ABSTRACT
Difficult and challenging behaviour by inpatients is a feature of acute psychiatric ward life. Different methods are used to contain these behaviours, and there is international variation in which are approved of or used. Previous research suggests that staff attitudes to patients may affect their willingness to use, or choice of, method. The aim of this study was to explore the relationship between approval of containment measures, perception of aggression and attitude to personality disorder. A survey of student psychiatric nurses was conducted, and using three attitudinal questionnaires related to aggression and containment. An association was found between positive attitude to patients and the approval of containment methods that involved nurses being in personal contact with patients. There was evidence that students' attitudes to patients deteriorated over time. The results highlighted the importance of (and linkage between) staffs' feelings of anger and fear towards patients, and their preparedness to use containment measures.
Subject(s)
Aggression , Attitude of Health Personnel , Personality Disorders/nursing , Psychiatric Nursing/methods , Safety Management/methods , Students, Nursing/psychology , Acute Disease , Aggression/psychology , Analysis of Variance , Anger , Clinical Competence , Factor Analysis, Statistical , Fear , Female , Humans , Hypnotics and Sedatives/therapeutic use , Male , Nurse-Patient Relations , Nursing Assessment/methods , Nursing Methodology Research , Patient Isolation/methods , Personality Disorders/psychology , Psychiatric Nursing/education , Restraint, Physical/methods , Self Efficacy , Surveys and Questionnaires , Time Factors , United KingdomABSTRACT
Acute mental disorder necessitating admission to hospital is often accompanied by disturbed behaviour that threatens the health of the person concerned or that of those around them. A range of containment methods are used by psychiatric professionals to keep patients and staff safe. These strategies are strongly emotive and attract strong moral valuations, yet differ sharply between countries. This paper reports a study to investigate the relationship between attitudes to these containment methods, and exposure to psychiatric education and practice. It was hypothesized that the culture of psychiatry in the study country would socialise students' views towards the locally dominant pattern of relative evaluations. Nine cohorts of student psychiatric nurses at different stages of their training at one UK University were asked to complete ratings on 11 containment methods. Containment methods fell into five groups, with mechanical restraint and net beds attracting the most severe disapproval. Neither the relative evaluation of methods, nor the intensity of those evaluations, changed systematically with duration of training. The findings support the interpretation that the relative evaluations of psychiatric containment methods are a property of wider national cultures, rather than an isolated tradition of professional psychiatric practice.
