Citation

Tully S, Bucci S, Berry K. J. Psychiatr. Ment. Health Nurs. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, John Wiley and Sons)

DOI

10.1111/jpm.12855

PMID

35771190

Abstract

INTRODUCTION: Inpatient care often involves restrictive interventions such as seclusion and restraint and restrictive practices that limit the person's freedom, rights, and daily activities. Restrictive practice has not been the explicit focus in previous research however, it often appears as an important theme, with participants identifying it can have a detrimental effect on their wellbeing. More research specifically on this topic in an inpatient setting is therefore needed. Women might be particularly vulnerable to adverse effects of restrictive practices compared to men as women generally occupy less powerful positions in society and more often experience abuse. AIMS: The study aimed to explore women's experiences of routine restrictive practices in mental health inpatient settings.

METHODS: Twenty-two women who were currently inpatients on mental health wards were interviewed about their experiences of restrictive practices in hospital. Interviews were analysed using thematic analysis.

RESULTS: An overarching theme emerged of powerlessness. Four key subthemes were also identified: restrictions perceived as punitive, having no voice, impact of restrictions on relationships, and restrictions providing safety and support.

DISCUSSION: Although restrictive practices were found to provide the women with a sense of safety, they were also found to impact upon the women's well-being, leading to increases in self-harm and over-reliance on restrictions.

IMPLICATIONS FOR PRACTICE: This research highlights the importance of gender-informed inpatient services for women that foster independence, empowerment and allow women to have their voices heard. Safewards interventions such as clear mutual expectations and soft words could contribute to mitigating the impact of restrictive practices.

Language: en

Keywords

Women; qualitative; inpatients; restrictive practice; thematic analysis