Influence of nursing staff attitudes and characteristics on the use of coercive measures in acute mental health services-A systematic review

4.1 Introduction<br/>The use of coercive measures generally has negative effects on patients. To help prevent its use, professionals need insight into what nurses believe about coercion and which staff determinants may influence its application. There is need for an integrated review on both attitude and influence of nurses on the use of coercion.<br/><br/>4.2 Aim<br/>To summarize literature concerning attitude of nurses towards coercive measures and the influence of staff characteristics on the use of coercive measures.<br/><br/>4.3 Method<br/>Systematic review.<br/><br/>4.4 Results<br/>The attitude of nurses changed during the last two decades from a therapeutic to a safety paradigm. Nurses currently view coercive measures as undesirable, but necessary to deal with aggression. Nurses express the need for less intrusive interventions, although familiarity probably influences its perceived intrusiveness. Literature on the relation between staff characteristics and coercive measures is inconclusive.<br/><br/>4.5 Discussion<br/>Nurses perceive coercive measures as unwanted but still necessary to maintain safety on psychiatric wards. Focussing on the determinants of perception of safety might be a promising direction for future research.<br/><br/>4.6 Implications for practice<br/>Mental health care could improve the focus on the constructs of perceived safety and familiarity with alternative interventions to protect patients from unnecessary use of coercive interventions.