A Meta-Ethnographic Review of Forensic Psychiatry Inpatient Care. Nursing Staff Experiences of the Nurse-Patient Encounter

Hellzén, Ove; Hammarström, Lars; Ekman, Oliva; Devik, Siri Andreassen

doi:10.1080/01612840.2023.2259997

Cited by 3 publications

(2 citation statements)

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“…This strengthened the objectivity, validity, and generalization of the results [27,28]. We wish to highlight the absence of recent studies regarding how carers in this context comprehend and manage their own emotions during interactions with patients [25], which poses a challenge when attempting to compare our findings with previous research.…”

Section: Methodological Considerationssupporting

confidence: 54%

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‘Fleeing’ as a Strategy for Navigating Resistance in Patient Encounters within Forensic Care

Hammarström,

Hellzén,

Devik

2023

Healthcare

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The aim of this study was to describe the phenomenon of “fleeing the encounter when facing resistance” as experienced by carers working in forensic inpatient care. Qualitative analysis, namely reflective lifeworld research, was used to analyze data from open-ended questions with nine carers from a Swedish regional forensic clinic. The data revealed three meaning constituents that describe the phenomenon: shielding oneself from coming to harm or harming the other, finding one’s emotional balance or being exposed, and offering the patient emotional space and finding patience. The carers described their approaches in the encounters with the patients as alternating between primitive instincts and expectant empathy in order to gain control and deal with the interaction for their own part, for that of the patient, and for that of their colleagues. The phenomenon of fleeing the encounter when facing resistance was intertwined with carers’ self-perception as professional carers. Negative encounters with patients evoked feelings of shame and self-blame. A carer is a key person tasked with shaping the care relationship, which requires an attitude on the part of the carer that recognizes not only the patient’s lifeworld but also their own.

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Section: Methodological Considerationssupporting

confidence: 54%

“…Nevertheless, the strategies used by carers when confronted with challenging patient behavior in forensic treatment remain largely unexplored [20]. The same applies to knowledge about how carers navigate their own emotions in general during interactions with patients in this context [25].…”

Section: Introductionmentioning

confidence: 99%

‘Fleeing’ as a Strategy for Navigating Resistance in Patient Encounters within Forensic Care

Hammarström,

Hellzén,

Devik

2023

Healthcare

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What influences the use of seclusion? A cross-sectional study of forensic mental health nurses in a UK high secure hospital

Tulloch,

Walker,

Ion

2024

JFP

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Purpose Incidents of violence and aggression are a regular occurrence within adult forensic mental health inpatient settings and often lead to the use of restrictive practices such as seclusion. Such events are frequently attributed to the complexity of the patients. Research commonly focuses on patient’s characteristics and their association with seclusion use. Less attention has been centred on forensic mental health nurses’ attitudes to seclusion and the association of nursing staff characteristics. Design/methodology/approach A cross-sectional survey was undertaken using a standardised questionnaire, “Survey of Nurses’ Attitudes to Seclusion”. Responses were received from n = 147 nurses at a high secure forensic mental health hospital in the UK. Findings Key findings indicate that most participants believed seclusion should remain part of clinical practice. A correlation was identified between forensic mental health nurses’ attitudes to seclusion use and their characteristics: gender, age range, educational level and experience. Practical implications This paper presents novel information on seclusion reduction opportunities through modifiable workforce factors such as gender-sensitive rostering and staff training and development. Furthermore, recruitment and retention strategies should be prioritised so forensic mental health is perceived as an attractive career and a safe workplace. Originality/value The paucity of research in this area has prompted calls for further research to explore nursing staff characteristics and seclusion use. This is particularly important now due to the current global difficulty in the recruitment and retention of mental health nurses.

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Exploring Social Interactions in the Context of Justice System Involvement: Perspectives of Patients and Psychiatric Nurses

Paradis-Gagné,

Cader,

Holmes

et al. 2024

Clin Nurs Res

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Psychiatric nurses who work with people who are involved with the justice system experience ethical and moral tension arising from their dual role (care and control). This is known to significantly affect the development of a therapeutic relationship between nurses and patients. (a) better understand how justice system involvement affects people living with mental disorders and the nurses who work with them; (b) explore the influence of judiciarization on social interactions between these actors. Grounded theory (GT) was used as the qualitative methodology for this research. Semi-structured interviews were conducted with participants. The study was carried out in three different units of a psychiatric institution: Psychiatric Intensive Care Unit, Emergency Department, and Brief Intervention Unit. A sample of 10 patients and 9 psychiatric nurses was recruited ( n = 19). Theoretical sampling was used to recruit participants. We followed the iterative steps of qualitative GT analysis (open coding, axial coding, constant comparison, and modelization). Three main themes emerged from the qualitative analysis: (a) Experience of Justice System Involvement, (b) Crisis, (c) Relational Aspects and Importance of the Approach. These results will inform nurses and healthcare providers about the impacts of justice system involvement on people living with mental illness and how clinical practices can be better adapted to this population with complex health needs.

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A Meta-Ethnographic Review of Forensic Psychiatry Inpatient Care. Nursing Staff Experiences of the Nurse-Patient Encounter

Cited by 3 publications

References 44 publications

‘Fleeing’ as a Strategy for Navigating Resistance in Patient Encounters within Forensic Care

‘Fleeing’ as a Strategy for Navigating Resistance in Patient Encounters within Forensic Care

What influences the use of seclusion? A cross-sectional study of forensic mental health nurses in a UK high secure hospital

Exploring Social Interactions in the Context of Justice System Involvement: Perspectives of Patients and Psychiatric Nurses

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