Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 2;11(21):2890.
doi: 10.3390/healthcare11212890.

'Fleeing' as a Strategy for Navigating Resistance in Patient Encounters within Forensic Care

Lars Hammarström  1 , Ove Hellzén  1 , Siri Andreassen Devik  2
Affiliations

'Fleeing' as a Strategy for Navigating Resistance in Patient Encounters within Forensic Care

Lars Hammarström et al. Healthcare (Basel). .

Abstract

The aim of this study was to describe the phenomenon of "fleeing the encounter when facing resistance" as experienced by carers working in forensic inpatient care. Qualitative analysis, namely reflective lifeworld research, was used to analyze data from open-ended questions with nine carers from a Swedish regional forensic clinic. The data revealed three meaning constituents that describe the phenomenon: shielding oneself from coming to harm or harming the other, finding one's emotional balance or being exposed, and offering the patient emotional space and finding patience. The carers described their approaches in the encounters with the patients as alternating between primitive instincts and expectant empathy in order to gain control and deal with the interaction for their own part, for that of the patient, and for that of their colleagues. The phenomenon of fleeing the encounter when facing resistance was intertwined with carers' self-perception as professional carers. Negative encounters with patients evoked feelings of shame and self-blame. A carer is a key person tasked with shaping the care relationship, which requires an attitude on the part of the carer that recognizes not only the patient's lifeworld but also their own.

Keywords: emotional regulation; forensic psychiatry; nurse–patient interactions; reflective lifeworld research.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Similar articles

See all similar articles

Cited by

References

    1. Seppänen A., Törmänen I., Shaw C., Kennedy H. Modern forensic psychiatric hospital design: Clinical, legal and structural aspects. Int. J. Ment. Health Syst. 2018;12:58. doi: 10.1186/s13033-018-0238-7. - DOI - PMC - PubMed
    1. Bowers L. Safewards: A new model of conflict and containment on psychiatric wards. J. Psychiatr. Ment. Health Nurs. 2014;21:499–508. doi: 10.1111/jpm.12129. - DOI - PMC - PubMed
    1. Socialstyrelsen . Säkerhet vid psykiatrisk tvångsvård och rättspsykiatrisk vård och rättspsykiatrisk undersökningsverksamhet—Handbok med information och vägledning för tillämpning av Socialstyrelsens föreskrifter om säkerhet vid sjukvårdsinrättningar som ger psykiatrisk tvångsvård och rättspsykiatrisk vård samt vid enheter för rättspsykiatrisk undersökningsverksamhet (Safety in Compulsory Psychiatric Care Forensic Psychiatric Care and Forensic Psychiatric Examination Activities—Handbook with Information and Guidance for the Application of the National Board of Health and Welfare’s Regulations on Safety at Health Care Institutions That Provide Compulsory Psychiatric Care and Forensic Psychiatric Care and at Units for Forensic Psychiatric Examination Activities) The National Board of Health and Welfare; Stockholm, Sweden: 2007. [(accessed on 30 August 2023)]. SOSFS 2006:9; Artikelnr: 2007-101-4. Available online: https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelk.... (In Swedish)
    1. Gudde C.B., Olsø T.M., Whittington R., Vatne S. Service users’ experiences and views of aggressive situations in mental health care: A systematic review and thematic synthesis of qualitative studies. J. Multidiscip. Healthc. 2015;8:449–462. doi: 10.2147/JMDH.S89486. - DOI - PMC - PubMed
    1. Swedish Municipalities and County Councils Vårdens innehåll i rättspsykiatrin—Kartläggning 2017 (Content of Care in Forensic Psychiatry—Mapping 2017) 2018. [(accessed on 30 August 2023)]. Available online: https://www.uppdragpsykiskhalsa.se/wp-content/uploads/2018/04/V%C3%A5rde.... (In Swedish)