A realist evaluation of weighted modalities as an alternative to pro re nata medication for mental health inpatients.
mixed methods
pro re nata
quality improvement
realist evaluation
sensory approaches
weighted modalities
Journal
International journal of mental health nursing
ISSN: 1447-0349
Titre abrégé: Int J Ment Health Nurs
Pays: Australia
ID NLM: 101140527
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
revised:
19
11
2021
received:
22
09
2021
accepted:
12
12
2021
pubmed:
8
1
2022
medline:
17
5
2022
entrez:
7
1
2022
Statut:
ppublish
Résumé
Implementing psychosocial approaches into mental health inpatient settings continues to be challenging. This is despite mental health policies prioritizing trauma-informed and recovery-orientated care approaches. This study reports on an interdisciplinary project that implemented and examined the uptake of weighted modalities in a psychiatric inpatient rehabilitation setting. While over-reliance on pro re nata (PRN) medication in these settings has been reported, weighted modalities are a sensory approach that can be self-initiated by consumers as an alternative to use of PRN to manage distress and agitation. A mixed-methods realist approach was used to determine what works, for whom, and in what circumstances weighted modalities were offered by clinicians and used by consumers. Additionally, we were interested in determining whether there was an associated change in PRN use during the trial. Data included in-depth interviews with consumers (n = 12) and clinicians (n = 11), and extraction of PRN medication use preceding, throughout, and following implementation. Statistical analysis revealed a significant increase in PRN rates in the first 3 months of implementation (mean difference from baseline = 29.5, P = 0.047) but a significant decrease in the second three-month period following implementation (mean difference from baseline = -30.7, P = 0.036). Qualitative findings highlighted the key components of successful implementation as being environmental restructuring (availability/accessibility and visibility of weighted modalities) and social influences. Strategies to enhance these components are discussed.
Types de publication
Journal Article
Langues
eng
Pagination
553-566Subventions
Organisme : Health Services Charitable Gifts Board
Informations de copyright
© 2022 John Wiley & Sons Australia, Ltd.
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