Experiences of Aggressive Behavior Patient after Physical Restraint in Mental Hospital, A Qualitative Study

Authors

  • Iyus Yosep
  • Ati Surya Mediawati
  • Ai Mardhiyah

DOI:

https://doi.org/10.33755/jkk.v8i2.361

Abstract

Aims. The prevalence of Violence in nurses and patients is an important issue today. One of the handlings of violent patients in mental hospitals is restraint. Restraint becomes a difficult choice for nurses in mental hospitals. This choice is still made with ethical considerations to prevent a worse risk. Restraints can violate patient rights. But if not done can threaten the environment. After physical restraint the patient has special experiences that need to be evaluated by the mental health nurse.

Purpose. The purpose of this study was to describe the experience of patients with physical violence after restraint at the Mental Hospital, West Java.

Methods. The informant selection technique used in this study was purposive sampling. The number of informants in this study was six patients. Patients were selected based on two inclusion criteria, first; have ever done physical violence, secondly, have experienced physical restraint. Patients have been selected by the head of the ward and approved by the nursing ethics board. Data was collected through focus group discussions (FGD). Data was recorded using an audiovisual camera. The discussion was conducted over three sessions, in three days, each for 60 minutes. The collected data is typed verbatim. The thematic analysis used in this study refer to six steps qualitative analysis.

Result. There are six themes that arise in the client's response to violent behavior during physical restraint. It includes ignoring the patient's basic needs, Feelings of anger and irritation, thinking that there is no perceived positive influence, controlling his behavior for fear of the next physical restraint, Surrender to the conditions experienced, Feelings of relief and joy after not undergoing physical restraint, there is a feeling of revenge and want to take revenge.

Conclusion. The patient's experience with physical violence after the act of restraint reveals the occurrence of neglect of basic human needs, the emergence of feelings of anger and irritation and thinking that restraint is of no benefit. After going through the angry phase, there is a sense of resignation to the patient and the informant's efforts to control his behavior for fear of getting physical restraint again. However, there is also a feeling of resentment that is triggered by the experience of being treated inhumanely.

 

References

Li Y-L, Li R-Q, Qiu D, Xiao S-Y. Prevalence of workplace physical violence against health care professionals by patients and visitors: a systematic review and meta-analysis. Int J Environ Res Public Health. 2020;17(1):299.

Subu MA, Holmes D, Elliot J. Stigmatisasi dan perilaku kekerasan pada orang dengan gangguan jiwa (ODGJ) di Indonesia. J Keperawatan Indones. 2016;19(3):191–9.

Yosep I, Hazmi H, Putit Z. Patient’s Experiences of Violence as Perpetrator: A Qualitative Study from Patients with Schizophrenia in Indonesia. Open Access Maced J Med Sci. 2022;10(G):58–63.

Yosep I, Mediani HS, Lindayani L, Sriati A. How patients with schizophrenia “as a Victim” cope with violence in Indonesia: a qualitative study. Egypt J Neurol Psychiatry Neurosurg. 2021;57(1):1–6.

Navarro LN, Osorio VL de L, Ortiz MFB, Liria AF. Salud mental y derechos humanos: La experiencia de los profesionales en formación en el uso de sujeciones mecánicas en Madrid, España. Salud Colect. 2021;17:e3045.

Cusack P, Cusack FP, McAndrew S, McKeown M, Duxbury J. An integrative review exploring the physical and psychological harm inherent in using restraint in mental health inpatient settings. Int J Ment Health Nurs. 2018;27(3):1162–76.

Clear SJ, Gardner AA, Webb HJ, Zimmer-Gembeck MJ. Common and distinct correlates of depression, anxiety, and aggression: Attachment and emotion regulation of sadness and anger. J Adult Dev. 2020;27(3):181–91.

Ulrich RS, Bogren L, Gardiner SK, Lundin S. Psychiatric ward design can reduce aggressive behavior. J Environ Psychol. 2018;57:53–66.

Ye J, Xiao A, Yu L, Wei H, Wang C, Luo T. Physical restraints: an ethical dilemma in mental health services in China. Int J Nurs Sci. 2018;5(1):68–71.

Crutchfield P, Gibb TS, Redinger MJ, Ferman D, Livingstone J. The conditions for ethical application of restraints. Chest. 2019;155(3):617–25.

Sashidharan SP, Mezzina R, Puras D. Reducing coercion in mental healthcare. Epidemiol Psychiatr Sci. 2019;28(6):605–12.

Sebastian J, Debnath S. Nursing management of patients with violent behaviour. Indian J Contin Nurs Educ. 2020;21(2):129.

Ling S, Cleverley K, Perivolaris A. Understanding mental health service user experiences of restraint through debriefing: a qualitative analysis. Can J Psychiatry. 2015;60(9):386–92.

Khatib A, Ibrahim M, Roe D. Re-building trust after physical restraint during involuntary psychiatric hospitalization. Arch Psychiatr Nurs. 2018;32(3):457–61.

Muir‐Cochrane E, O’Kane D, Oster C. Fear and blame in mental health nurses’ accounts of restrictive practices: Implications for the elimination of seclusion and restraint. Int J Ment Health Nurs. 2018;27(5):1511–21.

Geoffrion S, Goncalves J, Giguère C-É, Guay S. Impact of a program for the management of aggressive behaviors on seclusion and restraint use in two high-risk units of a mental health institute. Psychiatr Q. 2018;89(1):95–102.

Zheng C, Li S, Chen Y, Ye J, Xiao A, Xia Z, et al. Ethical consideration on use of seclusion in mental health services. Int J Nurs Sci. 2020;7(1):116–20.

Additional Files

Published

2022-04-30

How to Cite

Yosep, I. ., Mediawati, A. S. ., & Mardhiyah, A. . (2022). Experiences of Aggressive Behavior Patient after Physical Restraint in Mental Hospital, A Qualitative Study . Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal), 8(2). https://doi.org/10.33755/jkk.v8i2.361