Nursing care in mental health based on the TIDAL MODEL: an integrative review

an integrative literature review carried out by LILACS, MEDLINE, Scopus and Web of Science. Data were collected from December 2017 to March 2018. After selecting the studies, the sample totaled 24 articles.

Results:

the articles are in English (91.7%), were published in nursing journals (87.5%), are reflective and/or theoretical (50%) and have level of evidence VII (79.2%). The model brings contributions to nursing science, enabling person-centered care, with an emphasis on interdisciplinary work, nurses’ protagonism and the empowerment of subjects in mental suffering.

Final considerations:

the use of the Tidal Model enables changes in nurses practice working in the context of mental health. Its application by nurses who work in mental health services in Brazil is recommended.

Descriptors:
Nursing; Nursing Theory; Nursing Care; Mental Health; Stress, Psychological

Variables	n (%)
Language
English	22 (91.7)
Portuguese	2 (8.3)
Yar of publication
Articles published more than 5 years ago	20 (83.3)
Last 5 years (2014-2018)	4 (16.7)
Main theme of the journal
Mental health nursing	13 (54.2)
Nursing (overall)	8 (33.3)
Psiquiatria ou Saúde Mental (overall)	3 (12.5)
Indexation bases
MEDLINE (via EBSCO)	16 (66.7)
CINAHL	6 (25.0)
Scopus	2 (8.3)
Methodological outlining
Reflective/Theoretical	12 (50.0)
Experience reports	7 (29.2)
Quantitative primary studies	3 (12.5)
Qualitative primary studies	2 (8.3)

