부산대학교 도서관

This thesis focuses on acute mental health inpatient care settings within the UK, with a systematic review on factors influencing length of stay (LOS) and service users' experiences of care from admission to readmission. Paper One: Presents a systematic review, which aimed to synthesise and evaluate the research to date looking at predictors of length of stay in acute mental health inpatient care within the UK. Thirteen studies were identified for inclusion, exploring demographic, clinical, social, and provider level factors related to LOS. There was substantial variation in the factors examined in relation to LOS across studies, where consistency in findings across the factors investigated varied. However, older age, black and minority ethnic groups and involuntary admission were most consistently associated with increased LOS, and alcohol and substance misuse with a shorter LOS. Limitations of the literature and the review, and future clinical and research implications are discussed. Paper Two: Aimed to explore service users' experiences of care from admission to readmission to acute mental health inpatient care. The study used Interpretative Phenomenological Analysis (IPA) to gain an in-depth understanding of service users' experiences of care, including during admission, at discharge and follow-up care in the community and whether from their perspective this care met their needs. Participants' narratives highlighted inconsistencies in services abilities to meet their needs across the care pathway, which appeared to influence their need for readmission. Clinical implications and areas for future work are considered. Paper Three: Provides a critical reflection on the systematic review and empirical paper, including the planning, implementation, and interpretation during the research process, as well as clinical implications and areas for future research. Personal reflections on the research process are also provided.