Cross-sectional study on nurses' attitudes regarding coercive measures: The importance of socio-demographic characteristics, job satisfaction, and strategies for coping with stress

Abstract

Background: Coercive measures are containment methods used in psychiatry to curb patients' disruptive and aggressive behaviours towards themselves, others or objects. The prevalence of the practice of coercive measures in psychiatry is directly related to the attitudes of the staff. When discussing these attitudes, nurses are often particularly singled out. The purpose of the study is to research the impact of individual factors on nurses' attitudes in the decision-making process for the use of coercive measures. Methods: A cross-sectional study among all psychiatric nursing staff in Slovenia (n = 367, 79%) was conducted over the years 2013/2014. Standardized questionnaires were used, including a survey of nurses' attitudes to the use of seclusion, the Job Descriptive Index, and the Folkman-Lazarus test. Results: Nurses' attitudes towards special coercive measures are predominantly negative ( x = 11.312, SD = 2.641). The factors that explain a positive attitude are as follows: female gender (β = -0.236, p < 0.001), fewer years of service (β = -0.149, p = 0.023), emotion-focused strategies of coping with stress (β = 0.139, p = 0.020), and less-threatening patient behaviour (β = 0.157, p = 0.012). Conclusions: The effects of some known factors did not prove important in the model. Newly recognized factors are "less-threatening patient behaviour" and "emotion-focused strategies of coping with stress". Therefore, attitudes towards special coercive measures in psychiatry must be regarded as contextualized, interactive, and multidimensional phenomena that cannot be explained merely through a defined set of factors.