scholarly journals Ethical challenges of seclusion in psychiatric inpatient wards: a qualitative study of the experiences of Norwegian mental health professionals

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Espen W. Haugom ◽  
Torleif Ruud ◽  
Torfinn Hynnekleiv
Keyword(s):  
Mental Health Professionals ◽  
Qualitative Content Analysis ◽  
Psychiatric Inpatient ◽  
Clinical Intervention ◽  
Ethical Challenges ◽  
Milieu Therapy ◽  
Single Room ◽  
Written Descriptions ◽  
Closed Door ◽  
Ethical Reflections

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.

Intensive care nurses’ experiences of Covid-19 care: A practical and ethical challenge – a qualitative descriptive design

2021 ◽  
pp. 205715852110627
Author(s):  
Anna-Lena Stenlund ◽  
Gunilla Strandberg
Keyword(s):  
Intensive Care ◽  
Qualitative Content Analysis ◽  
Treatment Strategies ◽  
Ethical Challenge ◽  
Ethical Challenges ◽  
Structured Interviews ◽  
Intensive Care Nurses ◽  
Qualitative Descriptive ◽  
Heavy Burden ◽  
New Treatment

The Covid-19 pandemic has generated new experiences of intensive care. It has entailed new working methods, treatment strategies, and ethical dilemmas. The aim of this study was to describe intensive care nurses’ experiences of Covid-19 care and its ethical challenges. Data collection consisted of 11 individual semi-structured interviews and a qualitative content analysis was used. The COREQ checklist was followed. Three main themes emerged: to meet Covid-19 patients’ needs for specifically tailored intensive care; to have a changed approach to the excluded relatives is unethical, but defensible; and to strive to protect ethical values needs to be considered as good enough. In conclusion, ICU nurses shouldered a heavy burden in taking responsibility for the safety of these patients, continuously learning about new treatment strategies. Caring for Covid-19 patients was to strive to make the best of the situation.

scholarly journals Different forms of informal coercion in psychiatry – a qualitative study

2019 ◽  
Author(s):  
Veikko Pelto-Piri ◽  
Lars Kjellin ◽  
Ulrika Hylén ◽  
Emanuele Valenti ◽  
Stefan Priebe
Keyword(s):  
Mental Health ◽  
Content Analysis ◽  
Focus Group ◽  
Qualitative Study ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Qualitative Content Analysis ◽  
Focus Group Interviews ◽  
Informal Coercion ◽  
Group Interviews

Abstract Objectives The objective of the study was to investigate how mental health professionals describe and reflect upon different forms of informal coercion. Results In a deductive qualitative content analysis of focus group interviews, several examples of persuasion, interpersonal leverage, inducements, and threats were found. Persuasion was sometimes described as being more like a negotiation. Some participants worried about that the use of interpersonal leverage and inducements risked to pass into blackmail in some situations. In a following inductive analysis, three more categories of informal coercion was found: cheating, using a disciplinary style and referring to rules and routines. Participants also described situations of coercion from other stakeholders: relatives and other authorities than psychiatry. The results indicate that informal coercion includes forms that are not obviously arranged in a hierarchy, and that its use is complex with a variety of pathways between different forms before treatment is accepted by the patient or compulsion is imposed.

scholarly journals The Psychological Impact of Covid-19 on University Students: Their Expectations of Mental Health Professionals

2021 ◽  
Vol 8 (4) ◽  
pp. 1-20
Author(s):  
M.Siyabend KAYA ◽  
Yavuz KOŞAN
Keyword(s):  
Mental Health ◽  
University Students ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Psychosocial Support ◽  
Qualitative Content Analysis ◽  
Psychological Impact ◽  
Depression And Anxiety ◽  
Structured Interviews ◽  
Main Effects

The current study focused on exploring the psychological impact of the COVID -19 outbreak on university students and participants' expectations of mental health professionals. Semi-structured interviews were conducted with 80 university students aged 18 to 33 years from 19 cities in Turkey. Qualitative content analysis was used to identify important aspects of the students' experiences. According to the results, the main effects of the epidemic COVID -19 on the participants were depression and anxiety. We found that participants used various ways to cope with COVID -19 such as reading books and paying attention to hygiene. Participants also indicated that they perceived some positive situations, such as the value of nature and humanity, the importance of family, and various negative situations, such as mental exhaustion. Finally, participants stressed that they had different expectations regarding psychosocial support and the planning of individual activities by mental health professionals

