Pediatric psychiatric inpatients' perspectives of aggression management: Discernment in the doorway

Graham McCaffrey RN, BA, PhD, Melissa Adrian RN, MN
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Abstract

Problem

Aggressive behavior is common on psychiatric inpatient units. Seclusion and restraint interventions to manage patients' aggressive behavior may have the consequence of being traumatizing for patients. Pediatric psychiatric patients' perspective on the use of seclusion and restraint interventions is not present in the literature.

Methods

This hermeneutic nursing research study asked the question, “How might we understand children's experiences of seclusion and restraints on an inpatient psychiatric unit?” Four past pediatric psychiatric inpatients shared their hospitalization experiences that occurred within the previous year when they were 10 years old. The texts of the research interviews were compared to Attachment Theory for a deeper understanding of the meaning of the message.

Findings

Participants commonly described experiences with seclusion and restraints as feeling trapped and alone in a dark room. They recommended the nurses step into the room with them to help them heal. Interpretively, the rooms on inpatient units could be considered as actual and metaphorical spaces of possible harm or healing.

Conclusion

The participant's voices expand understanding of nurse's use of discernment at the doorway of a patient room to ensure the most therapeutic care is provided to the patient in these spaces through a secure nurse–patient relationship.

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儿科精神病住院患者对攻击管理的看法:门口的辨别。
问题:攻击行为在精神病住院病房很常见。为控制病人的攻击性行为而采取的隔离和约束干预措施可能会给病人造成心理创伤。儿科精神病患者对使用隔离和约束干预措施的看法在文献中并不存在:这项诠释学护理研究提出的问题是:"我们如何理解儿童在精神科住院病房使用隔离和约束措施的经历?四名过去的儿科精神病住院患者分享了他们在去年 10 岁时的住院经历。我们将研究访谈的文本与依恋理论进行了比较,以加深对信息含义的理解:参与者普遍将隔离和束缚的经历描述为在黑暗的房间里感到被困和孤独。他们建议护士与他们一起进入房间,帮助他们治愈。从解释的角度来看,住院部的房间可以被视为可能造成伤害或治愈的实际和隐喻空间:参与者的声音扩展了对护士在病房门口使用辨别力的理解,以确保通过安全的护患关系在这些空间为患者提供最具治疗性的护理。
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来源期刊
CiteScore
2.90
自引率
6.70%
发文量
41
期刊介绍: Journal of Child and Adolescent Psychiatric Nursing (JCAPN) is the only nursing journal to focus exclusively on issues of child and adolescent mental health around the world. As a primary resource for nurses and other healthcare professionals in clinical practice, educator roles, and those conducting research in mental health and psychiatric care, the journal includes peer-reviewed, original articles from a wide range of contributors in a broad variety of settings.
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