A systematic review on the use of action research methods in mental health nursing care.

AIMS: To identify and synthesize evidence on the use of action research methods in mental health nursing care. DESIGN: Systematic review. DATA SOURCES: CINAHL, Web of Science, PubMed and Scopus databases were searched in January 2021. REVIEW METHODS: Data were selected using the updated Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Two reviewers independently conducted the study selection, and quality appraisal using Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, data extraction and data analysis procedures. RESULTS: Sixteen studies, half of which used participatory action research, were included in this review. Nurses, along with other stakeholders, were an active part of the action research process. The main topics of interest addressed were categorized as improving the adoption of a person-centred approach to care and improving decision-making procedures. The use of action research helped the participants to identify the meaning they attached to the topic of interest to be improved. Moreover, this method helped to identify needs and strategies for improving care. The studies concurred that the use of action research enabled participants to gain awareness, improve attitudes and acquire knowledge. In addition, it enabled participants to gain confidence and security in the group context, as key aspects of their empowerment. CONCLUSION: This review shows the usefulness of action research in any mental health nursing context, contributing to the improvement of care at both the individual and collective levels. IMPACT: This paper demonstrates the use of the action research method in the field of mental health nursing. Its use has improved the clinical practice of nurses as well as that of teams in both community and hospital settings, addressing issues of the person-centred approach to care and decision-making procedures.

Efectividad de una Intervención Breve sobre motivación antitabáquica en usuarios drogodependientes ingresados en una UHD / Effectiviness of a Brief Intervention on anti-smoking motivation in drug addict patients staying in a UHD

Justificación: Existe una asociación entre tabaquismo y TUS, especialmente con alcohol y cannabis. Sin embargo, las intervenciones sanitarias parecen no ir encaminadas a su enfoque.Objetivo: Evaluar el grado de motivación para el abandono tabáquico tras realizar una intervención psicoeducativa breve sobre abordaje del tabaquismo.Metodología: Se trata de una investigación cuantitativa de tipo analítico cuasiexperimental que se lleva a cabo mediante dos cohortes experimentales, del tipo pre- y post-intervención. Se aplica una intervención breve educativa y se evalúan las diferencias en la motivación para el abandono tabáquico en un grupo antes de la intervención y en otro grupo después de la misma. Resultados: Existe una diferencia de 1,27 puntos en el grado de motivación encontrado en los individuos respecto a los grupos experimentales. Conclusiones: Las personas drogodependientes son fumadoras con altos grados de dependencia nicotínica por lo que es preciso diseñar estrategias de cesación adecuadas

Justification: There is a connection between smoking and substances use disorder, especially alcohol and cannabis. Nevertheless, health interventions seem not to be addressed to this approach. Objective: Evaluation of the motivation degree for the smoking quit after developing a brief psycho-educational intervention on smoking.Methodology: It is a quantitative research of analytical type, almost experimental, developed by means of two experimental series, of the types pre- and post- intervention. A brief educational intervention is applied and there is an evaluation of the differences in the motivation for the smoking quit in a group before the intervention and in another one after the intervention. Results: There is a difference of 1,27 points in the degree of motivation found in the individuals regarding the experimental groups. Conclusions: Drug addict people are smokers with a high degree of nicotinic dependence, so it is necessary to design suitable strategies of quitting

Improving the therapeutic relationship in inpatient psychiatric care: Assessment of the therapeutic alliance and empathy after implementing evidence-based practices resulting from participatory action research.

PURPOSE: To examine how evidence about the therapeutic alliance gleaned from participatory action project affected the level of this alliance and the degree of empathy of psychiatric nurses. DESIGN AND METHODS: Quasi-experimental study in two psychiatric units. In one group, evidence-based practices that affected the therapeutic alliance were implemented; in the comparison group, there was no such intervention. FINDINGS: The nurses from the intervention group improved their degree of empathy and factors such as agreement on objectives and tasks with the patient. PRACTICE IMPLICATIONS: The results confirm the possibility of measuring and improving the therapeutic relationship in psychiatric care.

Implementation of evidence on the nurse-patient relationship in psychiatric wards through a mixed method design: study protocol.

BACKGROUND: Psychiatric nurses are aware of the importance of the therapeutic relationship in psychiatric units. Nevertheless, a review of the scientific evidence indicates that theoretical knowledge alone is insufficient to establish an adequate therapeutic alliance. Therefore, strategies are required to promote changes to enhance the establishment of the working relationship. The aims of the study are to generate changes in how nurses establish the therapeutic relationship in acute psychiatric units, based on participative action research and to evaluate the effectiveness of the implementation of evidence through this method. METHODS/DESIGN: The study will use a mixed method design. Qualitative methodology, through participative action research, will be employed to implement scientific evidence on the therapeutic relationship. A quasi-experimental, one-group, pre-test/post-test design will also be used to quantitatively measure the effectiveness of the implementation of the evidence. Participants will consist of nurses and patients from two psychiatric units in Barcelona. Nurses will be selected by theoretical sampling, and patients assigned to each nurses will be selected by consecutive sampling. Qualitative data will be gathered through discussion groups and field diaries. Quantitative data will be collected through the Working Alliance Inventory and the Interpersonal Reactivity Index. Qualitative data will be analysed through the technique of content analysis and quantitative data through descriptive and inferential statistics. DISCUSSION: This study will help to understand the process of change in a nursing team working in an inpatient psychiatric ward and will allow nurses to generate knowledge, identify difficulties, and establish strategies to implement change, as well as to assess whether the quality of the care they provide shows a qualitative improvement.

