Exploring experiences of admission to inpatient services.
Research type
Research Study
Full title
Exploring experiences of admission to inpatient services for children with intellectual disabilities: A grounded theory approach.
IRAS ID
311919
Contact name
Helen Ross
Contact email
Sponsor organisation
Teesside University
Duration of Study in the UK
1 years, 3 months, 1 days
Research summary
Research Summary
This study aims to explore parent and caregivers’ understanding of the admission of their child with an Intellectual Disability, to Tier 4 Children and Adolescent Mental Health (CAMHS) inpatient services.Existing research has identified factors contributing to admission to inpatient services for individuals with an Intellectual Disability (i.e. Learning Disability). However, this was prior to service changes implemented following governmental and NHS guidance aiming to reduce inappropriate or avoidable admissions and reduce the length of stay to Tier 4 inpatient services. Whilst some inpatient admissions are necessary, research so far has not captured the impact of governmental and NHS guidance and how this is reflected in the experiences of service users before their admission.
To explore this topic, this research project aims to gather the views of primary caregivers (i.e., parents, kinship caregivers, foster parents and legal guardians) through interviews and consider how they understand their experiences and reasons for their child’s admission. Transcribed interviews will be analysed using a specific method of analysis (Grounded Theory), where themes will be generated and a theoretical model will be developed to visually represent categories and their relationships.
Summary of Results
Abstract:
Background: Although research has identified factors contributing to increased vulnerability of admission for children with a learning disability, the experiences of admissions to mental health hospitals for children are poorly understood. This research project aimed to understand experiences of admissions to Tier 4 CAMHS inpatient services for children with a learning disability by gathering parents’ views to understand how they understand their child’s admission and care experiences.Method: A constructivist grounded theory methodology was used to develop a model to understand their child’s experiences a Tier 4 CAMHS inpatient service. Following recruitment through social media, a total of 8 parents of children with a learning disability participated in the study. Participants were interviewed in a semi-structured interview using a coproduced interview guide developed with two Experts by Experience (EBE). Transcribed interviews were analysed using Grounded Theory (GT) to explain the child’s journey through inpatient services and their experiences of care and treatment.
Results: Seven categories, generated from participants’ data, informed the end model. These categories were: (1) ‘Helping the Child Through their Hospital Journey in Order to Support Their Needs’, (2) “I Felt as if I Hadn’t Been Listened To”: Understanding Through Relating’, (3) ‘Exploring Factors Influencing the Child’s Presentation to Understand Behaviours That Challenge’, (4) “Everyone is Saying He Shouldn’t Be In There”: Exposing Systemic Failures and Advocating for Care Reform’, (5) ‘Are Parents Being Included? Bridging the Gaps to Prevent Ostracism’, (6) “Revamping” Children’s Learning Disability Inpatient Provision in Order to Reduce Harm’, and (7) “We Should All Be Transparent and Working Together”: Embracing Transformative Change’. The end model is titled “I Cannot Bring Myself to Imagine What They Are Going Through” is diagrammatically presented.
Conclusion: This is the first study to provide a theoretical framework to understand the experiences of the inpatient hospital journey for children with a learning disability, solely within a child population. Findings reveal critical insights to care and treatment within inpatient services, painting an unfavourable view of inpatient hospital provision. The end model provides a framework that highlights parents’ perspectives of their child’s hospital journey, and how parents conclude that inpatient services are unsuitable for children with a learning disability due to the absence or the amelioration of the child’s presenting difficulties. Parents attribute their child’s poor presentation to unsuitable ward environments and the use of restrictive practices, compounding their view that hospitals are harmful and should be closed down. The model further demonstrates parents’ ostracism from information sharing and inclusion in their child’s care and treatment during the child’s inpatient stay. Implications for practice and recommendations are provided that emphasise the importance of key stakeholder involvement.
REC name
Wales REC 4
REC reference
22/WA/0135
Date of REC Opinion
22 Jul 2022
REC opinion
Further Information Favourable Opinion