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1 – 10 of 12Jaana Asikainen, Katri Vehviläinen-Julkunen, Eila Repo-Tiihonen and Olavi Louheranta
Inpatient violence is a substantial problem in psychiatric wards and de-escalation is difficult. When managing instances of violence through verbal techniques fail, mental…
Abstract
Purpose
Inpatient violence is a substantial problem in psychiatric wards and de-escalation is difficult. When managing instances of violence through verbal techniques fail, mental health-care staff may use restrictive practices. The Six Core Strategies and debriefing exist for managing violence and restrictive practices in different mental health settings. Debriefing is used to get patients’ views on restrictive practices, ensure proper patient care and strengthen the role of patients as experts. This study aims to provide new information on debriefing implementation and how debriefing was used among different patient groups in a forensic hospital.
Design/methodology/approach
Quantitative seclusion time and debriefing reports (n = 524) were examined with Poisson regression analysis. Fisher’s exact test was used to determine the associations between debriefing and seclusion/restraint.
Findings
Debriefing (n = 524) was provided in 93% of violent episodes, which is an excellent result on an international level. There was significant variation in how often debriefing was used (p < 0.001) among different patient groups, i.e. dangerous, difficult-to-treat patients and criminal offenders whose sentences have been waived. Previous debriefing research has rarely specified what types of psychiatric patients have been subjected to seclusion or restraint.
Practical implications
The implementation of debriefing requires multiprofessional work within the organization and wards.
Originality/value
Debriefing seems to stimulate reflection at every level of a health-care organization, which fosters learning and can ultimately change clinical practices. The use of debriefing can strengthen the role of patients as well as professionals.
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Kuan-Yu Yueh and Wen-Jung Chang
This paper aims to explore the trends in academic research on elder abuse from 1990 to 2023 using bibliometric analysis. It seeks to identify research trends, hotspots and gaps…
Abstract
Purpose
This paper aims to explore the trends in academic research on elder abuse from 1990 to 2023 using bibliometric analysis. It seeks to identify research trends, hotspots and gaps and proposes future research directions.
Design/methodology/approach
Using bibliometric analysis method, this study analyzes 2,404 documents related to elder abuse from the Scopus database. Visual analysis is conducted using VOSviewer software to reveal research trends, thematic clusters and their interrelationships.
Findings
The study shows a rising concern for elder abuse, especially in nursing homes, domestic settings and among dementia patients. However, research on prevention and intervention measures is lacking, despite increasing international collaboration. Yet, deeper exploration of cross-cultural and regional differences remains limited.
Practical implications
This study reveals that improving care conditions for nursing home residents and dementia patients requires increased funding, professional training for caregivers, the strengthening of regulations and the establishment of clear guidelines for reporting abuse. Additionally, promoting international cooperation, sharing best practices, raising public awareness and supporting ongoing research are essential measures to ensure the safety and dignity of older adults.
Originality/value
To the best of the authors’ knowledge, this study represents the first systematic review of elder abuse research using bibliometric analysis, providing researchers and policymakers with a comprehensive knowledge framework of the field’s development trends and research hotspots.
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Lisa Maria Beethoven Steene, Lisa Gaylor and Jane L. Ireland
The current review aims to focus on how risk and protective factors for self-harm in secure mental health hospitals are captured in the literature.
Abstract
Purpose
The current review aims to focus on how risk and protective factors for self-harm in secure mental health hospitals are captured in the literature.
Design/methodology/approach
Fifty-seven articles were included in a systematic review, drawn from an initial 1,119 articles, post duplicate removal. Databases included Psycinfo, Psycarticles, Psycnet, Web of Science and EBSCO host. A thematic analysis was used, which included a meta-ethnographic approach for considering qualitative papers.
Findings
There was a clear focus on risk factors, with eight identified (in order of occurrence): raised emotional reactivity and poor emotion regulation; poor mental health; traumatic experiences; personality disorder diagnosis and associated traits; increased use of outward aggression – dual harm; constraints of a secure environment and lack of control; previous self-harm and suicide attempts; and hopelessness. Protective factors featured less, resulting in only three themes emerging (in order of occurrence): positive social support and communication; positive coping skills; and hope/positive outlook.
Research limitations/implications
This includes a proposal to move focus away from “risk” factors, to incorporate “needs”, in terms of individual and environmental factors. There is also a need for more attention to focus on developing high quality research in this area.
Originality/value
The research captures an area where a synthesis of research has not been comprehensively undertaken, particularly with regards to capturing protective as well as risk factors.
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Ann-Marie Bright, Agnes Higgins and Annmarie Grealish
There has been a move towards the implementation of digital/e-health interventions for some time. Digital/e-health interventions have demonstrable efficacy in increasing…
Abstract
Purpose
There has been a move towards the implementation of digital/e-health interventions for some time. Digital/e-health interventions have demonstrable efficacy in increasing individual empowerment, providing timely access to psychological interventions for those experiencing mental ill-health and improving outcomes for those using them. This study aims to determine the efficacy of digital/e-health interventions for individuals detained in prison who experience mental ill-health.
