Ethical challenges of seclusion in psychiatric inpatient wards: a qualitative study of the experiences of Norwegian mental health professionals
| العنوان: | Ethical challenges of seclusion in psychiatric inpatient wards: a qualitative study of the experiences of Norwegian mental health professionals |
|---|---|
| المؤلفون: | Espen Woldsengen Haugom, Torfinn Hynnekleiv, Torleif Ruud |
| المصدر: | BMC Health Services Research, Vol 19, Iss 1, Pp 1-12 (2019) BMC Health Services Research |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Open-area seclusion, Attitude of Health Personnel, Coercion, Milieu therapy, education, Psychiatric Department, Hospital, Patient Isolation, 03 medical and health sciences, 0302 clinical medicine, Shielding, Medicine, Humans, Seclusion, 030212 general & internal medicine, Justice (ethics), Mental health services, Psychiatry, Qualitative Research, Ethics, Inpatients, Health professionals/mental health staff, business.industry, Norway, Health Policy, Nursing research, Mental Disorders, lcsh:Public aspects of medicine, Beneficence, lcsh:RA1-1270, Mental health, 030227 psychiatry, Personnel, Hospital, Ethics, Institutional, Female, business, Psychosocial, Qualitative research, Research Article |
| الوصف: | BACKGROUND: Seclusion is an invasive clinical intervention used in inpatient psychiatric wards as a continuation of milieu therapy with vast behavioural implications that raise many ethical challenges. Seclusion is in Norway defined as an intervention used to contain the patient, accompanied by staff, in a single room, a separate unit, or an area inside the ward. Isolation is defined as the short-term confinement of a patient behind a locked or closed door with no staff present. Few studies examine how staff experiences the ethical challenges they encounter during seclusion. By making these challenges explicit and reflecting upon them, we may be able to provide better care to patients. The aim of this study is to examine how clinical staff in psychiatric inpatient wards describes and assess the ethical challenges of seclusion. METHODS: This study was based on 149 detailed written descriptions of episodes of seclusion from 57 psychiatric wards. A descriptive and exploratory approach was used. Data were analysed using qualitative content analysis. RESULTS: The main finding is that the relationship between treatment and control during seclusion presents several ethical challenges. This is reflected in the balance between the staff's sincere desire to provide good treatment and the patients' behaviour that makes control necessary. Particularly, the findings show how taking control of the patient can be ethically challenging and burdensome and that working under such conditions may result in psychosocial strain on the staff. The findings are discussed according to four core ethical principles: autonomy, beneficence, non-maleficence, and justice. CONCLUSION: Ethical challenges seem to be at the core of the seclusion practice. Systematic ethical reflections are one way to process the ethical challenges that staff encounters. More knowledge is needed concerning the ethical dimensions of seclusion and alternatives to seclusion, including what ethical consequences the psychosocial stress of working with seclusion have for staff. KEYWORDS: Coercion; Ethics; Health professionals/mental health staff; Mental health services; Open-area seclusion; Seclusion; Shielding The first author was supported by The Norwegian Union of Social Educators and Social Workers (FO) at the Profession for Social Educators. The funding body had no role in the study, nor did they have an influence on the design of the study, data collection, analysis, interpretation of data or in writing the manuscript. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::76870f1727b361c099e5b7b81d573fa3 http://hdl.handle.net/10852/71020 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....76870f1727b361c099e5b7b81d573fa3 |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |