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A Narrative Inquiry Exploring the Values of Mental Health Nurses Working in In-patient Settings

Written by Gemma Stacey on . Posted in Projects and Dissemination

A Narrative Inquiry Exploring the Values of Mental Health Nurses Working in In-patient Settings

Project summary: This research project examined the values of mental health nurses working in inpatient settings. It considered the factors which influenced the development and maintenance of values during the transition from student to professional and considered implications for training and practice developments.

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Shared Decision Making in Mental Health In-patient Settings: Implications for Practice

Written by Gemma Stacey on . Posted in Projects and Dissemination

Shared Decision Making in Mental Health In-patient Settings: Implications for Practice

Project summary: This research explored the concept of shared decision making (SDM) in mental health in-patient settings. It was achieved through the facilitation of focus groups with service users, carers, OTs, social workers, peer support worker, psychiatrists and nurses. The focus groups aimed to gain insight into the experiences of each party within the decision making process. This included the degree to which they felt involved in the process and influential in the outcome. The data arising from the focus group was analysed collaboratively using a framework known as critical narrative analysis. This framework facilitates an analytical process which focuses on issues of power and subject positioning. The summary below provides an indication of the way in which the different groups regarded themselves within the decision making process.

The development of an alternative model to promote shared decision making in mental health in-patient care

Written by Gemma Stacey on . Posted in Projects and Dissemination

The development of an alternative model to promote shared decision making in mental health in-patient care

Project summary: This project considered what a shared decision making model might need to look like if it were able to acknowledge hierarchies and the effects of power in order to promote a radical level of transparency within the decision making process. Whilst it is important for professional groups to maintain their professional identities in healthcare settings, they might also need to consider the importance of talking about these identities within multidisciplinary groups and acknowledge uncertainties of role and identity when the power to decide is shared amongst professional groups, service users and carers. It is suggested that the concept of shared decision making should be broken down into its component parts. Borrowing a phrase from communication theory, we need to specify the “core conditions” for a shared decision to take place (Rogers 1957). We suggest that in order for this, to occur, all participants must be Informed, Involved and Influential (the three I’s) in the decision making process. However, the three “I”s of shared decision making are fluid, they refer to a sliding scale of influence that moves between these different positions depending on context, capacity and desire to influence. This model draws upon established theories of participation which recognises how the distribution of power results in a ladder of participation ranging from non-participation, which is viewed as manipulation, to involvement which can encompass consultancy but is also regarded as tokenism. Full participation is achieved when a partnership is genuinely present and results in shared power (Arnstein 1969)