Patient restrictions: Are there ethical alternatives to seclusion and restraint?

The use of patient restrictions (e.g. involuntary admission, seclusion, restraint) is a complex ethical dilemma in psychiatric care. The present study explored nurses’ (n = 22) and physicians’ (n = 5) perceptions of what actually happens when an aggressive behaviour episode occurs on the ward and wh...

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Bibliographic Details
Published in:Nursing ethics
Authors: Kontio, Raija (Author) ; Välimäki, Maritta (Author) ; Putkonen, Hanna (Author) ; Kuosmanen, Lauri (Author) ; Scott, Anne (Author) ; Joffe, Grigori (Author)
Format: Electronic Article
Language:English
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Published: Sage 2010
In: Nursing ethics
Year: 2010, Volume: 17, Issue: 1, Pages: 65-76
Further subjects:B patient restriction
B aggressive patient
B Restraint
B Seclusion
B inductive content analysis
B acute psychiatric care
Online Access: Volltext (lizenzpflichtig)
Description
Summary:The use of patient restrictions (e.g. involuntary admission, seclusion, restraint) is a complex ethical dilemma in psychiatric care. The present study explored nurses’ (n = 22) and physicians’ (n = 5) perceptions of what actually happens when an aggressive behaviour episode occurs on the ward and what alternatives to seclusion and restraint are actually in use as normal standard practice in acute psychiatric care. The data were collected by focus group interviews and analysed by inductive content analysis. The participants believed that the decision-making process for managing patients’ aggressive behaviour contains some in-built ethical dilemmas. They thought that patients’ subjective perspective received little attention. Nevertheless, the staff proposed and appeared to use a number of alternatives to minimize or replace the use of seclusion and restraint. Medical and nursing staff need to be encouraged and taught to: (1) tune in more deeply to reasons for patients’ aggressive behaviour; and (2) use alternatives to seclusion and restraint in order to humanize patient care to a greater extent.
ISSN:1477-0989
Contains:Enthalten in: Nursing ethics
Persistent identifiers:DOI: 10.1177/0969733009350140