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Cited by 127Healthcare Decision-Making and RestraintsPsychiatric care and mental health servicesElectroconvulsive Therapy Studies

“Treat me with respect”. A systematic review and thematic analysis of psychiatric patients’ reported perceptions of the situations associated with the process of coercion

Tingleff, E. B., Bradley, S. K., Gildberg, F. A., Munksgaard, G., Hounsgaard, L.·2017·Journal of Psychiatric and Mental Health Nursing
DOI 10.1111/jpm.12410
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Abstract

Accessible summary: What is known on the subject?: Psychiatric patients have generally negative experiences of being exposed to coercive measures. Existing research has generally not investigated coercion as a process; that is, it does not address issues that arise before, during and after exposure to coercion. A part of existing research within the area does not clarify and define the type of coercive measure(s) investigated. What this paper adds to existing knowledge?: Patients place great significance on the link between the positive and negative perceived impact of a coercive situation and the professionals’ ability and willingness to interact and communicate respectfully. Psychiatric patients associate the use of seclusion, physical restraint/holding, mechanical restraint and forced medication with strong negative perceptions and wish to be treated with respect by professionals, rather than being subjected to the professionals’ control. What patients perceive as moderating factors in regard to the use of coercive measures is currently under‐researched. What are the implications for practice?: Increased sensitivity to the patient's views of the situation at each point in the coercive process would help professionals to respond to the patients’ individual needs. Professionals need to articulate concern and empathy towards patients and to improve communication skills before, during and after a coercive incident. Greater emphasis should be placed on de‐escalation and the use of non‐coercive strategies or coping skills before the initiation of coercive measures. Introduction: There is a lack of research into psychiatric patients’ perceptions of coercion that discriminates between different types of coercive measures, while also investigating patients’ perceptions of undergoing coercion as a process. This knowledge is required to improve our understanding and provide a foundation for improving clinical practice. Aims: To review existing research literature in order to investigate adult psychiatric patients’ reported perceptions of situations before, during and after specific and defined types of coercive measures, and to investigate what patients perceive as moderating factors, in regard to the use of these coercive measures. Method: A systematic review and thematic analysis of 26 peer‐reviewed studies was undertaken. Results: The analysis identified six themes and additional subthemes, where “interactions with professionals” and “communication” were predominant themes across the timeline of coercion. Altogether, themes were associated with either “positive or negative patient‐perceived impact.” Implications for practice: Increased sensitivity to patients’ views of the situation at each point in the process is desirable in order to respond to the patients’ individual needs. Professionals also need to articulate concern and empathy towards the patient and to improve communication skills before, during and after a coercive incident. Use of de‐escalation and noncoercive strategies is required. Relevance statement: Coercion within psychiatric/mental health care remains controversial, and repeated international calls have recommended a reduction of their use. This review indicates that greater attention to how patients perceive the use of coercive measures (before, during, and after incidents) needs to be considered in order to improve the evidence‐based and clinical practice.

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Crossref · 10.1111/jpm.12410

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Authors
Tingleff, E. B., Bradley, S. K., Gildberg, F. A., Munksgaard, G., & Hounsgaard, L.
Affiliations
  • University of Southern Denmark (DK)
  • University College Cork (IE)
  • Ilisimatusarfik (GL)
Corresponding author
Tingleff, E. B.
ORCID
Venue
Journal of Psychiatric and Mental Health Nursing
Publisher
Wiley
Published
2017-09-12
Volume
24
Issue
9-10
Pages
681-698
ISSN
  • 1351-0126 (ISSN-L)
  • 1365-2850
DOI
10.1111/jpm.12410
OpenAlex
W2733636319
Cited by
127
References
95
Citations by year
2026: 11 · 2025: 20 · 2024: 16 · 2023: 24 · 2022: 16 · 2021: 10 · 2020: 13 · 2019: 12 · 2018: 5
FWCI
1.25
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Psychiatric and Mental Health Nursing (publishedVersion)
  • PubMed (publishedVersion)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
Funders
  • The Psychiatric Research Fund in the Region of Southern Denmark (R24-A1156)
  • The Novo Nordisk Foundation (NNF150C0016748)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Keywords
coercive measures, seclusion, physical restraint, mechanical restraint, forced medication, patient-professional communication, de-escalation, respect for patients, patient experience, mental health services, patient rights, patient safety
MeSH terms
Coercion, Humans, Inpatients, Patient Isolation, Professional-Patient Relations, Restraint, Physical, Persons with Psychiatric Disorders, Mentally Ill Persons

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