Nurses' perceptions of nurse–patient communication in seclusion rooms in psychiatric inpatient care: A focus group study

J Berg, E Lipponen, E Sailas, P Soininen… - Journal of psychiatric …, 2023 - Wiley Online Library
J Berg, E Lipponen, E Sailas, P Soininen, J Varpula, M Välimäki, M Lahti
Journal of psychiatric and mental health nursing, 2023Wiley Online Library
Accessible Summary What is known on the subject? Communication between nurses and
patients is essential in mental health nursing. Lack of communication during seclusion
causes dissatisfaction among patients. Coercive practices can cause psychological
discomfort for patients and staff members. Research related to nurses' perceptions of nurse–
patient communication during seclusion events is scant. In Finland, the use of coercive
practices has been high despite efforts to reduce the need for coercive practices through the …
Accessible Summary
What is known on the subject
  • Communication between nurses and patients is essential in mental health nursing.
  • Lack of communication during seclusion causes dissatisfaction among patients.
  • Coercive practices can cause psychological discomfort for patients and staff members.
  • Research related to nurses' perceptions of nurse–patient communication during seclusion events is scant.
  • In Finland, the use of coercive practices has been high despite efforts to reduce the need for coercive practices through the National Mental Health Policy since 2009.
  • Nurse–patient communication is referred to in the Safewards model as one issue of delivering high‐quality care.
What this paper adds to existing knowledge
  • Nurses aim to achieve high‐quality communication while treating patients in seclusion.
  • Nurses aim to communicate in a way that is more patient‐centred.
  • Various issues affect the quality of communication, such as nurses' professional behaviour and patients' state of health.
What are the implications for practice
  • Improved communication between nurses and patients will support therapeutic relationships and could lead to a better quality of care.
  • Nurses' enhanced communication may promote the use of noncoercive practices more frequently in psychiatric settings.
  • Improving nurses' communication skills may help support the dignity and autonomy of secluded patients, resulting in patient experiences that are more positive in relation to care offered in seclusion.
  • Nurses should be offered opportunities to take part in further training after education to enhance communication skills for demanding care situations.
  • Further research that incorporates the perspectives of patients and those with lived experience of mental health problems is needed.
  • Components of evidence‐based Safewards practices, such as using respectful and individual communication (Soft Words), could be relevant when developing nurse–patient communication in seclusion events.
Abstract
Introduction
Communication between nurses and patients is essential in mental health nursing. In coercive situations (e.g. seclusion), the importance of nurse–patient communication is highlighted. However, research related to nurses' perceptions of nurse–patient communication during seclusion is scant.
Aim
The aim of this study was to describe nurses' perceptions of nurse–patient communication during patient seclusion and the ways nurse–patient communication can be improved.
Method
A qualitative study design using focus group interviews was adopted. Thirty‐two nurses working in psychiatric wards were recruited to participate. The data were analysed using inductive qualitative content analysis.
Results
Nurses aimed to communicate in a patient‐centred way in seclusion events, and various issues affected the quality of communication. Nurses recognized several ways to improve communication during seclusion.
Discussion
Treating patients in seclusion rooms presents highly demanding care situations for nurses. Seclusion events require nurses to have good communication skills to provide ethically sound care.
Conclusion
Improved nurse–patient communication may contribute to shorter seclusion times and a higher quality of care. Improving nurses' communication skills may help support the dignity of the secluded patients. Safewards practices, such as respectful communication and recognizing the effect of non‐verbal behaviour, could be considered when developing nurse–patient communication in seclusion events.
Relevance Statement
This study deepens the understanding of nurse–patient communication during seclusion events from the …
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