Coercive Measures in Patients Hospitalized in Psychiatric Wards: A Contextual Concept Analysis Using a Hybrid Model

Area of Science:

• Psychiatry
• Medical Ethics
• Qualitative Research

Background:

• Coercive measures in psychiatric settings present a complex ethical and clinical challenge.
• Their use is debated regarding necessity versus patient rights and potential harm.

Purpose of the Study:

• To analyze the concept of coercive measures in inpatient psychiatric care.
• To define coercive measures and identify their antecedents and implications.

Main Methods:

• A hybrid concept analysis was employed, combining a literature review of 264 studies.
• Qualitative data from 27 interviews and 67 field notes in an Iranian psychiatric context were analyzed.

Main Results:

• Coercive measures were defined as interventions restricting patient freedom to control behavior or prevent harm.
• Their use involves ethical dilemmas and can cause significant physical and psychological harm.
• Both patients and staff recognized that many incidents are preventable through early intervention.

Conclusions:

• Coercive measures are multifaceted interventions with significant ethical, clinical, and psychological implications.
• Defining these measures and their triggers can inform guidelines balancing patient autonomy and safety.
• Reducing coercive practices necessitates addressing underlying causes while respecting human rights.