Impact of the 'Reserved Therapeutic Space' Nursing Intervention on Acute Mental Health Inpatients' Perceptions of the Therapeutic Relationship, Quality of Care, Perceived Coercion and Length of Stay: A Multicentre Quasi-Experimental Trial.
Maria Roviralta-Vilella, Khadija El-Abidi, Sara Sanchez-Balcells and 16 others
PMID 41556199WHAT IT FOUND
Nurses using a 'Reserved Therapeutic Space' intervention saw patients report stronger therapeutic relationships, higher perceived quality of care, and less coercion.
Length of stay also decreased, with patients in the intervention group discharged faster than those in usual care units.
Key findings
01Patients in the intervention group reported significantly higher therapeutic relationship scores at discharge compared to the control group.
02The intervention group reported significantly lower levels of perceived coercion and fear at discharge.
03Patients in the intervention group had a higher likelihood of being discharged by day 20 compared to those in the control group.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Randomization was performed at the unit level rather than the patient level, which may introduce bias despite matching. Assessors knew which units were in the intervention group, which could influence data collection. Baseline therapeutic relationship scores differed between groups, reflecting the immediate effect of the first RTS encounter, which complicates comparison. The study was conducted in Spain, so generalizability to other healthcare systems may be limited.
Declared interests
The study was funded by the Institute of Health Carlos III, the College of Nurses of Barcelona, and the European Regional Development Fund. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that the shorter length of stay is solely due to the RTS intervention itself, as the study design (quasi-experimental, unit-level randomization) and baseline differences in therapeutic relationship scores mean other factors related to the specific units or staff could have contributed to the outcomes.