Evidence map›Paper›PMID 31852502›Full record

Trial reportBMC psychiatry2019

The side effects of service changes: exploring the longitudinal impact of participation in a randomised controlled trial (DOORWAYS) on staff perceptions of barriers to change.

Caroline Laker, Matteo Cella, Deborah Agbediro, Felicity Callard, Til Wykes

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC psychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Caroline LakerFaculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford Campus, Bishop Hall Lane, Chelmsford, Essex, CM1 1SQ, UK. caroline.laker@anglia.ac.uk.ORCID 0000-0002-3650-8004
Matteo CellaDepartment of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, PO77, Room 2.11, London Henry Wellcome Building, 16 De Crespigny Park, London, SE5 8AF, UK.
Deborah AgbediroInstitute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Felicity CallardBirkbeck, Department of Psychosocial Studies, University of London, Malet Street, Bloomsbury, London, WC1E 7HX, UK.
Til WykesDepartment of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, PO77, Room 2.11, London Henry Wellcome Building, 16 De Crespigny Park, London, SE5 8AF, UK.
King's College London · GBAnglia Ruskin University · GBBirkbeck, University of London · GB

Funding

Department of Health RP-PG-0606-1050
6 · The paper itself

Abstract

backgroundStaff and service users have expressed concerns that service improvements in British mental health wards have been slow or transient. It is possible that certain changes are positive for some (e.g. service users), but negative for others (e.g. staff), which may affect implementation success. In this study, we explore whether a programme of change to improve the therapeutic milieu on mental health wards influenced staff perceptions of barriers to change, 12 months after implementation.

methodA cluster randomised controlled trial called DOORWAYS was conducted on eight British, inner-city acute mental health wards. Randomisation was achieved using a list randomly generated by a computer. A psychologist trained ward staff (mainly nurses) to deliver evidence-based groups and supported their initial implementation. The impact of these changes was measured over 12 months (when 4 wards were randomised), according to nurses' perceptions of barriers to change (VOCALISE), using unstructured multivariate linear regression models. This innovative analysis method allows maximum use of data in randomised controlled trials with reduced sample sizes due to substantial drop out rates. The contextual influences of occupational status (staff) and of workplace setting (ward) were also considered.

resultsStaff who participated in the intervention had significantly worse perceptions of barriers to change at follow up. The perceptions of staff in the control group did not change over time. In both groups (N = 120), direct care staff had more negative perceptions of barriers to change, and perceptions varied according to ward. Across time, direct care staff in the intervention group became more negative than those in the control group.

conclusionParticipation in this program of change, worsened staff perceptions of barriers to change. In addition, occupational status (being from the direct care group) had a negative effect on perceptions of barriers to change, an effect that continued across time and was worse in the intervention group. Those providing direct care should be offered extra support when changes are introduced and through the implementation process. More effort should be placed around reducing the perceived burden of innovation for staff in mental health wards.

trial registrationISRCTN, ISRCTN 06545047. Registered 29/04/2010, https://www.isrctn.com/search?q=06545047.

Indexed as

AdultAgedEmploymentFemaleHumansLongitudinal StudiesMaleMental HealthMiddle AgedNursing Staff, HospitalWorkplaceYoung AdultBarriers to changeMental health wardsNurses’ perceptionsUnstructured multivariate linear regression models

Identifiers

PMID31852502
PMCPMC6921549
OpenAlexW2996371599

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.