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. 2024 Oct;33(5):1407-1417.
doi: 10.1111/inm.13341. Epub 2024 Apr 23.

The attitudes of nurses towards seclusion: A New Zealand in-patient mental health setting

Carly Pohatu  1 , Tai Kake  1
Affiliations

The attitudes of nurses towards seclusion: A New Zealand in-patient mental health setting

Carly Pohatu et al. Int J Ment Health Nurs. 2024 Oct.

Abstract

Seclusion is a form of restraint practised in mental health services world-wide, and has been criticised as unethical and traumatising to patients. Several countries have committed to reducing or eliminating seclusion. In New Zealand, there has been a focus on reducing seclusion of the indigenous Māori population, who experience particularly high rates. Nurses typically lead decisions to place patients in seclusion and their attitudes towards seclusion likely influence this process. This study aimed to address the primary question: what are the attitudes of registered nurses towards the use of seclusion? A mixed methods pragmatic approach was used involving qualitative interviews of nurses working in a high seclusion mental health ward located in the North Island of New Zealand, and a quantitative analysis of the seclusion data from this ward. This report is adherent with COREQ and STROBE. Thirteen nurses were interviewed and four main themes were identified: seclusion is necessary; seclusion is being used unnecessarily; nurse characteristics influence the use of seclusion; nurses perceived their ward culture to be improving in the use of seclusion. However, analysis of seclusion data indicated that rates had been increasing for this ward prior to this study, and the rates for indigenous Māori patients were especially elevated. This pattern of increasing rates was congruent with the 'supportive' attitudes of nurses towards seclusion. Interestingly, during the time of this study, the seclusion rates began to decline, including for Māori patients. This decline may have been partially due to the increased awareness prompted by the study.

Keywords: New Zealand; mental health; registered nurses; restraint; service.

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References

REFERENCES

    1. Boumans, C.E., Egger, I.M., Bouts, R.A. & Hutshemaekers, G.J.M. (2015) Seclusion and the importance of contextual factors: an innovation project revisited. International Journal of Law and Psychiatry, 41, 1–11. Available from: https://doi.org/10.1016/j.ijlp.2015.03.001
    1. Braun, V. & Clarke, V. (2006) Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. Available from: https://doi.org/10.1191/1478088706qp063oa
    1. Drown, C., Harding, T. & Marshall, R. (2018) Nurse perceptions of the use of seclusion in mental health inpatient facilities: have attitudes to Māori changed? The Journal of Mental Health Training, Education and Practice, 13(2), 100–111. Available from: https://doi.org/10.1108/JMHTEP‐12‐2016‐0055
    1. Ezeobele, I.E., Malecha, A.T., Mock, A., Mackey‐Godine, A. & Hughes, M. (2014) Patients' lived seclusion experience in acute psychiatric hospital in the United States: a qualitative study. Journal of Psychiatric and Mental Health Nursing, 21(4), 303–312. Available from: https://doi.org/10.1111/jpm.12097
    1. Fisher, W.A. (1994) Restraint and seclusion: a review of the literature. The American Journal of Psychiatry, 151(11), 1584–1591. Available from: https://doi.org/10.1176/ajp.151.11.1584

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