Nurses’ and Patients’ Perceptions of Nursing Care Provision during the Initial Phase of Involuntary Admission to an Emergency Psychiatric Hospital

Abstract

Aim: This study aimed to reveal nurses’ and patients’ perceptions of nursing care provision during the initial phase of involuntary admission to an emergency psychiatric hospital.

Methods: Nursing staff and patients were interviewed based on the authors’ observation at the time of involuntary admission. Data were qualitatively analyzed according to the qualitative synthesis method (KJ method).

Results: Five nurses and five patients were interviewed. The nurses’ perceptions were divided into nine categories, and had a conflicted logical structure; for example “trying to remove the risk of violence,” and the other hand “making efforts to care according to patients’ wishes in cases of involuntary admission.” Patients’ perceptions were divided into six categories, had a conflicted logical structure; for example “anger and resignation to the irrational way of compulsory admissions” and the other hand “involvement from patient position that lead to treatment acceptance.”

Conclusions: These results indicate that both nurses’ and patients’ perceptions were conflicted with regard to two aspects of implementing compulsory treatment and supporting patients’ autonomy. Involuntary treatment might make patients perceive coercion even when the treatment is required. However, this study suggests that supporting patients’ autonomy may allow treatment to be performed safely and may also reduce patients’ perceived coercion. Therefore, patient autonomy needs to be considered from the initial phase of involuntary admission.