A hermeneutic phenomenological exploration of nurses' experience: positive behaviour support
This thesis explores the experience of registered nurses in relation to Positive Behaviour Support (PBS) in a mental health organisation. PBS has developed into an important, effective, and useful framework in delivering care for individuals with learning disability and mental health issues. Its use started in specialist schools, but it has gradually progressed into learning disability services, and evidence now suggests that PBS is being considered in mental health services for individuals with mental illnesses. However, it is evident that registered nurses’ views of PBS, as an autonomous group, is missing from current literature. Therefore, the aims of this study are: to explore these nurses’ experience, including their knowledge and understanding of PBS; to generate new knowledge and contribute towards the existing body of evidence on PBS; to explore any evidence in the current literature concerning nurses’ experience, knowledge and understanding of PBS; and to address any identified gaps. It also explores the findings and makes recommendations towards the advancement of employing PBS in a mental health context. Further, it aims to identify support that nurses would require to embed PBS in their day-to-day practice.The study has used 19 individual interviews as its data collection method. Data analysis adopted hermeneutic phenomenology, which is a theoretical and philosophical framework that helps understand and explore individual lived experience and phenomena. The computer software NVivo version (11) mainly assisted with storage and organisation of the transcripts. Six themes emerged from the study: (i) training, (ii) resources, (iii) psychology-led practice, (iv) restrictive interventions, (v) communication, and (vi) effectiveness of a new construct. Participants described PBS as an effective framework that is supportive to people who use services. They believed experience, knowledge, and training in PBS support to be a consistent delivery approach. Nurses were of the view that appropriate communication and leadership are essential elements for effective PBS practice. However, it is suggested that a lack of resources could potentially compromise the framework’s delivery and efficacy. Further, while PBS helps the reduction of restrictive interventions it was observed to be mostly psychology-led. The findings of this study clearly position nurses as key stakeholders at the centre of PBS delivery and in supporting service users in their recovery.
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