Brierley-Jones Lyn, Ramsey Lauren, Canvin Krysia, Kendal Sarah, Baker John
School of Healthcare, University of Leeds, Leeds, UK.
Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, UK.
Res Involv Engagem. 2022 Feb 28;8(1):8. doi: 10.1186/s40900-022-00337-x.
There is a growing need to involve patients in the development of patient safety interventions. Mental health services, despite their strong history of patient involvement, have been slow to develop patient safety interventions, particularly in inpatient settings.
A systematic search was undertaken of both academic and grey literature. Whilst no lay member of the team worked directly on the review, they were part of the project steering group which provided oversight throughout the review process. This included people with lived experience of mental health services. From a research perspective the main focus for lay members was in co-producing the digital technology, the key project output. Smits et al.'s (Res Involv Engagem 6:1-30, 2020) Involvement Matrix was used to taxonomise levels of patient involvement. Studies were included if they were set in any inpatient mental health care context regardless of design. The quality of all selected studies was appraised using Mixed Methods Appraisal Methodology (MMAT).
Fifty-two studies were classified, synthesised and their levels of patient involvement in the research and development of patient safety interventions were taxonomised. Almost two-thirds of studies (n = 33) researched reducing restrictive practices. Only four studies reported engaging patients in the research process as decision-makers, with the remaining studies divided almost equally between engaging patients in the research process as partners, advisors and co-thinkers. Just under half of all studies engaged patients in just one stage of the research process.
Involvement of patients in researching patient safety and developing interventions in an inpatient mental health context seems diverse in its nature. Researchers need to both more fully consider and better describe their approaches to involving patients in safety research in inpatient mental health. Doing so will likely lead to the development of higher quality safety interventions.
让患者参与患者安全干预措施的开发需求日益增长。尽管心理健康服务在患者参与方面有着悠久的历史，但在开发患者安全干预措施方面进展缓慢，尤其是在住院环境中。
对学术文献和灰色文献进行了系统检索。虽然团队中没有非专业成员直接参与综述工作，但他们是项目指导小组的成员，在整个综述过程中提供监督。这包括有心理健康服务亲身经历的人。从研究角度来看，非专业成员的主要重点是共同制作数字技术，这是关键的项目产出。使用斯米茨等人（《研究参与与工程》6:1 - 30，2020）的参与矩阵对患者参与水平进行分类。如果研究是在任何住院心理健康护理环境中进行的，无论其设计如何，均纳入研究。使用混合方法评估方法（MMAT）对所有选定研究的质量进行评估。
对52项研究进行了分类、综合，并对患者在患者安全干预措施研发中的参与水平进行了分类。近三分之二的研究（n = 33）研究了减少限制措施。只有四项研究报告让患者作为决策者参与研究过程，其余研究在让患者作为合作伙伴、顾问和共同思考者参与研究过程之间几乎平均分配。所有研究中，不到一半的研究仅让患者参与研究过程的一个阶段。
在住院心理健康背景下，患者参与患者安全研究和干预措施开发的性质似乎多种多样。研究人员需要更充分地考虑并更好地描述他们让患者参与住院心理健康安全研究的方法。这样做可能会导致开发出更高质量的安全干预措施。
