Coercion in a locked psychiatric ward

Larsen, Inger Beate; Terkelsen, Toril Borch

doi:10.1177/0969733013503601

Cited by 72 publications

(68 citation statements)

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“…1-3, 16, 22, 25 These studies state that it is of fundamental importance for a patient with serious mental health problems to be regarded and seen as an ordinary human being. 22,25 The patients describe a good health professional as someone who treats them as ordinary people, not as a diagnosis, 16,19 and it is argued that 'persons with psychotic experiences are deserving of our compassion, not in the sense of charity or pity, but in the more fundamental sense of showing respect for their dignity and shared humanity'. 16 As Davidson writes: 16 Persons with psychosis are deserving of practitioners who hold them in this kind of high regard, as the regard of others provides a key foundation for the person's efforts to reclaim his or her personhood from out of the ravages of the condition and the social consequences of discrimination.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10][11][12][13][14][15][16][17][18] There has been a growing awareness towards the central role and influence human relationships have in the recovery process. [12][13][14][15][16][17][18] Several studies have focused on the importance of user involvement 13,14,[18][19][20] and staff attitudes, 16,[21][22][23][24][25][26][27] but, interestingly, very little attention has been paid to how leading textbooks in the mental health field describe and present people having psychosis and how psychosis as such is communicated to students and the professionals. It is therefore, in our view, of great interest to study these texts and to investigate and discuss the descriptions that students are reading in their academic courses.…”

Section: Introductionmentioning

confidence: 99%

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Textbook descriptions of people with psychosis – some ethical aspects

Fredwall

Larsen

2018

Nurs Ethics

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Background: Textbooks are central for the education of professionals in the health field and a resource for practitioners already in the field. Objectives: This article focuses on how 12 textbooks in psychiatric nursing and psychiatry, published in Norway between 1877 and 2012, describe and present people with psychosis. Research design: We used qualitative content analysis. Ethical considerations: The topic is published textbooks, made available to be read by students, teachers and professionals, and no ethical approval was required. Findings: The analysis shows that all 12 textbooks describe and present people who are considered as psychotic from a 'perspective from above'. In this perspective, the readers are learning about psychosis in the professional's language and from the author's viewpoint. Most often the textbooks communicate a universal image of people with psychosis, a description that fits with the diagnostic criteria. The analysis also shows that two textbooks in psychiatric nursing combined this perspective with a 'perspective from within'. Here, the readers are learning about psychosis from the patients' own viewpoint. The authors communicate a personal, psychotic universe that differs from various people, even if they have the same diagnosis, and the descriptions are focusing on the patient as a whole person. Discussion and conclusion: Drawing partly on Rita Charon's writings about narrative knowledge in the health field, and partly on insights from Martha Nussbaum and her concept of narrative imagination, we argue that mental health professionals need to learn about, understand and fathom what patients go through by reading, listening to and acknowledging the patients' own stories and experiences. Cultivating the capacity for empathy and compassion are at the very heart of moral performance in the mental health field. A valuable moral resource in that regard is leading textbooks and how they describe and present people with severe mental illness.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Textbook descriptions of people with psychosis – some ethical aspects

Fredwall

Larsen

2018

Nurs Ethics

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“…Another participant, who was secluded in hospital in Norway, felt that seclusion further exacerbated his emotional distress. His interview was translated from Norwegian into English and he stated: “After a while it only makes you feel worse.” (Larsen & Terkelsen, , p. 430).…”

Section: Resultsmentioning

confidence: 99%

“…These sections were then reviewed and findings that were not explicitly related to seclusion (such as quotes about restraint without seclusion) were excluded. Five of the eight papers included some data that were not related to seclusion (Haw, Stubbs, Bickle, & Stewart, ; Kontio et al, ; Larsen & Terkelsen, ; Ling et al and Mayers, Keet, Winkler, & Flisher, ), and therefore, these pieces of data were not included in the synthesis. The data were transferred verbatim into QSR's NVivo v11 software (), which was used in order to help organize codes and themes.…”

