TITLE

Post-incident treatment following coercive measures: a Delphi study

AUTHOR(S)
Grywa, Diana; Needham, Ian
PUB. DATE
January 2007
SOURCE
BMC Psychiatry;2007 Supplement 1, Vol. 7, Special section p1
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background Coercive measures may traumatize patients and may disturb their relationship to carers. To maintain a good therapeutic relationship and to help avoid future coercion carers should address the aftermath of coercion with the patients involved. Much variation exists regarding post-incident treatment and Swiss data show that only about 30% of patients receive such treatment. Thus, the study objective was to ascertain the possible content of post-incident treatment. Methods A Delphi study including 28 psychiatric professionals (nurses, psychologists, psychiatrists) was conducted. The major themes presented in the first round were: terminology, objectives, timing, content, necessity, contra-indications and exemption, carer responsibility, atmospheric aspects, recording, and general remarks. Results 22 (79%) of the surveyed institutions have no guidelines regarding post-incident treatment and in the hospitals with guidelines only 3 (50%) use them systematically. After three Delphi rounds a positive consensus was established on the following themes: Professionals view post-incident treatment as supportive and helpful in helping to cope with trauma, to promote the patient-carer relationship, and to help prevent future coercion. Trying to convince patients of the justification of the coercive measures or using the post-incident treatment to debrief personnel were consensually rejected. No consensus was established e.g. on the "right" time or the frequency for the post-incident treatment or on regarding possible re-traumatisation of patients as a contraindication for post-incident treatment. Conclusion Post-incident treatment is generally viewed as helpful although some details are difficult to regulate (timing, possible re-traumatisation). Minimal standards/guidelines could possibly motivate carers to increase the number of post-incident treatment. However, the expert opinion established on post-incident treatment must be subjected to empirical testing.
ACCESSION #
35704281

 

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