The Therapeutic Relationship in Inpatient Psychiatric Care: A Narrative Review of the Perspective of Nurses and Patients.

PURPOSE: To study the significance of 'therapeutic relationship' between nurses and patients within the context of a psychiatric hospital. METHOD: Narrative literature review. Content analysis. FINDINGS: The significance of the therapeutic relationship is quite similar for both nurses and patients in psychiatric hospital units. Nevertheless, several factors may separate the two positions: the time available for the relationship, the negative perceptions on the part of both parties, and the insecurity of the setting. PRACTICE IMPLICATIONS: Increased knowledge and understanding of the significance of the therapeutic relationship from the perspective of nurses and patients would allow the strengthening of areas of mutual interest.

Un día en la unidad de hospitalización de psiquiatría / Um dia na unidade de internação psiquiátrica / A day in the psychiatric inpatient unit

Se presenta el relato de la que podría ser la experiencia vivida por una persona hospitalizada en una unidad de psiquiatría cualquiera. Los datos se generan mediante la observación no participante, entrevistas informales y la propia experiencia asistencial de los autores. La persona protagonista está hospitalizada de forma involuntaria en una unidad de agudos de psiquiatría, ha recibido del 'sistema' la etiqueta diagnóstica de psicosis. A través de su mirada, los autores reflexionan en torno a las percepciones y vivencias que le acontecen en relación con el devenir cotidiano del hospital, y por supuesto con el cuidado recibido por las enfermeras de la unidad (AU)

We present the story of what could be the experience of a hospitalized person in whatever psychiatric unit. The data are generated by non-participant observation and care experience of the authors. The protagonist person is involuntarily admitted in a psychiatric acute unit; he has received the diagnostic label of psychosis by the 'system'. Through his eyes, the authors reflect about perceptions and experiences that happen him in relation to the daily workings of the hospital, and of course with the care received by nurses in the unit (AU)

Nós apresentamos a história do que poderia ser a experiência de uma pessoa internada em qualquer unidade psiquiátrica. Os dados são gerados pela observação não participante e experiência de cuidado dos autores. A pessoa protagonista é involuntariamente internado em uma unidade psiquiátrica aguda; ele recebeu o rótulo diagnóstico de psicose pelo 'sistema'. Através de seus olhos, os autores refletem sobre as percepções e experiências que lhe suceder em relação aos trabalhos diários do hospital, e, claro, com o cuidado recebido por enfermeiras da unidade (AU)

Autonomía y competencia en las unidades psiquiátricas de enfermos agudos / Autonomy and competence in psychiatric units for acute patients

En las Unidades de Psiquiatría de enfermos agudos es habitual que ingresen pacientes de forma no voluntaria. Eso implica que cuidara enfermos que no quieren ser cuidados pueda ser frecuente. El hecho de que un paciente haya sido declarado incompetente en cuanto a su ingreso, ¿determina que también lo sea en las decisiones que atañen a su cuidado? ¿Es incompetente para decidir sobre cualquier cuidado? ¿Debemos solicitar siempre su consentimiento para toda intervención? La no existencia de herramientas metodológicas enfermeras que contribuyan a prestar unos cuidados de mayor calidad, en personas que no quieren ser cuidadas, hace que sea necesaria una revisión profunda del estado de la cuestión. El objetivo de este trabajo es reflexionar entorno a la capacidad para determinar la competencia, y por tanto la autonomía del paciente, a la hora de aplicar cuidados de Enfermería en una Unidad de Psiquiatría de enfermos agudos (AU)

It is usual that patients are admitted non-voluntarily in Psychiatry Units for acute patients. This involves that it might be frequent to care for patients who refuse any care. The fact that a patient has been declared incompetent regarding his admission, does also determine that they are incompetent in terms of decisions about their care? Is this patient incompetent to decide about any kind of care? Must we always ask for their consent for any intervention? The lack of methodological tools for nurses which help to provide higher quality care for patients who don’t want any care requires a review in depth of the current state of this issue. The objective of this paper is to think about the ability to determine patient’s competence, and therefore their autonomy, when providing nursing care in a Psychiatry Unit for acute patients (AU)