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Patients’ lived seclusion experience in acute psychiatric hospital in the United States: a qualitative study

Authors

  • I. E. Ezeobele PhD,

    Senior Nurse Manager, Corresponding author
    1. UTHealth- The University of Texas Health Science Center at Houston Harris County Psychiatric Center, Houston, TX, USA
    • Correspondence:

      I. E. Ezeobele

      Harris County Psychiatric Center

      University of Texas

      2800 South MacGregor Way

      Houston

      TX 77021

      USA

      E-mail: ifeomaezeobele@yahoo.com

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  • A. T. Malecha PhD,

    Professor
    1. College of Nursing, Texas Woman's University, Houston, TX, USA
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  • A. Mock MSN,

    Senior Nurse Manager
    1. UTHealth- The University of Texas Health Science Center at Houston Harris County Psychiatric Center, Houston, TX, USA
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  • A. Mackey-Godine M.Ed,

    Associate Director of Nursing
    1. UTHealth- The University of Texas Health Science Center at Houston Harris County Psychiatric Center, Houston, TX, USA
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  • M. Hughes BS

    Staff Nurse
    1. UTHealth- The University of Texas Health Science Center at Houston Harris County Psychiatric Center, Houston, TX, USA
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Abstract

Accessible summary

  • The findings revealed that the patients perceived seclusion as an intervention that is punitive and a means used by the staff to exert control.
  • Patients perceived that staff incitements and lack of communication skills led to their being secluded.
  • The findings provided recommendations and strategies for seclusion reduction that were based on the patients’ first-hand seclusion experiences.

Abstract

This phenomenological study used Husserlian's philosophy to explore and describe the lived experiences of psychiatric patients who were secluded at a free-standing acute care hospital located in South-western United States (US). The study is crucial because very few studies have been conducted in this area in the US. The study examined a purposive sample of 20 patients, 3 days post-seclusion. Data were generated through face-to-face, semi-structured interviews incorporating open-ended questions and probes to facilitate discussion until saturation was reached. Interviews were transcribed verbatim and data analysed using Colaizzi's seven steps method. Results were described according to the themes and subthemes identified. Findings uncovered four themes: (1) alone in the world; (2) staff exert power and control; (3) resentment towards staff; and (4) time for meditation. The findings from this study illuminated the views surrounding patients’ seclusion experience. It provided first-hand information on the patients’ seclusion experience that might be helpful to the mental health professionals in the seclusion reduction process.

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