From the old to the new

Gillespie, Mark; Flowers, Paul

doi:10.1111/j.1939-3938.2009.01056.x

Cited by 9 publications

(1 citation statement)

References 17 publications

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“…In line with case study research, the results are not generalizable; yet, they are transferable to other contexts as they can provide suggestions for interpretation of experiences and for practice improvement (21). This study is in line with other studies, signaling difficulties in comparable transitions within forensic psychiatry, and a need for support and supervision to deal with this (22,23). Dilemmas of whether or not to touch a patient can arise in this transition, as is also noticed by Weiskopf (24).…”

Section: Discussionsupporting

confidence: 58%

Moral Dilemmas in Contact-Based Care: The Relevance of Moral Case Deliberation for Forensic Psychiatry

et al. 2020

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Currently, forensic psychiatry shows a shift from a control-based to a contact-based approach. Working from contact may, however, entail new moral questions and dilemmas. How to secure safety when focusing on contact? Does contact imply being physically close to the patient, or should one refrain from intimate relations? In order to help care professionals to deal with these moral issues, clinical ethics support can be useful. A specific approach in clinical ethics support is moral case deliberation (MCD). An MCD is a structured dialogue between professionals on a moral issue they experience in practice, structured by a conversation method and guided by a facilitator. In this article, we describe the background and procedures of MCD. Furthermore, we present a case example in which care professionals reflect on the moral question of whether provision of care in forensic psychiatry may entail physical closeness. The MCD shows that an open conversation results in a better understanding of different perspectives and creates the basis for finding a joint way to proceed in the case. We conclude that MCD can enable professionals to reflect on moral issues and develop shared values in forensic psychiatry.

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Section: Discussionsupporting

confidence: 58%

Moral Dilemmas in Contact-Based Care: The Relevance of Moral Case Deliberation for Forensic Psychiatry

et al. 2020

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Staff Attitudes Towards Seclusion and Restraint in Forensic Settings

Laiho

Hottinen

Lindberg

et al. 2016

The Use of Coercive Measures in Forensic Psychiatric Care

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Controlling emotions—nurses’ lived experiences caring for patients in forensic psychiatry

Hammarström

Häggström

Devik

2019

International Journal of Qualitative Studies on Health and Well

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Purpose: Nurses working in forensic psychiatry often encounter offenders who have a severe mental illness, which may cause ethical challenges and influence nurses’ daily work. This study was conducted to illuminate the meaning of nurses’ lived experiences of encounters with patients with mental illnesses in forensic inpatient care.Methods: This qualitative study employed narrative interviews with 13 nurses. Interviews were audiotaped and transcribed verbatim and analysed following a phenomenological-hermeneutic approach.Results: Four key themes were revealed: “Being frustrated” (subthemes included “Fighting resignation” and “Being disappointed”), “Protecting oneself” (subthemes included “To shy away,” “Being on your guard,” and “Being disclosed”), “Being open-minded” (subthemes included “Being confirmed,” “Developing trust,” and “Developing compassion”), and “Striving for control” (subthemes included “Sensing mutual vulnerability” and “Regulating oneself”). Further, working in forensic psychiatry challenged nurses’ identity as healthcare professionals because of being in a stressful context.Conclusions: Dealing with aggressive patients with severe mental illnesses threatens nurses’ professional identity. Nurses must attempt to empathize with patients’ experiences and respond accordingly. Utilizing strategies rooted in compassion such as self-reflection, emotional regulation, and distancing themselves when necessary may enable nurses to more effectively respond to patients’ needs.

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From the old to the new

Cited by 9 publications

References 17 publications

Moral Dilemmas in Contact-Based Care: The Relevance of Moral Case Deliberation for Forensic Psychiatry

Moral Dilemmas in Contact-Based Care: The Relevance of Moral Case Deliberation for Forensic Psychiatry

Staff Attitudes Towards Seclusion and Restraint in Forensic Settings

Controlling emotions—nurses’ lived experiences caring for patients in forensic psychiatry

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