Raija Kontio - Academia.edu (original) (raw)

Papers by Raija Kontio

Research paper thumbnail of Family Involvement in Managing Violence of Mental Health Patients

Perspectives in Psychiatric Care, 2015

This study aimed to explore relatives' perceptions of violent epi... more This study aimed to explore relatives' perceptions of violent episodes and their suggestions on managing violence. Qualitative design with focus groups including relatives (n = 8) was carried out. Data were analyzed using inductive content analysis. The relatives described patient violence in different contexts: at home, in a psychiatric hospital, and after discharge from the psychiatric hospital. They suggested interventions to achieve safer and more humane management of violent episodes. Relatives are a valuable source of information in developing strategies to manage patient violence humanely. Their views on developing the quality of psychiatric care merit more attention.

Research paper thumbnail of Implementing the Dynamic Appraisal of Situational Aggression in Mental Health Units

Clinical Nurse Specialist, 2015

The aims of this study are to explain the intervention of implementing a structured violence risk... more The aims of this study are to explain the intervention of implementing a structured violence risk assessment procedure in mental health inpatient units using the Ottawa Model of Research Use (OMRU) as a guiding framework and to consider nurses' perspectives of its clinical utility and implementation process. Patient aggression toward staff is a global concern in mental health units. The limited extant literature exploring the use of structured violence risk assessments in mental health units, although small and inconsistent, reveals some positive impacts on the incidence of aggression and staff's use of restrictive interventions. Although numerous violence risk assessment instruments have been developed and tested, their systematic implementation and use are still limited. A project titled "Safer Working Management" (111298) was conducted in a Finnish hospital district, across 3 mental health units. The 6 steps of OMRU were followed during implementation of the Dynamic Appraisal of Situational Aggression (DASA). Nurses' views toward structured violence risk assessment procedures varied. Although implementation of the DASA was seen as a useful method to increase discussions with patients and nursing staff, some staff preferred their own clinical judgment for assessment of violence risk. It is possible to use a specific model to promote the implementation of risk assessment instruments in mental health units. However, the complex mental health inpatient environment and the difficulties in understanding and managing aggressive patients present challenges for the implementation of structured violence risk assessment methods. The OMRU provides a tool for clinical nurse specialists to guide implementation process in mental health units. Clinical nurse specialists must promote training for staff regarding use of new innovations, such as the DASA. Implementation processes should be reviewed so that clinical nurse specialists can lead and support mental health staff to properly use structured violence risk assessment measures.

Research paper thumbnail of HUS-alueen mielenterveys- ja päihdepalvelut liian laitoskeskeisiä

Suomen lääkärilehti. Finlands läkartidning

Lähtökohdat Asiakkaan kannalta parhaita ovat sellaiset mielenterveys- ja päihdepalvelut, jotka ov... more Lähtökohdat Asiakkaan kannalta parhaita ovat sellaiset mielenterveys- ja päihdepalvelut, jotka ovat saatavilla avohoidon lähipalveluna ympäri vuorokauden. Kansallinen Mieli 2009 -suunnitelma suosittaa näiden palvelujen lisäämistä avohoidossa ja peruspalveluissa, laitoshoidon vähentämistä sekä mielenterveys- ja päihdepalvelujen yhdistämistä. Osana eurooppalaista mielenterveyspalvelujen rahoitusmalleja ja hoidon laatua tutkivaa hanketta selvitimme, miten aikuisväestön mielenterveys- ja päihdepalvelut Helsingin ja Uudenmaan sairaanhoitopiirin (HUS) kunnissa vastaavat kansallisia suosituksia. Menetelmät Tiedot HUS-alueen 26 kunnan järjestämisvastuulla olevista mielenterveys- ja päihdepalveluyksiköistä ja niiden toiminnoista kerättiin järjestelmällisesti vuodenvaihteessa 2011–2012. Toiminnot luokiteltiin ESMS-R-työkalulla (European service mapping schedule, revised). Tulokset HUS-alueella on 539 mielenterveys- tai päihdetoimintoa, joista 38 % on ympärivuorokautisia sairaalatai asumispalv...

