tailieunhanh - Báo cáo y học: "Factors affecting staff morale on inpatient mental health wards in England: a qualitative investigation"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Factors affecting staff morale on inpatient mental health wards in England: a qualitative investigation | Totman et al. BMC Psychiatry 2011 11 68 http 1471-244X 11 68 BMC Psychiatry RESEARCH ARTICLE Open Access Factors affecting staff morale on inpatient mental health wards in England a qualitative investigation Jonathan Totman1 Gillian Lewando Hundt2 Elizabeth Wearn1 Moli Paul3 and Sonia Johnson1 4 Abstract Background Good morale among staff on inpatient psychiatric wards is an important requirement for the maintenance of strong therapeutic alliances and positive patient experiences and for the successful implementation of initiatives to improve care. More understanding is needed of mechanisms underlying good and poor morale. Method We conducted individual and group interviews with staff of a full range of disciplines and levels of seniority on seven NHS in-patient wards of varying types in England. Results Inpatient staff feel sustained in their potentially stressful roles by mutual loyalty and trust within cohesive ward teams. Clear roles supportive ward managers and well designed organisational procedures and structures maintain good morale. Perceived threats to good morale include staffing levels that are insufficient for staff to feel safe and able to spend time with patients the high risk of violence and lack of voice in the wider organisation. Conclusions Increasing employee voice designing jobs so as to maximise autonomy within clear and well-structured operational protocols promoting greater staff-patient contact and improving responses to violence may contribute more to inpatient staff morale than formal support mechanisms. Background Psychiatric inpatient wards are potentially highly stressful places to work. In England the shift towards community-based care in the post-deinstitutionalisation era has raised the threshold for admission with more patients detained under section and shorter lengths of stay 1 . Policy makers managers clinicians and service users have all expressed concerns regarding the quality of inpatient care 2-4 . .