Gendered experiences of physical restraint on locked wards for women

Fish, Rebecca; Hatton, Chris

doi:10.1080/09687599.2017.1329711

Cited by 20 publications

(18 citation statements)

References 62 publications

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“…These were generally seen as aversive or as punishments. The potential for highlighting the imbalance of power and subsequent damage to relationships due to the use of restrictive interventions is well‐documented (Fish & Hatton, 2017; Quinn, 2018), and there is a growing body of resources that offer approaches to avoid their use (McDonnell & Ridout, 2019; McKeown et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

“Them two are around when I need their help” The importance of good relationships in supporting people with learning disabilities to be “in a good space”

Fish

Morgan

2021

Brit J Learn Disabil

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Accessible summary We talked to people who lived in a secure unit and their staff. We asked them about good relationships with each other. The majority of the people said that good relationships with staff can help people move back to the community and be “in a good space”. Staff said that good relationships can stop people feeling angry. They said that they like to help people and have trust. It is important to have a good staff team who know the person well. Residents said staff help them and listen to them when they are upset. They said they like it when staff spend time with them doing activities. Based on what residents told us, we think it is important that services work on helping people to have good relationships. This is because these relationships were very important in helping people to move more quickly back into the community. Please see an easier to read version here: https://wp.me/pcRSAn‐3V Abstract Background Despite repeated policy initiatives, an enduring number of people with learning disabilities remain resident in secure settings (also referred to as locked wards). The spatial and emotional distance from family and friends means that relationships with staff become central to people's lives, and are critical for a successful transition to making their home in the community. Methods This article uses a synthesis of evidence from two qualitative studies. We re‐analysed data from fieldnotes and interview transcripts with people with learning disabilities resident in secure settings and with staff who worked with them. The purpose of the original studies was service improvement however, relationships —particularly with between staff and residents— emerged as a significant theme in both studies. Therefore, the data were revisited to explore these relationships in more depth. Findings The analysis identified that positive relationships with staff were critical in enabling residents to be “in a good space”—something they and staff viewed as a crucial factor for moving on. The analysis identified four main themes: (i) the characteristics of positive relationships, (ii) the challenges for positive relationships, (iii) how positive relationships can be encouraged and (iv) how positive relationships support people to move on. Conclusion We conclude that flattening the hierarchy between staff and residents is key when supporting people with learning disabilities to move on. We stress the importance of the “soft skills” in enabling people to transition back to their community. There is a pressing need for research with people who have made the transition from hospital to generate retrospective narratives about what elements of these relationships are most significant in supporting a successful transition.

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Section: Resultsmentioning

confidence: 99%

“Them two are around when I need their help” The importance of good relationships in supporting people with learning disabilities to be “in a good space”

Fish

Morgan

2021

Brit J Learn Disabil

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“…Violence is common in inpatient mental health settings where around 17.0% of inpatients commit at least one act during admission (Iozzino et al, 2015). In turn, the restrictive practices that staff sometimes use to prevent violence including restraint and seclusion cause physical and psychological harm to all concerned (Bonner et al, 2002; Fish & Hatton, 2017; Renwick et al, 2016). Managing violence is costly, involving increased staffing levels, compensation claims, and related work absence (Bowers et al .…”

Section: Introductionmentioning

confidence: 99%

Violence Prevention Climate in General Adult Inpatient Mental Health Units: Validation study of the VPC‐14

Dickens

Tabvuma

Hadfield

et al. 2020

Int J Mental Health Nurs

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Ward social climate is an important contributor to patient outcomes in inpatient mental health services. Best understood as the general ‘vibe’ or ‘atmosphere’ on the unit, social climate has been subject to a significant research aimed at its quantification. One aspect of social climate, the violence prevention climate, describes the extent to which the ward is perceived as safe and protective against the occurrence of aggression by both the patients and the staff. The violence prevention climate scale (VPC‐14), developed in a UK forensic setting, was used in this study in a test of its validity in an Australian general mental health setting. The VPC‐14 was administered across eleven wards of one metropolitan Local Health District in Sydney, NSW. N = 213 valid responses from nursing staff and patients were returned (response rates 23.4 and 24.3%, respectively). The VPC‐14 demonstrated good internal reliability, and convergent validity was evidenced through moderate correlations with the WAS's anger and aggression subscale and the GMI total score. Concurrent validity was demonstrated by expected staff–patient differences in VPC‐14 rating and by correlations between incidents of conflict and containment on wards and the VPC‐14 ratings of staff and patients from those wards. Rasch analysis suggested that future tool development should focus on identifying ways to discriminate between ratings at the high end of the scale. The VPC‐14 supplies valid and useful information about the violence prevention climate in general adult mental health wards.

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“…Studies explored staff,148–157 patient147 158–165 and mixed groups’166–173 views and experiences of seclusion and restraint. Nine studies focused on the processes surrounding seclusion and restraint 136 137 174–180.…”

Section: Resultsmentioning

confidence: 99%

Patient safety in inpatient mental health settings: a systematic review

et al. 2019

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ObjectivesPatients in inpatient mental health settings face similar risks (eg, medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (eg, self-harm), and the measures taken to address these (eg, restraint), may result in further risks to patient safety. The objective of this review is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology.DesignSystematic review and meta-synthesis. Embase, Cumulative Index to Nursing and Allied Health Literature, Health Management Information Consortium, MEDLINE, PsycINFO and Web of Science were systematically searched from 1999 to 2019. Search terms were related to ‘mental health’, ‘patient safety’, ‘inpatient setting’ and ‘research’. Study quality was assessed using the Hawker checklist. Data were extracted and grouped based on study focus and outcome. Safety incidents were meta-analysed where possible using a random-effects model.ResultsOf the 57 637 article titles and abstracts, 364 met inclusion criteria. Included publications came from 31 countries and included data from over 150 000 participants. Study quality varied and statistical heterogeneity was high. Ten research categories were identified: interpersonal violence, coercive interventions, safety culture, harm to self, safety of the physical environment, medication safety, unauthorised leave, clinical decision making, falls and infection prevention and control.ConclusionsPatient safety in inpatient mental health settings is under-researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety, which require investment in research, policy development, and translation into clinical practice.PROSPERO registration numberCRD42016034057.

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Gendered experiences of physical restraint on locked wards for women

Cited by 20 publications

References 62 publications

“Them two are around when I need their help” The importance of good relationships in supporting people with learning disabilities to be “in a good space”

“Them two are around when I need their help” The importance of good relationships in supporting people with learning disabilities to be “in a good space”

Violence Prevention Climate in General Adult Inpatient Mental Health Units: Validation study of the VPC‐14

Patient safety in inpatient mental health settings: a systematic review

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