Research paper thumbnail of Size Matters — Determinants of Modern, Community-Oriented Mental Health Services

International Journal of Environmental Research and Public Health, 2014

Governances, structures and contents of mental health services are being reformed across countrie... more Governances, structures and contents of mental health services are being reformed across countries. There is a need for data to support those changes. The aim of this study was to explore the quality, i.e., diversity and community orientation, and quantity, i.e., personnel resources, of mental health and substance abuse services (MHS) and evaluate correlation between population needs and quality and quantity of MHS. The European Service Mapping Schedule-Revised (ESMS-R) was used to classify mental health and substance abuse services in southern Finland. Municipal-level aggregate data,

Research paper thumbnail of Does Primary Care Mental Health Resourcing Affect the Use and Costs of Secondary Psychiatric Services?

International Journal of Environmental Research and Public Health, 2014

Collaborative care models for treatment of depression and anxiety disorders in primary care have ... more Collaborative care models for treatment of depression and anxiety disorders in primary care have been shown to be effective. The aim of this study was to investigate at the municipal level to what extent investment in mental health personnel at primary care health centres in the study area is reflected in the costs and use of secondary psychiatric services. Furthermore, we analysed whether the service provision and use of secondary psychiatric care correlates with the socioeconomic indicators of need. We found significant variation in the amount of mental health personnel provided at the health centres, uncorrelated with the indicators of need nor with the costs of secondary psychiatric care. The amount of mental health nurses at the health centres correlated inversely with the number of secondary psychiatric outpatient visits, whereas its relation to inpatient days and

Research paper thumbnail of Influence of patient characteristics on duration of seclusion/restrain in acute psychiatric settings in Japan

Psychiatry and Clinical Neurosciences, 2013

Aim: The aim of this study was to investigate the current state of duration of seclusion/restrain... more Aim: The aim of this study was to investigate the current state of duration of seclusion/restraint in acute psychiatric settings in Japan and the effect of patient characteristics on duration of seclusion/ restraint.

Research paper thumbnail of Occupational Stress and Implementation of Information Technology Among Nurses Working on Acute Psychiatric Wards

Perspectives in Psychiatric Care, 2013

CITATIONS 4 READS 143 5 authors, including: Some of the authors of this publication are also work... more CITATIONS 4 READS 143 5 authors, including: Some of the authors of this publication are also working on these related projects: Research on financing systems' effect on quality on mental health care (REFINEMENT) View project Correction added on 16 October 2012, after first online publication: The last sentence in the Abstract's Findings section has been amended.

Research paper thumbnail of Seclusion and Restraint in Psychiatry: Patients' Experiences and Practical Suggestions on How to Improve Practices and Use Alternatives

Perspectives in Psychiatric Care, 2012

CITATIONS 34 READS 880 7 authors, including:

Research paper thumbnail of Nurses' and Physicians' Educational Needs in Seclusion and Restraint Practices

Perspectives in Psychiatric Care, 2009

CITATIONS 16 READS 241 7 authors, including: Some of the authors of this publication are also wor... more CITATIONS 16 READS 241 7 authors, including: Some of the authors of this publication are also working on these related projects: Research on financing systems' effect on quality on mental health care (REFINEMENT) View project Raija Kontio Hospital District for Helsinki and Uusimaa PURPOSE. This study aimed to explore nurses' (N = 22) and physicians' (N = 5) educational needs in the context of their perceived seclusion and restraint-related mode of action and need for support. METHOD. The data were collected by focus group (N = 4) interviews and analyzed with inductive content analysis. RESULTS. Participants recognized a need for on-ward and problem-based education and infrastructural and managerial support. The declared high ethical principles were not in accordance with the participants' reliance on manpower and the high seclusion and restraint rates. PRACTICE IMPLICATIONS. Future educational programs should bring together written clinical guidelines, education on ethical and legal issues, and the staff's support aspect.

