Influence of nursing staff attitudes and characteristics on the use of coercive measures in acute mental health services-A systematic review.
Influence of nursing staff attitudes and characteristics on the use of coercive measures in acute mental health services-A systematic review.
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DOI：
10.1111/jpm.12586
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发表时间：
2020-08
影响因子：
2.7
通讯作者：
de Haan L
中科院分区：
文献类型：
--
作者：
Doedens P;Vermeulen J;Boyette LL;Latour C;de Haan L
攻击性行为是精神保健临床实践中的一个主要问题，可能导致使用强制措施。强制性措施对精神病患者是危险的，国际精神卫生保健致力于消除这些干预措施。以往没有综述总结护理人员对强制措施的态度以及护理人员特征对态度和使用强制措施的影响。护士的态度从治疗范式（强制措施对患者有积极影响）转变为安全范式（强制措施是不可取的，但对病房的安全是必要的）。护士表示需要较少的强制性干预措施，以防止隔离和限制，但他们的侵入性的看法是如何经常使用具体的强制措施的影响。从科学文献的知识对强制措施的影响，护理人员是非常不确定的，虽然护士的安全感可能被证明是有前途的进一步研究。有必要特别增加对护士安全感的关注，以更好地装备护士，使其能够在急性精神健康病房开展困难的工作。使用强制措施通常会对病人产生负面影响。为了帮助防止其使用，专业人士需要深入了解护士对胁迫的看法以及哪些工作人员决定因素可能影响其应用。有必要对护士使用胁迫的态度和影响进行综合审查。总结有关护士对强制措施的态度以及工作人员特征对强制措施使用的影响的文献。系统评价。在过去的二十年里，护士的态度发生了变化，从治疗到安全的范式。护士目前认为强制措施是不可取的，但有必要处理侵略。护士表示需要较少的侵入性干预，虽然熟悉可能会影响其感知的侵入性。关于工作人员特征与强制措施之间关系的文献尚无定论。护士认为强制措施是不必要的，但仍然有必要保持精神科病房的安全。关注安全感知的决定因素可能是未来研究的一个有前途的方向。精神卫生保健可以提高对感知安全和熟悉替代干预措施的结构的关注，以保护患者免受不必要的强制性干预措施的使用。
Aggressive behaviour is a major problem in clinical practice of mental health care and can result in the use of coercive measures. Coercive measures are dangerous for psychiatric patients and international mental healthcare works on the elimination of these interventions. There is no previous review that summarizes the attitude of nursing staff towards coercive measures and the influence of nursing staff characteristics on attitude towards and the use of coercive measures. The attitude of nurses shifted from a therapeutic paradigm (coercive measures have positive effects on patients) to a safety paradigm (coercive measures are undesirable, but necessary for the wards’ safety). Nurses express the need for less coercive interventions to prevent seclusion and restraint, but their perception of intrusiveness is influenced by how often they use specific coercive measures. The knowledge from scientific literature on the influence of nursing staff on coercive measures is highly inconclusive, although the feeling of safety of nurses might prove to be promising for further research. There is need for increased attention specifically for the feeling of safety of nurses, to better equip nurses for their difficult work on acute mental health wards. The use of coercive measures generally has negative effects on patients. To help prevent its use, professionals need insight into what nurses believe about coercion and which staff determinants may influence its application. There is need for an integrated review on both attitude and influence of nurses on the use of coercion. To summarize literature concerning attitude of nurses towards coercive measures and the influence of staff characteristics on the use of coercive measures. Systematic review. The attitude of nurses changed during the last two decades from a therapeutic to a safety paradigm. Nurses currently view coercive measures as undesirable, but necessary to deal with aggression. Nurses express the need for less intrusive interventions, although familiarity probably influences its perceived intrusiveness. Literature on the relation between staff characteristics and coercive measures is inconclusive. Nurses perceive coercive measures as unwanted but still necessary to maintain safety on psychiatric wards. Focussing on the determinants of perception of safety might be a promising direction for future research. Mental health care could improve the focus on the constructs of perceived safety and familiarity with alternative interventions to protect patients from unnecessary use of coercive interventions.
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2.1
作者：
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