Nurses' Perspectives of Factors That Influence Therapeutic Relationships in Secure Inpatient Forensic Hospitals

The therapeutic relationship is synonymous with mental health nursing and fundamental to the provision of nursing care, regardless of the setting in which care is provided. This literature review examines, from a nursing perspective, factors influencing the formation and maintenance of therapeutic relationships in forensic mental health settings.

A systematic search of the literature, using a range of electronic databases, focusing on nurse-patient therapeutic relationships in forensic settings was conducted. Articles were Critical Appraisal Skills Programme quality appraised, followed by a meta-aggregative thematic approach to data analysis and synthesis to identify themes and, finally, a production of an "action" policy statement.

Eight articles met the criteria for review inclusion. Nine themes were identified; seven were categorized as internal/interpersonal factors, and two were categorized as external/environmental factors (with some themes interconnected). Synthesis of findings resulted in the production of a policy statement encouraging forensic mental health nurses to be aware of intrapersonal influences on therapeutic relationships and the need to provide a safe and supportive clinical environment for these relationships to form.