Research paper thumbnail of Toward a Safer Working Environment on Psychiatric Wards: Service Users' Delayed Perspectives of Aggression and Violence-Related Situations and Development Ideas

Perspectives in Psychiatric Care, 2014

To explore service users' (n = 9)... more To explore service users' (n = 9) delayed perceptions of and suggestions for improvement of management of aggression/violence in psychiatry. Focus group interviews, inductive content analysis. Participants reported aggression/violence-related negative perceptions (including loneliness, boredom, excessive control, and fear) but also memories of humane and caring personnel. The suggestions included meaningful activities and humane, interactive nursing. Delayed perceptions and proposals resembled the proximate ones. Perceptions may persist for years. Such perceptions and proposals, if taken into account from the beginning of treatment, may prevent negative long-term consequences of witnessed or experienced aggression/violence. Humane, interactive nursing models should be studied and disseminated.

Research paper thumbnail of Knowledge transfer from an e-learning course to clinical practice

Nurse Education Today, 2014

Background: Continuing education is essential in improving practical psychiatric nursing skills. ... more Background: Continuing education is essential in improving practical psychiatric nursing skills. However, little is known about how knowledge gained in continuing education is transferred to nurses' daily work. Objectives: To describe the transfer of knowledge gained from an e-learning course to daily practice. Design: Qualitative study design. Settings: One hospital district in Southern Finland with three specialized psychiatric wards (acute, rehabilitation, geriatric wards). Participants: Nursing staff (N = 53) were recruited and 35 participated voluntarily in the e-learning continuing education course in spring 2009. Methods: The data comprised nurses' reflective writing during the e-learning course and course evaluation forms completed after the course. We used qualitative design with inductive content analysis to analyze nurses' writings. Results: The nurses were willing and able to transfer what they learned to their daily practice including the course themes, communication and co-operation among staff members, understanding of preventive and alternative treatment methods and critical thinking regarding one's own work. After the e-learning course the nurses were able to identify development areas such as issues related to staff members' daily work, the patient's role on the ward, alternative methods to avoid coercion, issues pertaining to the care environment on the ward, psychiatric nurses' education, and making an action plan for aggressive situations. All nurses would recommend the course to other nurses. Conclusions: New knowledge is easily adopted and transferred to daily practice.

Research paper thumbnail of eLearning course may shorten the duration of mechanical restraint among psychiatric inpatients: A cluster-randomized trial

Nordic Journal of Psychiatry, 2013

The management of psychiatric inpatients exhibiting severely disturbed and aggressive behaviour i... more The management of psychiatric inpatients exhibiting severely disturbed and aggressive behaviour is an important educational topic. Well structured, IT-based educational programmes (eLearning) often ensure quality and may make training more affordable and accessible. The aim of this study was to explore the impact of an eLearning course for personnel on the rates and duration of seclusion and mechanical restraint among psychiatric inpatients. In a cluster-randomized intervention trial, the nursing personnel on 10 wards were randomly assigned to eLearning (intervention) or training-as-usual (control) groups. The eLearning course comprised six modules with specific topics (legal and ethical issues, behaviour-related factors, therapeutic relationship and self-awareness, teamwork and integrating knowledge with practice) and specific learning methods. The rates (incidents per 1000 occupied bed days) and durations of the coercion incidents were examined before and after the course. A total of 1283 coercion incidents (1143 seclusions [89%] and 140 incidents involving the use of mechanical restraints [11%]) were recorded on the study wards during the data collection period. On the intervention wards, there were no statistically significant changes in the rates of seclusion and mechanical restraint. However, the duration of incidents involving mechanical restraints shortened from 36.0 to 4.0 h (median) (P < 0.001). No statistically significant changes occurred on the control wards. After our eLearning course, the duration of incidents involving the use of mechanical restraints decreased. However, more studies are needed to ensure that the content of the course focuses on the most important factors associated with the seclusion-related elements. The eLearning course deserves further development and further studies. The duration of coercion incidents merits attention in future research.

