Can we improve the morale of staff working in psychiatric units? A systematic review.

Background: Those working in psychiatric units care for some of the most vulnerable and needy patients within health services, and suffer some of the highest levels of job dissatisfaction and burnout within healthcare workforce. Poor staff morale is bad for patient care and is economically wasteful....

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Publicado en:Journal of Mental Health Vol. 15; no. 1; pp. 7 - 18
Autores principales: Gilbody S, Cahill J, Barkham M, Richards D, Bee P, Glanville J
Formato: research systematic review tables/charts Journal Article
Publicado: Taylor & Francis Ltd Feb2006
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2006
      vid: 15
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        10.1080/09638230500512482
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        atl: Can we improve the morale of staff working in psychiatric units? A systematic review.
      aug:
        au:
          Gilbody S
          Cahill J
          Barkham M
          Richards D
          Bee P
          Glanville J
        affil: Department of Health Sciences, University of York
      sug:
        subj:
          Attitude of Health Personnel
          Burnout, Professional Prevention and Control
          Job Satisfaction
          Morale
          Psychiatric Units Psychosocial Factors
          CINAHL Database
          Computerized Literature Searching
          Cost Benefit Analysis
          Embase
          Employee Assistance Programs
          Medline
          Professional Competence
          Psychological Well-Being
          Psycinfo
          Sick Leave
          Staff Development
          Stress, Occupational
          Support, Psychosocial
          Systematic Review
          United Kingdom
          Funding Source
          Human
      ab: Background: Those working in psychiatric units care for some of the most vulnerable and needy patients within health services, and suffer some of the highest levels of job dissatisfaction and burnout within healthcare workforce. Poor staff morale is bad for patient care and is economically wasteful. The same level of evidence of effectiveness and efficiency should be considered in workforce planning as is required in patient care. This has hitherto not occurred. Aim: To examine the impact and cost effectiveness of strategies to improve staff morale and reduce 'burnout' amongst staff working in psychiatric units. Methods: We conducted a systematic review of robust evaluations of strategies designed to improve psychological wellbeing or the working experience of staff working in psychiatric units. We searched the following databases: EMBASE; MEDLINE; PsycINFO; CINAHL; Sociological Abstracts; HMIC; Management and Marketing Abstracts; Management Contents and Inside Conferences (all to 2004), and sought the following outcomes: Psychological wellbeing; Job satisfaction; staff burnout and stress; staff sickness and turnover; Direct and indirect costs. The following designs were included: Randomised Controlled Trails (RCTs); Controlled Clinical Trials (CCTs); Controlled Before and after studies (CBAs); and interrupted time series (ITSs). We conducted a narrative overview of key design features, endpoints and results. Results: We identified eight evaluations of strategies to improve staff morale (3 RCTs; 3 CCTs and 2 CBAs). Educational interventions designed to enhance the skill and competency of staff were the most commonly evaluated, and showed positive impact on at least one outcome of interest. Psycho-social interventions that sought out members of staff who were experiencing emotional problems and offered work-based support and enhanced social support networks were positive in US healthcare settings, but had been incompletely implemented and evaluated in UK settings. Organisational interventions, such as a shift to continuous care and primary nursing also showed a potential to be effective in reducing sickness rates and improving job satisfaction. Conclusions: There is substantial opportunity to design and implement interventions to improve the working experience of staff in psychiatric units. There is an onus to evaluate the longer term impact and cost effectiveness of these strategies. Unfortunately strategies are currently being implemented in the absence of any prospective evaluation. Declaration of interest: The authors have no conflict of interest.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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