Title	Year/ Country	Outlining/ Nmber of Patients	Interventions	Result/Outcome	Level of evidence⁽⁵5 Galvão CM. Evidence hierarchies. Acta Paul Enferm. 2006;19(2):VI. doi: 10.1590/S0103-21002006000200001 https://doi.org/10.1590/S0103-2100200600... ⁾
Mental Health Nursing and the Politics of Recovery: a Global Reflection⁽⁶6 Barker PJ, Buchanan-Barker P. mental health nursing and the politics of recovery: a global reflection. Arch Psychiatr Nurs. 2011;25(5):350-8. doi: 10.1016/j.apnu.2011.03.009 https://doi.org/10.1016/j.apnu.2011.03.0... ⁾	2011 Australia	Reflective/Theoretical Article	Analysis of the concept of recovery from the perspective of the "Tidal Model" Theory on the policy and practice agenda from a "psychiatric nursing" perspective and "mental health nursing"	The definition of recovery brings a theoretical and practical confusion in the work of the nurse in mental health; the concept of recovery worked by the model implies a better development of person-centered care	Level of evidence VII
Thetidalmodel:thelived-experienceinperson-centred mentalhealth nursingcare⁽⁷7 Barker P. The tidal model: the lived-experience in person-centred mental health nursing care. Nurs Philos. 2001;2(3):213-23. doi: 10.1046/j.1466-769X.2000.00062.x https://doi.org/10.1046/j.1466-769X.2000... ⁾	2001 Australia	Reflective/Theoretical Article	Description of the philosophical background of the Tidal Model, which emerged from a series of studies on "psychiatric nursing needs"	Tidal develops the assumption of care centered on interpersonal relationships, emphasizing the importance of meanings, life experience, and the role of narrative in the development of care plans for the individual	Level of evidence VII
Reclaiming nursing: making it personal⁽⁸8 Barker P, Buchanan-Barker P. Reclaiming nursing: making it personal. Ment Health Pract [Internet]. 2008 [cited 2017 Dec 23];11(9):12-6. Available from: https://www.deepdyve.com/lp/royal-college-of-nursing-rcn/reclaiming-nursing-making-it-personal-YBmjhYbCsi https://www.deepdyve.com/lp/royal-colleg... ⁾	2008 England	Reflective/Theoretical Article	Reflection on how Tidal has helped people live more meaningfully	After 11 development, nurses report that the model has had a considerable impact on mental health nursing, helping people to live their lives significantly	Level of evidence VII
How the tidal model was used to overcome a risk-averse ward culture⁽⁹9 Henderson J. How the tidal model was used to overcome a risk-averse ward culture. Ment Health Pract [Internet]. 2013 [cited 2017 Dec 23];17(1):34-7. Available from: https://www.deepdyve.com/lp/royal-college-of-nursing-rcn/how-the-tidal-model-was-used-to-overcome-a-risk-averse-ward-culture-J0cwLJqzTd https://www.deepdyve.com/lp/royal-colleg... ⁾	2013 Scotland	Experience report at a Psychiatric Hospital	"Ethos" of nursing care description in a mental health ward in Scotland. There is a need for change and the underlying principles of improved care delivered	The model was discussed and implemented during 9 months, adopting the values of the theory. The idea was to change the environment from "prison" to a recovery-centric environment. Users who previously suffered from the stigma of madness could experience support, autonomy, and independence	Level of evidence VII
Sustaining a Culture of Practice Development in an Acute Adolescent Inpatient Mental Health Unit⁽¹⁰10 Vella N, Page L, Edwards C, Wand T. Sustaining a culture of practice development in na acute adolecent inpatient mental health unit. J Child Adolesc Psychiatr Nurs. 2014;27(3):149-55. doi: 10.1111/jcap.12080 https://doi.org/10.1111/jcap.12080... ⁾	2014 Australia	Experience Report Site: Psychiatric Hospital Group: Adolescents	The processes that allowed the implementation of the Tidal Model in a mental health unit for adolescents in an acute state of distress were detailed	An educational plan was created adopting the theory in of the unit's nurses practice. Changes have been successful and care was improved or adolescents	Level of evidence VII
