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Table 5 Initial themes from the qualitative analysis of the case study data

From: Recovery-based staff training intervention within mental health rehabilitation units: a two-stage analysis using realistic evaluation principles and framework approach

Theme Context Mechanism Outcome
Reception of GetREAL Lack of prior information and engagement that involved all staff Delay in staff engaging with the short term intervention Only short term changes
Maintaining initial enthusiasm Looking afresh and starting new activities Stimulating strong enthusiasm and seeing service users respond positively Carrying on new activities long term
The training was interesting and collaborative Felt engaged, listened to and supported Short term changes
Lack of equipment and staff time Service user disappointed because they were not able to continue activities they liked. New activities stopped
Impact of GetREAL GetREAL featured: Predisposing meeting to engage managers and senior staff;
Enabling stage with trainers working alongside each unit team for 5 weeks to deliver a tailored programme
Staff felt energised and motivated; more confident and empowering, and that they knew patients better. More collaborative working, improved staff skills in the short term.
GetREAL featured: Modelling ways to involve service users in developing the service Service users started having a voice more, and giving positive feedback on the increased activities, which pleased staff. Wider variety of activities offered to service users and their involvement was encouraged in the short term
The Legacy of GetREAL Involvement of all staff Staff engagement in activities was set as a norm. The evidence for a long-term legacy following the GetREAL training was mixed.
Some new activities continued long term
Positive feedback from service users Services users enjoyed the activities and were happy to keep them continue.
Regular review of the action plan. Joint planning and working
Lack of staff available to support a range of activities and staff being too busy to extend their job roles. No role flexibility