Proposal Introduction The aims of the study will be

Proposal for a
qualitative study examining the wellbeing of NHS mental health staff: Why is
morale low?



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The aims of the study will be to work out the reasoning for why well-being
among nhs mental health staff has declined. A qualitative research study will
be conducted using semi-structured interviews. This research is highly relevant
and necessary due to the budget cuts the NHS are currently facing in society,
especially with a rise in mental health. This research will be interesting as
due to the style of interview it will be possible to gain in-depth knowledge of
how participants are feeling within the workplace. This is useful and
interesting as it is highly possible that if the wellbeing of the staff can be
improved then the quality of work being completed will rise and this can impact
patients at the hospital positively. Overall the research will create a
snowball effect if the problem is solved once it is identified. The study is
good value for money as solving the cause of low wellbeing among staff will
save further costs to the system in the future. The importance of positive
wellbeing in the workplace is also highlighted in Graham and Shiers (2010)
research. The idea that by addressing issues you will in turn be improving the
workplace. Grawitch,Gottschalk & Munz (2006) also confirm the idea of the
importance of wellbeing in the workplace with their study. They conclude that
there are direct  links between “healthy workplace practices and organizational
improvements are proposed.” A qualitative study conducted by Music (2017)
clearly established “the need for more compassionate and emotionally secure
settings for patients and mental health providers of the National Health
Service (NHS).” Whilst this is similar to the study being offered at this time,
it is clear more research is needed now as the study so closely linked to the
one mentioned was incredibly recent. Having more studies within this area will
back up the validity of the work and ensure future changes within the workplace
is made. An interesting perspective was discussed in Raffay, Wood and Todd’s
qualitative research (2016). The idea of spirituality being a positive
influence on the wellbeing of NHS mental health services and therefore creating
a more positive wellbeing in the workplace. Laschinger, Leiter, Day & Gilin
(2009) studied nurses perceptions. The study concluded
that “perceptions of empowerment, supervisor incivility, and cynicism were
strongly related to job satisfaction, organizational commitment, and turnover
intentions.” The suggested changes in the workplace are that managerial
strategies are used to empower nurses may be helpful in preventing workplace
burnout and low wellbeing.

The initial question being looked at for this
research is: How do the nurses perceive their relationships with
their employers? There will also be some secondary questions that are worth
answering in this research such as: What provisions do employers provide the
staff when they are feeling vulnerable? What support is offered to staff? How
often are staff at work during the week? A qualitative
methodology is appropriate here as the aim of the research is to find out
in-depth information about the feelings of the participants.



A qualitative research design will be used to conduct this study. This design
has been chosen due to its use in the collection of more detail rich data.
Qualitative designs are comparatively more flexible than their Quantitative
counterparts, as the research focus can be more readily altered and revised to
ensure that research conducted continues to focus more on the responses
collected from participants and building a greater research base, rather than
proving previously existing theories (Patton, 1990). One particular benefit of
using qualitative data in research is that the researchers are able to gain
greater insight into the interpretations that participants hold of their
workplaces, and the attitudes they have surrounding this environment.



The study will include a sample of 10 male and 10
female participants from the target population of NHS Mental Health Nurses (?).
Participants will be between the ages of 18 and 50. The more variety in ages in
the sample, the richer variation in opinion, and also provide and age range
comparison on the possible impact of age on staff members well-being. The
gender variable will also be included in analysis, to test and control for any
potential gender influences in responses, similar to that of age impact.
Inclusion criteria will include a “work experience” requirement of at least 2
years as part of the department. This is again to increase the variation of
experiences between staff members, including any potential changes to the
department (budget cuts, well-being initiatives etc.), as well as offer another
potential comparison point – how long participants have spent in that job, and
how this time period may influence well-being.



