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Developing a measure to assess clinicians’ ability to reflect on key staff–patient dynamics in forensic settings

Adam Polnay (The State Hospital, Carstairs, UK and Division of Psychiatry, The University of Edinburgh, Edinburgh, UK)
Helen Walker (Forensic Network, Lanarkshire, UK and School of Health and Life Sciences, University of the West of Scotland, Lanarkshire Campus, Paisley, UK)
Christopher Gallacher (The State Hospital, Carstairs, UK)

The Journal of Forensic Practice

ISSN: 2050-8794

Article publication date: 30 November 2021

Issue publication date: 1 February 2022

197

Abstract

Purpose

Relational dynamics between patients and staff in forensic settings can be complicated and demanding for both sides. Reflective practice groups (RPGs) bring clinicians together to reflect on these dynamics. To date, evaluation of RPGs has lacked quantitative focus and a suitable quantitative tool. Therefore, a self-report tool was designed. This paper aims to pilot The Relational Aspects of CarE (TRACE) scale with clinicians in a high-secure hospital and investigate its psychometric properties.

Design/methodology/approach

A multi-professional sample of 80 clinicians were recruited, completing TRACE and attitudes to personality disorder questionnaire (APDQ). Exploratory factor analysis (EFA) determined factor structure and internal consistency of TRACE. A subset was selected to measure test–retest reliability. TRACE was cross-validated against the APDQ.

Findings

EFA found five factors underlying the 20 TRACE items: “awareness of common responses,” “discussing and normalising feelings;” “utilising feelings,” “wish to care” and “awareness of complicated affects.” This factor structure is complex, but items clustered logically to key areas originally used to generate items. Internal consistency (α = 0.66, 95% confidence interval (CI) = 0.55–0.76) demonstrated borderline acceptability. TRACE demonstrated good test–retest reliability (intra-class correlation = 0.94, 95% CI = 0.78–0.98) and face validity. TRACE indicated a slight negative correlation with APDQ. A larger data set is needed to substantiate these preliminary findings.

Practical implications

Early indications suggested TRACE was valid and reliable, suitable to measure the effectiveness of reflective practice.

Originality/value

The TRACE was a distinctive measure that filled a methodological gap in the literature.

Keywords

Acknowledgements

The authors extend their gratitude to the two anonymous reviewers; study participants; Rebecca Hart (librarian); Jamie Pitcairn and The State Hospital Research Committee; Jon Patrick, Katharine Russell and Forensic Network (NHS Scotland) report authors whose work laid the groundwork for this paper.

The authors thank those who gave feedback on early drafts of the TRACE, namely, Adam Burley, Victoria Barker, Aileen Burnett, Patricia Cawthorne, Josephine Clerk, James Johnston, Jon Patrick, Katharine Russell and Leeann Stevenson.

Funding was received from The State Hospital, Carstairs.

Citation

Polnay, A., Walker, H. and Gallacher, C. (2022), "Developing a measure to assess clinicians’ ability to reflect on key staff–patient dynamics in forensic settings", The Journal of Forensic Practice, Vol. 24 No. 1, pp. 34-47. https://doi.org/10.1108/JFP-07-2021-0041

Publisher

:

Emerald Publishing Limited

Copyright © 2021, Emerald Publishing Limited

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