Section: Procedures Of Thematic Synthesismentioning

confidence: 99%

What are adult psychiatric inpatients' experience of seclusion: A systematic review of qualitative studies

Askew

Fisher

Beazley

2019

Psychiatric Ment Health Nurs

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Accessible summary What is known on the subject? Seclusion involves isolating a patient in a room away from other patients in order to contain aggressive behaviour, and it is used in psychiatric hospitals. Research has found that seclusion is often viewed by patients as negative; however, there is limited in‐depth understanding of the deeply personal experience. What this paper adds to existing knowledge? This systematic review found that the published research may have flaws with the quality of analysis, mainly due to limited researcher reflexivity. The review of qualitative research revealed that during seclusion, patients feel vulnerable, neglected and abused, disconnected from the experience and that it is dangerous to their mental health. What are the implications for practice? For clinicians facilitating the seclusion process to use their therapeutic skills to provide patients with a sense of being cared for. For clinical supervision to allow space to explore interpersonal dynamics during seclusion in order to enhance therapeutic staff–patient interaction. Abstract IntroductionThere is limited understanding of patients' seclusion experience. A 2013 systematic review provides some insight; however, more knowledge is required in order to improve patient care. This is a systematic review of qualitative research into the patient experience of seclusion. The qualitative focus enables the phenomena to be the central focus. Question“What are adult psychiatric inpatients' experience of seclusion?” and “What is the quality of the applicable research?” MethodElectronic searches for qualitative research published between 2006 and 2017 were undertaken. Data were excluded if it was not explicitly related to seclusion. Research was appraised using three standardized appraisal criterion. Themes were generated through thematic synthesis. ResultsEight papers met inclusion criteria; four had been translated into English. Four themes were identified: “feeling vulnerable,” “feeling neglected and abused,” “disconnecting” and “seclusion is dangerous to mental health.” Participants felt vulnerable and without control. They experienced staff and room as neglectful and abusive. Participants mentally disconnected. The experience threatened participants' mental health. DiscussionParticipants' experience is an amalgamation of interpersonal experience and the environment. Disconnecting may be a coping strategy. Implications for practiceThe findings have implications for seclusion practice, staff training and clinical supervision. Specific attention needs to be paid to the staff–patient interaction.

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“…As others reasoned, one may argue that it is problematic to ask people who are involuntarily admitted to an institution because of vulnerability or 'lack of mental capacity' to take part in a study. 30,31 However, our participants appeared fully competent to talk about their experiences; they even enjoyed the interview. It gave them an opportunity to express their feelings.…”

Section: Ethical Considerationsmentioning

confidence: 88%

Ethical considerations on the value of patient knowledge in long-term care

Hooff

Goossensen

2014

Nurs Ethics

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This study deepens our understanding of the value of patient knowledge in situations where patients see the world in a different manner as do healthcare professionals. The conversations revealed personal subjective knowledge which our respondents create and live by. Healthcare professionals are encouraged to discover and affirm the understandings of these patients, and not be prepossessed due to the diagnosis or general nursing home rules. Understanding patients' unique knowledge through appreciation of the complexity and richness of different views on the situation can assist to give a more humane response to individual needs and pain. Health staff in healthcare institutions are encouraged to evaluate the - unintended - effect of rigidly applied nursing home rules, and the government is challenged to rethink its policy about care, and provide more resources permitting relational care that nurtures the dignity of patients suffering from Korsakoff's syndrome.

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Coercion in a locked psychiatric ward

Abstract: Background: In spite of a national strategy for reducing coercion in the mental health services,

Cited by 72 publications

References 12 publications

Textbook descriptions of people with psychosis – some ethical aspects

Textbook descriptions of people with psychosis – some ethical aspects

What are adult psychiatric inpatients' experience of seclusion: A systematic review of qualitative studies

Ethical considerations on the value of patient knowledge in long-term care

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