Patienters upplevelser av psykiatrisk tvångsvård inom heldygnsvård : En litteraturstudie

Sammanfattning

Background: Mental illness is a global public health issue where deficiencies regarding human rights in psychiatric care are frequently identified. Psychiatric coercive care is applied when a person with a serious mental disorder lacks capacity to consent or poses a danger to themselves or others, creating complex ethical conflicts between protecting the patient and respecting their integrity. The key concepts of autonomy and power imbalance are central to understanding patients' experiences of coercive care. Nurses have a central responsibility to promote dignity and participation, and a deeper understanding of patients' own experiences is required to ensure safe and dignified care. Aim: The aim of this literature review was to describe patients' experiences of compulsory psychiatric inpatient care. Method: A structured literature review with a qualitative approach was conducted based on Polit and Beck's nine-step model. Systematic searches were performed in CINAHL, PubMed and PsycINFO using the PEO framework and predefined inclusion and exclusion criteria. A total of 12 scientific articles were selected following a screening process of titles, abstracts, and full texts. The articles were quality assessed using SBU's review template and analyzed through a thematic analysis. Results: Three themes were identified: losing control in a frightening environment, losing dignity in a position of powerlessness, and retrospectively recognizing what was helpful. Patients experienced loss of autonomy and power imbalance, but accepted coercion as necessary when staff offered a trusting relationship, participation and a respectful approach that supported recovery. Conclusion: Communication and participation are crucial to patients' experiences of coercive care. Through person-centered practice, structured conversations and ethical reflection, the specialist nurse can alleviate experiences of loss of control. Further research is needed to evaluate nursing models in a Swedish context and to quantitatively map patient groups, enabling needs-based interventions that strengthen the therapeutic relationship and safeguard patient dignity. Keywords: Compulsory care, Inpatient care, Literature review, Patient experience.