UsingtheTidalModelof MentalHealthRecovery toPlan PrimaryHealthCareforWomen inResidential Substance Abuse Recovery⁽¹¹11 Young BB. Using the tidal model of mental health recovery to plan primary health care for women in residential substance abuse recovery. Issues Ment Health Nurs. 2010;31(9):569-75. doi: 10.3109/01612840.2010.487969 https://doi.org/10.3109/01612840.2010.48... ⁾	2010 USA	Experience Report Site: Treatment Center for Women in Substance Abuse Group: Women	Tidal was described, and it was identified how the model can improve the primary care delivery to women in residential treatment of substance abuse	When implementing the model in a residence for the treatment of women in substance abuse, a partnership between caregiver and client was perceived; care planning guidance	Level of evidence VII
TheTidal Model: Developing a Person-Centered approach to Psychiatric and Mental Health Nursing⁽¹²12 Barker P. The Tidal Model: developing a person-centered approach to psychiatric and mental health nursing. Perspect Psychiatr Care. 2001;37(3):79-87. doi: 10.1046/j.1365-2850.2001.00391.x https://doi.org/10.1046/j.1365-2850.2001... ⁾	2001 USA	Reflective/Theoretical Article	The history of Tidal development and some of the processes that aim at patient empowerment and develop genuinely collaborative approaches to care have been discussed	Tidal provides elements to support mental health nursing care	Level of evidence VII
The TidalModel of Mental Health Recovery and Reclamation:Application in Acute CareSettings⁽¹³13 Barker P, Buchanan-Barker P. The Tidal Model of mental health recovery and reclamation: application in acute care settings. Issues Ment Health Nurs. 2010;31(3):171-80. doi: 10.3109/01612840903276696 https://doi.org/10.3109/0161284090327669... ⁾	2010 Australia	Reflective/Theoretical Article	In the last decade, the development of the Tidal Model of Recovery and Rehabilitation in mental health has been described and provided subsidies for application of the various care processes based on Tidal	Approach of the conceptual elements of the model: domains of the Self, the world and the Other; continuum of care	Level of evidence VII
The Tidal Model: developing an empowering, person-centred approach to recovery within psychiatric and mental health nursing⁽¹⁴14 Barker P. The Tidal Model: developing an empowering, person-centred approach to recovery within psychiatric and mental health nursing. J Psychiatr Ment Health Nurs. 2001;8(3):233-40. doi: 10.1046/j.1365-2850.2001.00391.x https://doi.org/10.1046/j.1365-2850.2001... ⁾	2001 USA	Reflective/Theoretical Article	Tidal's theoretical and philosophical foundations, which emerged from a 5-year study of the "need for psychiatric nursing," were described	Nurses and subjects need to explore together the experience of health and disease. Care in this way can represent acts of courage and passion	Level of evidence VII
Cultural boundary surfing in mental health nursing: A creative narration⁽¹⁵15 Kidd J. Cultural boundary surfing in mental health nursing: A creative narration. Contemp Nurse. 2010;34(2):277-88. doi: 10.5172/conu.2010.34.2.277 https://doi.org/10.5172/conu.2010.34.2.2... ⁾	2010 England	Experience Report Group: Nurses	Report on the individual nature of cultural boundaries and discover hidden messages that affect our efforts to build connections between cultures and ethnicities in mental health settings; Presentation of how the conversation between the protagonists explores cultural competence alongside the notion of "discovery", and the potential of the model	Dialogue in the form of play among mental health nurses. The model allows to "navigate" between the cultural identities of patients	Level of evidence VII
The ten commitments: a value base for mental health recovery⁽¹⁶16 Barker PJ, Buchanan-Barker P. The ten commitments: A value base for mental health recovery. J Psychosoc Nurs Ment Health Serv. 2006;44(9):29-33.⁾	2006 Australia	Reflective/Theoretical Article	Discussion on the concept of recovery, as well as the ten essential commitments for the mental health nursing care	Nurses following the ten appointments become part of the team and the client becomes the "captain of his ship" (his own life)	Level of evidence VII
The tidal model as experienced by patients and nurses in a regional forensic unit⁽¹⁷17 Cook NR, Phillips BN, Sadler D. The Tidal Model as experienced by patients and nurses in a regional forensic unit. J Psychiatr Ment Health Nurs. 2005;12(5):536-40. doi: 10.1111/j.1365-2850.2005.00872.x https://doi.org/10.1111/j.1365-2850.2005... ⁾	2005 New Zeland	Qualitative / Phenomenological article N = 4 nurses 4 patients	Description of nursing care from the perspective of nurses with special patients	Subjects report good experiences from the use of the Tidal Model. Patients report that nursing care from the model helped in the steps for recovery and family involvement. Nurses report improvement in job satisfaction	Level of evidence VI
