Attitudes towards different containment measures: a questionnaire survey in Finnish adolescent psychiatry

Abstract

Use of containment measures in the treatment of underage patients is controversial, and empirical evidence about which containment methods are preferred is lacking. This study aimed to investigate attitudes of staff towards various containment measures in the field of adolescent psychiatry. The sample comprised 128 Finnish nurses and doctors working in closed wards with 13- to 17-year-old patients. The attitudes were studied using the Attitude to Containment Measures Questionnaire. The three methods with the most approval were as-needed medication, transfer to specialist locked wards and mechanical restraint. The method with the least approval was the net bed. Total approval scores for the various containment measures were very similar among nurses and doctors. The differences appeared in attitudes towards mechanical restraint and constant observation, doctors showing a more critical attitude. Women tended to be more critical than men, but only intramuscular medication and mechanical restraint reached statistical significance. The results emphasize the importance of wide-ranging and in-depth training as well as the difficulty of changing practices in psychiatric wards while attitudes are so strongly pro-containment.

Psychiatric nursing staffs’ attitudes towards the use of containment methods in psychiatric inpatient care: An integrative review

“…Net bed was the containment method with the lowest approval ratings (Hottinen et al . ; Özcan et al . ; Whittington et al .…”

“…), as male staff, in general, expressed higher approval levels than their female counterparts (Hottinen et al . ; Whittington et al . ) and younger staff were more likely to approve of containment methods than older staff (Whittington et al .…”

“…The approval of containment also depended on sex and age (Whittington et al 2009), as male staff, in general, expressed higher approval levels than their female counterparts (Hottinen et al 2012;Whittington et al 2009) and younger staff were more likely to approve of containment methods than older staff (Whittington et al 2009). Net bed was the containment method with the lowest approval ratings (Hottinen et al 2012;€ Ozcan et al 2015;Whittington et al 2009). Moreover, according to Whittington et al (2009), mechanical restraint and open area seclusion had low approval ratings.…”

Underaged Patients' Opinions Toward Different Containment Measures: A Questionnaire Survey in Finnish Adolescent Psychiatry

“…The control group comprised 128 staff members working in the adolescent psychiatric inpatient units. These data were collected between October 2009 and March 2010 (Hottinen et al., ). The study was approved by the ethics committee and pertinent institutional authorities.…”

“…Most studies investigating the attitudes toward specific containment methods have been performed among mental health professionals (Bowers, Alexander, Simpson, Ryan, & Carr‐Walker, ; Bowers et al., ; Hottinen et al., ; Wynn, ). The views of mental health service users toward specific containment measures seem to differ markedly from those of the staff.…”