Improving the Use of Sensory Approaches in an Acute Inpatient Mental Health Unit Using a Co-Designed Multifaceted Implementation Strategy.

Lisa Wright, Pamela Meredith, Sally Bennett, Emmah Doig
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Abstract

Despite the therapeutic benefits of sensory approaches being well documented, little research has focused on improving their implementation in acute mental health units. The use of implementation frameworks to improve the use of evidence-based practices has shown promising results in healthcare; however, there is little evidence for their use in acute mental health units. A pre-post comparison design was used to determine the effect of an 11-month co-designed theory-informed multifaceted implementation strategy on the use of sensory approaches and the use of seclusion/restraint in one acute mental health ward. This study was guided by Integrated Knowledge Translation (IKT) and informed by the Behaviour Change Wheel (BCW) approach. Implementation strategies were co-designed and included provision of sensory materials/resources; education/training; prompts/reminders; modelling; audit and feedback; workplace coalition; and facilitation. Data were collected through pre- and post-project questionnaires (pre- n = 37, post- n = 40) and routine clinical data. Data were analysed using SPSS and thematic analysis. Data for matched pairs (n = 19) revealed significant improvements between pre- and post-perceived levels of knowledge and confidence in using sensory approaches. Significant increases were found in the use of sensory kits, weighted modalities and sensory assessment/plans. Post participants' recommendations to sustain the use of sensory approaches in their unit included ongoing training; funding; maintenance and supply of sensory equipment; increased staffing; and support from colleagues. This is the first study to use the IKT and BCW to design, facilitate and evaluate a co-designed, theory-informed implementation strategy to improve the use of sensory approaches in an acute mental health unit.

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利用共同设计的多层面实施策略,改善感官疗法在急诊精神疾病住院病房中的应用。
尽管感官治疗法的治疗效果有据可查,但很少有研究关注如何在急症心理健康机构中更好地实施这些方法。在医疗保健领域,使用实施框架来改进循证实践的使用已经取得了可喜的成果;然而,在急诊精神卫生单位使用这些框架的证据却很少。本研究采用了前后对比设计,以确定为期 11 个月的共同设计理论指导下的多方面实施策略对一个急症精神科病房中感官方法的使用和隔离/约束的使用所产生的影响。这项研究以综合知识转化(IKT)为指导,并借鉴了行为改变轮(BCW)方法。实施策略是共同设计的,包括提供感官材料/资源;教育/培训;提示/提醒;示范;审核和反馈;工作场所联盟;以及促进。通过项目前后的调查问卷(项目前 n = 37,项目后 n = 40)和常规临床数据收集数据。数据采用 SPSS 和主题分析法进行分析。配对数据(前 n = 19)显示,在使用感官方法的知识和信心方面,项目前后的认知水平有了显著提高。在使用感统工具包、加权模式和感统评估/计划方面均有显著提高。参加培训后的人员就如何在其所在单位持续使用感统方法提出了建议,包括持续培训、资金、感统设备的维护和供应、增加人员配备以及同事的支持。这是第一项使用IKT和BCW来设计、促进和评估共同设计的、以理论为指导的实施策略的研究,旨在改善感统训练方法在急诊精神卫生部门的使用。
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