Mahesh Sharanya, Bharatan Ila, Miller Robin
Department of Social Work and Social Care, University of Birmingham, Birmingham, UK.
Warwick Business School, Coventry, UK.
NIHR Open Res. 2024 Aug 22;4:19. doi: 10.3310/nihropenres.13532.2. eCollection 2024.
There has been increasing emphasis towards adopting strengths-based practice (SBP) within adult social care in England. Whilst there is agreement that SBP is the right approach to discharge adult social care duties, there is limited evidence regarding the implementation of SBP. This paper presents findings from the evaluation of the implementation of SBP in fourteen local authorities in one region in England.
We employed a mixed methods research design, drawing on data from a scoping review, 36 interviews with practice leaders and two surveys, one with wider adult social care staff and the other, with external organisations like independent care providers and community and voluntary organisations. Our data collection and analysis were guided by two well established implementation theories: the Consolidated Framework for Implementation Research (CFIR) and Normalisation Process Theory (NPT). Interviews were analysed deductively, and surveys were analysed descriptively.
Local authorities are at different stages in their implementation journey. The Care Act 2014 and support for SBP demonstrated by key professional groups were seen as major drivers for implementing SBP. Whilst SBP resonated with the professional principles of social workers and occupational therapists, staff did not always have the confidence and skills to adapt to SBP. Changing paperwork and recording systems, providing training opportunities to develop staff competencies, establishing new care pathways, genuine co-production, and senior management buy-in were key enablers supporting implementation.
To successfully implement SBP, a whole system approach that meaningfully collaborates with key professionals across sectors is essential. When implemented well, SBP has the potential to empower individuals by focusing on what matters to them.
在英格兰的成人社会护理领域，越来越强调采用基于优势的实践（SBP）。虽然人们一致认为SBP是履行成人社会护理职责的正确方法，但关于SBP实施情况的证据有限。本文介绍了对英格兰一个地区14个地方当局实施SBP的评估结果。
我们采用了混合方法研究设计，借鉴了范围审查的数据、对实践领导者的36次访谈以及两项调查，一项针对更广泛的成人社会护理人员，另一项针对独立护理提供者、社区和志愿组织等外部组织。我们的数据收集和分析以两种成熟的实施理论为指导：实施研究综合框架（CFIR）和规范化过程理论（NPT）。访谈采用演绎法进行分析，调查采用描述性方法进行分析。
地方当局在实施进程中处于不同阶段。2014年《护理法案》以及关键专业团体对SBP的支持被视为实施SBP的主要驱动力。虽然SBP与社会工作者和职业治疗师的专业原则相契合，但工作人员并不总是有信心和技能来适应SBP。改变文书工作和记录系统、提供培训机会以提升工作人员能力、建立新的护理途径、真正的共同生产以及高级管理层的支持是支持实施的关键因素。
要成功实施SBP，采用一种与各部门关键专业人员进行有效协作的全系统方法至关重要。如果实施得当，SBP有可能通过关注对个人重要的事情来增强他们的权能。
