Jesper Bak skrev masterafhandlingen

"Tvangsfiksering i psykiatrien - Patienters oplevelser"

med undertitlen

"Patienters forslag til en nedsættelse af antallet af tvangsfikseringer på Sct. Hans Hospital" 

Master of Public Health. Københavns Universitet 2004. Udgivelse nr. 130

Den engelske titel er  "Physical Restraint in Psychiatry – Patients’ Experiences. Patients’ Suggestions to Physical Restraint Minimisation at Sct. Hans Hospital"

Lånt på Statsbiblioteket

69 sider:

Forord

1. Introduktion
2. Materiale og metoder
3. Godkendelse og etik
4. Analyse
5. Diskussion
6. Konklusion
7. Perspektivering
8. Resumé
9. Abstract
10. Litteratur
11. Bilagsoversigt
12. Tabel- og firguroversigt

Abstract:

Background: Physical restraint of psychiatric patients is a major restriction in the liberty of the subject. Our inability to solve this problem causes a negative response in the public opinion towards the psychiatric speciality. In 2002 nearly 2000 persons were physically restrained in Denmark. Physical restraint is carried out according to legislation and this means that the patient is tied to the bed with leather strips around the waist and sometimes also tied on hands and feet. Even though the society is characterised by such concepts as individualism and autonomy, patient’s view to solution of the problem is rarely addressed. Objective: The objective of this study was to investigate which changes could be done to minimise or eliminate the use of physical restraint and hereby also minimising the negative emotional impact. Material and method: This issue is addressed through qualitative, semi-structured interviews of 10 psychiatric patients at SHH. All respondents had experienced time in physical restraint within 14 days prior to the interview. The interviews were conducted from April through June 2004. The sampling was theoretical and the method of analysis was grounded theory, as described by Strauss and Corbin (1998). Main results: All changes proposed by the patients could be described as learning activities in the context described by Illeris (2003) in his theory of learning. Among the learning activities the patients described were: Conditions serving the purpose of minimising the psychotic experiences, the use of drugs and alcohol, conflict management, management of emotional intelligence, management of negative aggressive actions, the relationship to the staff members, acceptance of rules, norms and conditions (house rules), safety (prevention of injuries and discomfort), joint influence, presence of the staff, physical conditions during the physical restraint and debriefing. To discover which learning activities are of current interest to the patients, the staff members, the unit, the department, the hospital and the society, the “cyclic process model of intervention analysis of physical restraints” was developed. The model describes the conditions that always will be present in the physical restraint sequence: Causes, feelings, actions and frameworks. These factors are interrelated in a matter of cause and effect and at the same time chronologically interrelated. Conclusions: There are not one or a few interventions that can eliminate the use of physical restraint. The conditions that encapsulate physical restraint are multifaceted. If you want to minimise the use of physical restraint in-dept analysis is required regarding the patient, the staff member, the unit, the department, the hospital and the society’s capacity and ability to handle conditions that surround the phenomenon (causes, feelings, actions and frameworks)."

Kilde: http://mph.ku.dk/uddannelsen/master/afhandlinger/afhandlinger/130._Bak__Jesper.pdf