Browsing by Author "Adrian, Melissa Jacqueline"

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    Pediatric Psychiatry Inpatients' Perspectives of Aggression Management: Discernment in the Doorway
    (2023-04-14) Adrian, Melissa Jacqueline; McCaffrey, Graham Philip; McCaffrey, Graham Philip; Raffin Bouchal, Donna Shelley; Rankin, Janet; Kelly, Martina Ann
    Aggressive behavior is common on psychiatry inpatient units (Bonner et al., 2002). Seclusion rooms and restraints used as interventions for patients’ aggressive behaviour may have the consequence of being traumatizing for patients (O’Brien & Cole, 2004). The voices of many stakeholders involved in the controversial conversation of the use of seclusion and restraint interventions are represented in the literature. In pediatric psychiatry, however, the voices of the children are not represented, even though they hold the most vulnerable position with the most at stake in the practice of seclusion and restraint interventions for aggression management. This hermeneutic nursing research study asked the question “How might we understand children’s experiences of seclusion and restraint on an inpatient psychiatry unit?”. Four pediatric psychiatry inpatients responded to the invitation to be research participants and shared their hospitalization experiences that occurred within the past year when they were 10 years old. Their interviews lead to the interpretation of the importance of nursing discernment in decision making upon the entrance to each room that holds a patient, physically and metaphorically, to ensure the most therapeutic, ethical, and beneficial care is provided to the patient. The text of the research interviews was compared to the theories and models of Attachment Theory (Bowlby, 1980), Trauma Informed Care (Harris & Fallot, 2001), and Collaborative Problem Solving (Greene, 2014) for practical application, and the fairy tale of Hansel and Gretel (The Brothers Grimm, 1812) for a historical illustration of the relevant social-cultural issue regarding the maltreatment of children that continues to resonate today. Key Words: Nursing, aggression, seclusion, trauma, discernment, relationships, healing