Methodological theory
In order to analyse the data, thematic analysis will be used, taking an
inductive approach. Braun and Clarke (2006) describe thematic analysis as “a
method for identifying, analysing and reporting patterns (themes) within data”.
 This method of analysis is flexible in its theoretical application, allowing
researchers a choice in epistemological position- comparatively different to
any other qualitative method, which are, by large attached to a particular
theoretical position (Braun & Clarke, 2006). This research will take a
“contextualist” approach to the method. This places the analysis between two
camps. Constructionism – Identifying themes and analysing them by the potential
social implication relating to the topic being investigated; and Essentialism-
Reporting the themes by participant experience, and the meanings that they
ascribe to them through their reality. Contextualism utilises the best of both
worlds, both investigating the ways in which people make sense of their
experiences through the application of “meaning”, as well as how broader social
contexts and issues way against these meanings, and how this influence may warp
an individuals interpretation of themselves and their experiences (Braun &
Clarke, 2006). This is particularly apropos in the analysis of this data, as
the topic of investigation centres around investigating the well-being of NHS
staff, with an understanding of the potential contributions towards wellness
decline via social matters, such as budget cuts.
Method of data collection


Semi-structured interviews will be employed in data
collection for this study. This will allow the researcher to guide the
interview in particular directions, but will also present the opportunity for
the participant to speak more freely, allowing for a more organic flow of
conversation – whilst still maintaining the structure required to make
effective use of the time to ask the relevant questions. The lack of rigidity
in question patterns also reduce inhibition of participant responses (Cohen
& Crabtree, 2006). Some examples of questions that will be asked are as

What are your approximate hours a week spent working per
week? To probe: What are your typical shift hours?
kind of support do you receive in the workplace if you need it?
you have a good relationship with your higher ups? To probe: Are you and
those higher up on talking terms or on more of a first name a basis? What
would a typical conversation with your higher ups be like? Can you give me
a recent example?



The semi-structured interviews will be conducted in
private rooms within participants workplace. Participants will be presented
with a consent form including a brief outline of the study, to ensure informed
consent, but also reduce the chance of answer bias.
Interviews with participants will be audio recorded, and participants will be
informed of this during the initial briefing, prior to agreeing to take part in
the research. The recordings will be transcribed verbatim after the interview
process, so that the thematic analytical process is made easier. They will also
have the option to withdraw from the study at any time, through the use of a
“participant code” provided to them on their consent form. This can be used by
the researcher to dispose of their data upon being notified of a participants
desire to withdraw. Outside of this, all data will be disposed of within 6
months of conclusion of the research. The approximate length of the interview
will be one hour. This however, varies from participant to participant
depending on how detailed their answers are. The debrief will also contain any
information they may need about seeking counselling and support services if
they are made to feel distressed during the interview process. The interview
schedule will be used to direct the conversation in a fixed order with probing
questions that may help the participant give more detailed answers (Crowley,
2010, p, 239).



Ethical considerations

The research process will adhere strictly to BPS Ethical Guidelines (BPS Code of Human Research Ethics 2nd edition, 2014), and participants will be required to provide their
informed consent in writing prior to the commencement of the research (detailed
above). Participants will be made fully aware of their freedom to refuse to
answer questions, and their right to withdraw from the research at any time –
in this instance, any already collected data, personal or research based, will
be destroyed (detailed above). No personal information including names and
contact information will be shared included in publication or in anyway made
known outside of the researcher themselves (participants will be provided with
a code by which they will be known in paper work for the duration of the
research), thus protecting the anonymity and confidentiality if participants.
All data collected will be stored electronically on a password protected
computer, and will be destroyed within 6 months of the studies completion.
Participants will be provided with contact information for counselling and support
services during the full debrief at the end of the study.


Analytic strategy


The thematic analysis will be aimed at finding the
similarities and differences in the common themes through the data. These
themes do not have to be the most prevalently discussed, they just have to
accurately represent the data in relation to the research. The thematic
analysis will be conducted according to the six phases proposed in the paper by
Braun and Clarke (2006).
These are: familiarising yourself with the data; producing codes which
highlight the most meaningful information; sorting such codes into themes;
refining the themes; defining and naming the themes; and the final production
of the thematic analysis.




Like mentioned in the introduction this research,
Music’s research (2017) and further research being done will ensure validity in
what is being concluded. It could be learnt that there are reasons different to
the previous research discussed about regarding the wellbeing of participants.