dc.contributor.author | Haugom, Espen Woldsengen | |
dc.contributor.author | Ruud, Torleif | |
dc.contributor.author | Hynnekleiv, Torfinn | |
dc.coverage.spatial | Norway | en_US |
dc.date.accessioned | 2020-05-13T13:29:30Z | |
dc.date.available | 2020-05-13T13:29:30Z | |
dc.date.created | 2019-11-25T09:45:09Z | |
dc.date.issued | 2019 | |
dc.identifier.citation | BMC Health Services Research. 2019, 19 (879), . | en_US |
dc.identifier.issn | 1472-6963 | |
dc.identifier.uri | https://hdl.handle.net/11250/2654300 | |
dc.description.abstract | Abstract 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 | en_US |
dc.description.sponsorship | 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. | en_US |
dc.language.iso | eng | en_US |
dc.relation.uri | https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4727-4 | |
dc.rights | Navngivelse 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/deed.no | * |
dc.subject | Coercion; | en_US |
dc.subject | Ethics; | en_US |
dc.subject | Health professionals/mental health staff; | en_US |
dc.subject | Mental health services; | en_US |
dc.subject | Open-area seclusion; | en_US |
dc.subject | Seclusion; | en_US |
dc.subject | Shielding | en_US |
dc.title | Ethical challenges of seclusion in psychiatric inpatient wards: a qualitative study of the experiences of Norwegian mental health professionals | en_US |
dc.type | Peer reviewed | en_US |
dc.type | Journal article | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. | en_US |
dc.source.pagenumber | 12 | en_US |
dc.source.volume | 19 | en_US |
dc.source.journal | BMC Health Services Research | en_US |
dc.source.issue | 879 | en_US |
dc.identifier.doi | 10.1186/s12913-019-4727-4 | |
dc.identifier.cristin | 1751656 | |
cristin.unitcode | 1991,9,0,0 | |
cristin.unitname | Div Psykisk helsevern | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 2 | |