Research paper thumbnail of Impact of eLearning course on nurses' professional competence in seclusion and restraint practices: 9-month follow-up results of a randomized controlled study (ISRCTN32869544)

Journal of Psychiatric and Mental Health Nursing, 2013

Research paper thumbnail of Factors affecting assessment of severity of aggressive incidents: using the Staff Observation Aggression Scale - Revised (SOAS-R) in Japan

Journal of Psychiatric and Mental Health Nursing, 2012

The aim of this study is to investigate factors associated with overall judgements of aggression ... more The aim of this study is to investigate factors associated with overall judgements of aggression severity as provided by ward nurses, using the Japanese-language version of the Staff Observation Aggression Scale - Revised (SOAS-R). Nurses who observed 326 aggressive incidents involving psychiatric inpatients at five mental health facilities in Japan provided their assessments of the incident severity both on the established rating scale, the SOAS-R, and on a visual analogue scale (VAS), a one-item scale to indicate overall aggression severity. To evaluate the factors influencing the VAS severity scores, a multiple regression analysis was performed, in which consumer, nurse and ward characteristics were added consecutively, along with SOAS-R severity scores as independent variables. SOAS-R scores explained 17.6% of the VAS severity scores. Independently from the SOAS-R scores, the gender and age of the aggressive consumers (adjusted R(2) = 10.0%), as well as the gender of the nurses who reported the aggression (adjusted R(2) = 4.1%), each explained VAS severity score to a significant degree. Apart from the SOAS-R scores, consumer and nurse characteristics appeared to influence the overall judgements of severity of aggressive incidents, which may be connected to decisions about the use of coercive measures, such as seclusion/restraint or forced medication.

Research paper thumbnail of Psychiatric staff on the wards does not share attitudes on aggression

International Journal of Mental Health Systems, 2014

CITATIONS 3 READS 67 7 authors, including: Some of the authors of this publication are also worki... more CITATIONS 3 READS 67 7 authors, including: Some of the authors of this publication are also working on these related projects: Research on financing systems' effect on quality on mental health care (REFINEMENT) View project Implementing ja researhing Cognitive Adapatation Training (Vellingan) model View project Abstract

Research paper thumbnail of Family Involvement in Managing Violence of Mental Health Patients

Perspectives in Psychiatric Care, 2015

This study aimed to explore relatives' perceptions of violent epi... more This study aimed to explore relatives' perceptions of violent episodes and their suggestions on managing violence. Qualitative design with focus groups including relatives (n = 8) was carried out. Data were analyzed using inductive content analysis. The relatives described patient violence in different contexts: at home, in a psychiatric hospital, and after discharge from the psychiatric hospital. They suggested interventions to achieve safer and more humane management of violent episodes. Relatives are a valuable source of information in developing strategies to manage patient violence humanely. Their views on developing the quality of psychiatric care merit more attention.

Research paper thumbnail of Implementing the Dynamic Appraisal of Situational Aggression in Mental Health Units

Clinical Nurse Specialist, 2015

The aims of this study are to explain the intervention of implementing a structured violence risk... more The aims of this study are to explain the intervention of implementing a structured violence risk assessment procedure in mental health inpatient units using the Ottawa Model of Research Use (OMRU) as a guiding framework and to consider nurses' perspectives of its clinical utility and implementation process. Patient aggression toward staff is a global concern in mental health units. The limited extant literature exploring the use of structured violence risk assessments in mental health units, although small and inconsistent, reveals some positive impacts on the incidence of aggression and staff's use of restrictive interventions. Although numerous violence risk assessment instruments have been developed and tested, their systematic implementation and use are still limited. A project titled "Safer Working Management" (111298) was conducted in a Finnish hospital district, across 3 mental health units. The 6 steps of OMRU were followed during implementation of the Dynamic Appraisal of Situational Aggression (DASA). Nurses' views toward structured violence risk assessment procedures varied. Although implementation of the DASA was seen as a useful method to increase discussions with patients and nursing staff, some staff preferred their own clinical judgment for assessment of violence risk. It is possible to use a specific model to promote the implementation of risk assessment instruments in mental health units. However, the complex mental health inpatient environment and the difficulties in understanding and managing aggressive patients present challenges for the implementation of structured violence risk assessment methods. The OMRU provides a tool for clinical nurse specialists to guide implementation process in mental health units. Clinical nurse specialists must promote training for staff regarding use of new innovations, such as the DASA. Implementation processes should be reviewed so that clinical nurse specialists can lead and support mental health staff to properly use structured violence risk assessment measures.

