Patients' lived seclusion experience in acute psychiatric hospital in the United States: a qualitative study

J Psychiatr Ment Health Nurs. 2014 May;21(4):303-12. doi: 10.1111/jpm.12097. Epub 2013 Jul 3.

Abstract

The findings revealed that the patients perceived seclusion as an intervention that is punitive and a means used by the staff to exert control. Patients perceived that staff incitements and lack of communication skills led to their being secluded. The findings provided recommendations and strategies for seclusion reduction that were based on the patients' first-hand seclusion experiences. This phenomenological study used Husserlian's philosophy to explore and describe the lived experiences of psychiatric patients who were secluded at a free-standing acute care hospital located in South-western United States (US). The study is crucial because very few studies have been conducted in this area in the US. The study examined a purposive sample of 20 patients, 3 days post-seclusion. Data were generated through face-to-face, semi-structured interviews incorporating open-ended questions and probes to facilitate discussion until saturation was reached. Interviews were transcribed verbatim and data analysed using Colaizzi's seven steps method. Results were described according to the themes and subthemes identified. Findings uncovered four themes: (1) alone in the world; (2) staff exert power and control; (3) resentment towards staff; and (4) time for meditation. The findings from this study illuminated the views surrounding patients' seclusion experience. It provided first-hand information on the patients' seclusion experience that might be helpful to the mental health professionals in the seclusion reduction process.

Keywords: acute hospital; alternative interventions; mental health; phenomenology; seclusion and restraint.

MeSH terms

  • Adult
  • Female
  • Hospitals, Psychiatric / standards*
  • Humans
  • Inpatients / psychology*
  • Male
  • Middle Aged
  • Patient Isolation / psychology*
  • Patient Isolation / standards
  • Professional-Patient Relations*
  • Qualitative Research
  • United States
  • Young Adult