The Tidal Model: psychiatric colonization, recovery and the paradigm shift in mental health care⁽¹⁸18 Barker P. The Tidal Model: Psychiatric colonization, recovery and the paradigm shift in mental health care. Int J Ment Health Nurs. 2003;12(2):96-102. doi: 10.1046/j.1440-0979.2003.00275.x https://doi.org/10.1046/j.1440-0979.2003... ⁾	2003 Australia	Reflective/Theoretical Article	Discussion on the characteristics of the Tidal Model addressing significant criticisms for psychiatric nursing practice	The Tidal Model is an alternative to the psychiatric paradigm, based on the "care with" proposal, emphasizing the process of change	Level of evidence VII
Launching the Tidal Model: evaluating the evidence⁽¹⁹19 Gordon W, Morton T, Brooks G. Launching the Tidal Model: evaluating the evidence. J Psychiatr Ment Health Nurs. 2005;12(6):703-12. doi: 10.1111/j.1365-2850.2005.00901.x https://doi.org/10.1111/j.1365-2850.2005... ⁾	2005 England	Quantitative Article /Action Research N = 4 patients 7 Nurses Neighborhood: Queen Elizabeth Psychiatric Hospital	Report on the assessment of the Tidal Model in the context of two acute admission units, one in Birmingham (2004) and one in Newcastle (2001)	After implantation of the model, there was a 55% reduction in accidents due to hospitalization; all the patients interviewed indicated to appreciate the changes in the hospital with the use of the model; nurses evaluated how better or better after implantation; results similar to the Newcastle hospital	Level of evidence VI
The Tidal Commitments: extending the value base of mental health recovery⁽²⁰20 Barker PJ, Buchanan-Barker P. The Tidal Commitments: extending the value base of mental health recovery. J Psychiatr Ment Health Nurs. 2008;15(2):93-100. doi: 10.1111/j.1365-2850.2007.01209.x https://doi.org/10.1111/j.1365-2850.2007... ⁾	2008 England	Reflective/Theoretical Article	Review of the Tidal Model assumptions, describing the development of the model value base, the 10 Commitments, and illustrate the 20 competencies of the model that aim to generate evidence-based practices for the recovery process	In a decade, the model has been successful in the countries where it is developed. It is believed that the social action of the produced care brings transformations in the construction of new values for the society, that the scientific method has not produced	Level of evidence VII
Judgement days: developing an evaluation for an innovative nursing model⁽²¹21 Stevenson C, Barker P, Fletcher E. Judgement days: developing an evaluation for an innovative nursing model. . J Psychiatr Ment Health Nurs. 2002;9(3):271-6. doi: 10.1046/j.1365-2850.2002.00472.x https://doi.org/10.1046/j.1365-2850.2002... ⁾	2002 England	Quantitative Article / descriptive N = 69 patients in the pretest phase 81 patients in the post-test phase Site: Psychiatric Hospital Newcastle	Report of the assessment process and results of an innovative nursing model (Tidal)	There was a decrease in the period of hospitalization, and a significant association between admission, assessment and stay after the use of the model	Level of evidence VI
Guiding practice development using the Tidal Commitments⁽²²22 Brookes N, Murata L, Tansey M. Guiding practice development using the Tidal Commitments. J Psychiatr Ment Health Nurs. 2006;13(4):460-3. doi: 10.1111/j.1365-2850.2006.01006.x https://doi.org/10.1111/j.1365-2850.2006... ⁾	2006 Canada	Experience Report Site: Ontario Psychiatric Hospital Group: Nurses	Reporting the experience of implementing Tidal Model in a psychiatric hospital in Canada	Hospital started to adopt the 10 commitments, with an emphasis on valuing the voice, respecting the language, becoming an apprentice, using the available toolkit, and giving time as a gift	Level of evidence VII
Patient-centred care in acute psychiatric admission units: reality or rhetoric?⁽²³23 O'Donovan A. Patient-centred care in acute psychiatric admission units: reality or rhetoric? J Psychiatr Ment Health Nurs. 2007;14(6):542-8. doi: 10.1111/j.1365-2850.2007.01125.x https://doi.org/10.1111/j.1365-2850.2007... ⁾	2007 Ireland	Qualitative/descriptive article N = 8 nurses Site: Psychiatric admission ward of a hospital in Ireland	Exploring the approach of psychiatric nurses and the philosophical foundations of care	Nurses responded that the model is the basis for developing the person-centered care plan, but in practice some report the use of coercion, rigorous application of punishment, centered on the medical figure. The framework did not help to promote a person-centered	Level of evidence VI
