Experiences of restrictive practices in inpatient psychiatric services: Staff and patient perspectives

Despite the increasing regulation of their use, restrictive interventions continue to be used in psychiatric inpatient services, including secure services. The literature asserts such practices cause distress to all involved. This thesis informs an in-depth understanding of the experiences of both the nursing staff and patients involved in incidents of restrictive practice, concluding with the author’s reflections on the research process. Chapter I: Chapter one offers a meta-ethnographical review of the qualitative literature exploring nurses’ experiences of restrictive interventions in inpatient psychiatric services. Following a systematic search of the literature, 11 studies were included for review and the quality of each was assessed. The review generated three meta-themes, including ‘The Conflicted Nurse’, ‘The Distressed Nurse’ and ‘The Surviving Nurse’, reflecting nurses’ journeys before, during and after incidents of restrictive practice. The clinical implications of the findings, along with future directions for research are discussed. Chapter II: Chapter two reflects an empirical piece of qualitative research. Using interpretative phenomenological analysis, patients’ lived experiences of restrictive interventions in a forensic, inpatient service were explored. Three superordinate themes emerged, including ‘Powerlessness’, ‘A Sense of Injustice’ and ‘A Sense of Resignation’. The clinical implications of the findings, along with future directions for research are discussed. Chapter III: Chapter three offers a reflective account of the author’s experiences of the research process. Specifically, it explores the reason that the author chose to study restrictive practices, followed by reflections on the recruitment and interview stages of the research, and the conflicts experienced between the researcher and clinician roles