Key Aspects of Recovery-Oriented Practice in Caring for People With Mental Ill-Health in General Emergency Departments: A Modified Delphi Study.
Katharina Derblom, Karuna Dahlberg, Sebastian Gabrielsson and 2 others
PMID 39710600WHAT IT FOUND
Nurses, researchers and people with lived experience considered 39 ED nursing care behaviours very important for patients with mental ill-health, including active listening, respect, assessing physical symptoms, conveying hope and challenging stigma.
Key findings
01The panel reached consensus that 39 of 73 recovery-oriented care statements were very important.
02The statements were organised around four themes: person-centred, strength-based, collaborative and reflective.
03Experts emphasised not judging or diminishing the person and combating stigma.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is expert consensus about nursing care, not a study of patient outcomes, so it cannot show that the agreed behaviours improve care. The panel had 24 experts, recruited through author networks and snowball sampling, and 23 experts completed the final round. The study focused on Swedish general ED nursing staff, so it does not report other settings or professions. The 80% consensus threshold and the 5-point scale were chosen by the authors, and changing them could have changed the agreed statements. Free-text comments said some statements may be hard to apply because of urgent cases, policies, time constraints and ED workload.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Kempe Foundation.
The easy way to misread this
Do not read the 39 agreed statements as evidence that these practices improve patient outcomes. The study asked experts to rate importance, not patients or nurses after an intervention, and several person-centred ideas did not reach consensus.