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Rapid realist review of the evidence: achieving lasting change when mental health rehabilitation staff undertake recovery‐oriented training
Author(s) -
Gee Melanie,
Bhanbhro Sadiq,
Cook Sarah,
Killaspy Helen
Publication year - 2017
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.13232
Subject(s) - cinahl , documentation , psychological intervention , mental health , theory of change , medline , intervention (counseling) , rehabilitation , nursing , medicine , cochrane library , psychology , medical education , grey literature , applied psychology , psychotherapist , political science , computer science , physical therapy , management , law , economics , programming language
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 (Get REAL ). Design Rapid realist review methodology was used to generate and prioritize programme theories. Data sources ASSIA , CINAHL , Cochrane Library, Medline, Psyc INFO , Scopus, Web of Science and grey literature searches were performed in September 2014–March 2015 with no date restrictions. Stakeholders suggested further documents. Get REAL 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.