Vânia L. Martins

Objective: This review will map and summarize international evidence on the determinants of implementation of adult psychiatric home hospitalization (PHH) services. Introduction: Adult PHH is increasingly recognized as a viable alternative to acute inpatient care for adults experiencing mental health crises. Yet, despite growing implementation, guidance on how PHH services are organized, integrated, and adapted remains scattered and heterogeneous. Additionally, international variation remains high, and key determinants affecting their adoption, integration, and sustainability are still insufficiently explored. Eligibility criteria: This review will include international sources published from 2000 onward that describe the implementation of PHH services for adults (≥ 18 years) in acute mental health crisis. It will explore any mental health care setting—community-based, hospital-linked, or home-based—where PHH is employed as an alternative to traditional inpatient admission. Methods: The scoping review will be conducted in accordance with the JBI methodology for scoping reviews and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive 3-step search strategy will be applied across academic databases (eg, PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, Scopus, and CINAHL Complete), guideline repositories (eg, World Health Organization, National Institute for Health and Care Excellence), and gray literature sources (eg, Google Scholar, ProQuest Dissertations and Theses, and institutional or organizational websites). Eligible sources will include formal guidance documents, empirical studies (eg, qualitative, quantitative, mixed methods), and gray literature related to the determinants of implementation of PHH services. To support a structured examination of implementation determinants, this review will apply the Consolidated Framework for Implementation Research and the Implementation Outcomes Framework as guiding frameworks for data charting, analysis, and presentation. Review registration: OSF (https://osf.io/y5482/)

The lack of evidence synthesis studies on the role of psychiatric mental health nursing in the context of psychiatric home hospitalization underscores the limited research on nurses providing care in these teams, particularly concerning their experiences and responsibilities and the actual role of nurses in this context. This knowledge has the potential to improve the quality of mental healthcare by guiding nursing practices. Objective: To map the concepts related to the role of mental health nurses in psychiatric home hospitalization. Methods: A scoping review was conducted using the methodology proposed by the JBI, involving five methodological stages. No search limits were applied except for language. Results: The review identified five key dimensions of nursing in psychiatric home hospitalization: satisfaction; care models; the therapeutic relationship; the care environment; the organization of care. These interconnected dimensions influence quality care. Satisfaction among nurses, patients, and families is associated with improved outcomes and reduced stigma. The therapeutic relationship is characterized by a humanistic approach, emphasizing dialogue, empathy, and shared decision making. Additionally, the importance of care organization is highlighted, including individualized care plans, medication management, and intersectoral collaboration. Discussion: The five nursing dimensions align with the Quality Standards of the Portuguese Nursing Council and are consistent with the scientific literature. Conclusions: Although there is a shortage of studies on this topic, this review allows for the synthesis of nursing interventions and reflection on the paradigm shift in care within the scope of psychiatric mental health nursing interventions. Future studies highlighting the value of mental health nursing interventions, with a particular focus on nursing-sensitive indicators and employing quantitative or mixed methods, will be crucial to furthering the analysis conducted thus far.