Clinical Practice in Mental Health

Introduction to Clinical Practice in Mental Health

A critical analysis is described as the process of evaluation of any pre-existing literature. A critical approach helps determine the reliability of any source (Morse, 2015). Furthermore, critical analysis is considered as a highly resourceful source for a proper understanding of a topic or literature. Critical analysis writing is subjective as it reflects the opinion of the author. Nursing is a discipline where there is a requirement of continuous improvement so that positive patient outcomes could be promoted. Identification of pros and cons in the current nursing practices is important as it helps to design better practices that will benefit the patient care and are within the scope of practice of nurses. Nurses have a significant role in the healthcare system and they are the ones who spend the maximum amount of time with the patient and ensures recovery. Person-centred care is an important concept in the nursing practice and it is an essential component of the nursing code of conduct in Australia (NMBA, 2018). Picker has described eight principles to ensure patient-centred care. The described essay critically analyzes a research article with the title “Management of multimorbidity using a patient-centred care model: a pragmatic cluster-randomised trial of the 3D approach” by the researchers Salisbury et al. (2018).

Background of Clinical Practice in Mental Health

Person-centred care includes providing care to a patient with dignity and respect. The patients are involved in the decision-making process regarding their health (Ortiz, 2018). The person-centred care ensures that all the healthcare rights that are provided to a patient remain conserved. Picker described eight basic principles that are included in person-centred care (Ramaswami et al., 2016). The principles include access to care, continuity and transition. Furthermore, the involvement of family and friends in nursing care, providing emotional and physical support is also included in the principle. Additionally, information and education, proper coordination and integration of care are also considered in the care (Vimalchandran et al., 2017). The nurses are also required to respect the preferences of a patient to ensure patient-centred care. The patients with multiple morbidities require a multidisciplinary team for the care and sometimes the multidisciplinary management compromises the quality of care. The researchers have used a 3D model approach to ensure the person-centred care.

A Brief Analysis of The Paper

The paper starts with the summary of the entire research in which the researchers have provided an overview of the entire research that was conducted. The summary of the research has been properly framed. The factors that are supposed to be considered while writing a summary or abstract include the length and specificity. A good summary or abstract is short, highly specific and it should mention all the considerations that a scientist has taken to generate best conclusions from their study (Atanassova, Bertin&Lariviere, 2016). The summary shall include a general overview of the entire paper and the abstract shall not be more than 250 words. Furthermore, the language that of the paper should be in the way that it could be easily understood by its readers. The paper which is framed in an understandable language that is not only understood by a specific group of people but also with to the people who do not have much insight into the theme of research can convey its findings to a greater number of people. The research has used typical English that can be understood by the majority of the people throughout the world. The summary used sub-headings that properly bifurcates one theme from another. The researchers have mentioned their findings and have provided the credit to the funding agencies as well. The sub-headings help to grab the attention of the readers and make the paper well organized. The paper published by Lines et al. (2015) that also described the person-centred care did not provide any bifurcation in the paper and everything seemed overlapped.

The introductory part generally comes after the abstract section of the paper. The introduction part provides the background of the study, problems that the paper is trying to counter and relevance of the study. Additionally, the objectives of the study and the beneficiaries from the study are also needed to be described in the introduction section. The introduction section is crucial for grabbing the attention of its readers along with that, the introduction section lays a roadmap for the rest of the paper (Fried, Foltz, Lendner& Vaccaro, 2018). The introductory part did not provide any specific definition of the patient centred care and its importance. The research has majorly focused on the geographical location of the UK and the USA. In contrast to that, the researchers Faizo et al. (2018) in their research about person-centred care have properly described the definition and significance of person-centred care in the introductory part. The analyzed research has briefly described the requirement of the research and how the outcomes of this research will benefit from achieving person-centred care in patients with multimorbidity.

The researchers described the components of the patient-centered care model and chronic care model that are followed by the European countries and America. The patient-centred care model consists of the eight principles described by Picker (Rawson & Mortez, 2016). Meanwhile, the chronic care model is also a multidimensional approach for improving the health of patients that are suffering from any chronic disease (Dunn & Conard, 2018). The chronic care model is used in the primary care setting. However, the analyzed paper has discussed the drawbacks of those two models despite the international support of those models. The introductory part of the paper describes that there is a lack of shreds of evidence regarding the effectiveness of these models in improving the patient outcome in the multimorbidity condition. Afterwards, the aim of the study is described in the introductory part of the paper which discussed a new strategy for the management of the patients with multimorbidity in their primary care. The aim described that the study uses a 3-dimensional approach which is also based on patient-centred care model along with the different strategies that were suggested in the newly prescribed international guidelines. A person can easily figure out the aim of the study by reading it as it is described in a precise and clear manner. A clear aim in research is essential as it helps to develop the proper objective and methodology for research (Doody & bailey, 2016).

