seven one to one sessions were performed with the intervention group. Inter-group comparison of pre- and post-test variation showed significant variations in favor of the intervention group in perception of the future and RSA scale total scores. Consequently the resilience of the intervention group increased, and they had a more positive, target-focused view of the future.
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Affiliation(s)
- Emel Öztürk Turgut
- Mental Health and Psychiatric Nursing Department, Ege University Faculty of Nursing, İzmir, Turkey
| | - Mahire Olcay Çam
- Mental Health and Psychiatric Nursing Department, Ege University Faculty of Nursing, İzmir, Turkey
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Savaşan A, Çam O. The Effect of the Psychiatric Nursing Approach Based on the Tidal Model on Coping and Self-esteem in People with Alcohol Dependency: A Randomized Trial. Arch Psychiatr Nurs 2017; 31:274-281. [PMID: 28499567 DOI: 10.1016/j.apnu.2017.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/26/2016] [Accepted: 01/03/2017] [Indexed: 11/19/2022]
Abstract
INTRODUCTION People with alcohol dependency have lower self-esteem than controls and when their alcohol use increases, their self-esteem decreases. Coping skills in alcohol related issues are predicted to reduce vulnerability to relapse. It is important to adapt care to individual needs so as to prevent a return to the cycle of alcohol use. The Tidal Model focuses on providing support and services to people who need to live a constructive life. AIM The aim of the randomized study was to determine the effect of the psychiatric nursing approach based on the Tidal Model on coping and self-esteem in people with alcohol dependency. METHOD The study was semi-experimental in design with a control group, and was conducted on 36 individuals (18 experimental, 18 control). An experimental and a control group were formed by assigning persons to each group using the stratified randomization technique in the order in which they were admitted to hospital. The Coping Inventory (COPE) and the Coopersmith Self-Esteem Inventory (CSEI) were used as measurement instruments. The measurement instruments were applied before the application and three months after the application. In addition to routine treatment and follow-up, the psychiatric nursing approach based on the Tidal Model was applied to the experimental group in the One-to-One Sessions. RESULTS The psychiatric nursing approach based on the Tidal Model is an approach which is effective in increasing the scores of people with alcohol dependency in positive reinterpretation and growth, active coping, restraint, emotional social support and planning and reducing their scores in behavioral disengagement. It was seen that self-esteem rose, but the difference from the control group did not reach significance. DISCUSSION The psychiatric nursing approach based on the Tidal Model has an effect on people with alcohol dependency in maintaining their abstinence. IMPLICATIONS FOR PRACTICE The results of the study may provide practices on a theoretical basis for improving coping behaviors and self-esteem and facilitating the recovery process of alcohol dependents with implications for mental health nursing.
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Affiliation(s)
| | - Olcay Çam
- Ege University, Faculty of Nursing, Izmir, Turkey
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Doyle M, Jones P. Hodges' Health Career Model and its role and potential application in forensic mental health nursing. J Psychiatr Ment Health Nurs 2013; 20:631-40. [PMID: 22989034 DOI: 10.1111/j.1365-2850.2012.01961.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Forensic mental health nursing is increasingly recognized as a speciality of mental health nursing. Despite this, there are limited examples of theoretical models to underpin this specialism. This paper describes a conceptual framework known as the Hodges' Health Career - Care Domains - Model, hereafter referred to as the Health Career Model (HCM). Readers will learn of the model's origins, development, structure and content together with its application in forensic mental health nursing. Created in the 1980s, the model was developed in the North West of England by Brian E. Hodges. Overall, the purpose of the paper is to demonstrate the model's potential in forensic mental health nursing, its flexibility, adaptability and its increasing relevance to the problems of 21st century health, social care and well-being. Forensic nursing is discussed and the rationale for a nursing model is made. Hodges' model is introduced by explaining its original purposes, structure, its four knowledge (care) domains, its current status, publications and resources. The model's relevance and application in forensic nursing is explored, in particular the demands and unique constraints of this care environment as exercised upon service users, the multidisciplinary team, families, carers and other stakeholders. Future implications for research and recovery-orientated practice are discussed.
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Affiliation(s)
- M Doyle
- University of Manchester, Centre for Mental Health and Risk, and Adult Forensic Mental Health Services, Greater Manchester West NHS Mental Health Foundation Trust, Manchester, UK.
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Bak J, Brandt-Christensen M, Sestoft DM, Zoffmann V. Mechanical restraint--which interventions prevent episodes of mechanical restraint?- a systematic review. Perspect Psychiatr Care 2012; 48:83-94. [PMID: 21967236 DOI: 10.1111/j.1744-6163.2011.00307.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To identify interventions preventing mechanical restraints. DESIGN AND METHODS Systematic review of international research papers dealing with mechanical restraint. The review combines qualitative and quantitative research in a new way, describing the quality of evidence and the effect of intervention. FINDINGS Implementation of cognitive milieu therapy, combined interventions, and patient-centered care were the three interventions most likely to reduce the number of mechanical restraints. PRACTICE IMPLICATIONS There is a lack of high-quality and effective intervention studies. This leaves patients and metal health professionals with uncertainty when choosing interventions in an attempt to prevent mechanical restraints.
