Mental Health Service Users Involvement in Nursing Education - Term Paper Example

Mental Health Service Users Involvement in Nursing Education. Professor Surname 16 July 2016 Table of Contents LIST OF TABLES 3 LIST OF FIGURES 4 2.0 CHAPTER TWO: METHODOLOGY 5 2.1 Systematic Review Process 5 2.1.1 Search Terms 5 2.1.2 Inclusion and Exclusion Criteria 7 2.1.3 Data Extraction and Analysis 12 2.1.4 Evidence Synthesis 14 REFERENCES 16 APPENDICES 17 APPENDIX A: Databases Searched and Search Terms used 17 LIST OF TABLES Table 1: Inclusion and Exclusion Criteria for title and abstract review and in-depth full article review 9 Table 2: PEO Table 11 Table 3: Data extraction items (quantitative studies) 12 Table 4: Data extraction items (qualitative studies) 13 Table 5: General principles of meta-ethnography 15 LIST OF FIGURES Figure 1: PRISM Flow Diagram Illustrating the Systematic Review Process 8 2.0 CHAPTER TWO: METHODOLOGY 2.1 Systematic Review Process The systematic review process entailed a detailed step by step procedure as illustrated below: Formulation of search terms Identification of key articles expected to be included in the literature. Conduction of a literature search to pool all the relevant articles. Review of titles and abstracts to select relevant studies based on a set of four screening criteria. Quality assessment and partial data extraction to evaluate the quality of the relevant articles. Synthesis of qualitative and quantitative evidence to develop key messages The overall research question in this systematic review process was: How do mental health nursing students experience learning from mental health service users? 2.1.1 Search Terms The following key search terms were used to make initial searches into databases for relevant studies to the literature review. Mental health service user: A mental health service user is an individual who has had lived experience with mental distress which has helped to shape his/her health plans and therefore know what works best for them (Newton, Beales, Collins, & Basset, 2013). Lived experience: Describes an individual’s own experiences of mental distress (Newton et al., 2013). Service Survivor: An individual with the experience of using mental health services and believes there is a need for increased user involvement and a reduction in compulsory intervention (Newton et al., 2013). Mental health service user involvement: This is the active participation of an individual who has had lived with the experience of mental distress in the commissioning, design, evaluation and delivery of mental health services, as well as in local and national policy development. It is also the inclusion of the perspectives of mental health service users in the planning and shaping of health plans based on their fore knowledge of what plans work best (Newton et al., 2013). Mental Health/Psychiatric nursing students: These are students who study the branch of nursing that is associated with the care, cure and prevention of mental disorders/illnesses/dysfunction and their consequent diseases. They learn about the theories of human behavior through the use of self as a tool for their learning practice. Students who graduate work in a variety of work settings based on their experience and level of training (Donnell, H., & Gormeley, K. (2013). Mental health nursing: Mental health nurses work to promote the recovery of individuals with mental health distress while engaging them in their personal recovery (Department of Health, 2014). Psychiatric Nursing: Psychiatric nursing is a specialty in nursing that involves working with individuals, groups, families and communities to assess their needs for mental health services. Psychiatric nurses develop nursing diagnoses and care plans, evaluate their effectiveness and implement effective nursing processes (Department of Health, 2014). Involvement in mental health education: This refers to the involvement of individuals and groups in the development, delivery and evaluation professional education. It emphasizes on increased involvement of service users in the training programs of students taking mental health programs (Newton et al., 2013). Mental Health Patient: An individual who suffers from a serious mental illness that impairs their mental functioning. Such individuals have symptoms that include: hallucinations, delusions, severe mood disturbance, disorders in thought forms and sustained irrational behaviors (Donnell, H., & Gormeley, K. (2013). Mental Health Client: An individual who voluntary seeks mental health services Perceptions in an attempt to seek professional medical care, treatment, cure and medication. Perceptions/Views: The mental impression, understanding and interpretation of an individual on something (Donnell, H., & Gormeley, K. (2013). 2.1.2 Inclusion and Exclusion Criteria A total of 5 databases of scientific literature were used for the literature review search over the month of June, 2016. Key terms were used for the search as known information sources were also contacted. See APPENDIX A for a list of the search terms used. The electronic data bases that were used were: CINAHL Complete (EBSCO host) MEDLINE (EBSCO host) PsychInfo (EBSCO host) CHORINE LIBRARY SCOPUS Figure 1: PRISM Flow Diagram Illustrating the Systematic Review Process The search strategy that was employed was broad, but significantly limited by the language used in the databases. In the title and abstract screening stage, articles not written in English were excluded. The inclusion and exclusion criteria is highlighted in Table 1 below. Selected articles included those conducting studies on mental health service user involvement in health education (Bettany-Saltikov, 2012). Articles considered were those that studies the involvement of mental health users in the development and delivery of professional mental health education. In accordance to the PEO guidelines as indicated in Table 2, participants in the qualitative studies had to be adult mental health nursing or psychiatric health students taking courses in mental health or psychiatric courses. Studies were included if they had an analytical focus on mental health and psychiatric health nursing and their relationship with mental health service user involvement, for instance, studies that focused on the role of user service involvement in mental health nursing treatment and care plans (Aveyard, 2014). Table 1: Inclusion and Exclusion Criteria for title and abstract review and in-depth full article review Questions Response Options Comments 1. Is this article/paper/publication a peer-reviewed study? YES NO UCLEAR If no, exclude 2. Does this study have an analytical focus on mental health service user involvement? YES NO UNCLEAR If no, exclude 3. Does this study include findings and outcomes on the experience of mental and psychiatric health students towards service user involvement in training? YES NO UNCLEAR If no, exclude 4. Is this a conceptual article little or no empirical data (narrative reviews, opinion pieces and theoretical papers)? YES NO UNCLEAR If yes, exclude Table 2: PEO Table Titles and abstracts were screened for inclusion in the literature review. In instances where there was insufficient data from titles and abstracts, full texts were retrieved for evaluation and screening (Aveyard, 2014). Quality control checks were also independently carried out to eliminate selection bias during the process. To ensure a comprehensive literature review, the reference lists of all the articles that underwent full review were similarly scanned for any studies that may be included in the review. Both qualitative and quantitative studies were given due focus and consideration. The papers that passed the inclusion stage were then reviewed for focus and method for final inclusion. At this stage of the verification of focus and method for final inclusion, incorrectly sorted studies were excluded (Bettany-Saltikov, 2012). 2.1.3 Data Extraction and Analysis Data extraction was carried out to identify and extract relevant information to the literature review research question (MacEachen, 2008). This helped to set forth data synthesis and aggregation for collective evidence. Full and partial data was collected from all the included studies. For quantitative studies, data was extracted on: the study design, characteristics of the sample population, year of study, exposure, characteristics and nature of the measures, statistical analyses and study findings. These are illustrated in table 3 below: Table 3: Data extraction items (quantitative studies) Name author(s) and year of publication 1. Statement of objectives and research question 2. List of inclusion criteria used in the study 3. List of exclusion criteria used in the study 4. Description of type of exposure in the study (involvement in mental health education, education, training, teaching, assessment 5. Description of the overall study group 6. Description of exposure (teacher: mental health service user, service survivor, service user, patient, client, lived experience) 7. Describe the process of selecting exposure items 8. What was the duration of the study? Hours/days/months 9. Which covariates were measured? 10. List of outcome variables used for evaluating the effectiveness of intervention 11. What were the changes implemented as a measure of the intervention (processes, tasks, organization)? 12. Mark the final analyses that were done to test the observed effects of the intervention 13. For each intervention, describe the observed outcome 14. What are the additional statistical analyses that were conducted to increase confidence in intervention strategy For qualitative studies data was extracted on: the theoretical orientation of the study, the research question, sampling strategy, study method, study context, study participants, data analysis, reflexivity of the study, study findings and how they are relevant in understanding the role and effectiveness of mental health service user involvement in the training of mental health students (Bettany-Saltikov, 2012). These data items for qualitative studies are illustrated in the table 4 below: Table 4: Data extraction items (qualitative studies) A1.What was the research question of the study? B1. What was the theoretical orientation of the study? (implicit perspective or description given) B2. What was the effect of the theoretical perspective on the study method and findings (areas of enhancements, strengths and weaknesses) C1. What was the effect of the study method on the outcomes? (strengths, weaknesses and areas of enhancement) D1. What the analysis system used? E1. Describe the study participants (teacher: mental health service user, service survivor, service user, patient, client, lived experience) E2. How were they selected? What were the study elements that were being examined? F1. Provide a description of the author’s description of the analysis F2. Provide comments on the depth, scope and integrity of the analysis G1. Summarize the findings from the study (key issues and themes G2. What is the major contribution of the study to the paper in line with the following concepts: a) constant comparison (comparison of same construct), b) refutation (contradictory findings), c) line of argument (varied findings that create an interesting observation)? Partial data extraction involved extraction of data on: sample/study location, age and size of study samples, study design and method, time frame for the study, description of sampling method and type of intervention (if applicable). 