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Recovery‐oriented practice: Participant observations of the interactions between patients and health professionals in mental health inpatient settings
Author(s) -
Waldemar Anna Kristine,
Esbensen Bente Appel,
Korsbek Lisa,
Petersen Lone,
Arnfred Sidse
Publication year - 2019
Publication title -
international journal of mental health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.911
H-Index - 54
eISSN - 1447-0349
pISSN - 1445-8330
DOI - 10.1111/inm.12537
Subject(s) - mental health , negotiation , cornerstone , participant observation , nursing , scale (ratio) , psychology , qualitative research , medicine , psychiatry , political science , sociology , art , social science , physics , quantum mechanics , anthropology , law , visual arts
Despite an increasing attention towards recovery orientation in the mental health services, the provision of recovery‐oriented practice is challenged in the inpatient wards. Moreover, the existing research within this area is modest and we currently have limited knowledge of how recovery‐oriented practice is integrated into inpatient settings. A cornerstone of recovery‐oriented practice is the collaboration, patient involvement, and choices, particularly when deciding and planning treatment options. Thus, this ethnographic study aimed to explore how recovery‐oriented practice is reflected in the interactions between patients and health professionals around treatment in two mental health inpatient wards in Denmark. Participant observations were conducted in two mental health inpatient wards from November 2014 to January 2015. The Recovery Self‐Assessment scale inspired the observation guide and the initial data analysis. Field notes were analysed deductively and inductively using qualitative content analysis. One theme with four subthemes emerged showing that interactions were characterized by an ‘ as‐if collaboration’ where ‘ negotiating on limited grounds’ was an important feature of interactions, in which health professionals seemed to have superiority, acting on behalf of ‘ competing demands’ . Patients had to navigate in a field of ‘ inconsistent guidance and postponed decisions’ and faced tendencies of ‘ control and condescending communication’ . The results suggest that recovery oriented values such as equal collaboration, choice and patients’ personal preferences are reflected rhetorically in the interactions between patients and health professionals. However, they are negotiated within organizational logics and often overruled by competing demands.