A qualitative exploration of staff responses to a formulation based upon a psychodynamic ward observation study

A mixed methods literature review was conducted to investigate the association between ward environment and patient outcome. Eleven articles were retrieved that met the inclusion criteria. The data were synthesized and critiqued according to methodological features, with limitations evaluated. Results were presented according to how ward environment and patient outcome has been measured and how the association between the two has been explored. Clinical implications were considered as was the complexity of measuring patient outcomes. Recommendations for improving the environments of wards was also discussed. The research explored staff responses to a formulation based upon a psychodynamic ward observation study for the initial evaluation of the psychodynamic method of observation. Data from staff discussions of the formulation during two away days was analysed using thematic analysis (Braun & Clarke, 2006). Six main themes were created to describe the different responses staff had. Staff engaged selectively with ideas in the formulation. Some responses appeared to confirm parts of the formulation, whereas other responses were considered potentially valuable for re-formulation. It was hypothesised that findings showed some preliminary evidence of the validity of the psychodynamic observation method. This was discussed with reference to the psychotherapy literature. A critical appraisal is included which describes the researcher’s reflections throughout the research, particularly influences on the process of analysis of data.