Furniaux, Jan and Reilly, Siobhan and Froggatt, Katherine (2018) Lost without translation - understanding restrictive intervention management for people with dementia in a mental health setting : an interpretive description. PhD thesis, Lancaster University.
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Abstract
Background: Dementia is characterised by a set of symptoms that affect the functioning of the brain. It is estimated that there are 850,000 people living with dementia in the UK and 46 million people worldwide – more than 60% of whom are women. In the UK, approximately one third of people with dementia live in care settings where staff may apply restrictive interventions guided by legislative frameworks. Aim: To understand the management of restrictive intervention practice by mental health workers in an acute mental health setting for people with dementia. Methods: An interpretive descriptive study was undertaken. Vignettes were developed using evidence based literature, case law and practice guidance and used to frame semi-structured interviews. Mental health workers and practice leaders were purposively sampled and interviewed from an English NHS Foundation Trust which provides mental health services across two counties. Thematic analysis of data was undertaken which followed six phases and utilised NVIVO-10. Results: Four key themes were identified: 1) legislation, 2) policy, 3) training and supervision and 4) person-centred restrictive intervention practice. Discussion: Practice leaders are able to translate knowledge from legislation to frame restrictive intervention policy, practice guidance and training content for mental health workers. Mental health workers can then deliver restrictive intervention practice based on person-centred care principles although specific characteristics such as gender may not be acknowledged as shaping a person’s experience of dementia. A ‘Model of Translated Ways of Knowing’ was developed that demonstrates the knowledge journey from legislation to practice. Conclusions: Restrictive intervention practice can be enabled when legislation, case law, research and national policy are translated into an accessible format for mental health workers. Translated knowledge can then facilitate person-centred restrictive interventions for people with dementia.