Measuring the evidence: Reviewing the literature of the measurement of therapeutic engagement in acute mental health inpatient wards

Abstract

Quality nursing plays a central role in the delivery of contemporary health and social care, with a positive correlation being demonstrated between patient satisfaction and the quality of nursing care received. One way to ensure such quality is to develop metrics that measure the effectiveness of various aspects of care across a variety of settings. Effective mental health nursing is predicated on understanding the lived experiences of service users in order to provide sensitively-attuned nursing care. To achieve this, mental health nurses need to establish the all-important therapeutic relationship, showing compassion and creating a dialogue whereby service users feel comfortable to share their experiences that help contextualize their distress. Indeed, service users value positive attitudes, being listened to, and being able to trust those who provide care, while mental health nurses value their ability to relate through talking, listening, and expressing empathy. However, the literature suggests that within mental health practice, a disproportionate amount of time is taken up by other activities, with little time being spent listening and talking to service users. The present study discusses the evidence relating to the therapeutic relationship in acute mental health wards and explores why, after five decades, it is not recognized as a fundamental metric of mental health nursing.

Engagement as an Element of Safe Inpatient Psychiatric Environments

“…The atmosphere and physical structure of the unit must be conducive as a healing experience to foster a calm, peaceful, and safe environment. Thus patients' perceptions of care, which provide important data on nursing interactions that are supportive, and types of relationships that are helpful, shape the elements and texture of the inpatient engagement process (McAndrew, Chambers, Nolan, Thomas, & Watts, 2013).…”

A qualitative evaluation of patient’s perceptions of therapeutic alliance on mental health acute inpatient wards

“…A study carried by psychologists [3] show that the nurses are not enough available and not trained adequately to form a real relationship having therapeutic potential with their patients, even though they hold a pivotal position to establish therapeutic alliance. This assessment is also found in other research [4][5][6]. The Therapeutic Alliance is mainly defined in the form of a face to face relation, but [7], Pulido, et al delineates the possibility of an Institutional Therapeutic Alliance (ITA).…”

‘Give us something to do’: reflections on running a group therapy programme

“…The vital role of mental health nurses in establishing good therapeutic relationships with patients through highly-skilled talking, listening and empathising is wellestablished (McAndrew et al, 2014). However, a recent review of 13 studies of nursing and patient activities concluded that very little nursing time is spent delivering therapeutic interventions and may even be reducing over time (Sharac et al, 2010).…”