Research paper thumbnail of HUS-alueen mielenterveys- ja päihdepalvelut liian laitoskeskeisiä

Suomen lääkärilehti. Finlands läkartidning

Lähtökohdat Asiakkaan kannalta parhaita ovat sellaiset mielenterveys- ja päihdepalvelut, jotka ov... more Lähtökohdat Asiakkaan kannalta parhaita ovat sellaiset mielenterveys- ja päihdepalvelut, jotka ovat saatavilla avohoidon lähipalveluna ympäri vuorokauden. Kansallinen Mieli 2009 -suunnitelma suosittaa näiden palvelujen lisäämistä avohoidossa ja peruspalveluissa, laitoshoidon vähentämistä sekä mielenterveys- ja päihdepalvelujen yhdistämistä. Osana eurooppalaista mielenterveyspalvelujen rahoitusmalleja ja hoidon laatua tutkivaa hanketta selvitimme, miten aikuisväestön mielenterveys- ja päihdepalvelut Helsingin ja Uudenmaan sairaanhoitopiirin (HUS) kunnissa vastaavat kansallisia suosituksia. Menetelmät Tiedot HUS-alueen 26 kunnan järjestämisvastuulla olevista mielenterveys- ja päihdepalveluyksiköistä ja niiden toiminnoista kerättiin järjestelmällisesti vuodenvaihteessa 2011–2012. Toiminnot luokiteltiin ESMS-R-työkalulla (European service mapping schedule, revised). Tulokset HUS-alueella on 539 mielenterveys- tai päihdetoimintoa, joista 38 % on ympärivuorokautisia sairaalatai asumispalv...

Research paper thumbnail of Size Matters — Determinants of Modern, Community-Oriented Mental Health Services

International Journal of Environmental Research and Public Health, 2014

Governances, structures and contents of mental health services are being reformed across countrie... more Governances, structures and contents of mental health services are being reformed across countries. There is a need for data to support those changes. The aim of this study was to explore the quality, i.e., diversity and community orientation, and quantity, i.e., personnel resources, of mental health and substance abuse services (MHS) and evaluate correlation between population needs and quality and quantity of MHS. The European Service Mapping Schedule-Revised (ESMS-R) was used to classify mental health and substance abuse services in southern Finland. Municipal-level aggregate data,

Research paper thumbnail of Does Primary Care Mental Health Resourcing Affect the Use and Costs of Secondary Psychiatric Services?

International Journal of Environmental Research and Public Health, 2014

Collaborative care models for treatment of depression and anxiety disorders in primary care have ... more Collaborative care models for treatment of depression and anxiety disorders in primary care have been shown to be effective. The aim of this study was to investigate at the municipal level to what extent investment in mental health personnel at primary care health centres in the study area is reflected in the costs and use of secondary psychiatric services. Furthermore, we analysed whether the service provision and use of secondary psychiatric care correlates with the socioeconomic indicators of need. We found significant variation in the amount of mental health personnel provided at the health centres, uncorrelated with the indicators of need nor with the costs of secondary psychiatric care. The amount of mental health nurses at the health centres correlated inversely with the number of secondary psychiatric outpatient visits, whereas its relation to inpatient days and

Research paper thumbnail of Influence of patient characteristics on duration of seclusion/restrain in acute psychiatric settings in Japan

Psychiatry and Clinical Neurosciences, 2013

Aim: The aim of this study was to investigate the current state of duration of seclusion/restrain... more Aim: The aim of this study was to investigate the current state of duration of seclusion/restraint in acute psychiatric settings in Japan and the effect of patient characteristics on duration of seclusion/ restraint.

