Nursing model for minimizing coercive measures: shared decision making with psychiatric patients in seclusion room

2022 Fiscal Year Final Research Report

• Project/Area Number: 17K17519
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Gerontological nursing
• Research Institution: Kanazawa Medical University
• Principal Investigator: NAGAYAMA Yutaka 金沢医科大学, 看護学部, 准教授 (10636062)
• Project Period (FY): 2017-04-01 – 2023-03-31
• Keywords: 共同意思決定 / 行動制限最小化

Outline of Final Research Achievements

The purpose of this study is to clarify the collaborative decision-making process of psychiatric nurses to minimize coercive measures for psychiatric inpatients who are secluded or physically restrained in a seclusion room. 17 psychiatric nurses were interviewed and analyzed using a modified grounded theory approach. As a result, because it was difficult to predict changes in the patient's mental state, nurses tried to detect sensitive reactions to trigger stimuli and performed "negotiation of boundaries of self-care". Then, nurses carried out joint measures to prevent worsening of mental symptoms and joint confirmation of anxiety factors during open observation, and performed coordination for goal achievement with patients.

Free Research Field

精神看護学

Academic Significance and Societal Importance of the Research Achievements

精神科病院で保護室を長期使用したり、入退室を繰り返す精神疾患患者に対して、行動制限最小化に向けて、看護師が患者と共同関係を構築するための戦略的な看護実践のプロセスが抽出された。本研究で作成した共同意思決定プロセスに関する理論を臨床現場の複雑な状況に応用し、患者の個別性に合わせて看護実践を展開することにより、患者の自律性・セルフケアが向上し、行動制限最小化に寄与する可能性がある。