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Seclusion and Restraint in Psychiatry: Patients' Experiences and Practical Suggestions on How to Improve Practices and Use Alternatives

2011; Wiley; Volume: 48; Issue: 1 Linguagem: Inglês

10.1111/j.1744-6163.2010.00301.x

1744-6163

Raija Kontio, Grigori Joffe, Hanna Putkonen, Lauri Kuosmanen, Kimmo Hane, Matti Holi, Maritta Välimäki,

Mental Health and Psychiatry

Perspectives in Psychiatric CareVolume 48, Issue 1 p. 16-24 Seclusion and Restraint in Psychiatry: Patients' Experiences and Practical Suggestions on How to Improve Practices and Use Alternatives Raija Kontio RN, MSN, Corresponding Author Raija Kontio RN, MSN Raija Kontio, RN, MSN, is a Doctoral Student and Assistant Chief, Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Grigori Joffe, MD, PhD, is the Psychiatrist-in-Chief, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital, Helsinki, Finland; Hanna Putkonen, MD, PhD, is a Senior Researcher, Vanha Vaasa Hospital, Vaasa, Finland; Lauri Kuosmanen, RN, PhD, is a Project Manager, University of Turku, Department of Nursing Science, Turku, Finland, and Primary Health Care Organisation of City of Vantaa, Vantaa, Finland; Kimmo Hane, RN, is a Masters of Science Nursing Student and Head Nurse, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Matti Holi, MD, PhD, is the Medical Director, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital/Peijas, Vantaa, Finland; and Maritta Välimäki, RN, PhD, is Professor and Director of Nursing, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Southwest Finland, Turku, Finland.Author contact:[email protected], with a copy to the Editor: [email protected]Search for more papers by this authorGrigori Joffe MD, PhD, Grigori Joffe MD, PhD Raija Kontio, RN, MSN, is a Doctoral Student and Assistant Chief, Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Grigori Joffe, MD, PhD, is the Psychiatrist-in-Chief, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital, Helsinki, Finland; Hanna Putkonen, MD, PhD, is a Senior Researcher, Vanha Vaasa Hospital, Vaasa, Finland; Lauri Kuosmanen, RN, PhD, is a Project Manager, University of Turku, Department of Nursing Science, Turku, Finland, and Primary Health Care Organisation of City of Vantaa, Vantaa, Finland; Kimmo Hane, RN, is a Masters of Science Nursing Student and Head Nurse, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Matti Holi, MD, PhD, is the Medical Director, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital/Peijas, Vantaa, Finland; and Maritta Välimäki, RN, PhD, is Professor and Director of Nursing, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Southwest Finland, Turku, Finland.Search for more papers by this authorHanna Putkonen MD, PhD, Hanna Putkonen MD, PhD Raija Kontio, RN, MSN, is a Doctoral Student and Assistant Chief, Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Grigori Joffe, MD, PhD, is the Psychiatrist-in-Chief, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital, Helsinki, Finland; Hanna Putkonen, MD, PhD, is a Senior Researcher, Vanha Vaasa Hospital, Vaasa, Finland; Lauri Kuosmanen, RN, PhD, is a Project Manager, University of Turku, Department of Nursing Science, Turku, Finland, and Primary Health Care Organisation of City of Vantaa, Vantaa, Finland; Kimmo Hane, RN, is a Masters of Science Nursing Student and Head Nurse, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Matti Holi, MD, PhD, is the Medical Director, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital/Peijas, Vantaa, Finland; and Maritta Välimäki, RN, PhD, is Professor and Director of Nursing, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Southwest Finland, Turku, Finland.Search for more papers by this authorLauri Kuosmanen RN, PhD, Lauri Kuosmanen RN, PhD Raija Kontio, RN, MSN, is a Doctoral Student and Assistant Chief, Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Grigori Joffe, MD, PhD, is the Psychiatrist-in-Chief, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital, Helsinki, Finland; Hanna Putkonen, MD, PhD, is a Senior Researcher, Vanha Vaasa Hospital, Vaasa, Finland; Lauri Kuosmanen, RN, PhD, is a Project Manager, University of Turku, Department of Nursing Science, Turku, Finland, and Primary Health Care Organisation of City of Vantaa, Vantaa, Finland; Kimmo Hane, RN, is a Masters of Science Nursing Student and Head Nurse, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Matti Holi, MD, PhD, is the Medical Director, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital/Peijas, Vantaa, Finland; and Maritta Välimäki, RN, PhD, is Professor and Director of Nursing, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Southwest Finland, Turku, Finland.Search for more papers by this authorKimmo Hane RN, Kimmo Hane RN Raija Kontio, RN, MSN, is a Doctoral Student and Assistant Chief, Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Grigori Joffe, MD, PhD, is the Psychiatrist-in-Chief, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital, Helsinki, Finland; Hanna Putkonen, MD, PhD, is a Senior Researcher, Vanha Vaasa Hospital, Vaasa, Finland; Lauri Kuosmanen, RN, PhD, is a Project Manager, University of Turku, Department of Nursing Science, Turku, Finland, and Primary Health Care Organisation of City of Vantaa, Vantaa, Finland; Kimmo Hane, RN, is a Masters of Science Nursing Student and Head Nurse, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Matti