Research paper thumbnail of Occupational Stress and Implementation of Information Technology Among Nurses Working on Acute Psychiatric Wards

Perspectives in Psychiatric Care, 2013

CITATIONS 4 READS 143 5 authors, including: Some of the authors of this publication are also work... more CITATIONS 4 READS 143 5 authors, including: Some of the authors of this publication are also working on these related projects: Research on financing systems' effect on quality on mental health care (REFINEMENT) View project Correction added on 16 October 2012, after first online publication: The last sentence in the Abstract's Findings section has been amended.

Research paper thumbnail of Seclusion and Restraint in Psychiatry: Patients' Experiences and Practical Suggestions on How to Improve Practices and Use Alternatives

Perspectives in Psychiatric Care, 2012

CITATIONS 34 READS 880 7 authors, including:

Research paper thumbnail of Nurses' and Physicians' Educational Needs in Seclusion and Restraint Practices

Perspectives in Psychiatric Care, 2009

CITATIONS 16 READS 241 7 authors, including: Some of the authors of this publication are also wor... more CITATIONS 16 READS 241 7 authors, including: Some of the authors of this publication are also working on these related projects: Research on financing systems' effect on quality on mental health care (REFINEMENT) View project Raija Kontio Hospital District for Helsinki and Uusimaa PURPOSE. This study aimed to explore nurses' (N = 22) and physicians' (N = 5) educational needs in the context of their perceived seclusion and restraint-related mode of action and need for support. METHOD. The data were collected by focus group (N = 4) interviews and analyzed with inductive content analysis. RESULTS. Participants recognized a need for on-ward and problem-based education and infrastructural and managerial support. The declared high ethical principles were not in accordance with the participants' reliance on manpower and the high seclusion and restraint rates. PRACTICE IMPLICATIONS. Future educational programs should bring together written clinical guidelines, education on ethical and legal issues, and the staff's support aspect.

Research paper thumbnail of Toward a Safer Working Environment on Psychiatric Wards: Service Users' Delayed Perspectives of Aggression and Violence-Related Situations and Development Ideas

Perspectives in Psychiatric Care, 2014

To explore service users' (n = 9)... more To explore service users' (n = 9) delayed perceptions of and suggestions for improvement of management of aggression/violence in psychiatry. Focus group interviews, inductive content analysis. Participants reported aggression/violence-related negative perceptions (including loneliness, boredom, excessive control, and fear) but also memories of humane and caring personnel. The suggestions included meaningful activities and humane, interactive nursing. Delayed perceptions and proposals resembled the proximate ones. Perceptions may persist for years. Such perceptions and proposals, if taken into account from the beginning of treatment, may prevent negative long-term consequences of witnessed or experienced aggression/violence. Humane, interactive nursing models should be studied and disseminated.

Research paper thumbnail of Knowledge transfer from an e-learning course to clinical practice

Nurse Education Today, 2014

Background: Continuing education is essential in improving practical psychiatric nursing skills. ... more Background: Continuing education is essential in improving practical psychiatric nursing skills. However, little is known about how knowledge gained in continuing education is transferred to nurses' daily work. Objectives: To describe the transfer of knowledge gained from an e-learning course to daily practice. Design: Qualitative study design. Settings: One hospital district in Southern Finland with three specialized psychiatric wards (acute, rehabilitation, geriatric wards). Participants: Nursing staff (N = 53) were recruited and 35 participated voluntarily in the e-learning continuing education course in spring 2009. Methods: The data comprised nurses' reflective writing during the e-learning course and course evaluation forms completed after the course. We used qualitative design with inductive content analysis to analyze nurses' writings. Results: The nurses were willing and able to transfer what they learned to their daily practice including the course themes, communication and co-operation among staff members, understanding of preventive and alternative treatment methods and critical thinking regarding one's own work. After the e-learning course the nurses were able to identify development areas such as issues related to staff members' daily work, the patient's role on the ward, alternative methods to avoid coercion, issues pertaining to the care environment on the ward, psychiatric nurses' education, and making an action plan for aggressive situations. All nurses would recommend the course to other nurses. Conclusions: New knowledge is easily adopted and transferred to daily practice.

