Professionals’ Attitudes Toward Reducing Restraint: The Case of Seclusion in The Netherlands

Doeselaar, M. van; Sleegers, P.J.C.; Hutschemaekers, G.J.M.

doi:10.1007/s11126-007-9063-x

Cited by 67 publications

(79 citation statements)

References 31 publications

(34 reference statements)

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“…The critical attitude of psychologists and the more pragmatic attitude of psychiatrists is also found in the study by Doeselaar et al [28] in which they described three types of attitudes/groups: ‘transformers’ (on average: above 40 year, psychologists, more often involved in seclusion), ‘maintainers’ (on average: around 30 year, psychiatrists, monthly involved in seclusion), and ‘doubters’ (on average: under 30 year, most nurses, daily involved in seclusion).…”

Section: Discussionmentioning

confidence: 55%

Staff’s normative attitudes towards coercion: the role of moral doubt and professional context—a cross-sectional survey study

et al. 2017

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BackgroundThe use of coercion is morally problematic and requires an ongoing critical reflection. We wondered if not knowing or being uncertain whether coercion is morally right or justified (i.e. experiencing moral doubt) is related to professionals’ normative attitudes regarding the use of coercion.MethodsThis paper describes an explorative statistical analysis based on a cross-sectional survey across seven wards in three Norwegian mental health care institutions.ResultsDescriptive analyses showed that in general the 379 respondents a) were not so sure whether coercion should be seen as offending, b) agreed with the viewpoint that coercion is needed for care and security, and c) slightly disagreed that coercion could be seen as treatment. Staff did not report high rates of moral doubt related to the use of coercion, although most of them agreed there will never be a single answer to the question ‘What is the right thing to do?’.Bivariate analyses showed that the more they experienced general moral doubt and relative doubt, the more one thought that coercion is offending. Especially psychologists were critical towards coercion. We found significant differences among ward types. Respondents with decisional responsibility for coercion and leadership responsibility saw coercion less as treatment. Frequent experience with coercion was related to seeing coercion more as care and security.ConclusionsThis study showed that experiencing moral doubt is related to some one’s normative attitude towards coercion. Future research could investigate whether moral case deliberation increases professionals’ experience of moral doubt and whether this will evoke more critical thinking and increase staff’s curiosity for alternatives to coercion.

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Section: Discussionmentioning

confidence: 55%

Staff’s normative attitudes towards coercion: the role of moral doubt and professional context—a cross-sectional survey study

et al. 2017

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“…Staff in pharmacies with negative attitudes towards drug users have been less likely to provide needle exchange services [39]. Psychiatric staff with positive attitudes towards seclusion of patients have been more likely to be involved in this treatment practice [40]. In the current study centres with "rehabilitation-oriented" staff urine drug screened more frequently and had increased case management (interdisciplinary meeting attendance) of their patients.…”

Section: Discussionmentioning

confidence: 99%

Staff attitudes and the associations with treatment organisation, clinical practices and outcomes in opioid maintenance treatment

Gjersing

Waal

Caplehorn

et al. 2010

BMC Health Serv Res

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BackgroundIn opioid maintenance treatment (OMT) there are documented treatment differences both between countries and between OMT programmes. Some of these differences have been associated with staff attitudes. The aim of this study was to 1) assess if there were differences in staff attitudes within a national OMT programme, and 2) investigate the associations of staff attitudes with treatment organisation, clinical practices and outcomes.MethodsThis study was a cross-sectional multicentre study. Norwegian OMT staff (n = 140) were invited to participate in this study in 2007 using an instrument measuring attitudes towards OMT. The OMT programme comprised 14 regional centres. Data describing treatment organisation, clinical practices and patient outcomes in these centres were extracted from the annual OMT programme assessment 2007. Centres were divided into three groups based upon mean attitudinal scores and labelled; "rehabilitation-oriented", "harm reduction-oriented" and "intermediate" centres.ResultsAll invited staff (n = 140) participated. Staff attitudes differed between the centres. "Rehabilitation-oriented" centres had smaller caseloads, more frequent urine drug screening and increased case management (interdisciplinary meetings). In addition these centres had less drug use and more social rehabilitation among their patients in terms of long-term living arrangements, unemployment, and social security benefits as main income. "Intermediate" centres had the lowest treatment termination rate.ConclusionsThis study identified marked variations in staff attitudes between the regional centres within a national OMT programme. These variations were associated with measurable differences in caseload, intensity of case management and patient outcomes.

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“…In the Netherlands, van Doeselaar et al [28] developed and used the Professionals’ Attitude Toward Seclusion Questionnaire (PATS-Q), which is also used in this study before and after a seclusion reduction program [29, 30]. This questionnaire is described in more detail in the methods section.…”

Section: Introductionmentioning

confidence: 99%

“…van Doeselaar et al [28] conducted a cluster analysis, using PATS-Q scores of 540 Dutch professionals and identified three types of professionals; maintainers, doubters and transformers. The group maintainers scored low on average for all attitude sub scales.…”

Section: Introductionmentioning

confidence: 99%

“…Building on the results of van Doeselaar [28], we expected that after participating in a seclusion reduction program (SRP) from 2004 till 2008, professionals would show a significant change in their attitudes on the PATS-Q. Moreover, we hypothesized that professionals would change their attitude in the direction of the ‘transformers’, because of the three different types determined, especially these professionals wanted to change the current seclusion practice.…”

Section: Introductionmentioning

confidence: 99%

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Professionals’ Attitudes After a Seclusion Reduction Program: Anything Changed?

et al. 2012

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Changing professionals’ attitudes toward seclusion is seen as an important condition to reduce its use. The purpose of this study was to determine whether professionals from a mental health institute in the Netherlands changed in their attitudes toward seclusion after implementation of a multifaceted seclusion reduction program. Professionals working on four acute admission wards filled in the Professional Attitudes Toward Seclusion Questionnaire (PATS-Q) before and after a seclusion reduction program. Changes were analyzed by comparing mean scores on the PATS-Q. After the program, professionals scored significantly higher on ‘ethics’ and ‘more care’. As expected, no change occurred on ‘reasons’ for the use of seclusion. In addition, no significant changes were found on ‘confidence’, ‘better care’ and ‘other care’. Significant changes in professional attitudes concerning the ethics of using seclusion and involving issues of more care were observed after a seclusion reduction program. Mental health professionals moved in the direction of ‘transformers’, indicating an increased criticism of the practice of seclusion and increased willingness to change their own use of seclusion.

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Professionals’ Attitudes Toward Reducing Restraint: The Case of Seclusion in The Netherlands

Abstract: Professionals working in clinical settings are not really opposed to restraint. This could explain the limited effects of innovation projects.

Cited by 67 publications

References 31 publications

Staff’s normative attitudes towards coercion: the role of moral doubt and professional context—a cross-sectional survey study

Staff’s normative attitudes towards coercion: the role of moral doubt and professional context—a cross-sectional survey study

Staff attitudes and the associations with treatment organisation, clinical practices and outcomes in opioid maintenance treatment

Professionals’ Attitudes After a Seclusion Reduction Program: Anything Changed?

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