Indonesian clinical psychologists’ perceptions of complementary and alternative medicine research and knowledge: a content analysis study

2019 ◽  
Vol 14 (3) ◽  
pp. 164-173 ◽  
Author(s):  
Andrian Liem
Keyword(s):  
Mental Health ◽  
Content Analysis ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Qualitative Content Analysis ◽  
Clinical Psychologists ◽  
Content Type ◽  
Complementary And Alternative

Purpose As part of a nationwide research about knowledge, attitude, experiences and educational needs towards complementary and alternative medicine (CAM) among Indonesian clinical psychologists (CPs), the purpose of this paper is to explore CPs’ perceptions of CAM research and their interest in learning CAM. Design/methodology/approach A link to an online survey was e-mailed to all 1,045 CPs across Indonesia. At the end of the survey, two open-ended questions were asked: “What do you think about CAM research in Indonesia?” and “Why are you interested in learning about CAM?”, which were responded to by 127 participants (87 per cent of females; Mage=36.67, SD=9.02). Participants’ responses were analysed using inductive qualitative content analysis. Findings It was found that two global themes for CPs’ perceptions of CAM were to improve participants’ professionalism and as part of continuing education and development for mental health professionals. The favourable responses in this study may reflect participants’ willingness to be involved in collaborative CAM research and education. Moreover, CAM was perceived as part of Indonesian culture and participants viewed CAM research and knowledge as a chance to promote Indonesian local wisdom to complement conventional psychotherapy. Research limitations/implications These findings might call for stakeholders to integrate CAM knowledge into psychology education, facilitate CAM research in psychology settings and encourage collaborative CAM research. However, self-selection bias may limit the findings of this study. Originality/value This study explored perceptions of CAM research and interest in learning CAM that have rarely been investigated among mental health professionals and particularly, until now, have not been investigated in Indonesia.

Knowledge of Patients’ Voting Rights Amongst Mental Health Professionals Working in The London Borough of Westminster During The 2015 Uk General Election

2016 ◽  
Vol 33 (S1) ◽  
pp. S450-S450
Author(s):  
T. MacLaren ◽  
J. Townell ◽  
S. Shanmugham ◽  
V. Argent ◽  
L. De Ridder ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Social Inclusion ◽  
Psychiatric Inpatient ◽  
Voting Rights ◽  
General Election ◽  
Staff Members ◽  
Inpatient Settings

IntroductionBeing able to participate in elections and to vote are important components of social inclusion; empowering people with mental illness to have a voice.It is important that mental health professionals understand the voting rights of adults with mental illness in order to be able to provide appropriate advice and support.ObjectivesTo explore knowledge of the voting rights of adults living with mental illness amongst mental health professionals working in both community and inpatient settings in Westminster, London.AimsTo understand the level of knowledge amongst mental health professionals regarding the voting rights of patients with mental illness in order to identify unmet training needs.MethodsA survey, in the form of a staff quiz was undertaken in all community and inpatient teams prior to the May 2015 general election. All multidisciplinary team members were included.Resultsin total, 211 surveys were completed. Ninety-eight percent of staff correctly identified that being a psychiatric inpatient does not change an individual's right to vote. Less than 50% of the staff members demonstrated correct understanding of the rights of patients detained under forensic sections, and the rights of the homeless to vote.ConclusionsIt is encouraging that knowledge of voting rights amongst staff appeared higher in our survey than in some published surveys. However, despite the development of a Trust Voting Rights Policy and Educational Film prior to the 2015 general election further staff education, particularly the rights of those detained under forensic sections or who are homeless, is required.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Clinical intervention to address violent radicalization: The Quebec model

