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NURSES’ EXPERIENCES ON USING OPEN DIALOGUE APPROACH IN A LOCAL MENTAL HEALTH SERVICE: AN INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS
  • Mark Jones,
  • Nicola Evans,
  • Steven Whitcombe
Mark Jones
Welsh Ambulance Services NHS Trust

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Nicola Evans
Cardiff University School of Healthcare Sciences
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Steven Whitcombe
Cardiff University School of Healthcare Sciences
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Abstract

Open Dialogue Approach is a collaborative intervention and framework for using with service users with complex mental health challenges such as psychosis. The aim of the study was to explore nurses’ experiences when using the approach through an interpretative phenomenological analysis, using semi structured interviews conducted with five mental health nurses. Data were thematically analysed and organised within three themes: • Experiential learning vs formalised training. • Efficacy of the approach: o Therapeutic relationship, o Service user empowerment o Openness/ transparency. • Tolerance of uncertainty principle; perceived as a barrier to implementing in UK. A key finding from the study was that participants (mental health nurses) disclosed that they felt conflicted when using the approach, because of the principle of tolerating uncertainty, that advocates minimal patient record keeping; which is at odds with current legislation (UK and Wales) that stipulates clinicians must keep full and accurate patient records. However, the study also indicates a mechanism for overcoming this and highlights the approach’s effectiveness by increasing service user control and empowerment of the service user and openness/ transparency from clinicians. If this is employed, then it appears that the principle of tolerance of uncertainty can be ameliorated to fit with UK legislation. Open Dialogue Approach is also reported as being effective by all of the participants within this study, but it will require further research to demonstrate this effectiveness within the UK to the wider clinical body and policy developers.