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Seclusion and restraint in psychiatry: patients' experiences and practical suggestions on how to improve practices
Raija Kontio1, Grigori Joffe, Hanna Putkonen
1Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland. raija.kontio@utu.fi
Purpose:
This study explored psychiatric inpatients' experiences of, and their suggestions for, improvement of seclusion/restraint, and alternatives to their use in Finland.
Methods:
The data were collected by focused interviews (n= 30) and were analyzed with inductive content analysis.
Results:
Patients' perspectives received insufficient attention during seclusion/restraint processes. Improvements (e.g., humane treatment) and alternatives (e.g., empathetic patient-staff interaction) to seclusion/restraint, as suggested by the patients, focused on essential parts of nursing practice but have not been largely adopted.
Practice Implications:
Patients' basic needs have to be met, and patient-staff interaction has to also continue during seclusion/restraint. Providing patients with meaningful activities, planning beforehand, documenting the patients' wishes, and making patient-staff agreements reduce the need for restrictions and offer alternatives for seclusion/restraint. Service users must be involved in all practical development.
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