Yiu Pui Lok Joshua, McDonogh Abbie, Gill Harpreet, Billings Jo
Division of Psychiatry, University College London, London, United Kingdom.
Camden and Islington NHS Foundation Trust, London, United Kingdom.
PLoS One. 2025 Jan 3;20(1):e0316030. doi: 10.1371/journal.pone.0316030. eCollection 2025.
Working in inpatient mental health settings is often characterised by highly emotive work and staff shortages. Despite the suggested benefits of reflective practice groups on staff well-being and clinical practice across healthcare settings, to date, there have been limited empirical studies on reflective practice groups in inpatient mental health settings, especially on group engagement and improvement.
We interviewed fifteen participants, including both facilitators and attendees of reflective practice groups. Participants were from eight inpatient mental health wards across two National Health Service settings in the UK. We analysed interview transcripts using thematic analysis.
We deductively organised the data into themes and subthemes under three overarching domains-"Impact", "Factors on Engagement", and "Improvement". Theme development was generated inductively from the data. For impacts, we found reflective practice groups may bolster staff reflective capacity and team cohesion. The groups may help attendees create appropriate distance from their emotions and overcome power hierarchies. We discovered that the availability of reflective practice, sense of containment in groups, and team composition may influence group facilitation and engagement. For improvements, different measures could be adopted to improve access and engagement of staff with difficulties attending. Facilitators may benefit from more support to establish a reflective culture and experiment with new ways of facilitating.
Our findings add to the growing evidence base of the potential value of reflective practice groups in inpatient settings and elaborate on novel mechanisms of their potential impact. This study highlights changeable factors for engagement, concrete recommendations for improvements, and opportunities for further research.
在住院精神卫生机构工作通常具有工作情感强度高和人员短缺的特点。尽管反思实践小组在整个医疗环境中对员工幸福感和临床实践有潜在益处，但迄今为止，关于住院精神卫生机构中反思实践小组的实证研究有限，尤其是在小组参与度和改进方面。
我们采访了15名参与者，包括反思实践小组的主持人和参与者。参与者来自英国国民医疗服务体系两个机构的8个住院精神卫生病房。我们使用主题分析法分析访谈记录。
我们将数据演绎性地组织成三个总体领域下的主题和子主题——“影响”、“参与度的影响因素”和“改进”。主题的形成是从数据中归纳得出的。对于影响方面，我们发现反思实践小组可能会增强员工的反思能力和团队凝聚力。这些小组可能会帮助参与者在情感上保持适当距离并克服权力等级制度。我们发现反思实践的可用性、小组中的包容感和团队构成可能会影响小组的促进作用和参与度。对于改进方面，可以采取不同措施来提高难以参与的员工的参与度。主持人可能会从更多支持中受益，以建立反思文化并尝试新的促进方式。
我们的研究结果进一步证明了反思实践小组在住院环境中的潜在价值，并阐述了其潜在影响的新机制。本研究突出了参与度的可变因素、具体的改进建议以及进一步研究的机会。