Holi, MD, PhD, is the Medical Director, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital/Peijas, Vantaa, Finland; and Maritta Välimäki, RN, PhD, is Professor and Director of Nursing, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Southwest Finland, Turku, Finland.Search for more papers by this authorMatti Holi MD, PhD, Matti Holi MD, PhD Raija Kontio, RN, MSN, is a Doctoral Student and Assistant Chief, Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Grigori Joffe, MD, PhD, is the Psychiatrist-in-Chief, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital, Helsinki, Finland; Hanna Putkonen, MD, PhD, is a Senior Researcher, Vanha Vaasa Hospital, Vaasa, Finland; Lauri Kuosmanen, RN, PhD, is a Project Manager, University of Turku, Department of Nursing Science, Turku, Finland, and Primary Health Care Organisation of City of Vantaa, Vantaa, Finland; Kimmo Hane, RN, is a Masters of Science Nursing Student and Head Nurse, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Matti Holi, MD, PhD, is the Medical Director, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital/Peijas, Vantaa, Finland; and Maritta Välimäki, RN, PhD, is Professor and Director of Nursing, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Southwest Finland, Turku, Finland.Search for more papers by this authorMaritta Välimäki RN, PhD, Maritta Välimäki RN, PhD Raija Kontio, RN, MSN, is a Doctoral Student and Assistant Chief, Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Grigori Joffe, MD, PhD, is the Psychiatrist-in-Chief, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital, Helsinki, Finland; Hanna Putkonen, MD, PhD, is a Senior Researcher, Vanha Vaasa Hospital, Vaasa, Finland; Lauri Kuosmanen, RN, PhD, is a Project Manager, University of Turku, Department of Nursing Science, Turku, Finland, and Primary Health Care Organisation of City of Vantaa, Vantaa, Finland; Kimmo Hane, RN, is a Masters of Science Nursing Student and Head Nurse, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Matti Holi, MD, PhD, is the Medical Director, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital/Peijas, Vantaa, Finland; and Maritta Välimäki, RN, PhD, is Professor and Director of Nursing, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Southwest Finland, Turku, Finland.Search for more papers by this author Raija Kontio RN, MSN, Corresponding Author Raija Kontio RN, MSN Raija Kontio, RN, MSN, is a Doctoral Student and Assistant Chief, Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Grigori Joffe, MD, PhD, is the Psychiatrist-in-Chief, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital, Helsinki, Finland; Hanna Putkonen, MD, PhD, is a Senior Researcher, Vanha Vaasa Hospital, Vaasa, Finland; Lauri Kuosmanen, RN, PhD, is a Project Manager, University of Turku, Department of Nursing Science, Turku, Finland, and Primary Health Care Organisation of City of Vantaa, Vantaa, Finland; Kimmo Hane, RN, is a Masters of Science Nursing Student and Head Nurse, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Matti Holi, MD, PhD, is the Medical Director, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital/Peijas, Vantaa, Finland; and Maritta Välimäki, RN, PhD, is Professor and Director of Nursing, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Southwest Finland, Turku, Finland.Author contact:[email protected], with a copy to the Editor: [email protected]Search for more papers by this authorGrigori Joffe MD, PhD, Grigori Joffe MD, PhD Raija Kontio, RN, MSN, is a Doctoral Student and Assistant Chief, Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Grigori Joffe, MD, PhD, is the Psychiatrist-in-Chief, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital, Helsinki, Finland; Hanna Putkonen, MD, PhD, is a Senior Researcher, Vanha Vaasa Hospital, Vaasa, Finland; Lauri Kuosmanen, RN, PhD, is a Project Manager, University of Turku, Department of Nursing Science, Turku, Finland, and Primary Health Care Organisation of City of Vantaa, Vantaa, Finland; Kimmo Hane, RN, is a Masters of Science Nursing Student and Head Nurse, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Matti Holi, MD, PhD, is the Medical Director, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital/Peijas, Vantaa, Finland; and Maritta Välimäki, RN, PhD, is Professor and Director of Nursing, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Southwest Finland, Turku, Finland.Search for more papers by this authorHanna Putkonen MD, PhD, Hanna Putkonen MD, PhD Raija Kontio, RN, MSN, is a Doctoral Student and Assistant Chief, Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Grigori Joffe, MD, PhD, is the Psychiatrist-in-Chief, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital, Helsinki, Finland; Hanna Putkonen, MD, PhD, is a Senior Researcher, Vanha Vaasa Hospital, Vaasa, Finland; Lauri Kuosmanen, RN, PhD, is a Project Manager, University of Turku, Department of Nursing Science, Turku, Finland, and Primary Health Care Organisation of City of Vantaa, Vantaa, Finland; Kimmo Hane, RN, is a Masters of Science Nursing Student and Head Nurse, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Matti Holi, MD, PhD, is the Medical Director, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital/Peijas, Vantaa, Finland; and Maritta Välimäki, RN, PhD, is Professor and Director of Nursing, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Southwest Finland, Turku, Finland.Search