Search results

The purpose of this paper is to develop an understanding of the experience of secure care from the patients’ perspective.

A systematic review of qualitative literature was conducted. The data was sourced from the electronic databases: PsychINFO, CINAHL, Medline and the Web of Science Core Collection using pre-defined search terms. A total of 17 studies, conducted in various countries worldwide and covering high, medium and low secure inpatient settings, were included for review. The analysis involved integrating findings from across the literature and was guided by thematic synthesis.

A total of eight themes were generated from the data, three of which provided an understanding of the experience of forensic secure care, and the remaining five themes provided an understanding of the factors which may influence the experience of secure care.

Developing understanding of patient experience can lead to service improvements, potentially impacting patients’ motivation and engagement and thus reducing admission times, potential recalls and recidivism.

To the best of the authors’ knowledge, this is the first systematic review to date to exclusively explore the broad topic of the patient experience of secure mental health care.

The purpose of this paper is to ascertain the most relevant quality factors and communication activities that are suitable as competitive levers in dentistry.

The research is based on a model that highlights the reciprocal influence between patient satisfaction and dentist reputation. The model points out that experience/behaviours, explicit communication and word‐of‐mouth are antecedents of both patient satisfaction and dentist reputation. This research is based on interviews with senior dentists, focus groups with patients and a survey of dentistry patients.

The most important quality factors for patient satisfaction are the doctor‐patient relationship and the clarity of information about treatment and cost. Key communication levers are first, the implicit communication that arises from successful treatment and overall service quality; second, the explicit communication that arises from interpersonal relations with the dentist and the staff, and the referrals of previous patients.

In order to gain competitive advantages, dentists should achieve an average level of patient satisfaction for “given” and “secondary” factors; to pay careful attention to “strategic factors”; and to explicitly communicate “opportunity factors” since patients are usually unaware of their value. Furthermore, dentists should emphasize interpersonal, experiential and third‐party communication with patients.

The paper puts forward a model that integrates previous service quality and reputation management models, and makes suggestions for the improvement of service quality management and communication in dentistry.

While the literature contains plenty of theoretical models for cultural competence training of health care staff, the personnel and clinicians have seldom been asked for their views on transcultural competence. Focus group interviews that we carried out in this study showed that the main concern of the participants (interprofessional teams in Swedish psychiatry) is to understand the culturally diverse in psychiatry, rather than being culturally competent. Three major themes of the process of understanding emerged in our analyses: (1) diversity reflection (sub‐themes: reflecting on co‐existent cultural differences and similarities, moving from a one‐dimensional to a multi‐dimensional approach to cultural diversity and self‐reflection), (2) cultural knowledge and skill acquisition (generic and specific) and (3) communication (sources, discrimination). Listening to staff's learning needs may motivate greater sensitivity to the needs of their culturally diverse patients.

The rapid changes in the environment have exerted significant pressures on healthcare providers to reassess their strategies. Furthermore, it is a paradox that the best clinicians are, themselves, not the best managers in running the healthcare services. Hence, a management model is set up using quality function deployment (QFD) where strategies are developed through a partnership between managers and clinicians for the provision of total quality healthcare in the light of dramatic changes in the health‐care environment. The QFD‐led model consists of seven parts, which includes service planning, operational planning and new concepts deployment. The power of the QFD‐led model comes from the detailed discussions with customers about their expectations, comparisons with competitors and considerations of how the healthcare provider can meet the customers’ expectations most effectively. The application of QFD in a restructured regional acute‐care hospital is discussed.

Night confinement (NC) has been proposed as an appropriate and safe way to make cost improvements in a high secure NHS hospital. Given potential controversy, evaluating the impact of this change is vital. This paper aims to focus on the issue.

The study used a mixed methods design to assess the impact of a three month night confinement pilot on four high secure admission wards. In total, 158 staff and 42 patients were approached to complete questionnaires and interview prior to and following the pilot. Questionnaires were analysed using T tests, ANOVA and Mann Whitney‐U to asses perceived changes in ward climate, working environment and quality of life. Thematic and saliency analysis was used to explore themes arising from semi structured interviews. Hospital data were collected to identify behavioural changes.

The study found that NC had no adverse effects and incidents of self harm, other incidents and seclusion hours dropped by a third during this period. This was contrary to staff expectations.

Limitations include: a large number of researchers involved; average response rate and a disproportionate number of patients on Tilt restrictions on the pilot wards. Further evaluation is necessary if NC is to be adopted more widely.

This evaluation suggests that NC can contribute to providing an efficient and effective secure mental health service.

This study provides a unique opportunity to assess the impact of NC on patients and is of value to other secure units seeking effective cost improvements.

Therapeutic relationships have been identified to be a key feature of staff working with patients within mental health settings and are widely referred to within research literature. The aim of this study is to explore the experiences of support staff within secure mental health services with regards to the formation and development of therapeutic relationships with patients.

