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Rapid realist review of the evidence: achieving lasting change when mental health rehabilitation staff undertake recovery-oriented training

Gee, M; Bhanbhro, S; Cook, S; Killaspy, H; (2017) Rapid realist review of the evidence: achieving lasting change when mental health rehabilitation staff undertake recovery-oriented training. [Review]. The Journal of Advanced Nursing , 73 (8) pp. 1775-1791. 10.1111/jan.13232. Green open access

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Abstract

Aim: The aim of this study was to identify the factors contributing to lasting change in practice following a recovery‐based training intervention for inpatient mental health rehabilitation staff. Background: Staff training may help nurses and other staff groups in inpatient mental health rehabilitative settings to increase their recovery‐oriented practice. There are no published reviews on the effectiveness of such training and few long‐term evaluations. This review informed a realist evaluation of a specific intervention (GetREAL). Design: Rapid realist review methodology was used to generate and prioritize programme theories. Data sources: ASSIA, CINAHL, Cochrane Library, Medline, PsycINFO, Scopus, Web of Science and grey literature searches were performed in September 2014–March 2015 with no date restrictions. Stakeholders suggested further documents. GetREAL project documentation was consulted. Review methods: Programme theory development took place iteratively with literature identification. Stakeholders validated and prioritized emerging programme theories and the prioritized theories were refined using literature case studies. Results: Fifty‐one relevant documents fed into 49 programme theories articulating seven mechanisms for lasting change. Prioritized mechanisms were: staff receptiveness to change; and staff feeling encouraged, motivated and supported by colleagues and management to change. Seven programme theories were prioritized and refined using data from four case studies. Conclusion: Lasting change can be facilitated by collaborative action planning, regular collaborative meetings, appointing a change agent, explicit management endorsement and prioritization and modifying organizational structures. Conversely, a challenging organizational climate, or a prevalence of ‘change fatigue’, may block change. Pre‐intervention exploration may help identify any potential barriers to embedding recovery in the organizational culture.

Type: Article
Title: Rapid realist review of the evidence: achieving lasting change when mental health rehabilitation staff undertake recovery-oriented training
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/jan.13232
Publisher version: http://doi.org/10.1111/jan.13232
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: in-service training, lasting change, multidisciplinary teams, nursing, psychiatric nursing, psychiatric rehabilitation, rapid realist review, recovery, staff training
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10053485
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