After the introductory part, this paper has the section of literature review in it. A literature review section discusses the work of other researchers or authors that have conducted studies in the same field. This section includes a discussion or review about the things that are known in the same field and how that information was retrieved. The pattern of literature review goes from general to specific. According to Denny & Tewksbury (2013), a literature review includes a comprehensive overview of various researches that had been already conducted and what are the things that are still unknown. The literature review helps to give a specific direction for the appropriate methodology that can be used to conduct the research. The literature review section occupies a separate heading in the research paper as it is a crucial part of the research. The analyzed paper does not contain any separate literature review section which is one of the limitations of the paper. However, the paper has presented evidence of different literature reviews that were done for research in a dispersed manner. Furthermore, the researchers have also merged their obtained data with other coherent studies. The researchers Nwanzu and Mbanefo (2017) described that a literature review section has significant importance and it demands an equal amount of attention.

For every research, a specific, the researcher follows a specific methodology that is most suited for his study (Phanse, 2018). The research can be either qualitative or quantitative types that are sub-categorized into primary and secondary. The type of research philosophy selected for the particular research is also crucial, it could be either positivism or it can be interpretivism type. Additionally, a research can either be a primary study using an experimental approach or the research could be secondary that includes a collection of data from pre-existing literature and generate results (Robbers et al., 2017). The analysed paper has conducted primary research and has used randomised control trials as the methodology of the study. The randomised control trial method is highly reliable as it helps to eliminate the bias in the research, particularly bias in the process of selection and confounding (Caparrotta et al., 2019). Furthermore, randomised control trial is a research approach that is based on evidence (Herodotou et al., 2017). The researchers collected the data of 4500 patients using an electronic medical record system.

The study included the data of patients who were more than 18 years old and the data of patients who had an expectancy of fewer than 12 months were excluded from the study. The 3-dimensional reviews included the reviews from the nurses, pharmacist and physician. The reason for it was to identify the measures and guidelines that are considered by the caregivers and the scope of improvement was identified. However, the reviews of the patient and their families were excluded from the study. The perspective of the patient and their families is significantly important for improving patient-centred care (Groves, 2017). The researchers asked the caregivers to follow the 3D plan for six months at least. Furthermore, the patients were provided with the printed copy of the trials to ensure that RCT remains unbiased. The outcomes of the study were measured using the EQ-5D-5L instrument which consists of five questions that are related to the anxiety, depression, self-care, pain, discomfort mobility and so on. The EQ-5D-5L instrument is a genuine instrument that is used world-wide (McClure et al., 2017). The outcomes that were concluded were primary and secondary outcomes that promoted the reliability of the research.

The next section in the paper included the results and discussions from the research. The researchers utilized 33 practices that included 248488 registered adult patients which are a big fat number. The sample size has for a study has a major inference on real-world significance (Hopkins & Will, 2017). The paper has described a trial profile where the filtered the patients and selected the most appropriate candidates that included 1546 patients who were considered in the intention-to-treat analysis. The patients were divided into two unequal groups’ one consisted of 749 patients and another group had 797 patients. However, 5% of the total patients died during the trial. The trial went for 15 months. The trials that undergo long run have the possibility of deterioration of relevance of the results from the study (Hemkens et al., 2016). The researchers in the discussion section claimed that the conducted trial was the largest so far for the identification of intervention for the patients with multimorbidity to provide patient-centred care. Furthermore, the discussion stated that the trial did not provide any association with the improvisation of quality of life for a patient but it showed promising results in enhancing person-centred care. The discussion part properly described all the results from the experiments and also provided a few suggestions for the future research perspective.

Conclusion on Clinical Practice in Mental Health

The critical analysis plays a significant role in evaluating any pre-existing literature. The reliability and credibility of any literature can be identified by the use of critical analysis. The paper selected for the critical analysis was found to be a highly credible and reliable source for improving the person-centred care while caring for a patient. Eight basic principles are described to ensure patient-centred care. However, the effectiveness of these patients with multimorbidity has not been studied much. The paper described a three-dimensional model that can be implemented in patient-centred care for patients with multimorbidity. A separate heading for literature review was found to be missing from the paper. The study was designed as the primary research that adapted pragmatic randomized control trails that enhanced the credibility and reliability of the research. The large sample size also benefited the study. Furthermore, the selection of large sample size also benefited the study. The review was only taken from the nurses, physicians and pharmacist. The opinion of the patients and their family was not included in the study which served as another limitation of the paper. However, the methodology, significance and the results from the study made the paper a highly credible source of information. 

References for Clinical Practice in Mental Health

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