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The psychiatric mental health nurse's ethical considerations regarding the use of coercive measures: a qualitative interview study
Psychiatric assessment unit, adult psychiatry, Region Skane, Helsingborg, Sweden.
Psychiatric psychosis unit, adult psychiatry, Region Skane, Helsingborg, Sweden.
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Regionhälsan, The Västra Götaland Competence Centre on Intimate Partner Violence, Gothenburg, Sweden.ORCID iD: 0000-0002-0228-1358
2023 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 22, no 1, article id 23Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In psychiatric inpatient care, situations arise where it may be necessary to use coercive measures and thereby restrict individual autonomy. The ethical principles of healthcare, i.e., respect for autonomy, beneficence, nonmaleficence, and justice, are recognized as central aspects in healthcare practice, and nurses must be clear about which ethical theories and principles to prioritize and what values are needed for a thorough ethical consideration. The aim of this study is to shed light on psychiatric mental health nurses' ethical considerations and on the factors influencing them when performing coercive measures.

METHODS: This qualitative interview study included twelve psychiatric mental health nurses with experience from psychiatric inpatient care. A content analysis was made. The interviews were audio recorded and transcribed verbatim, and categories were formulated.

RESULTS: The study revealed a duality that created two categories: Ethical considerations that promote the patient's autonomy and health and Obstacles to ethical considerations. Based on this duality, ethical considerations were made when performing coercive measures to alleviate suffering and promote health. The result shows a high level of ethical awareness in clinical work. However, a request emerged for more theoretical knowledge about ethical concepts that could be implemented among the staff.

CONCLUSION: The psychiatric mental health nurses in this study strive to do what is best for the patient, to respect the patient's autonomy as a guiding principle in all ethical considerations, and to avoid coercive measures. An organizational ethical awareness could increase the understanding of the difficult ethical considerations that nurses face with regard to minimizing the use of coercive measures in the long run.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023. Vol. 22, no 1, article id 23
Keywords [en]
Autonomy, Care, Coercive, Considerations, Ethical, Psychiatric mental health nurse
National Category
Nursing Psychiatry
Identifiers
URN: urn:nbn:se:mau:diva-58518DOI: 10.1186/s12912-023-01186-zISI: 000918436100001PubMedID: 36698105Scopus ID: 2-s2.0-85146769456OAI: oai:DiVA.org:mau-58518DiVA, id: diva2:1741098
Available from: 2023-03-03 Created: 2023-03-03 Last updated: 2024-02-05Bibliographically approved

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Sjöström, KarinÖrmon, Karin

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