Service user-oriented research

Mental Health Nursing,  Sep 2004  

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Co-operative inquiry into the involvement of service users in clinical decisions. Southampton University.

The impetus for the inquiry has been to involve mental health service users more effectively in the learning experience of mental health nurses undertaking training. The inquiry, established in July 2003, used an experiential research method which involved a group of mental health service users and student or qualified nurses coming together as coresearchers, as a result of a proposal from an initiating facilitator. The co-researchers then participated together as co-subjects to explore how service users could be involved more effectively in the clinical decisions of student and qualified mental health nurses.

The inquiry adopted the four phase process described by Reason (1994, Participation in Human Inquiry, Sage Publications, London). In the first phase the group agreed the focus for exploring the issue in action. Having undertaken the agreed 'actions' in phase two participants observed and recorded the process and outcomes of their own and each others' experience. Having been fully immersed in their experience, participants developed new understandings in phase three which were shared and recorded in phase four when the group reassembled.

This cycle was repeated several times in order to develop understanding and achieve new learning. Two important principles underpinning this inquiry were that the research was directed by the participants and any conclusions or interpretations were shared and validated by the participants.

The process enabled nurse participants to explore aspects of their clinical practice within a challenging but supportive environment where clinical issues could be debated with people who regularly use mental health services:

'It has made me think a bit more about what it costs somebody who I am involved in. You are asking these intrusive questions and sometimes I ask if I would like to be asked these questions.' (student nurse participant)

The inquiry also provided a forum where new knowledge could be revealed and where creative approaches to clinical practice could be initiated and tested out by those participating in the inquiry:

'...it's given me the opportunity to develop my practice, feedback and share our findings with the ward. I've changed as a result of coming here and sharing these experiences, my confidence in practice has grown.' (nurse participant)

The service users who participated also found that role boundaries disappeared:

'What did change was the perception that as a group we've moved from being a "service user" or a "student" to being "people" and to understanding each other's world.' (service user participant)

Steve Tee, senior lecturer, Southampton University, School of Nursing and Midwifery; Jackie Shaw, student nurse; Tina Coldham, independent user consultant; Bella East, Staff Nurse, Lorraine Beilby student nurse; Lesley Herbert, service user/carer liaison office, Hampshire Partnership NHS Trust PALS; Ian Rogerson, patient; Sharon Simpson, student nurse; Tammy Jo Haydon, student nurse; Penny Jardine, service user; Sandra Delamare, staff nurse; Beatrice Tshabalala, student nurse. Email: J.R. Tee@satan.co.uk

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