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Barriers and enablers to implementation of the therapeutic engagement questionnaire in acute mental health inpatient wards in England: A qualitative study.
Taylor, Francesca; Galloway, Sarah; Irons, Kris; Mess, Lorna; Pemberton, Laura; Worton, Karen; Chambers, Mary.
  • Taylor F; Joint Faculty of Health, Social Care and Education, Kingston University and St George's University of London, London, UK.
  • Galloway S; South-West London and St George's Mental Health NHS Trust, London, UK.
  • Irons K; Priory Group, London, UK.
  • Mess L; North-East London NHS Foundation Trust, London, UK.
  • Pemberton L; Southern Health NHS Foundation Trust, London, UK.
  • Worton K; Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, London, UK.
  • Chambers M; Joint Faculty of Health, Social Care and Education, Kingston University and St George's University of London, London, UK.
Int J Ment Health Nurs ; 31(6): 1467-1479, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1992826
ABSTRACT
A strong association exists between the quality of nurse-service user therapeutic relationship and care outcomes on acute mental health inpatient wards. Despite evidence that service users desire improved therapeutic engagement, and registered mental health nurses recognize the benefits of therapeutic relationships, such interactions remain sub-optimal. There is a dearth of evidence on factors influencing implementation of interventions to support and encourage therapeutic engagement. This study aimed to understand the barriers and enablers to implementation of the Therapeutic Engagement Questionnaire (TEQ), across fifteen acute inpatient wards in seven English mental health organizations. Qualitative methods were used in which data were collected from ethnographic field notes and documentary review, coded, and analysed using thematic analysis. Theoretical framing supported data analysis and interpretation. Reporting adheres to the Standards for Reporting Qualitative Research. The TEQ as an evidence-based intervention co-produced with service users and nurses was valued and welcomed by many nurse directors, senior clinicians, and ward managers. However, a range of practical and perceptual factors impeded implementation. Furthermore, many existing contextual challenges for intervention implementation in acute inpatient wards were magnified by the COVID-19 pandemic. Suitable facilitation to address these barriers can help support implementation of the TEQ, with some transferability to implementation of other interventions in these settings. Our study suggests several facilitation methods, brought together in a conceptual model, including encouragement of reflective, facilitative discussion meetings among stakeholders and researchers, effort put into winning nurse 'buy-in' and identifying and supporting ward-level agents of change.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Mental Health / COVID-19 Type of study: Observational study / Qualitative research / Randomized controlled trials Limits: Humans Language: English Journal: Int J Ment Health Nurs Journal subject: Nursing / Psychology Year: 2022 Document Type: Article Affiliation country: Inm.13047

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Mental Health / COVID-19 Type of study: Observational study / Qualitative research / Randomized controlled trials Limits: Humans Language: English Journal: Int J Ment Health Nurs Journal subject: Nursing / Psychology Year: 2022 Document Type: Article Affiliation country: Inm.13047