Mental Health Professionals’ Perspectives of Family-focused Practice across Child and Adult Mental Health Settings: A Qualitative Synthesis

Shah-Anwar, Sadia; Gumley, Andrew; Hunter, Stephanie

doi:10.1080/0145935x.2019.1591947

Cited by 15 publications

(29 citation statements)

References 31 publications

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“…Of the 24 included studies, 11 studies implemented a family-centered care approach ( Boztepe & Kerimoğlu Yıldız, 2017 ; Gomes da Silva et al, 2016 ; Hamilton et al, 2020 ; Kleinpell et al, 2019 ; MacKay & Gregory, 2011 ; Maree et al, 2017 ; Mirlashari et al, 2019 ; Shah-Anwar et al, 2019 ; Toivonen et al, 2019 ; Weis et al, 2014 ; Wells et al, 2014 ). Ten studies implemented Family Systems Nursing ( Beierwaltes et al, 2020 ; Blöndal et al, 2014 ; Eggenberger & Sanders, 2016 ; Naef, Kaeppeli et al, 2020 ; Naef, Kläusler-Troxler et al, 2020 ; Petursdottir et al, 2019 ; Svavarsdottir et al, 2015 ; Wong, 2014 ; Zimansky et al, 2018 , 2020 ).…”

Section: Resultsmentioning

confidence: 99%

The Implementation of Evidence-Informed Family Nursing Practices: A Scoping Review of Strategies, Contextual Determinants, and Outcomes

2022

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There is a lack of knowledge about the successful implementation of family nursing practices. This scoping review maps current knowledge about the implementation of evidence-informed family nursing practices across settings and populations. A systematic search (CINAHL, PubMed, Medline) identified 24 publications, published between 2010 and 2020. We found nurses’ implementation experience to be one of disruption, learning, and moving to new ways of practicing. The implementation resulted in benefits to families and self but was marked by fluctuation and partial integration of evidence-informed family nursing practices into care delivery. Uptake was shaped by various contextual determinants, with barriers mainly at the team and organizational levels. We identified low-quality, tentative evidence that capacity-building strategies coupled with dissemination-educational strategies may enable family nursing practice skills and increase the quality of family care. More rigorous research is needed to build further knowledge about effective implementation. Future implementation endeavors should utilize the evolving knowledge base in family nursing and tailor implementation strategies to contextual barriers.

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Section: Resultsmentioning

confidence: 99%

The Implementation of Evidence-Informed Family Nursing Practices: A Scoping Review of Strategies, Contextual Determinants, and Outcomes

2022

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“…Particular strengths lay in the authors' efforts to capture all relevant studies and include clients' and family members' perspectives but as family-focused practice has increased, more research has been conducted and an updated review is needed. A more recent review by Shah-Anwar et al (2019) synthesized practitioner experiences of FFP in both child and adult settings but focused solely on qualitative reports (nine in total). Conclusions were similar to those of Maybery and Reupert (2009) and highlighted the importance of the organizational context and policies supportive of FFP (theme 1) and clinicians' attitudes, knowledge and practice (theme 2).…”

Section: Introductionmentioning

confidence: 99%

“…A more recent review by Shah‐Anwar et al . (2019) synthesized practitioner experiences of FFP in both child and adult settings but focused solely on qualitative reports (nine in total). Conclusions were similar to those of Maybery and Reupert (2009) and highlighted the importance of the organizational context and policies supportive of FFP (theme 1) and clinicians’ attitudes, knowledge and practice (theme 2).…”

Section: Introductionmentioning

confidence: 99%

The implementation of family‐focused practice in adult mental health services: A systematic review exploring the influence of practitioner and workplace factors

