4.1 IntroductionThe 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.4.2 AimTo summarize literature concerning attitude of nurses towards coercive measures and the influence of staff characteristics on the use of coercive measures.4.3 MethodSystematic review.4.4 ResultsThe 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.4.5 DiscussionNurses 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.4.6 Implications for practiceMental 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.
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Background: While the interest of health promotion researchers in change methods directed at the target population has a long tradition, interest in change methods directed at the environment is still developing. In this survey, the focus is on methods for environmental change; especially about how these are composed of methods for individual change ('Bundling') and how within one environmental level, organizations, methods differ when directed at the management ('At') or applied by the management ('From'). Methods: The first part of this online survey dealt with examining the 'bundling' of individual level methods to methods at the environmental level. The question asked was to what extent the use of an environmental level method would involve the use of certain individual level methods. In the second part of the survey the question was whether there are differences between applying methods directed 'at' an organization (for instance, by a health promoter) versus 'from' within an organization itself. All of the 20 respondents are experts in the field of health promotion. Results: Methods at the individual level are frequently bundled together as part of a method at a higher ecological level. A number of individual level methods are popular as part of most of the environmental level methods, while others are not chosen very often. Interventions directed at environmental agents often have a strong focus on the motivational part of behavior change. There are different approaches targeting a level or being targeted from a level. The health promoter will use combinations of motivation and facilitation. The manager will use individual level change methods focusing on self-efficacy and skills. Respondents think that any method may be used under the right circumstances, although few endorsed coercive methods. Conclusions: Taxonomies of theoretical change methods for environmental change should include combinations of individual level methods that may be bundled and separate suggestions for methods targeting a level or being targeted from a level. Future research needs to cover more methods to rate and to be rated. Qualitative data may explain some of the surprising outcomes, such as the lack of large differences and the avoidance of coercion. Taxonomies should include the theoretical parameters that limit the effectiveness of the method.
Aim of the proposal and urban challenge it addresses* (max 200)The aim of this proposal is to develop an educational program with the provisional name ‘Care and Law’. The aim of this multidisciplinary educational program is to increase the knowledge of future professionals working at the intersection of health, wellbeing and law in the urban environment of Amsterdam.In the Amsterdam metropolitan society, legal and healthcare professionals (including social workers) are increasingly confronted with issues at the intersection of (health)care and justice. Special areas of interest are the problems surrounding people suffering from a mental illness, youngsters that cause nuisances of themselves on the streets and homeless people. The approach to this kind of problems requires a multidisciplinary approach. This means that healthcare, social welfare and legal professionals have to work together, for instance to apply for involuntary care. However, these professionals all have their own perspective and responsibility in these situations which often results in tensions among the professionals and as a result a delayed provision of care (van den Hooff, 2015).External partner(s) (if applicable) Project description abstract (max 750 woorden)We like to develop a new educational program in which students from different faculties work together on real time cases. At this moment, students at the Faculty of Applied Social Sciences and Law and the Faculty of Health are primarily trained in a monodisciplinary manner. They may be better equipped for their future work, if they get interdisciplinary training and courses. They need to learn what is meant by ‘Transcending Responsibility’; which means to be open to the perspective of the others professionals and to create a new shared responsibility (van den Hooff, 2015).In this project, we like to work together with and learn from the expertise of other members of the consortium to enhance the quality of this educational project. The focus of the present project is to develop a new multidisciplinary educational program surrounding legal and care related themes. The idea is to familiarize students with the legal contexts in which they have to operate (for instance themes related to pressure and coercion) as well as the welfare and care context in which the client/patient is situated (the care from neighborhood teams, youth care teams or mental health care teams). In addition, student might jointly develop integrated approaches based on case studies from the professional field.We like to be inspired, informed about and discuss innovative approaches which make interdisciplinary educational programs possible. Maybe it is possible to develop an international educational program with members of the consortium.
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