2021 ◽  
pp. 153-168
Author(s):  
Cécile Rousseau ◽  
Christian Savard ◽  
Anna Bonnel ◽  
Richard Horne ◽  
Anousheh Machouf ◽  
...  
Keyword(s):  
Psychological Factors ◽  
Clinical Intervention ◽  
Social Suffering ◽  
Ethical Challenges ◽  
Clinical Model ◽  
Psychosocial Services ◽  
Intervention Models ◽  
Political Interests ◽  
Significant Public Health ◽  
Severe Psychopathology

Radicalization to violence is a world social phenomenon that is related to mental health in multiple ways, not only because psychological factors and psychopathology are determinants of violent radicalization, but also because psychological distress, grief, and trauma are significant public health consequences of this form of violence. The complexity of violent radicalization manifestations and its increasing association with severe psychopathology in lone actors suggests that there is an important role for clinicians to play in supporting and complementing the work of frontline psychosocial services, as well as contributing to the transdisciplinary network needed to develop effective intervention models. However, given the risks of medicalizing forms of social suffering and of being co-opted by ideologically driven political interests, this professional involvement cannot take place without continuous ethical reflection and systemic evaluation. This chapter will describe the clinical model of intervention developed in Quebec (Canada), and discuss some of the organizational, clinical, and ethical challenges encountered.

Becoming a Voluntary Doula: Personal and Caring Motives

2018 ◽  
Vol 8 (2) ◽  
pp. 101-114
Author(s):  
Terese Bondas ◽  
Anita Wikberg
Keyword(s):  
Public Health ◽  
Health Care ◽  
Content Analysis ◽  
Qualitative Content Analysis ◽  
Public Health Care ◽  
Public Health Care System ◽  
Midwifery Care ◽  
The Public ◽  
Primary Focus ◽  
Ethical Reflections

Background:Voluntary doula care, as a complement to midwifery care, is emerging as support for women and their families throughout the childbearing period. Doula care is not an official part of the public health care system in Nordic countries.Aim:The aim was to describe and interpret women’s experiences of becoming voluntary unpaid doulas and to generate a model as part of a research program.Method:Latent qualitative content analysis was chosen using interviews with nine voluntary doulas in an NGO group in Finland.Findings:Becoming a voluntary doula seems to be related to two motives, personal and caring. Interest in and fascination with childbearing, doula care as rewarding and joyous but challenging work, and networking and affinity in the doula group are personal motives. The caring motives were seeing doula care as important for the childbearing woman and her partner, being humble about childbearing knowledge, understanding vulnerability and uniqueness in childbearing based on their own experiences, and seeing doula care as a complement to midwifery care.Conclusion:A model has been created suggesting that the balance between the two motives might be crucial for doula care. Ethical reflections on the motives for becoming and being a doula need to be supported in a caring culture where the primary focus is the best care for the woman and her partner in childbearing.

Ethical problems in practice as experienced by Malawian student nurses

2011 ◽  
Vol 19 (1) ◽  
pp. 128-138 ◽  
Author(s):  
Eva Merethe Solum ◽  
Veronica Mary Maluwa ◽  
Elisabeth Severinsson
Keyword(s):  
Clinical Practice ◽  
Role Models ◽  
Qualitative Content Analysis ◽  
Student Nurses ◽  
Patient Rights ◽  
Moral Awareness ◽  
Ethical Challenges ◽  
Pedagogical Strategies ◽  
Ethical Problems ◽  
Course Of Action

Student nurses are confronted by many ethical challenges in clinical practice. The aim of the study was to explore Malawian students’ experiences of ethical problems during their clinical placement. A phenomenological hermeneutic design comprising interviews and qualitative content analysis was used. Ten students were interviewed. Three main themes emerged: 1) Conflict between patient rights and the guardians’ presence in the hospital; 2) Conflict between violation of professional values and patient rights caused by unethical behaviour; and 3) Conflict between moral awareness and the ideal course of action. The students had difficulties ensuring patient rights and acting in accordance with western norms and values which are not always appropriate in the Malawian context. The students require role models who demonstrate professional attitudes towards patients’ rights and values. There is a need to create pedagogical strategies in which a caring attitude and ethical reflection can be learned and cultivated in clinical practice.

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