Nursing care process for releasing psychiatric inpatients from long-term seclusion in Japan: modified grounded theory approach

Nurs Health Sci. 2014 Sep;16(3):284-90. doi: 10.1111/nhs.12094. Epub 2013 Oct 31.

Abstract

Based on a modified grounded theory approach, in this study, we sought to elucidate the nursing care process used to guide psychiatric inpatients in long-term seclusion towards release from seclusion. Participant observations and interviews were conducted with a total of 18 nurses from three long-term psychiatric wards at two institutions from September 2011 to November 2012, to collect data on the nursing care they provided for psychiatric patients in long-term seclusion. Consequently, four categories and 15 concepts were extracted. The nurses viewed "a mature therapeutic environment that utilizes flexible apportionment of care" as the foundation (i.e. the core category) in guiding psychiatric inpatients towards release from long-term seclusion. The results revealed a care structure in which nurses in such a treatment environment provided care by flexible apportionment of three types of care: care aimed at avoiding mental and physical exhaustion, standardized care that does not confer a disadvantage to patients, and immediately responding to prevent problematic behaviors.

Keywords: long-term psychiatric ward; modified grounded theory approach; psychiatric nurse; schizophrenia; seclusion.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adaptation, Psychological
  • Clinical Competence / statistics & numerical data
  • Female
  • Grounded Theory
  • Hospitals, Psychiatric
  • Humans
  • Inpatients*
  • Interviews as Topic
  • Japan
  • Length of Stay / statistics & numerical data
  • Long-Term Care / methods*
  • Long-Term Care / statistics & numerical data
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / nursing*
  • Nurse-Patient Relations*
  • Nursing Care / methods*
  • Observation
  • Patient Discharge / standards*
  • Psychiatric Aides / classification
  • Psychiatric Aides / standards
  • Psychiatric Nursing / methods
  • Psychiatric Nursing / standards