Gregg

Adderley

Calam

et al. 2021

Int J Mental Health Nurs

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There is increased recognition of the need for greater and more appropriate support to be offered to families in which a parent experiences mental illness and has dependent children. One way of meeting this need is for adult mental health services to take a more familyfocused approach. However, there are recognized difficulties in facilitating family-focused practice (FFP). The current review systematically synthesized quantitative and qualitative literature of practitioner perspectives and experiences of FFP in adult mental health settings to identify modifiable factors associated with its successful implementation. Five databases were searched systematically leading to the inclusion and quality assessment of 19 papers, ten of which were quantitative and nine qualitative. Analysis was guided by a narrative synthesis approach. Factors shown to influence FFP functioned at both practitioner and workplace levels and included personal attitudes, beliefs about job role, and perceptions of workplace support. Practitioners who felt that a family-focussed approach was inappropriate or detrimental to service users or outside of their remit as mental health professionals were less likely to adopt this approach. For those who saw the potential benefits of FFP, lack of confidence in their ability to deliver such an approach and lack of training can be barriers, as can lack of support and resources within services. This review highlights the need for actions to boost the awareness of adult mental health practitioners working with parents and to increase their confidence. It also makes the case for broader organizational support if family-focussed practice is to be implemented successfully.

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“…Even though attempts to transform adult mental health services to incorporate FFP began decades ago (1), most mental health systems still do not operate in this manner (9)(10)(11). Reasons for this are manifold, and include fragmented service systems, inadequate funding to address needs beyond the individual's most urgent problems, lack of organizational commitment and leadership reflected, for example, in a lack of policies or guidelines on identifying parenting status, and limited knowledge or skills among practitioners (12,13).…”

Section: Introductionmentioning

confidence: 99%

Towards a Program Theory for Family-Focused Practice in Adult Mental Health Care Settings: An International Interview Study With Program Leaders

et al. 2021

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Objectives: In several high-income countries, family-focused practice programs have been introduced in adult mental health care settings to identify and support children whose parents live with mental health problems. Whilst their common goal is to reduce the impact of parental mental illness on children, the mechanisms by which they improve outcomes in different systems and settings are less well known. This kind of knowledge can importantly contribute to ensuring that practice programs achieve pre-defined impacts.Methods: The aim of this study was to develop knowledge about relationships between contextual factors, mechanisms and impact that could inform a program theory for developing, implementing, and evaluating family-focused practice. Principles of a realist evaluation approach and complex system thinking were used to conceptualize the design of semi-structured in-depth interviews with individuals who led the implementation of programs. Seventeen individuals from eight countries participated in the study.Results: Interviewees provided rich accounts of the components that programs should include, contextual factors in which they operated, as well as the behavior changes in practitioners that programs needed to achieve. Together with information from the literature, we developed an initial program theory, which illustrates the interconnectedness between changes that need to co-occur in practitioners, parents, and children, many of which related to a more open communication about parental mental health problems. Stigma, risk-focused and fragmented health systems, and a lack of management commitment were the root causes explaining, for example, why conversations about parents' mental illness did not take place, or not in a way that they could help children. Enabling practitioners to focus on parents' strengths was assumed to trigger changes in knowledge, emotions and behaviors in parents that would subsequently benefit children, by reducing feelings of guilt and improving self-esteem.Conclusion: To our knowledge, this is the first research, which synthesizes knowledge about how family-focused practice programs works in a way that it can inform the design, implementation, and evaluation of programs. Stakeholder, who fund, design, implement or evaluate programs should start co-developing and using program theories like the one presented in this paper to strengthen the design and delivery of family-focused practice.

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Mental Health Professionals’ Perspectives of Family-focused Practice across Child and Adult Mental Health Settings: A Qualitative Synthesis

Cited by 15 publications

References 31 publications

The Implementation of Evidence-Informed Family Nursing Practices: A Scoping Review of Strategies, Contextual Determinants, and Outcomes

The Implementation of Evidence-Informed Family Nursing Practices: A Scoping Review of Strategies, Contextual Determinants, and Outcomes

The implementation of family‐focused practice in adult mental health services: A systematic review exploring the influence of practitioner and workplace factors

Towards a Program Theory for Family-Focused Practice in Adult Mental Health Care Settings: An International Interview Study With Program Leaders

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