for more papers by this authorLauri Kuosmanen RN, PhD, Lauri Kuosmanen RN, PhD Raija Kontio, RN, MSN, is a Doctoral Student and Assistant Chief, Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Grigori Joffe, MD, PhD, is the Psychiatrist-in-Chief, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital, Helsinki, Finland; Hanna Putkonen, MD, PhD, is a Senior Researcher, Vanha Vaasa Hospital, Vaasa, Finland; Lauri Kuosmanen, RN, PhD, is a Project Manager, University of Turku, Department of Nursing Science, Turku, Finland, and Primary Health Care Organisation of City of Vantaa, Vantaa, Finland; Kimmo Hane, RN, is a Masters of Science Nursing Student and Head Nurse, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Matti Holi, MD, PhD, is the Medical Director, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital/Peijas, Vantaa, Finland; and Maritta Välimäki, RN, PhD, is Professor and Director of Nursing, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Southwest Finland, Turku, Finland.Search for more papers by this authorKimmo Hane RN, Kimmo Hane RN Raija Kontio, RN, MSN, is a Doctoral Student and Assistant Chief, Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Grigori Joffe, MD, PhD, is the Psychiatrist-in-Chief, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital, Helsinki, Finland; Hanna Putkonen, MD, PhD, is a Senior Researcher, Vanha Vaasa Hospital, Vaasa, Finland; Lauri Kuosmanen, RN, PhD, is a Project Manager, University of Turku, Department of Nursing Science, Turku, Finland, and Primary Health Care Organisation of City of Vantaa, Vantaa, Finland; Kimmo Hane, RN, is a Masters of Science Nursing Student and Head Nurse, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Matti Holi, MD, PhD, is the Medical Director, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital/Peijas, Vantaa, Finland; and Maritta Välimäki, RN, PhD, is Professor and Director of Nursing, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Southwest Finland, Turku, Finland.Search for more papers by this authorMatti Holi MD, PhD, Matti Holi MD, PhD Raija Kontio, RN, MSN, is a Doctoral Student and Assistant Chief, Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Grigori Joffe, MD, PhD, is the Psychiatrist-in-Chief, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital, Helsinki, Finland; Hanna Putkonen, MD, PhD, is a Senior Researcher, Vanha Vaasa Hospital, Vaasa, Finland; Lauri Kuosmanen, RN, PhD, is a Project Manager, University of Turku, Department of Nursing Science, Turku, Finland, and Primary Health Care Organisation of City of Vantaa, Vantaa, Finland; Kimmo Hane, RN, is a Masters of Science Nursing Student and Head Nurse, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Matti Holi, MD, PhD, is the Medical Director, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital/Peijas, Vantaa, Finland; and Maritta Välimäki, RN, PhD, is Professor and Director of Nursing, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Southwest Finland, Turku, Finland.Search for more papers by this authorMaritta Välimäki RN, PhD, Maritta Välimäki RN, PhD Raija Kontio, RN, MSN, is a Doctoral Student and Assistant Chief, Department of Psychiatry, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Grigori Joffe, MD, PhD, is the Psychiatrist-in-Chief, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital, Helsinki, Finland; Hanna Putkonen, MD, PhD, is a Senior Researcher, Vanha Vaasa Hospital, Vaasa, Finland; Lauri Kuosmanen, RN, PhD, is a Project Manager, University of Turku, Department of Nursing Science, Turku, Finland, and Primary Health Care Organisation of City of Vantaa, Vantaa, Finland; Kimmo Hane, RN, is a Masters of Science Nursing Student and Head Nurse, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland; Matti Holi, MD, PhD, is the Medical Director, Hospital District of Helsinki and Uusimaa, Helsinki University Central Hospital/Peijas, Vantaa, Finland; and Maritta Välimäki, RN, PhD, is Professor and Director of Nursing, University of Turku, Department of Nursing Science, Turku, Finland, and Hospital District of Southwest Finland, Turku, Finland.Search for more papers by this author First published: 16 February 2011 https://doi.org/10.1111/j.1744-6163.2010.00301.xCitations: 108Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract PURPOSE: This study explored psychiatric inpatients' experiences of, and their suggestions for, improvement of seclusion/restraint, and alternatives to their use in Finland. METHODS: The data were collected by focused interviews (n= 30) and were analyzed with inductive content analysis. RESULTS: Patients' perspectives received insufficient attention during seclusion/restraint processes. Improvements (e.g., humane treatment) and alternatives (e.g., empathetic patient–staff interaction) to seclusion/restraint, as suggested by the patients, focused on essential parts of nursing practice but have not been largely adopted. PRACTICE IMPLICATIONS: Patients' basic needs have to be met, and patient–staff interaction has to also continue during seclusion/restraint. Providing patients with meaningful activities, planning beforehand, documenting the patients' wishes, and making patient–staff agreements reduce the need for restrictions and offer alternatives for seclusion/restraint. Service users must be involved in all practical development. Citing Literature Volume48, Issue1January 2012Pages 16-24 RelatedInformation