Research paper thumbnail of eLearning course may shorten the duration of mechanical restraint among psychiatric inpatients: A cluster-randomized trial

Nordic Journal of Psychiatry, 2013

The management of psychiatric inpatients exhibiting severely disturbed and aggressive behaviour i... more The management of psychiatric inpatients exhibiting severely disturbed and aggressive behaviour is an important educational topic. Well structured, IT-based educational programmes (eLearning) often ensure quality and may make training more affordable and accessible. The aim of this study was to explore the impact of an eLearning course for personnel on the rates and duration of seclusion and mechanical restraint among psychiatric inpatients. In a cluster-randomized intervention trial, the nursing personnel on 10 wards were randomly assigned to eLearning (intervention) or training-as-usual (control) groups. The eLearning course comprised six modules with specific topics (legal and ethical issues, behaviour-related factors, therapeutic relationship and self-awareness, teamwork and integrating knowledge with practice) and specific learning methods. The rates (incidents per 1000 occupied bed days) and durations of the coercion incidents were examined before and after the course. A total of 1283 coercion incidents (1143 seclusions [89%] and 140 incidents involving the use of mechanical restraints [11%]) were recorded on the study wards during the data collection period. On the intervention wards, there were no statistically significant changes in the rates of seclusion and mechanical restraint. However, the duration of incidents involving mechanical restraints shortened from 36.0 to 4.0 h (median) (P < 0.001). No statistically significant changes occurred on the control wards. After our eLearning course, the duration of incidents involving the use of mechanical restraints decreased. However, more studies are needed to ensure that the content of the course focuses on the most important factors associated with the seclusion-related elements. The eLearning course deserves further development and further studies. The duration of coercion incidents merits attention in future research.

Research paper thumbnail of Impact of eLearning course on nurses' professional competence in seclusion and restraint practices: 9-month follow-up results of a randomized controlled study (ISRCTN32869544)

Journal of Psychiatric and Mental Health Nursing, 2013

Research paper thumbnail of Factors affecting assessment of severity of aggressive incidents: using the Staff Observation Aggression Scale - Revised (SOAS-R) in Japan

Journal of Psychiatric and Mental Health Nursing, 2012

The aim of this study is to investigate factors associated with overall judgements of aggression ... more The aim of this study is to investigate factors associated with overall judgements of aggression severity as provided by ward nurses, using the Japanese-language version of the Staff Observation Aggression Scale - Revised (SOAS-R). Nurses who observed 326 aggressive incidents involving psychiatric inpatients at five mental health facilities in Japan provided their assessments of the incident severity both on the established rating scale, the SOAS-R, and on a visual analogue scale (VAS), a one-item scale to indicate overall aggression severity. To evaluate the factors influencing the VAS severity scores, a multiple regression analysis was performed, in which consumer, nurse and ward characteristics were added consecutively, along with SOAS-R severity scores as independent variables. SOAS-R scores explained 17.6% of the VAS severity scores. Independently from the SOAS-R scores, the gender and age of the aggressive consumers (adjusted R(2) = 10.0%), as well as the gender of the nurses who reported the aggression (adjusted R(2) = 4.1%), each explained VAS severity score to a significant degree. Apart from the SOAS-R scores, consumer and nurse characteristics appeared to influence the overall judgements of severity of aggressive incidents, which may be connected to decisions about the use of coercive measures, such as seclusion/restraint or forced medication.

Research paper thumbnail of Psychiatric staff on the wards does not share attitudes on aggression

International Journal of Mental Health Systems, 2014

CITATIONS 3 READS 67 7 authors, including: Some of the authors of this publication are also worki... more CITATIONS 3 READS 67 7 authors, including: Some of the authors of this publication are also working on these related projects: Research on financing systems' effect on quality on mental health care (REFINEMENT) View project Implementing ja researhing Cognitive Adapatation Training (Vellingan) model View project Abstract