Barriers to the sustainability of an intervention designed to improve patient engagement within NHS mental health rehabilitation units: a qualitative study nested within a randomised controlled trial

LEAN, Melanie, LEAVEY, Gerard, KILLASPY, Helen, GREEN, Nicholas, HARRISON, Isobel, COOK, Sarah, CRAIG, Thomas, HOLLOWAY, Frank, ARBUTHNOTT, Maurice and KING, Michael (2015). Barriers to the sustainability of an intervention designed to improve patient engagement within NHS mental health rehabilitation units: a qualitative study nested within a randomised controlled trial. BMC Psychiatry, 15 (209), 1-10.

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Link to published version:: 10.1186/s12888-015-0592-9

Abstract

Background - We undertook a cluster randomised controlled trial to assess the effectiveness of a staff training intervention to improve patient engagement in activities in inpatient mental health rehabilitation units. Concurrently, we undertook a qualitative study to investigate the experiences of staff within the intervention units and the contextual issues that may have influenced the effectiveness of the intervention. Method - We conducted focus groups with staff working in the inpatient units that received the intervention, sampled using a maximum variation strategy. Results - The intervention was accepted by staff. However, the skills gained, and changes to the unit’s processes and structures that were agreed with the intervention team were not sustained after they left. The main reasons for this were a) external factors (economic recession, resource limitations); b) organisation level factors (lack of senior staff support; competing priorities); c) limitations of the intervention itself (length of intensive training period; reinforcement of skills). Conclusion - This study illustrates some of the inter-related factors which operate at different levels within and outside of NHS organisations that may impact on the success of complex interventions. These factors need to be considered when designing interventions to ensure adequate buy-in from senior staff.

Item Type: Article
Research Institute, Centre or Group: Centre for Health and Social Care Research
Identification Number: 10.1186/s12888-015-0592-9
Depositing User: Margaret Boot
Date Deposited: 22 Jul 2016 11:27
Last Modified: 19 Oct 2016 23:02
URI: http://shura.shu.ac.uk/id/eprint/12913

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