Racialised staff–patient relationships in inpatient mental health wards: a realist secondary qualitative analysis of patient experience data
<strong>Background</strong> The current study is a secondary analysis of qualitative data collected as part of EURIPIDES, a study which assessed how patient experience data were used to improve the quality of care in National Health Service (NHS) mental health services. <br><str...
| Main Authors: | , , , |
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| Format: | Journal article |
| Sprog: | English |
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BMJ Publishing Group
2023
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| _version_ | 1826311171067609088 |
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| author | Hua, P Shakoor, S Fenton, S-J Bhui, K |
| author_facet | Hua, P Shakoor, S Fenton, S-J Bhui, K |
| author_sort | Hua, P |
| collection | OXFORD |
| description | <strong>Background</strong> The current study is a secondary analysis of qualitative data collected as part of EURIPIDES, a study which assessed how patient experience data were used to improve the quality of care in National Health Service (NHS) mental health services.
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Objective </strong>We undertook a detailed realist secondary qualitative analysis of 10 interviews in which expressions of racialisation were unexpectedly reported. This theme and these data did not form part of the primary realist evaluation.
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Methods </strong>Interviews were originally conducted with the patients (18–65 years: 40% female, 60% male) from four different geographically located NHS England mental health trusts between July and October 2017. Secondary qualitative data analysis was conducted in two phases: (1) reflexive thematic analysis and retroduction; (2) refinement of context–mechanism–outcome configurations to explore the generative mechanisms underpinning processes of racialisation and revision of the initial programme theory.
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Findings </strong>There were two main themes: (1) absence of safe spaces to discuss racialisation which silenced and isolated patients; (2) strained communication and power imbalances shaped a process of mutual racialisation by patients and staff. Non-reporting of racialisation and discrimination elicited emotions such as feeling othered, misunderstood, disempowered and fearful.
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Conclusions </strong>The culture of silence, non-reporting and power imbalances in inpatient wards perpetuated relational racialisation and prevented authentic feedback and staff–patient rapport.
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Clinical implications</strong> Racialisation in mental health trusts reflects lack of psychological safety which weakens staff–patient rapport and has implications for authentic patient engagement in feedback and quality improvement processes. Larger-scale studies are needed to investigate racialisation in the staff–patient relationships. |
| first_indexed | 2024-03-07T08:05:54Z |
| format | Journal article |
| id | oxford-uuid:f2c15d2f-cd47-4f48-8bc4-87a54d174f00 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T08:05:54Z |
| publishDate | 2023 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:f2c15d2f-cd47-4f48-8bc4-87a54d174f002023-10-20T10:12:57ZRacialised staff–patient relationships in inpatient mental health wards: a realist secondary qualitative analysis of patient experience dataJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f2c15d2f-cd47-4f48-8bc4-87a54d174f00EnglishSymplectic Elements BMJ Publishing Group2023Hua, PShakoor, SFenton, S-JBhui, K<strong>Background</strong> The current study is a secondary analysis of qualitative data collected as part of EURIPIDES, a study which assessed how patient experience data were used to improve the quality of care in National Health Service (NHS) mental health services. <br><strong> Objective </strong>We undertook a detailed realist secondary qualitative analysis of 10 interviews in which expressions of racialisation were unexpectedly reported. This theme and these data did not form part of the primary realist evaluation. <br><strong> Methods </strong>Interviews were originally conducted with the patients (18–65 years: 40% female, 60% male) from four different geographically located NHS England mental health trusts between July and October 2017. Secondary qualitative data analysis was conducted in two phases: (1) reflexive thematic analysis and retroduction; (2) refinement of context–mechanism–outcome configurations to explore the generative mechanisms underpinning processes of racialisation and revision of the initial programme theory. <br><strong> Findings </strong>There were two main themes: (1) absence of safe spaces to discuss racialisation which silenced and isolated patients; (2) strained communication and power imbalances shaped a process of mutual racialisation by patients and staff. Non-reporting of racialisation and discrimination elicited emotions such as feeling othered, misunderstood, disempowered and fearful. <br><strong> Conclusions </strong>The culture of silence, non-reporting and power imbalances in inpatient wards perpetuated relational racialisation and prevented authentic feedback and staff–patient rapport. <br><strong> Clinical implications</strong> Racialisation in mental health trusts reflects lack of psychological safety which weakens staff–patient rapport and has implications for authentic patient engagement in feedback and quality improvement processes. Larger-scale studies are needed to investigate racialisation in the staff–patient relationships. |
| spellingShingle | Hua, P Shakoor, S Fenton, S-J Bhui, K Racialised staff–patient relationships in inpatient mental health wards: a realist secondary qualitative analysis of patient experience data |
| title | Racialised staff–patient relationships in inpatient mental health wards: a realist secondary qualitative analysis of patient experience data |
| title_full | Racialised staff–patient relationships in inpatient mental health wards: a realist secondary qualitative analysis of patient experience data |
| title_fullStr | Racialised staff–patient relationships in inpatient mental health wards: a realist secondary qualitative analysis of patient experience data |
| title_full_unstemmed | Racialised staff–patient relationships in inpatient mental health wards: a realist secondary qualitative analysis of patient experience data |
| title_short | Racialised staff–patient relationships in inpatient mental health wards: a realist secondary qualitative analysis of patient experience data |
| title_sort | racialised staff patient relationships in inpatient mental health wards a realist secondary qualitative analysis of patient experience data |
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