Ten participants were interviewed, all of whom were unqualified support staff based within secure establishments and working directly with patients.

Interpretative phenomenological analysis of the data resulted in the identification of three themes: “Building bridges”: developing relationships with patients; “You do forget what they've done”: seeing the person and managing risk, and “Playing your cards close to our chest”: maintaining boundaries.

The themes are discussed and evaluated in terms of relationship formation and development, barriers that may prevent such relationships from being built and the implications for clinical practice.

Team formulation, used to understand patient problems and plan care, is a growing practice in adult mental health and learning disability services. The purpose of this paper is to explore definitions applied to team formulation (as distinct to therapy formulation), its underpinning theories, and the inter-relationship between the team and the process of formulation.

A database search (main search term of team formulation) of peer-reviewed studies was conducted using PRISMA guidelines. A main and second reviewer conducted quality appraisals and thematic analysis. Data were analysed by convergent qualitative synthesis design using thematic analysis to transform evidence from quantitative and qualitative studies into qualitative findings.

Initial searching produced 4,532 papers, 10 of which were eligible for inclusion. Team formulation has no distinct definition. Theories underpinning the practice of therapy formulation emanating from general psychological theory underpin team formulation. Seven studies applied psychological theories to the examination of team formulation. No studies examined the impact of the team on the formulation. Six themes were generated regarding the impact of team formulation on the team; “increased knowledge and understanding”, “altered perceptions, leading to altered relationships, feelings and behaviours”, “space to reflect”, “useful when stuck or challenged”, “perceived increase in effectiveness” and “improved team working”.

Limited evidence and variable quality compromised the availability of review evidence.

This is the first review to examine team formulation through the context of the team. The authors argue that a conceptual framework to encompass team inputs, processes and outputs in team formulation practice should guide future research.

The aim of this paper is to highlight the challenges in evaluating psychological input into acute wards using more traditional methods; and also to provide an example of how it is possible to evaluate such services capturing outcomes at multiple levels.

Data were gathered from multiple levels including staff, patients and the wider organisation mainly using self report questionnaires. The paper looks at the impact on satisfaction, service utilisation, development of recovery principles, quality of therapeutic environment and alliance with treatment teams following the introduction of a dedicated psychology team.

The results show positive trends in patient experiences of the ward environment, alliance with treating teams and staff recovery principles, along with reduced readmission rates and length of stay in hospital. Qualitative data demonstrate the value of the service to both staff and patients.

Much of the data do not meet the criteria for more sophisticated statistical analysis.

The paper provides an example of evaluation of a contemporary model of service delivery for which there is currently a limited evidence base and looks to stimulate current thinking on the practice of mental health service delivery.

Promoting patient satisfaction is crucial for healthcare quality improvement. However, literature on patient satisfaction with nursing care in Ghana is limited. The aim of this study was to assess patient satisfaction with perioperative nursing care in Korle-Bu Teaching Hospital, the largest tertiary hospital in Ghana.

The study was a cross-sectional study. A sample of one hundred (n = 100) in-patients in the surgical department were interviewed. Statistical Package for Social Science (SPSS), version 22, was used to analyze the data. The results were presented using univariate, bivariate and multivariate analyses.

It was found that majority of the respondents were males (53%), employed (56%) and insured (85%). It was also found that eight in ten respondents were satisfied with the perioperative nursing care. Overall patient satisfaction with perioperative nursing care was significantly associated with information provision (p < 0.001), nurse–patient relationship (p < 0.001), fear and concern (p < 0.05) and discomfort and need (p < 0.05). At the multivariate level, overall patient satisfaction was significantly influenced by nurse–patient relationship (β = 0.430, p = 0.002).

There is limited literature on nursing care in surgical departments and rarely are patients' views considered in assessing quality of perioperative care, especially in Low- and Middle- Income Countries (LMICs). This study is a modest contribution to the literature on patient satisfaction with perioperative nursing care in Ghana.

Service users’ voice is at the forefront of movements within psychiatry that look to create more humanising care. Although genuine co-production of knowledge is limited by the power differential intrinsically functional to the health care setting, the arts have the potential to create collaborative environments and equalise relationships. The purpose of this case study is to describe and discuss the design and pilot evaluation of creative writing workshops in a forensic mental health ward as an innovative method for humanising care.

A creative writing intervention focussing on everyday experiences was implemented in a forensic mental health ward and involved four residents and four mental health professionals working together. Interviews were conducted with the four mental health professionals as part of a service evaluation. Transcripts were analysed using thematic analysis.

Two themes emerged from the analysis of interviews with mental health professionals: “a new way of learning about each other” and “imagining beyond the staff-resident relationship”. The authors discuss the intervention’s benefits in terms of its potential to foster mutuality and empathy beyond the illness narrative.

Creative writing can be used to engage patients and mental health professionals to jointly share everyday experiences and identities beyond illness.

The creative writing workshops present an innovative approach concerning the use of creative arts for humanising care through mutuality.