Using the Theoretical Domain Framework to understand what helps and hinders the use of different sensory approaches in Australian psychiatric units: A survey of mental health clinicians

Author:

Wright Lisa12ORCID,Bennett Sally1ORCID,Meredith Pamela13ORCID

Affiliation:

1. School of Health and Rehabilitation Sciences The University of Queensland Brisbane Australia

2. Metro North Mental Health – The Prince Charles Hospital Metro North Hospital and Health Service Brisbane Australia

3. School of Health and Behavioural Sciences University of Sunshine Coast Sunshine Coast Australia

Abstract

AbstractBackground/AimAlthough sensory approaches are recommended to relieve distress and agitation and reduce the use of seclusion and restraint, many Australian psychiatric units have struggled to sustain their practice. The aim of this study was to investigate the barriers and enablers influencing the use of different sensory approaches across one health region in Australia and to obtain recommendations for strategies to improve their use.MethodThis cross‐sectional survey was informed by the Theoretical Domain Framework. Likert scale questions considered barriers and enablers to the use of non‐weighted sensory interventions, weighted modalities, sensory rooms, and sensory assessments/plans. Open‐ended questions explored participant concerns and recommendations to improve the use of sensory approaches.ResultsParticipants (n = 211) were from nursing, allied health, medical, and peer support staff across inpatient psychiatric units. Factors most frequently identified as enablers for using sensory approaches were beliefs of positive benefits to consumers (e.g. decreasing distress and agitation); belief it was within the staff's role; and knowledge of the approaches. Limited time was the most common identified barrier. Factors statistically associated with more frequent use were knowledge, skills, confidence, availability, and easy access to sensory tools/equipment. Only 30% of participants were concerned about potential risks of sensory approaches, with this risk mitigated through adequate supervision and thorough risk assessment. Recommendations to improve practice included improved access to, and maintenance of, equipment, more training, and increased staffing.ConclusionThis study revealed how barriers and enablers vary for different sensory approaches and how these factors impact their frequency of use in psychiatric units. It provides insights into staff recommendations to improve the use of sensory approaches in one health region in Australia. This knowledge will lead to the development of implementation strategies to address identified barriers and improve the use of sensory approaches in psychiatric units.

Funder

Prince Charles Hospital Foundation

Publisher

Wiley

Subject

Occupational Therapy

Reference52 articles.

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2. A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems

3. Australian College of Mental Health Nurses. (2017).Supporting mental health professional towards cultural and clinical change: Facilitating ongoing reduction in seclusion and restraint in mental health settings in Australia project summary. Australian College of Mental Health Nurses.https://www.researchgate.net/publication/323118907

4. Australian Institute of Health and Welfare. (2021).Restrictive practices 2019‐20 section.Restrictive practices (aihw.gov.au)

5. Azuela G.(2019).The implementation and impact of sensory modulation in Aotearoa New Zealand adult acute mental health service: Two organisational case studies. [Doctoral dissertation Auckland University of Technology]https://openrepository.aut.ac.nz/handle/10292/12608

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