School of Nursing and Midwifery, Faculty Health and Medicine, The University of Newcastle, Callaghan, Australia.
Faculty of Health, Southern Cross University, Lismore, Australia.
BMC Health Serv Res. 2021 Sep 25;21(1):1013. doi: 10.1186/s12913-021-06993-1.
Evidence-based clinical practice is an inherent component of mental health professional practice in developed countries. However, little is known about professional perspectives of evidence-based practice in mental in developing countries such as Ghana. This paper describes the processes involved in the delivery of best practice in Ghana. The paper reports on a realistic evaluation of mental health nurses and allied health professionals' views on the evidence-based therapeutic process in Ghana.
A purposive sample of 30 mental health professionals (MHPs) was recruited to participate in semi-structured, in-depth interviews. Thematic analysis was used to analyse the data. A program theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis.
The thematic analysis identified two contexts, mechanism and outcome configurations (themes): 1) technical competency stimulates evidence-based mental health services, and 2) therapeutic relationship building ensures effective interaction. The study demonstrates that contextual factors (technical competencies and therapeutic relationship building) together with mechanisms (intentional and unintentional) help to promote quality in mental health service provision. However, contextual factors such as a lack of sign language interpreters yielded unintended outcomes including barriers to communication with providers for consumers with hearing impairment and those from linguistic minority backgrounds.
Government stakeholders and policymakers should prioritise policies, periodic monitoring and adequate financial incentives to support the mechanisms that promote technical competence in MHPs and the building of therapeutic relationship.
循证临床实践是发达国家心理健康专业实践的固有组成部分。然而，对于像加纳这样的发展中国家的专业人员对循证实践的看法却知之甚少。本文描述了在加纳提供最佳实践的相关过程。本文报告了对心理健康护士和相关卫生专业人员在加纳对循证治疗过程的看法的现实评估。
采用目的性抽样方法招募了 30 名心理健康专业人员（MHPs）参与半结构化深度访谈。使用主题分析来分析数据。从分析中得出了情境+机制=结果（CMO）配置的方案理论。
主题分析确定了两个情境、机制和结果配置（主题）：1）技术能力激发循证心理健康服务，2）治疗关系建立确保有效互动。研究表明，情境因素（技术能力和治疗关系建立）与机制（有意和无意）共同促进心理健康服务的质量。然而，缺乏手语翻译等情境因素导致了意外的结果，包括为有听力障碍和语言少数背景的消费者与提供者沟通带来障碍。
政府利益相关者和政策制定者应优先制定政策、定期监测和充足的财政激励措施，以支持促进心理健康专业人员技术能力和治疗关系建立的机制。
