The context of care: Issues of power and control between patients and community mental health nurses

Muir‐Cochrane, Eimear

doi:10.1046/j.1440-172x.2000.00219.x

Cited by 6 publications

(7 citation statements)

References 22 publications

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“…While there is a body of work about the nature of mental health care and the complexity of nurses’ roles and attitudes to restrictive measures (Bowers et al . , ; Muir‐Cochrane ; Muir‐Cochrane & Duxbury ; Van Der Merwe et al . ), this is the first time nurses’ concerns have been articulated as fear and blame about the potential elimination of containment measures.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, Slemon et al (2017) suggest that the risk management culture itself gives rise to and legitimizes restrictive practices. While there is a body of work about the nature of mental health care and the complexity of nurses' roles and attitudes to restrictive measures (Bowers et al 2010(Bowers et al , 2014Muir-Cochrane 2000;Muir-Cochrane & Duxbury 2017;Van Der Merwe et al 2013), this is the first time nurses' concerns have been articulated as fear and blame about the potential elimination of containment measures.…”

Section: Discussionmentioning

confidence: 99%

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Fear and blame in mental health nurses’ accounts of restrictive practices: Implications for the elimination of seclusion and restraint

Muir‐Cochrane

O’Kane

Oster

2018

Int J Mental Health Nurs

Self Cite

117

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Restrictive practices continue to be used in mental health care despite increasing recognition of their harms and an international effort to reduce and ultimately eliminate their use. The aim of this qualitative study was to explore mental health nurses' views of the potential elimination of these practices. Nine focus groups were conducted with 44 mental health nurses across Australia, and the data analysed using thematic analysis. Overall, the nurses expressed significant fear about the potential elimination of restrictive practices and saw themselves as being blamed for both the use of these practices and the consequences should they be eliminated. Findings detail the conflicts facing staff in balancing the need for ward safety for everyone present while at the same time providing person-centred care. Nurses described the changing role of the mental health nurse in acute settings, being more focussed on risk assessment and medication while at the same time attempting to practise in trauma-informed person-centred ways. The impact on ward safety with increasing acuity of consumers plus the presence of forensic consumers and those affected by methamphetamine was emphasized. Change initiatives need to take into account nurses' deep concerns about the consequences of eliminating all forms of control measures in hospitals and respond to the symptoms and behaviours consumers present with and associated unpredictable and concerning behaviours. Attempts to eliminate restrictive practices should, therefore, be carefully considered and come with a clear articulation of alternatives to ensure the safety of consumers, visitors, and staff.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fear and blame in mental health nurses’ accounts of restrictive practices: Implications for the elimination of seclusion and restraint

Muir‐Cochrane

O’Kane

Oster

2018

Int J Mental Health Nurs

Self Cite

117

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“…The main theme of having equal footing with the client resonates with the literature. Subthemes include respecting the client's will, developing an equal relationship, reflecting to increase self‐awareness, and trusting the client (Magnusson & Lutzen 1999; Muir‐Cochrane 2000; O'Brien 2000). Achieving positive attitudes is essential for home‐visit nurses to effectively help clients with schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

Home‐visit nurses' attitudes for providing effective assistance to clients with schizophrenia

Katakura

Yamamoto‐Mitani

Ishigaki

2010

Int J Mental Health Nurs

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There were two objectives of this study. The first was to identify the attitudes of home-visit nurses towards clients with schizophrenia that lead to the provisions of effective care and positive client outcomes for clients with schizophrenia. The second was to develop a framework to understand how nurses acquire nursing attitudes that lead to such provisions. Seven expert home-visit nurses who had successfully prevented rehospitalization of clients with schizophrenia for more than 2 years were interviewed. In the semistructured interviews, the nurses described their experiences in assisting one or two clients. Data were analyzed qualitatively. The central theme was having equal footing with the client. An effective nursing attitude was acquired through recognizing one's own preconceptions of clients with schizophrenia through two steps: encountering unexpected client behaviours and becoming aware of one's problematic care. For these clients, it was essential that the nurses reflect on their preconceptions towards clients with schizophrenia and alter these preconceptions by working with the clients and believing in their innate ability to live in the community. The findings suggest that the field of mental health home-visit nursing might benefit from adding these educational components in order to cultivate effective nursing attitudes for assisting clients with schizophrenia.

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“…Hammarström (1997) proposed adjustment, exit, and protest as patient power strategies, although these suggestions are not based on an empirical study. Muir-Cochrane (2000) found that patients controlled the encounter with community mental health nurses by, among other things, using noncommunicative or aggressive behavior. Johansson, Hamberg, Lindgren, and Westman (1996) have reported that patients with fibromyalgia sometimes use persuasion in their interaction with health care providers.…”

Section: Discussionmentioning

confidence: 99%

Patient Power and Control: A Study of Women with Uncertain Illness Trajectories

Åsbring

Närvänen

2004

Qual Health Res

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The authors interviewed 12 women diagnosed with chronic fatigue syndrome and 13 with fibromyalgia with the aim of determining the strategies they perceive themselves as using to gain control over their situation during the health care process. The results highlight various strategies that the women report applying to find a way of managing the illness and to influence caregivers. They describe, for example, how they try to gain control over their situation by acquiring knowledge about the illness. The women also describe various power strategies they use in their interaction with the caregivers to take command of their situation, namely exiting, noncompliance, confrontation, persuasion/insistence, making demands, and demonstrative distancing.

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The context of care: Issues of power and control between patients and community mental health nurses

Cited by 6 publications

References 22 publications

Fear and blame in mental health nurses’ accounts of restrictive practices: Implications for the elimination of seclusion and restraint

Fear and blame in mental health nurses’ accounts of restrictive practices: Implications for the elimination of seclusion and restraint

Home‐visit nurses' attitudes for providing effective assistance to clients with schizophrenia

Patient Power and Control: A Study of Women with Uncertain Illness Trajectories

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