2.1.4 Evidence Synthesis Quantitative Studies; as a measure of the significant level of heterogeneity of the studies that were reviewed, the best evidence synthesis approach adapted from Slavin and others was used. This best evidence synthesis matrix was used as it puts into consideration the quantity and quality of all the articles as well as the consistency of their findings (MacEachen, 2008). See APPENDIX B. Quantity in this matrix refers to the strength of study method used as mentioned above while quantity refers to the total number of studies with provided evidence of similar outcomes on the perceptions of mental health students towards the involvement of mental health service users in medical training programs (Aveyard, 2014). Consistency on the other hand refers to the similarity of the results observed across the different reviewed studies on the same findings. In cases where studies reported the same outcomes in a particular category, they were classified under one group as an effect even when one or two articles had significant difference between the groups. As seen in APPENDIX B, the study literature were classified into five major groups in terms of their level of evidence: relevance, quality and consistency with the aim and research question of the study. Studies had either a strong, moderate, limited, partial or insufficient level of evidence. Qualitative studies: Qualitative studies were systematically reviewed using the principles of meta-ethnography (MacEachen, 2008). Final synthesis involves a process of identifying the different concepts discussed in the studies and classifying them into major themes. These concepts being evaluated were the distinctive characteristics of each of the studies that were related to the study review question about the experiences of mental health learning from mental health service users. Studies were examined in accordance to whether or not the studies were contradictory (refutation), comparable (constant comparison), or whether there were inferences on the topic as a whole. This is seen in table 5 below: Table 5: General principles of meta-ethnography Constant comparison: This is also referred to as reciprocal translation and involves a comparison of the analogous or similar concepts and findings. It is the continual refinement of a certain distinctive concept. The aim of the review in this context is to identify the comparable or shared features of the different studies with the intention of developing a final report that is cohesive. Refutation: When refuting, the review identifies the findings that are contradictory and conflicting with the outcomes and findings from other studies. The aim of the review is therefore to account for or reconcile the conflict. A narrative is hence developed through the line of argument through adding, weaving and layering of all of these various findings. The syntheses of qualitative studies in general contain different elements of either refutation, comparison or lines of argument. However, depending on the sample of studies that are finally selected, the synthesis maybe dominated by either of these three elements. In this review, the final synthesis was dominated by constant findings. The concepts discussed in more than three of the studies were classified into overarching themes. These themes were created as a measure of the reciprocal translations of the concepts in comparison to those of other studies. 2.1.4.1 Mixed Method Synthesis After the synthesis of findings from the quantitative and quantitative literatures, interpretive and integrative analyses were carried out (MacEachen, 2008). Integrative analysis involved examining the quantitative and qualitative findings for essential comparability of elements. Data was examined for how it can be pooled and assembled. For example, it was observed that both of the literatures emphasized on the positive role of mental health users involvement in nursing education. Interpretive analysis involved the development of a framework for connecting quantitative and qualitative studies. The focus here was on how the findings complemented each other for a comprehensive picture of mental health user involvement in training programs for nursing health students. This interactive process helped reach the conclusion of the final synthesis. REFERENCES Aveyard, H. (2014) Doing a Literature Review in Health and Social Care. Bettany-Saltikov, J. (2012) How to Do a Systematic Literature Review in Nursing: a step by step guide. Department of Health. (2014). Working in Partnership: Report of the Review of Mental Health Nursing. London: HMSO. Donnell, H., & Gormeley, K. (2013). Service user involvement in nurse education: Perceptions of mental health nursing students. Journal of Psychiatric and Mental Health Nursing, 20, 193–202. MacEachen E., Breslin C., Kyle, N., Irvin, E., Kosny, A., Bigelow, P., Mahood, Q., Scott- Dixon, K., Morassaei, S., Facey, M., Chambers, L., Couban, R., Shannon, H., Cullen, K., & Amick, B. (2008). Effectiveness and implementation of health programs: A systematic review of qualitative and quantitative literature. Toronto: Institute for Work & Health. Newton, A., Beales, A., Collins, A., & Basset, T. 2013. Service user leadership: training and development for service users. Journal of Mental Health Training, Education and Practice, 8 (3), 134-140. APPENDICES APPENDIX A: Databases Searched and Search Terms used APPENDIX B: Best Evidence Synthesis Matrix (MacEachen, 2008). Read More