Tidal Waves: Implementing a New Model of Mental Health Recovery and Reclamation⁽²⁴24 Brookes N, Murata L, Tansey M. Tidal Waves: Implementing a New Model of Mental Health Recovery and Reclamation. Can Nurse. 2008;104(8):22-7.⁾	2008 Canada	Experience Report Site: Ottawa Mental Health Hospital Group: Nurses Experience Report	Description of the journey to excellence in Psychiatric Nursing and mental health after the introduction of Tidal	Phil Barker disponibilizou um material multimídia para o hospital, e os enfermeiros participaram de dois dias de workshop para aprender os valores da teoria. Atualmente todos os enfermeiros participam de capacitação do modelo	Level of evidence VII
My Life, My Encounters With Insanity⁽²⁵25 Biley FC. My life, my encounters with insanity. J Holist Nurs. 2010;28(2):150-5. doi: 10.1177/0898010109358767 https://doi.org/10.1177/0898010109358767... ⁾	2010 USA	Experience Report	Reflection on psychiatric nursing practices from a holistic approach centered on the person	Narrative about a nurse when starting her work in a psychiatric ward. Tidal is an option for holistic and non-pharmacological care.	Level of evidence VII
Observation: the original sin of mental health nursing?⁽²⁶26 Buchanan-Barker P, Barker P. Observation: the original sin of mental health nursing? J Psychiatr Ment Health Nurs. 2005;12(5):541-9. doi: 10.1111/j.1365-2850.2005.00876.x https://doi.org/10.1111/j.1365-2850.2005... ⁾	2005 England	Reflective/Theoretical Article	Review of the historical and interdisciplinary dimensions of observation practice, contrasting this with the research of Mental Health Nursing in the last two decades, in the United Kingdom, for professional autonomy	The construction of "bridges" between patient and nurse appears as an alternative to observation based on clinical practice. Tidal allows this new perspective in psychiatric care	Level of evidence VII
Perspectiva estética esociopoética do cuidarde pessoascom sofrimento psíquico:apropriação do Tidal Model⁽²⁷27 Santos I, Silva LA, Clos AC, Silva AV. An esthetic and sociopoetic perspective on caring for people with mental disorder: appropriating the Tidal Model. Rev Enferm UERJ. 2014;22(6):765-7. doi: 10.12957/reuerj.2014.15663 https://doi.org/10.12957/reuerj.2014.156... ⁾	2014 Brazil	Reflective/Theoretical Article	Outlining of the nursing care perspective based on the essential values proposed by Phil Barker in this model	No Brazilian studies have been found that address the theory. Presents the main elements of Tidal	Level of evidence VII
Teoria da Maré: análise pautada na perspectiva de Meleis ⁽ ²⁸28 Teixeira LA, Monteiro ARM, Guedes MVC, Silva LF, Freitas MC. The Tidal Model: analysis based on Meleis's perspective. Rev Bras Enferm. 2018;71(2):457-62. doi: 10.1590/0034-7167-2016-0394 https://doi.org/10.1590/0034-7167-2016-0... ⁾	2018 Brazil	Reflective/Theoretical Article	Critical reflection on the conceptual components of the Tide Model in the application of the mental health care process	Assessment of the theory by the Meleis method. The clarity of the theory was verified through the demonstration of the functional components, assumptions, concepts and propositions	Level of evidence VII
The Effect of the Psychiatric Nursing Approach Based on the Tidal Model on Coping and Self-esteem in People with Alcohol Dependency: A Randomized Trial⁽²⁹29 Savasan A, Çam O. The effect of the psychiatric nursing approach based on the Tidal Model on coping and self-esteem in people with alcohol dependency: a randomized trial. Arch Psychiatr Nurs. 2017;31(3):274-81. doi: 10.1016/j.apnu.2017.01.002 https://doi.org/10.1016/j.apnu.2017.01.0...	2017 Australia	Quantitative article/randomized trial N = 36 patients Site: Alcohol and Substance Treatment Clinic	The effect of the psychiatric nursing approach based on the Tidal Model on coping and self-esteem in people with alcohol dependence was determined	The Tidal Model had an effect on people with alcohol dependence in maintaining abstinence and coping behaviors	Level of evidence II

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[1] Corresponding Author: Rodrigo Jácob Moreira de Freitas, E-mail: rodrigojmf@gmail.com