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Conceptualising nurse-patient therapeutic engagement on acute mental health wards: An integrative review
Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom.
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom.ORCID iD: 0000-0001-8781-6675
Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom.
Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom.
2019 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 93, p. 106-118Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The review aimed to 1) explore the constituents of nurse-patient therapeutic engagement on acute mental health wards; 2) map factors that influence engagement to the Theoretical Domains Framework and 3) integrate results into a conceptual model of engagement to inform the development of interventions to improve engagement.

DESIGN: A systematic integrative review using an established framework specific to the integrative review methodology.

DATA SOURCES: Database searches (CINAHL, PsycINFO, BNI and Cochrane Library) and hand searching identified 3414 articles. After screening, applying eligibility criteria, and quality appraisal, 37 articles were included: n = 27 empirical research studies, n = 10 expert opinion pieces, n = 1 case study and n = 1 theoretical report.

REVIEW METHODS: Peer-reviewed empirical studies, theoretical reports or expert opinion pieces that explored therapeutic engagement as a stated aim and were conducted in acute mental health inpatient settings from the patient or nurse perspective were included. Data were extracted from the introduction, results and discussion sections of empirical research, and the complete article of theoretical and expert opinion pieces. Data were coded then grouped into subthemes and themes. Data relating to influencing factors were further categorised according to the Theoretical Domains Framework. Results were synthesised into a conceptual model of engagement.

RESULTS: Five conceptually distinct, but closely related constructs of engagement - called the "Principles of Engagement" - emerged: 1) Understanding the person and their experiences; 2) Facilitating growth; 3) Therapeutic use of self; 4) Choosing the right approach and 5) Authoritative vs. emotional containment. Influences on engagement ranged across all 14 theoretical domains of the Theoretical Domains Framework.

CONCLUSION: A holistic understanding of the essential components of engagement may make it easier for nurses to recognise what they do, and to do it well. The model can be used to generate testable hypotheses about how and where to target behavioural change interventions. The Principles of Engagement must be reflected in the development of interventions to improve engagement.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 93, p. 106-118
Keywords [en]
Integrative review, Intervention development, Mental health nursing, Theoretical Domains Framework, Therapeutic engagement
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Nursing
Identifiers
URN: urn:nbn:se:hj:diva-47058DOI: 10.1016/j.ijnurstu.2019.02.013ISI: 000468710200012PubMedID: 30908958Scopus ID: 2-s2.0-85063202716Local ID: HOA HHJ 2019;HHJIMPROVEISOAI: oai:DiVA.org:hj-47058DiVA, id: diva2:1377209
Available from: 2019-12-11 Created: 2019-12-11 Last updated: 2019-12-11Bibliographically approved

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Robert, Glenn

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