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Factors influencing decisions of mental health professionals to release service users from seclusion: A qualitative study.

Abstract：

AIM:This study aims to explore and understand factors influencing the decisions of mental health professionals releasing service users from seclusion. BACKGROUND:Seclusion should only be used as a last resort and for the minimum possible duration. Current evidence outlines which service users are more likely to be secluded, why and what influences professionals' decision to seclude. Little is known about factors professionals consider when releasing service users. DESIGN:A qualitative study was undertaken to explore factors which influence decision-making of mental health professionals when terminating episodes of seclusion. METHODS:Semi-structured face-to-face interviews with 21 professionals were undertaken between May 2017-January 2018. Framework analysis was used to systematically manage, analyse, and identify themes, while maintaining links to primary data and providing a transparent audit trail. RESULTS:Six themes were identified where professionals looked for service users to demonstrate cooperation and compliance before they would be released. Decisions were subjective, being influenced by the experience and composition of the review team, the availability of resources plus the emotional tone and physical environment of the ward. Release could be delayed by policy and protocol. CONCLUSION:Professionals should have greater awareness of factors that hinder or facilitate decisions to release service from seclusion and an understanding of how service user views and involves in decisions regarding seclusion should be explored. IMPACT:Senior staff should be available to facilitate release at the earliest opportunity. Staff should ensure that policy and procedures do not prolong the time service users remain secluded. :目的: 本研究旨在于探讨并理解影响心理健康专业人员决定让服务用户脱离隔离状态的因素。背景: 隔离仅应作为最后的手段,并且尽可能在最短的时间内使用。现有迹象大致显现了哪些服务用户更可能被隔离,为什么隔离以及影响专业人员决定隔离的因素。专业人士在释放服务用户时很少考虑影响因素。设计: 本项定性研究探讨响心理健康专业人员终止隔离决策的因素。方法: 2017年5月至2018年1月,对21名专业人士进行了半结构式面对面访谈。框架分析方法用于系统管理、分析和确定主题,同时保持与原始数据的联系并进行透明的审计追踪。结果: 确定了6大主题,专业人士希望服务用户在得到释放之前进行配合并且服从指挥。决策具有主观性,受审查小组的经验和构成、资源的可用性、情绪基调以及病房的物理环境的影响。释放时间可能会因为政策和医疗方案而延迟。结论: 专业人士应提高对将服务用户从隔离状态中释放出来的决策起到阻碍或推动作用因素的认识,并了解如何探讨服务用户看待和参与有关隔离的决策。影响: 应安排高级工作人员尽早获释。工作人员应确保政策和程序不会延长服务使用者的隔离时间。.

journal_name

J Adv Nurs

journal_title

Journal of advanced nursing

authors

Jackson H,Baker J,Berzins K

doi

10.1111/jan.14086

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

2178-2188

issue

eissn

0309-2402

issn

1365-2648

journal_volume

pub_type

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Factors influencing decisions of mental health professionals to release service users from seclusion: A qualitative study.