Adverse mental health inpatient experiences: Qualitative systematic review of international literature

IF 7.5 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2024-10-03 DOI:10.1016/j.ijnurstu.2024.104923

Nutmeg Hallett , Rachel Dickinson , Emachi Eneje , Geoffrey L. Dickens

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引用次数: 0

Abstract

Background

Trauma has a well-established link with poor health outcomes. Adverse experiences in mental health inpatient settings contribute to such outcomes and should impact service design and delivery. However, there is often a failure to fully address these experiences.

Objective

To describe the spectrum of negative experiences that people identify while they are inpatients in adult mental health services.

Design

Qualitative systematic review of the international literature.

Setting(s)

Inpatient mental health settings globally.

Participants

Analysis includes findings from 111 studies across 25 countries.

Methods

CINAHL, MEDLINE and PsycINFO were searched from 2000 onwards, supplemented by Google Scholar. Studies were appraised using the Critical Appraisal Skills Programme qualitative checklist. Data were synthesised using the ‘best-fit’ framework synthesis approach, enriched by patient and public involvement.

Results

Adverse mental health inpatient experiences can be conceptualised under three headings: the ecosystem (the physical environment and the resources available, and other people within or influential to that environment); systems (processes and transitions); and the individual (encroachments on autonomy and traumatisation).

Conclusions

This paper highlights the interplay between systemic, environmental and individual factors contributing to adverse experiences in mental health inpatient settings. By recognising and addressing these factors, we can significantly enhance patient outcomes. Application of adversity to Bronfenbrenner’s ecological systems theory provides a strategic approach to improving service design and delivery, advocating for environments that prioritise patient safety, dignity and respect. However, further research is needed to validate the framework and effectively integrate these insights into practice, ultimately transforming the inpatient care experience for all stakeholders.

Registration

The review was registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022323237).

Tweetable abstract

Review suggests traumatic experiences in mental health inpatient settings can worsen outcomes. Urges redesign of environment, processes and autonomy to improve care @dr_nutmeg @EmxEn @RAVresearchUoB @IMH_UoB

查看原文本刊更多论文

心理健康住院病人的不良经历：对国际文献的定性系统回顾。

背景：创伤与不良健康后果之间的联系已得到证实。在精神疾病住院环境中的不良经历会导致这种结果，并对服务的设计和提供产生影响。然而，这些经历往往未能得到充分解决：描述人们在成人精神健康服务机构住院期间所发现的各种负面经历：设计：对国际文献进行定性系统回顾：环境：全球范围内的精神健康住院环境：分析包括来自 25 个国家 111 项研究的结果：方法：检索 2000 年以来的 CINAHL、MEDLINE 和 PsycINFO，并以 Google Scholar 作为补充。使用 "批判性评估技能计划 "定性检查表对研究进行评估。采用 "最合适 "框架综合法对数据进行综合，并在患者和公众参与的基础上加以充实：结果：住院病人的不良心理健康经历可以在三个标题下进行概念化：生态系统（物理环境和可用资源，以及该环境中的其他人或对该环境有影响的人）；系统（流程和过渡）；以及个人（自主权受到侵犯和创伤）：本文强调了导致住院精神病人不良经历的系统、环境和个人因素之间的相互作用。通过认识和解决这些因素，我们可以大大提高患者的治疗效果。将逆境应用到布朗芬布伦纳的生态系统论中，为改善服务设计和提供提供了一种战略性方法，倡导将患者安全、尊严和尊重放在首位的环境。然而，还需要进一步的研究来验证该框架，并将这些见解有效地融入到实践中，最终为所有利益相关者改变住院护理体验：该综述已在国际系统性综述前瞻性注册中心（PROSPERO；CRD42022323237）注册。Tweetable 摘要：综述表明，精神疾病住院患者的创伤经历可能会恶化治疗效果。敦促重新设计环境、流程和自主权，以改善护理 @dr_nutmeg @EmxEn @RAVresearchUoB @IMH_UoB.

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).