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Affiliation(s)
- Jesper Bak
- Mental Health Centre Sct. Hans, Roskilde, Denmark.
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Barker P, Buchanan-Barker P. The tidal model of mental health recovery and reclamation: application in acute care settings. Issues Ment Health Nurs 2010; 31:171-80. [PMID: 20144029 DOI: 10.3109/01612840903276696] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The development, over the last decade, of the Tidal Model of Mental Health Recovery and Reclamation is described, and a summary of the application of the various Tidal processes of care is provided. Studies of evaluations of the Tidal Model within acute care settings are summarised and the potential contribution that the model makes to the development of person-centred care, within acute settings, is discussed.
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Affiliation(s)
- Phil Barker
- University of Dundee, Dundee, Scotland, United Kingdom.
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Johnson S, Gilburt H, Lloyd-Evans B, Osborn DPJ, Boardman J, Leese M, Shepherd G, Thornicroft G, Slade M. In-patient and residential alternatives to standard acute psychiatric wards in England. Br J Psychiatry 2009; 194:456-63. [PMID: 19407278 DOI: 10.1192/bjp.bp.108.051698] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Acute psychiatric wards have been the focus of widespread dissatisfaction. Residential alternatives have attracted much interest, but little research, over the past 50 years. AIMS Our aims were to identify all in-patient and residential alternatives to standard acute psychiatric wards in England, to develop a typology of such services and to describe their distribution and clinical populations. METHOD National cross-sectional survey of alternatives to standard acute in-patient care. RESULTS We found 131 services intended as alternatives. Most were hospital-based and situated in deprived areas, and about half were established after 2000. Several clusters with distinctive characteristics were identified, ranging from general acute wards applying innovative therapeutic models, through clinical crisis houses that are highly integrated with local health systems, to more radical voluntary sector alternatives. Most people using the alternatives had a previous history of admission, but only a few community-based services accepted compulsory admissions. CONCLUSIONS Alternatives to standard acute psychiatric wards represent an important, but previously undocumented and unevaluated, sector of the mental health economy. Further evidence is needed to assess whether they can improve the quality of acute in-patient care.
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Affiliation(s)
- Sonia Johnson
- Department of Mental Health Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, UK.
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Abstract
Launching the Tidal Model: evaluating the evidence This paper reports on two evaluations of the Tidal Model, in the context of two separate acute admission wards, one in Birmingham (2004) and the other in Newcastle (2001), and makes recommendations concerning the criteria and type of reasoning appropriate to evaluating the evidence the two projects have generated. In the Birmingham study, results showed that in the year following the introduction of the Tidal Model, the total number of serious untoward incidents such as physical assault, violence and harassment, decreased by 57%. Nurse satisfaction with their work also improved with nurses rating the model superior to their previous way of working. Inpatient service user assessment of the overall quality of their care was also positive. These findings are then compared with the positive results of an earlier study of the Tidal Model undertaken in Newcastle in 2001. That study was criticized, however, for not showing conclusively that the positive results of the evaluation correlated with the introduction of the Tidal Model. This criticism is briefly examined in the light of both ancient (Aristotle) and modern (Charles Peirce) understandings of the nature of evidence and suggests that such criticism begs the question of the nature of proof. The paper concludes by arguing that, according to both Aristotle and the procedures of abductive reasoning advocated by Charles Peirce, inferring a positive correlation between the results of both studies and the introduction of Tidal Model is a good example of reasonable inference to the best explanation. The available evidence suggests that the results of both studies render the conclusion probable and thus 'good enough' to warrant serious consideration for implementing the Tidal Model more widely within and across Mental Health NHS Trusts.
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Affiliation(s)
- W Gordon
- Birmingham and Solihull NHS Mental Health Trust, Birmingham, UK.
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Abstract
Psychiatric research and practice involves the colonization of the personal experience of problems of human living. From a Western perspective, this process shares many similarities with the subjugation of women, people of colour and people embracing non-Christian faiths and cultures. The Tidal Model is a mental health recovery and reclamation model, developed to provide the framework for discrete alternatives to the colonizing approach of mainstream psychiatric practice. The Model asserts the intrinsic value of personal experience and the centrality of narrative in the development of contextually bound, personally appropriate, mental health care. This paper summarizes the features of the Model, which attempt to address the foci of the more significant critiques of psychiatric practice (and psychiatric nursing), against a background sketch of psychiatric colonization.
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Affiliation(s)
- Phil Barker
- Clan Unity Mental Health Consultancy, Fife, Scotland, United Kingdom.
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Abstract
The nurse-patient relationship has traditionally been viewed as the essence of nursing practice. This paper disputes that the ideals of such a relationship occur effortlessly in nursing practice. Findings from a phenomenological study of individuals hospitalized with a depressive illness found that a therapeutic relationship did not come instinctively to the mental health nurses, and that there was a dichotomy between the close relationship expected by patients and the distant relationship provided by nurses. It is unclear whether nurses' distancing behaviour was as a result of the participant's depressive illness, a normal part of nursing practice, or whether other features such as nurses' workloads were an influencing factor. Further research is required to explore this issue.
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Affiliation(s)
- Wendy Moyle
- Faculty of Nursing and Health, Griffith University, Kessels Road, Nathan, Qld 4111, Australia.
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