Peter Sandy
University of South Africa, South Africa
Title: The use of seclusion in secure forensic environments: an investigation of factors influencing nurses’ attitudes.
Biography
Biography: Peter Sandy
Abstract
Background: Secure forensic mental health services always need interventions to manage aggressive and violent behaviours. Seclusion is one of a number of interventions used for managing these behaviours in these settings. Service users experiences with seclusion are mainly negative with feelings of punishment and threat being the most commonly reported reactions. Some nurses regard seclusion as antitherapeutic, while others consider it an effective intervention. Despite these discrepancies, nurses continue to support the practice of seclusion.
Objective: To investigate factors that might influence attitudes of nurses working in a secure forensic mental health setting toward the use of seclusion.
Methods: This study utilised an analytic cross-sectional survey design to investigate and explain associations between the use of seclusion and attitudes toward it. Data were collected between October and December of 2014 using a self-administered questionnaire: staff attitudes toward seclusion. Eighty-eight nurses (N=88) completed the questionnaires. The data were analysed using descriptive statistics (percentages and frequency distributions) and inferential statistics, specifically spearman’s rank correlation coefficients, chi square and mann-whitney tests.
Results: The reasons for the use of seclusion noted in this study were consistent with Mason’s (1993) treatment, containment and punishment framework. The study revealed several significant but mostly negative associations between attitudes of nurses toward the use of seclusion and factors, such as age, sex, post, experience, and registered practice. Positive and significant associations were also found between attitude variables and grades or rank of nurses.
Conclusion: These findings of this study offer insight into nurses’ attitudes toward the use of seclusion. They may serve as a useful resource for the development of guidelines, policies and training programme for enhancing positive attitudes toward seclusion.