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Life in acute mental health settings: experiences and perceptions of service users and nurses

Published online by Cambridge University Press:  16 December 2013

D. Rose*
Affiliation:
Service User Research Enterprise, Institute of Psychiatry, King's College London, UK
J. Evans
Affiliation:
Service User Research Enterprise, Institute of Psychiatry, King's College London, UK
C. Laker
Affiliation:
Service User Research Enterprise, Institute of Psychiatry, King's College London, UK
T. Wykes
Affiliation:
Department of Psychology, Institute of Psychiatry, King's College London, UK
*
*Address for correspondence: Dr Diana Rose, Institute of Psychiatry, King's College London, De Crespigny Park, PO 34, London SE5 8AF, UK. (Email: [email protected])

Abstract

Background.

Acute psychiatric provision in the UK today as well as globally has many critics including service users and nurses.

Method.

Four focus groups, each meeting twice, were held separately for service users and nurses. The analysis was not purely inductive but driven by concerns with the social position of marginalised groups – both patients and staff.

Results.

The main themes were nurse/patient interaction and coercion. Service users and nurses conceptualised these differently. Service users found nurses inaccessible and uncaring, whereas nurses also felt powerless because their working life was dominated by administration. Nurses saw coercive situations as a reasonable response to factors ‘internal’ to the patient whereas for service users they were driven to extreme behaviour by the environment of the ward and coercive interventions were unnecessary and heavy handed.

Conclusion.

This study sheds new light on living and working in acute mental health settings today by comparing the perceptions of service users and nurses and deploying service user and nurse researchers. The intention is to promote better practice by providing a window on the perceptions of both groups.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

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References

Austin, W, Bergum, V, Goldberg, L (2003). Unable to answer the call of our patients: mental health nurses' experience of moral distress. Nursing Inquiry 10, 177183.CrossRefGoogle ScholarPubMed
Bowers, L, Crowhurst, N, Alexander, J, Callaghan, P, Eales, S, Guy, S (2002). Safety and security policies on psychiatric acute admission wards: results from a London-wide survey. Journal of Psychiatric and Mental Health Nursing 9, 427433.Google Scholar
Cleary, M, Edwards, C (1999). ‘Something always comes up’: nurse–patient interaction in an acute psychiatric setting. Journal of Psychiatric and Mental Health Nursing 6, 469477.Google Scholar
Cornwall, A, Jewkes, R (1995). What is participatory research? Social Science and Medicine 41, 16671676.Google Scholar
Evans, J, Rose, D, Flach, C, Csipke, E, Glossop, H, McCrone, P, Craig, T, Wykes, T (2012). VOICE: developing a new measure of service users' perceptions of inpatient care, using a participatory methodology. Journal of Mental Health 21, 5771.Google Scholar
Faulkner, A (2005). Institutional conflict: the state of play in adult acute psychiatric wards. Journal of Adult Protection 7, 612.Google Scholar
Gilburt, H, Rose, D, Slade, M (2008). The importance of relationships in mental health care: a qualitative study of service users experiences of psychiatric hospital admission in the UK. BMC Health Services Research 8, 92.Google Scholar
Gilburt, H, Slade, M, Rose, D, Lloyd-Evans, B, Johnson, S, Osborn, D (2010). Service users' experiences of residential alternatives to standard acute wards: qualitative study of similarities and differences. British Journal of Psychiatry 197, S26S31.CrossRefGoogle Scholar
Gillard, S, Borschmann, R, Turner, K, Goodrich-Purnell, N, Lovell, K, Chambers, M (2010). ‘What difference does it make?’ Finding evidence of the impact of mental health service user researchers on research into the experiences of detained psychiatric patients. Health Expectations 13, 185194.Google Scholar
Gordon, D, Alexander, DA, Dietzan, J (1979). The psychiatric patient: a voice to be heard. British Journal of Psychiatry 135, 115121.CrossRefGoogle Scholar
Harding, S (1991). ‘Strong objectivity’ and socially situated knowledge. In Whose Science? Whose Knowledge? (ed.) Harding, S, pp. 138163. Cornell University Press: New York.Google Scholar
Henkel, H, Stirrat, R (2001). Participation as spiritual duty; empowerment as secular subjection. In Participation, the New Tyranny? (ed.) Cooke, B and Kothari, U, pp. 168184. Zed Books: London.Google Scholar
Higgins, R, Hurst, K, Wistow, G (1999). Nursing acute psychiatric patients: a quantitative and qualitative study. Journal of Advanced Nursing 29, p5263.CrossRefGoogle ScholarPubMed
Jenkins, R, Elliott, P (2004). Stressors, burnout and social support: nurses in acute mental health settings. Journal of Advanced Nursing 48, 622631.Google Scholar
Kendall, T, Crawford, M, Taylor, C, Whittington, C, Rose, D (2012). Improving the experience of care for adults using NHS mental health services: summary of NICE guidance. British Medical Journal 344, 13631365.Google Scholar
Laker, C, Rose, D, Flach, C, Csipke, E, McCrone, P, Craig, T, Kelland, H, Wykes, T (2012). Views of the Therapeutic Environment (VOTE): Stakeholder involvement in measuring staff perceptions of acute in-patient care. International Journal of Nursing Studies 49, 14031410.Google Scholar
Mason, R, Boutilier, M (1996). The challenge of genuine power sharing in participatory research: the gap between theory and practice. Canadian Journal of Community Mental Health 15, 145152.CrossRefGoogle Scholar
MIND (2004). WardWatch. MIND: London.Google Scholar
Peplau, H (1952). Interpersonal relations in nursing. American Journal of Nursing 52, 765.CrossRefGoogle Scholar
Pope, C, Mays, N (ed.) (2008). Qualitative Research in Health Care. Wiley.com. Google Scholar
Quirk, A, Lelliott, P (2001). What do we know about life on acute psychiatric wards in the UK? A review of the research evidence. Social Science and Medicine 53, 15651574.CrossRefGoogle Scholar
Rose, D (2001). Users' Voices. Sainsbury Centre for Mental Health: London.Google Scholar
Rose, D, Evans, J, Sweeney, A, Wykes, T (2011). A model for developing outcome measures from the perspectives of mental health service users. International Review of Psychiatry 23, 4146.Google Scholar
Sainsbury Centre for Mental Health (1996). Acute Problems. Sainsbury Centre for Mental Health: London.Google Scholar
Saxena, S, Barrett, T (2007). Atlas: Nurses in Mental Health 2007. World Health Organisation Press: Geneva.Google Scholar
Sharac, J, McCrone, P, Sabes-Figuera, R, Csipke, E, Wood, A, Wykes, T (2010). Nurse and patient activities and interaction on psychiatric inpatients wards: a literature review. International Journal of Nursing Studies 47, 909917.Google Scholar
Sullivan, P (1993). Occupational stress in psychiatric nursing. Journal of Advanced Nursing 18, 591601.Google Scholar
Walsh, J, Boyle, J (2009). Improving acute psychiatric hospital services according to inpatient experiences. A user-led piece of research as a means to empowerment. Issues in Mental Health Nursing 30, 3138.Google Scholar
Wing, J, Marriott, S, Palmer, C, Thomas, V (1998). The Management of Imminent Violence: Clinical Practice Guidelines to Support Mental Health Services. Royal College of Psychiatrists: London.Google Scholar
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