The contribution of quality of life to developing therapeutic nursing in special hospitals

Many changes have been made to the management of special hospitals (state hospitals which house patients for an indeterminate stay who are mentally ill, who may have committed a serious offence, and who are considered to be a danger to society and/or to themselves). A key objective of the authority which currently manages these hospitals is to ensure a good quality of life (QoL) for patients and staff. This paper argues first that in order to meet their obligation to treat detained patients, mental health nurses in special hospitals must aim to improve the QoL of those in their care. This viewpoint is echoed by Coid (1993), who considers that society has a moral responsibility, which should be expressed formally in legislation to ensure that detained patients have a high QoL. The paper then addresses the issues involved in attaining an adequate QoL for detained patients, examines the methodological problems in QoL research and its indications for nurses working in this field, and outlines appropriate indicators for examining QoL for patients living in special hospitals. The intention is to initiate debate and outline an approach for mental health nurses towards development of a QoL measure for use in special hospitals. This is considered a necessary first stage if an adequate QoL is to be attained for detained patients.