Post-incident Reviews after Restraints, – Potential and Pitfalls. Patients' experiences and considerations

Abstract

4.1 Introduction Post-incident reviews (PIRs), including patients, nurses and other care providers, following incidents of restraints are recommended in mental health services. Few studies have examined patients’ experiences and considerations concerning PIRs.

4.2 Aim The study aims to explore patients’ perspectives on PIRs in relation to how they experience participation in PIRs and further view PIRs’ potential for care improvement and restraint prevention.

4.3 Method We conducted a qualitative study based on individual interviews. Eight current and previous inpatients from two Norwegian mental health services were interviewed.

4.4 Results The patients experienced PIRs as variations on a continuum from being strengthened, developing new coping strategies and processing the restraint event to at the other end of the continuum; PIRs as meaningless, feeling objectified and longing for living communication and closeness.

4.5 Discussion PIRs’ beneficial potential is extended in the study. The findings highlight however that personal and institutional conditions influence whether patients experience PIRs as an arena for recovery promotion or PIRs as continuation of coercive contexts.

4.6 Implications for practice We recommend patients’ active participation in planning the PIR. PIRs should be conducted in a supportive atmosphere, including trusted persons, emphasizing and acknowledging a dialogical approach.