Design/methodology/approach
A systematic search of five academic databases – CINAHL, ASSIA, PsycINFO, Embase and Medline – was completed in December 2020 and updated in February 2022. The review was guided by the Whittemore and Knafl (2005) framework for integrative reviews. A total of 6,255 studies were returned and screened by title and abstract. A full-text screening of nine (n = 9) studies was conducted.
Findings
No study met the inclusion criteria for the clinical efficacy of digital/e-health interventions in a prison setting. Subsequently, a review of the literature that made it to the full-text review stage was conducted, and gaps in the literature were identified to inform policy, practice and future research.
Originality/value
To the best of the authors’ knowledge, this is the first integrative review conducted on the efficacy of digital/e-health interventions for mental ill-health in prison settings.
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Miisa Törölä and Mika Rautanen
Globally, health problems are very common among prisoners. A mental state examination aims to help in recognising psychiatric problems among offenders and the possible association…
Abstract
Purpose
Globally, health problems are very common among prisoners. A mental state examination aims to help in recognising psychiatric problems among offenders and the possible association of these psychiatric issues with their committed crime. The legal-medical term “reduced criminal responsibility” refers to a weakened sense of reality and the ability to control one’s behaviour because of compromised mental health and without an evaluated need for forensic psychiatric hospitalisation. However, little is known about the actual need for the health care of prisoners with reduced criminal responsibility (PRCR). The purpose of this study was to explore treatment-related visits to prison by PRCR in Finland.
Design/methodology/approach
The research data comprise information on PRCR’s treatment-related visits and that of a matched control group (n = 222). Descriptive cross-tabulation with X²- and nonparametric Mann–Whitney U-tests and Cox regression analyses are applied.
Findings
The results show that almost every PRCR had at least one treatment-related visit during their sentences. Visits to a psychiatric hospital for prisoners, to the prison hospital and especially to a civil hospital are more common among PRCR. The need for treatment appears significantly earlier in their sentences.
Originality/value
These findings demonstrate the PRCR’s greater need for access to health services and the need for further development between the Health Care Services for Prisoners, Prison and Probation Service of Finland and public health and social services in Finland. More exploration of the medical reasons and locational distribution of the vast amount of civil hospitalisation is needed.
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Antaine Stíobhairt, David Staunton and Suzanne Guerin
This paper aims to explore the extent to which principles of recovery-oriented practice are evident in the published perspectives and experiences of health professionals and…
Abstract
Purpose
This paper aims to explore the extent to which principles of recovery-oriented practice are evident in the published perspectives and experiences of health professionals and service users on seclusion in adult mental health services.
Design/methodology/approach
A systematic review informed by PRISMA guidelines was conducted, drawing from four databases, which were searched in August 2018 and August 2022. Only original empirical studies rated as having “major” relevance were included. Data were extracted from 31 studies and qualitatively synthesised through deductive analysis using recovery principles as themes.
Findings
There was limited evidence of perceptions of seclusion being being consistent with recovery principles, with greater evidence of perceptions that directly opposed them. Studies of service user perspectives highlighted this more often than staff perspectives. The findings highlight paradoxical relationships between care and control and conflicting rights and emphasise the need to openly acknowledge the complexity of seclusion and its interface with recovery.
Research limitations/implications
This review was developed in line with international best practice and the protocol was registered. Using a search string with only three components maximised sensitivity during searches and minimised the risk of relevant literature being missed. Limitations include the focus on studies where the full text was published in English.
Originality/value
This review makes a unique contribution, highlighting that, to the best of the authors’ knowledge, no studies to date have explicitly explored the perspectives and experiences of staff and service users on the use of seclusion in the context of recovery-oriented practice. The findings are relevant to clinical practice, policy and future research, including amending procedures and practices to partially reconcile seclusion and recovery where the seclusion is deemed necessary.
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Gill Thomson, Rose Mortimer, Michelle Baybutt and Karen Whittaker
This paper reports on insights from an evaluation of Birth Companions (BC) (a UK-based charity) perinatal support in two prison settings in England. The initiative involved the…
Abstract
Purpose
This paper reports on insights from an evaluation of Birth Companions (BC) (a UK-based charity) perinatal support in two prison settings in England. The initiative involved the provision of group and/or one-to-one perinatal support and training women prisoners as peer supporters.
Design/methodology/approach
A mixed-methods study was undertaken that involved observations of support groups and peer support supervision sessions (n = 9); audio recorded interviews (n = 33) with prison and health-care staff, women in prison, peer supporters and BC staff; analysis of existing routinely collected data by BC and notes undertaken during regular meetings (n = 10) with the BC Project Manager. Thematic analysis was undertaken supported by MAXQDA qualitative data analysis software.
Findings
BC provided instrumental/practical support, emotional support, information support, signposting to services and advocating for women to the prison concerning their perinatal needs and rights. Key themes revealed that support had an impact on the lives of perinatal women by creating a safe place characterised by meaningful interactions and women-centred approaches that facilitated access to wider care and support. The service made a difference by empowering women and providing added value for peer supporters, prison, health-care and BC staff. Key enablers and strategies for the care of perinatal women and the delivery of perinatal support are also detailed.
Originality/value
Through longitudinal data and the involvement of a range of stakeholders, this study evidences the subtleties of support provided by BC and the potential it has to make a difference to perinatal women in prison and those volunteering or working within the prison system.
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