TY - JOUR

T1 - Patients’ experiences with physical holding and mechanical restraint in the psychiatric care

T2 - an interview study

AU - Lynge, Mads C.

AU - Dixen, Søren T.

AU - Johansen, Katrine S.

AU - Düring, Signe W.

AU - U.-Parnas, Annick

AU - Nordgaard, Julie

N1 - Publisher Copyright: © 2022 The Nordic Psychiatric Association.

PY - 2023

Y1 - 2023

N2 - Background: In the continuous work to reduce the use of coercion in psychiatric care, attention in Denmark has especially been directed towards mechanical restraint. While the use of mechanical restraint is currently decreasing, an increase in other types of coercion is observed (e.g. medication and hour-long episodes of physical holding). Physical holding has, in this cultural context, been considered less intrusive to a patient’s autonomy than the use of mechanical restraint. However, no study has yet compared the experiences of the patients on these two types of coercion in the same population. The objective of this study was to explore patients’ perspectives on physical holding and mechanical restraint, respectively. Methods: Audio-recorded, semi-structured interviews following an interview guide were conducted with patients sharing their experiences with both types of coercion. The interviews were transcribed verbatim. The analytical approach was based on the principles of thematic content analysis. Results: Nine informants were interviewed between September 2020 and April 2021. Four main themes were identified: experiences with physical holding, experiences with mechanical restraint, the effects of coercion on patients and their relation to mental health care, and improved mental health care. Conclusion: It is inconclusive which type of restraint the patients preferred. This challenges the present hierarchy of coercive measures. To avoid coercion in the first place more communication and time with the patient are needed.

AB - Background: In the continuous work to reduce the use of coercion in psychiatric care, attention in Denmark has especially been directed towards mechanical restraint. While the use of mechanical restraint is currently decreasing, an increase in other types of coercion is observed (e.g. medication and hour-long episodes of physical holding). Physical holding has, in this cultural context, been considered less intrusive to a patient’s autonomy than the use of mechanical restraint. However, no study has yet compared the experiences of the patients on these two types of coercion in the same population. The objective of this study was to explore patients’ perspectives on physical holding and mechanical restraint, respectively. Methods: Audio-recorded, semi-structured interviews following an interview guide were conducted with patients sharing their experiences with both types of coercion. The interviews were transcribed verbatim. The analytical approach was based on the principles of thematic content analysis. Results: Nine informants were interviewed between September 2020 and April 2021. Four main themes were identified: experiences with physical holding, experiences with mechanical restraint, the effects of coercion on patients and their relation to mental health care, and improved mental health care. Conclusion: It is inconclusive which type of restraint the patients preferred. This challenges the present hierarchy of coercive measures. To avoid coercion in the first place more communication and time with the patient are needed.

KW - Coercion

KW - mechanical restraint

KW - patient preference

KW - physical holding

U2 - 10.1080/08039488.2022.2087001

DO - 10.1080/08039488.2022.2087001

M3 - Journal article

C2 - 35732037

AN - SCOPUS:85132786085

VL - 77

SP - 247

EP - 255

JO - Nordisk Psykiatrisk Tidsskrift

JF - Nordisk Psykiatrisk Tidsskrift

SN - 0803-9496

IS - 3

ER -