Barriers and Facilitators—Lessons Learned From a Randomised Trial to Implement Clinical Practice Guidelines for the Prevention of Coercion in Psychiatry.
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| Title: | Barriers and Facilitators—Lessons Learned From a Randomised Trial to Implement Clinical Practice Guidelines for the Prevention of Coercion in Psychiatry. |
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| Authors: | Jaeger, Susanne, Kampmann, Marie, Baumgardt, Johanna, Bechdolf, Andreas, Bühling‐Schindowski, Felix, Cole, Celline, Flammer, Erich, Junghanss, Julia, Steinert, Tilman, Mahler, Lieselotte, Sauter, Dorothea, Vandamme, Angelika, Hirsch, Sophie |
| Source: | International Journal of Mental Health Nursing. Feb2025, Vol. 34 Issue 1, p1-12. 12p. |
| Subjects: | Violence prevention, Medical protocols, Control (Psychology), Psychiatry, Qualitative research, Research funding, Content analysis, Interviewing, Research, Employees' workload |
| Geographic Terms: | Germany |
| Abstract: | The PreVCo study ('Prevention of Violence and Coercion') investigated the effects of a structured programme for the implementation of guideline recommendations for the management of aggression and the prevention of violence and coercion in psychiatric hospitals in a multicentre randomised controlled trial with 55 participating wards. The intervention was a 1‐year individually tailored implementation programme supported by external consultants. An independent evaluation of the individual wards' process aimed at identifying barriers and facilitators in implementation. We conducted guideline‐based group interviews with 53 of 55 participating teams during the implementation process. The Consolidated Framework for Implementation Research (CFIR) was used for the qualitative analysis. Two coders independently coded the transcripts and conducted a summary content analysis. The focus was on facilitators and barriers in the implementation process. The design of the intervention, in particular the framework of a controlled study, external guidance and the opportunity to choose and adapt the implementation programme according to the wards' possibilities and needs, was generally perceived as useful and supportive. The context of pandemic management at the time of the study interfered with the implementation process, mostly because of organisational transformations, challenges for information exchange and increased workload of the staff. With regard to the wards participating in the study, the main facilitators were a receptive, collaborative ward culture, team spirit and previous experiences in successful transformation processes. Barriers included the demanding working situation, frequent fluctuation of staff and low team cohesion, obstacles in communication, a deficit‐oriented perception of patients and low priority of the implementation process. Provision of necessary resources by the organisation was not self‐evident. Stakeholders devoted to the ideas of transformation of psychiatry and reduction of coercion were important facilitators of the implementation; however, some employees kept a resigned attitude and could not be engaged. The analysis of barriers and facilitators shows that an implementation process of innovative routines on psychiatric wards can benefit from external, individually tailored guidance. However, the working conditions on psychiatric wards remain to be challenging. Trial Registration: Clinical Trial Registration at www.isrctn.com with the identifier ISRCTN 71467851 [ABSTRACT FROM AUTHOR] |
| Copyright of International Journal of Mental Health Nursing is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 183601486 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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Feb2025, Vol. 34 Issue 1, p1-12. 12p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Violence+prevention%22">Violence prevention</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+protocols%22">Medical protocols</searchLink><br /><searchLink fieldCode="DE" term="%22Control+%28Psychology%29%22">Control (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Psychiatry%22">Psychiatry</searchLink><br /><searchLink fieldCode="DE" term="%22Qualitative+research%22">Qualitative research</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Content+analysis%22">Content analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Interviewing%22">Interviewing</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Employees'+workload%22">Employees' workload</searchLink> – Name: SubjectGeographic Label: Geographic Terms Group: Su Data: <searchLink fieldCode="DE" term="%22Germany%22">Germany</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: The PreVCo study ('Prevention of Violence and Coercion') investigated the effects of a structured programme for the implementation of guideline recommendations for the management of aggression and the prevention of violence and coercion in psychiatric hospitals in a multicentre randomised controlled trial with 55 participating wards. The intervention was a 1‐year individually tailored implementation programme supported by external consultants. An independent evaluation of the individual wards' process aimed at identifying barriers and facilitators in implementation. We conducted guideline‐based group interviews with 53 of 55 participating teams during the implementation process. The Consolidated Framework for Implementation Research (CFIR) was used for the qualitative analysis. Two coders independently coded the transcripts and conducted a summary content analysis. The focus was on facilitators and barriers in the implementation process. The design of the intervention, in particular the framework of a controlled study, external guidance and the opportunity to choose and adapt the implementation programme according to the wards' possibilities and needs, was generally perceived as useful and supportive. The context of pandemic management at the time of the study interfered with the implementation process, mostly because of organisational transformations, challenges for information exchange and increased workload of the staff. With regard to the wards participating in the study, the main facilitators were a receptive, collaborative ward culture, team spirit and previous experiences in successful transformation processes. Barriers included the demanding working situation, frequent fluctuation of staff and low team cohesion, obstacles in communication, a deficit‐oriented perception of patients and low priority of the implementation process. Provision of necessary resources by the organisation was not self‐evident. Stakeholders devoted to the ideas of transformation of psychiatry and reduction of coercion were important facilitators of the implementation; however, some employees kept a resigned attitude and could not be engaged. The analysis of barriers and facilitators shows that an implementation process of innovative routines on psychiatric wards can benefit from external, individually tailored guidance. However, the working conditions on psychiatric wards remain to be challenging. Trial Registration: Clinical Trial Registration at www.isrctn.com with the identifier ISRCTN 71467851 [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of International Journal of Mental Health Nursing is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/inm.70011 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 12 StartPage: 1 Subjects: – SubjectFull: Violence prevention Type: general – SubjectFull: Medical protocols Type: general – SubjectFull: Control (Psychology) Type: general – SubjectFull: Psychiatry Type: general – SubjectFull: Qualitative research Type: general – SubjectFull: Research funding Type: general – SubjectFull: Content analysis Type: general – SubjectFull: Interviewing Type: general – SubjectFull: Research Type: general – SubjectFull: Employees' workload Type: general – SubjectFull: Germany Type: general Titles: – TitleFull: Barriers and Facilitators—Lessons Learned From a Randomised Trial to Implement Clinical Practice Guidelines for the Prevention of Coercion in Psychiatry. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Jaeger, Susanne – PersonEntity: Name: NameFull: Kampmann, Marie – PersonEntity: Name: NameFull: Baumgardt, Johanna – PersonEntity: Name: NameFull: Bechdolf, Andreas – PersonEntity: Name: NameFull: Bühling‐Schindowski, Felix – PersonEntity: Name: NameFull: Cole, Celline – PersonEntity: Name: NameFull: Flammer, Erich – PersonEntity: Name: NameFull: Junghanss, Julia – PersonEntity: Name: NameFull: Steinert, Tilman – PersonEntity: Name: NameFull: Mahler, Lieselotte – PersonEntity: Name: NameFull: Sauter, Dorothea – PersonEntity: Name: NameFull: Vandamme, Angelika – PersonEntity: Name: NameFull: Hirsch, Sophie IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 02 Text: Feb2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 14458330 Numbering: – Type: volume Value: 34 – Type: issue Value: 1 Titles: – TitleFull: International Journal of Mental Health Nursing Type: main |
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