Seclusion and Physical Restraint in Psychiatry Essay

Seclusion and Physical Restraint in Psychiatry Essay


Physical restraint and seclusion tend to be used by healthcare professionals because they are believed to be beneficial when there is a necessity to control patient aggressiveness. In this way, they seem to be a great measure to prevent harm to both staff and other patients. However, some professionals state that they have adverse influences on the well-being of those individuals who are exposed to these techniques. They do not only develop additional psychological issues and lack emotional stability but also experience lethal outcomes more often than those patients who are not affected by the discussed measures. The ideas supported by empathetic nursing presuppose the necessity to change behaviors exercised by the facility staff so that there will be almost no need to resort to physical restraint and seclusion. Nurses need to meet patients’ needs, and these practices do not correspond to such an aim. There is an assumption that if nurses are taught to use more humane approaches during the empathy training program, they can overcome the necessity to utilize radical techniques.Seclusion and Physical Restraint in Psychiatry Essay

A Comparison of Research Questions

Eight articles that discuss the use of empathy and seclusion and restraint were analyzed to reveal current knowledge associated with the issue and discuss the necessity of the future research. Julie, Van Wijk, and Traut (2014) focused on the factors that contribute to patients’ aggressiveness and provided an opportunity to identify those practices that should be eliminated by nurses. Chang, Grant, Luther, and Beck (2014) discussed what alterations in nurses’ actions and perceptions could lead to the reduction of restraint and seclusion. A similar investigation was conducted by Yang, Hargreaves, and Bostrom (2014) and Gerace, Oster, Okane, Hayman, and Muir-Cochrane (2016). However, they focused on empathic procedures, in particular. Guzman-Parra et al. (2016) and Kontio, Pitkänen, Joffe, Katajisto, and Välimäki (2014) wondered if learning for nurses can shorten the duration of restraint and seclusion. Patients’ perceptions of these measures were discussed by Tingleff, Bradley, Gildberg, Munksgaard, and Hounsgaard (2017) and Kontio et al. (2012). Moreover, Kontio et al. (2012) also wanted to reveal how undesired experiences of restraint and seclusion can be improved in the patients’ point of view.Seclusion and Physical Restraint in Psychiatry Essay

A Comparison of Sample Populations

Sampling plays a critical role in the usefulness of the conducted research study because it allows identifying if the obtained results can be used for other populations. Those studies that are included in the literature evaluation do not have many participants, but they seem to be large enough to speak about the necessity to try using empathic approach while working with patients and minimalizing the utilization of seclusion and restraint. In the article presented by Yang et al. (2014), the number of participants is not mentioned. Nevertheless, it is possible to state that it included nurses of the University of California, San Francisco.

Kontio et al. (2014) conducted their study at 3 Finish hospitals with 20 wards, using electronic education course for nurses. Nursing training at the urban psychiatric ward serving 500.000 inhabitants was provided by Guzman-Parra et al. (2016). All in all, about 30 participants are included in each study. The sample of Chang et al. (2014) consisted of 29 members of the administrative staff at an urban inpatient unit. Gerace et al. (2016) gathered 13 nurses and 13 patients. 40 patients in two mental clinical settings in Cape Town were included by Julie et al. (2014) while 30 mental hospital patients participated in the study of Kontio et al. (2012). Unlike other articles, the one written by Tingleff et al. (2017) presents a systematic literature review, and its sample includes 26 peer-reviewed studies.Seclusion and Physical Restraint in Psychiatry Essay


A Comparison of the Limitations of the Study

Of course, it is not possible to conduct a perfect study from the very beginning. Each research has particular limitations that can be overcome in the future with the help of follow-up studies. On the basis of the already discussed information, it can already be claimed that the main limitation that is common for the articles selected for literature evaluation is the sample size. Even though together they discuss a diverse population, separate studies do not have a large randomized sample that allows generalizing obtained conclusions and using them widely. In addition to that, there was a possibility of selection bias for those studies that included patients as the major participants. Due to their mental state, some individuals were intimidated by nurses, as they asked not to talk nonsense (Julie et al., 2014). Moreover, it is not clear if all patients managed to understand the purpose of the study due to their condition. Other studies failed to consider nurses’ initial skills before the received education and additional things that might have affected the rates, duration, and incidence of seclusion/restraint (Kontio et al., 2014; Guzman-Parra et al., 2016). Nevertheless, these limitations do not mean that the articles are not good enough to be used for the project.Seclusion and Physical Restraint in Psychiatry Essay

 Conclusion and Recommendations

It is interesting that in their conclusions, the authors of the selected articles managed to reach similar ideas. For instance, those professionals who discussed the influence of empathic nursing claimed that it benefits patients and allows reducing the need for restraint and seclusion. All in all, the authors of eight studies recommended implementing initiatives (such as training programs) needed to build and develop empathy skills. Moreover, they encouraged professionals to pay more attention to patients’ wishes.Seclusion and Physical Restraint in Psychiatry Essay


Chang, N. A., Grant, P. M., Luther, L., & Beck, A. T. (2014). Effects of a recovery-oriented cognitive therapy training program on inpatient staff attitudes and incidents of seclusion and restraint. Community Mental Health Journal, 50(4), 415-21. Web.

Gerace, A., Oster, C., Okane, D., Hayman, C. L., & Muir-Cochrane, E. (2016). Empathic processes during nurse-consumer conflict situations in psychiatric inpatient units: A qualitative study. International Journal of Mental Health Nursing, 1-14. Web.

Guzman-Parra, J., Aguilera Serrano, C., García-Sánchez, J. A., Pino-Benítez, I., Alba-Vallejo, M., Moreno-Küstner, B., & Mayoral-Cleries, F. (2016). Effectiveness of a multimodal intervention program for restraint prevention in an acute Spanish psychiatric ward. Journal of the American Psychiatric Nurses Association, 22 (3), 233–241. Web.

Julie, H., Van Wijk, E., & Traut, A. (2014). Environmental and nursing-staff factors contributing to aggressive and violent behaviour of patients in mental health facilities: Original research. Curationis, 37(1), 1-9. Web.Seclusion and Physical Restraint in Psychiatry Essay

Kontio, R., Joffe, G., Putkonen, H., Kuosmanen, L., Hane, K., Holi, M., & Välimäki, M. (2012). Seclusion and restraint in psychiatry: Patients’ experiences and practical suggestions on how to improve practices and use alternatives. Perspectives in Psychiatric Care, 48(1), 16-24. Web.

Kontio, R., Pitkänen, A., Joffe, G., Katajisto, J., & Välimäki, M. (2014). eLearning course may shorten the duration of mechanical restraint among psychiatric inpatients: A cluster-randomized trial. Nordic Journal of Psychiatry, 68(7), 443-449. Web.Seclusion and Physical Restraint in Psychiatry Essay

 Tingleff, E. B., Bradley, S. K., Gildberg, F. A., Munksgaard, G., & Hounsgaard, L. (2017). “Treat me with respect.” A systematic review and thematic analysis of psychiatric patients’ reported perceptions of the situations associated with the process of coercion. Journal of Psychiatric and Mental Health Nursing, 24(9-10), 681-698. Web.

Yang, C. P., Hargreaves, W. A., & Bostrom, A. (2014). Association of empathy of nursing staff with reduction of seclusion and restraint in psychiatric inpatient care. Psychiatric Services, 65(2), 251-254. Web. Seclusion and Physical Restraint in Psychiatry Essay

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