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Participatory action research to improve physical health care within a crisis resolution home treatment service

Davidson, S 2012, Participatory action research to improve physical health care within a crisis resolution home treatment service , PhD thesis, Salford: University of Salford.

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Abstract

The thesis presents a participatory action research (PAR) study focusing on improving physical health assessment at a Crisis Resolution Home Treatment (CRHT) service. The aim of the study was to develop a robust and consistent approach in addressing an issue that had not previously been researched. It had been reported via clinical audit that physical health interventions were being missed and by means of an action research group (ARG) an inter-professional approach was used through which co-researchers were facilitated to discuss and explore the issue. The origins and key elements of PAR are illuminated and justification is given for its choice to answer the research questions by means of a problem-focused and context-specific approach within an emergent design. Five action research cycles included exploring the perspectives of professionals', service user experiences and a regional survey to capture current practice. Among a number of findings serviceusers described their physical well-being as extremely important and appreciated having this aspect of care assessed. Professionals viewed physical and mental health as inextricable and the regional survey revealed variable practice across the Northwest of England CRHT services. The study findings were used to generate actionable knowledge to improve clinical practice in physical health care which ultimately led to the embedding of physical health interventions within care pathways and the development of a service-user physical health questionnaire entitled Brief Overview of Physical health (BOP). Physical health strategies were absent in CRHT services within the region, and although physical assessment was taking place in many services, practice was inconsistent. This research developed an evidence based best practice framework that has wider national applicability and potentially offers clarity for existing vague Department of Health guidance. The challenges of utilising a PAR approach are examined including obtaining NHS ethical approval, staff turnaround and length of time to complete the project. The findings were augmented by substantive critical reflections focusing on salient aspects of the research process. Finally, the strength of the research is the sustained change to clinical practice within the CRHT service commensurate with the cultural and behavioural changes that colleagues made in the process of developing practice. It is argued that the research empowered colleagues with critical and research awareness, to continue in the process of transforming care.

Item Type: Thesis (PhD)
Schools: Schools > School of Nursing, Midwifery, Social Work & Social Sciences
Depositing User: WM Taylor
Date Deposited: 08 Mar 2016 16:34
Last Modified: 19 Jul 2016 10:03
URI: http://usir.salford.ac.uk/id/eprint/38086

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