Adverse mental health inpatient experiences: Qualitative systematic review of international literature.

Autor: Hallett N; School of Nursing and Midwifery, University of Birmingham, Birmingham, UK; Institute of Mental Health, University of Birmingham, Birmingham, UK. Electronic address: n.n.hallett@bham.ac.uk., Dickinson R; Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK., Eneje E; School of Nursing and Midwifery, University of Birmingham, Birmingham, UK., Dickens GL; Department of Nursing, Midwifery and Health, Northumbria University, Newcastle Upon Tyne, UK.
Jazyk: angličtina
Zdroj: International journal of nursing studies [Int J Nurs Stud] 2025 Jan; Vol. 161, pp. 104923. Date of Electronic Publication: 2024 Oct 03.
DOI: 10.1016/j.ijnurstu.2024.104923
Abstrakt: Background: Trauma has a well-established link with poor health outcomes. Adverse experiences in mental health inpatient settings contribute to such outcomes and should impact service design and delivery. However, there is often a failure to fully address these experiences.
Objective: To describe the spectrum of negative experiences that people identify while they are inpatients in adult mental health services.
Design: Qualitative systematic review of the international literature.
Setting(s): Inpatient mental health settings globally.
Participants: Analysis includes findings from 111 studies across 25 countries.
Methods: CINAHL, MEDLINE and PsycINFO were searched from 2000 onwards, supplemented by Google Scholar. Studies were appraised using the Critical Appraisal Skills Programme qualitative checklist. Data were synthesised using the 'best-fit' framework synthesis approach, enriched by patient and public involvement.
Results: Adverse mental health inpatient experiences can be conceptualised under three headings: the ecosystem (the physical environment and the resources available, and other people within or influential to that environment); systems (processes and transitions); and the individual (encroachments on autonomy and traumatisation).
Conclusions: This paper highlights the interplay between systemic, environmental and individual factors contributing to adverse experiences in mental health inpatient settings. By recognising and addressing these factors, we can significantly enhance patient outcomes. Application of adversity to Bronfenbrenner's ecological systems theory provides a strategic approach to improving service design and delivery, advocating for environments that prioritise patient safety, dignity and respect. However, further research is needed to validate the framework and effectively integrate these insights into practice, ultimately transforming the inpatient care experience for all stakeholders.
Registration: The review was registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022323237).
Tweetable Abstract: Review suggests traumatic experiences in mental health inpatient settings can worsen outcomes. Urges redesign of environment, processes and autonomy to improve care @dr_nutmeg @EmxEn @RAVresearchUoB @IMH_UoB.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: